The first treatise on a deviated septum causing nasal obstruction was written by Quellmaltz1 in 1750. While symptoms and sequelae are well described, no mention is made of treatment. In 1839 Velpeau2 in an indirect way quoted William of Salicet, who proposed the gradual dilation of the anterior part of the nares with a sponge to facilitate avulsion of nasal polypi. As late as 1889 Roberts3 spoke favorably of punching out a piece of the septum at the point of deviation to permit breathing through both nostrils.
The last two decades of the nineteenth century witnessed the development of two great schools of thought in regard to the function of the nasal septum and the respect with which it is to be treated. The first school, of which Asch4 was the foremost champion, preached that the cartilage of the septum should be preserved by destorying its resiliency and forcing it