(This was aired on Britain’s BBC Radio 4’s “Home Truths” programme [date unknown])

Anosmic Universe

Doreen Blanks is anosmic—she has no sense of smell. Yes, it is a real word. Anosmia is a condition and it can be quite hazardous. It also requires Doreen to ‘borrow’ the nose of her daughter or husband for all manner of smells. Mmmm...!

Doreen has never had a sense of smell, although her mother insists she could smell as a small child. Doreen had her adenoids out and thinks that could be the reason why she cannot smell.

Luckily, Doreen’s husband David has a nose which is ‘large and sensitive.’ She often ‘borrows’ it (or that of her daughter) to check the freshness of food, or whether she should wash her jumpers. She has a particular penchant for tinned fish and takes her life in her hands at these times, making every effort to avoid dented tins (remember the tinned salmon scare in the 70s?)

It saddens Doreen not to be able to smell. She has a beautiful garden, and wishes she could smell it. Food, perfume, flowers, even babies when bathed are things she’d like to be able to smell. She remembers looking at a peaceful sleeping baby, not smelling the dirty nappy and returning later to find them awake and playing with their nappy contents ... the clean-up was not pleasant.

Doreen’s greatest fear is growing up to be a smelly old lady. She is still sometimes given ‘smellies’ at Christmas by well-meaning friends and relatives. She likens it to giving videos to a blind person. If she is given a perfume she sees whether Dave her husband likes it and may then use it.

Touring in a car in Europe, Doreen committed a cardinal sin, spilling milk which seeped into inaccessible places under the front seat. After a day or two when the stench grew unbearable for everyone except Doreen, she did wonder whether they would abandon her on the roadside.

From: nytimes.com (date unknown)

I Was a Middle-Aged Anosmic
By Tom Miller

I can clearly recall the first time I nibbled corn on the cob in rural New Jersey, my first meaty lobster on Cape Cod and when I first bit into a crunchy chimichanga in southern Arizona. Pleasurable taste sensations like these stay in one’s memory for a lifetime. Then, about two years ago, I had a nasty virus that left me with a cough, and when that subsided I realized that the food I was eating had no flavor, only texture. At times it seemed as though I had metallic residue in my mouth.

The virus had attacked my olfactory nerve and, as most taste is smell, I was left without a sense of taste, a condition called anosmia. One day I had never heard of it, the next day I was anosmic. It put me through much personal introspection, outward observation and general aggravation.

A dentist suggested that I scrape my tongue with a tongue depressor to see if any gunk came off. My chiropractor, who thinks that everything short of finding weapons of mass destruction can be resolved through chiropractic treatment, considered facial adjustment. One Friday, a homeopath sold me pellet-size pills to put under my tongue, saying that by Sunday I would taste again. I didn’t. Not that Sunday nor a month of Sundays.

With no sense of smell, I was oblivious to burning toast and floral bouquets. Without taste, why dine out? There would be no difference between Lutèce and McDonald’s. I ate by memory, habit, texture, social setting, even color. A friend who served me an Indonesian dinner was devastated when I complimented him on its texture but could say nothing of its flavor. On occasion, my sense of taste would return for something wonderful, like fresh blueberries, then just as fast it would go away.

Fearful of a future without a functioning olfactory nerve, I rationalized that of all the senses to lose, smell seemed the most expendable. I visited Dr. A. J. Emami, a well-recommended ear, nose and throat specialist in Tucson, who explained that the olfactory nerve is the first of the 12 cranial nerves, and that the fifth one responds to toxic stimuli. He moistened a cotton swab with rubbing alcohol and slowly moved it toward my nose. It wasn’t until the swab was an inch or two away that I reacted, indicating that I had little, if any, olfactory capacity.

He asked if my job depended on a sense of smell. No, it didn’t. He cautioned against immediate treatment, saying that the olfactory nerve often begins to work again after a number of months. Many foods, he added, like salsa, salt and horseradish, are absorbed through taste buds and are not affected. I slathered salsa on a taco with disastrous results: it amounted to eating salsa by itself.

This seemed a good opportunity to shed pounds. But the opposite is often true. “People with anosmia tend to gain weight,” said Dr. Beverly J. Cowart, an anosmia specialist at the Monell Chemical Senses Center in Philadelphia, in a telephone interview. “They are searching for something that satisfies the desire for a pleasurable eating experience.”

Other psychological factors are at play with anosmia. Jon Hayman, 48, recalls losing his sense of taste nearly 25 years ago, when he was beginning a career as a stand-up comic. His friends were not supportive. “No one believed me, no one understood,” he said. “I didn’t get the degree of sympathy something as serious as this deserves. I became hermitlike.” (Mr. Hayman was treated for a severe zinc deficiency and regained his sense of taste.) I had similar reactions. “Lose your sense of taste, Miller? Why don’t you just move to Phoenix?”

Dr. Emami suggested that I undergo an M.R.I. to make sure there was no tumor or other problem at the base of the brain, where the olfactory is located. The results? No brain problem. Next, he recommended a minimal dosage of prednisone over a 10-day period, reasoning that the anti-inflammatory steroid might activate my olfactory nerve. It didn’t, yet in a few months I could taste a few things. Or perhaps I just thought I could.

“As people get older, 60 and beyond, they tend to lose some sense of smell through continual failure of the neurons in the nasal cavity to completely replace themselves,” Dr. Cowart said.

Gender, too, plays a role. Men tend to get anosmia from infections less often than women do, Dr. Cowart said, but they have more accidents that injure the olfactory bulbs. Chemotherapy can provoke taste problems, “but there are so many combinations of drugs involved that the specific cause is hard to pin down,” she added.

Frankly, there is no known preventive for anosmia, nor a ready cure. Although statistics for anosmia are shaky, one estimate puts the number of Americans with taste and smell disorders at two million.

Over the next six months, my sense of taste returned, then retreated. Dr. Emami had one more solution up his sleeve. Would I agree to a tiny amount of a steroid injected in each nostril? I would, if a local anesthetic was first applied. It was, and in minutes I had .25 cubic centimeters of triamcinolone in each nostril.

This was in March. My sense of taste returned to about 80 to 90 percent capacity within a week, and has stayed there since. One day I was anosmic, and the next morning I woke up and smelled the coffee.

The New York Times
August 30, 1982

1 in 100 Said to Suffer Taste or Smell Disorder

At least one of every 100 people in the United States suffers from some disorder involving the senses of taste and smell, according to a University of Pennsylvania researcher.

Dr. Richard Doty, scientific director of the university’s Clinical Smell and Taste Research Center, said last week that scientists had discovered “a much higher prevalence of these disorders than we previously thought.”

He said the center, founded in 1980 and financed by the National Institutes of Health, aimed to provide better treatment for people suffering from disorders affecting the two senses. Among the disorders are anosmia, a total loss of smell, and aguesia, a total loss of taste. Their causes can include accident, heredity, aging or air pollution, Dr. Doty said. He said an exposed nerve ending in the olfactory passage, known as the trigeminal nerve, was responsible for causing the cooling sensation that comes from menthol and other substances.

January 5, 1984

Detecting brain tumors by loss of smell
By Sharon Rutenberg

CHICAGO - Brain tumors could be detected sooner and treated successfully if people notice one of the first signs-loss of smell, a doctor said Thursday.

Patients usually lose their sense of smell years before a brain scan reveals presence of a growth, said Dr. Louis Bakay of State University of New York in Buffalo.

By the time the benign and slow-growing tumor reaches a size large enough to cause symptoms, the patient usually is middle-aged. Loss of sense of smell is followed, usually several years later, by loss of intellectual functions, reduced vision and sometimes blindness.

“Unfortunately, these tumors are rarely diagnosed in time,” Bakay said in the Journal of the American Medical Association.

Bakay studied 36 patients. In all the cases but one, he found their conditions were diagnosed late and not until the tumor had reached a very large size.

“By the time the proper diagnosis was made and the tumors were surgically removed, mental or visual disability often was irreversible,” he said.

“The delayed diagnosis could be explained in the past by the lack of appropriate, noninvasive diagnostic techniques. It is inexcusable in the present age of computed tomographic (CT) scanning.”

The majority of the patients did consult a physician years before but a brain tumor was the least suspected cause of their anosmia, or loss of smell, Bakay said.

Patients rarely are aware of their gradual loss of smell, he said, and often a close family member notices the problem.

“Yet it is interesting that anosmia alone was never the cause of subsequent diagnosis of olfactory meningioma”-a brain tumor located in the sinus region, Bakay said.

“Some persons are not overly concerned when they gradually lose their sense of smell over a protracted period of time.

“The majority of the patients in this series mentioned this complaint to a physician. They were usually told that it was the after-effect of a severe cold or sinusitis.”

Loss of sense of smell can be due to nasal obstruction or the common cold, Bakay said.

But he said CT brain scanning should be used in all patients in whom the loss of sense of smell cannot be explained by head injury, other disease or surgical procedures of the olfactory region.

“It seems obvious that a vague diagnosis of viral infection, often only suspected and hardly ever substantiated, should not be the end of the diagnostic line for patients with permanent anosmia,” he said.

Los Angeles Times
March 29, 1987

Victims of Nose Ills Try to Make Scents of It All
By Janny Scott

They are the afterthoughts on the road to Oz, searching not for a heart or brain but for a sense of smell. They come to San Diego from across the Western United States to have their noses peered into and probed and scraped and scanned. There are women who haven’t smelled their Christmas turkey in years. Men falter, trying to express how the pleasures of love have diminished. There are people haunted by phantom odors, and people for whom everything smells like chemicals.

“Most of the people have lost their sense of smell for anywhere from 1 to 15 years,” said Dr. Terence Davidson of UC San Diego Medical Center. “They’ve all been to multiple physicians, all of whom have said, ‘Yeah, your smell is gone. Don’t worry about it.’

“It’s not done heartlessly,” he said. “You’ve got to talk to 60 women who can’t smell Thanksgiving dinner. You’ve got to talk to someone who can’t smell their baby any more. And then you start to understand the emotions of this. It’s not like losing a limb. But it is real.”

Davidson is director of the Nasal Dysfunction Clinic at UCSD, one of only a handful of such clinics in the United States that have recently begun exploring the little-understood phenomenon of loss of smell, believed to afflict 2 million people nationwide.

Next month, the Western Journal of Medicine is to publish Davidson’s first report of his findings, based on 63 of the clinic’s patients. In it, Davidson and his colleagues report that their patients unanimously found the loss of smell a “major disability.”

Some suffered from anosmia, or the complete loss of smell, Davidson said. For others, their sensitivity was diminished or distorted or triggered unprovoked. For most, their first warning was what they took for loss of taste: Suddenly, everything seemed bland.

“The majority of our perception of food comes from its smell, not its chemical taste,” Davidson said. “Real taste is the tongue’s ability to detect sweet, sour, salt and bitter. Unfortunately, in the English language, we don’t really differentiate.”

The causes included infections, allergies, viruses and trauma, such as a severe blow to the head, Davidson and his colleagues found. Seven patients lost their sense of smell from exposure to toxins like ammonia, photo-developing chemicals and hairdressing chemicals.

For a few, the problem was congenital. For three, it was psychological.

Only in a fraction of the cases could the problem be treated; for example, inflammations were treated with steroid hormones. In many cases, the loss appeared to be permanent. In those cases, Davidson said, the aim is to enable people to accept their fate.

For them, pleasure in consuming food may depend on spices and hot sauces, which act on the taste buds on the tongue instead of the olfactory receptors in the nose. Davidson encourages them to savor the texture and appearance of food once the flavor is out of reach.

“I keep thinking I smell something because I remember it,” said Frances Verbest, a Poway woman who has not tasted anything since a year ago Christmas. “What I have to do is eat and cook by ear. I just have to use my imagination.”

The sense of smell is poorly understood, because of its complexity and because of the traditional view that it is relatively insignificant. Medical educations have included little about the nose, and until the late 1970s, little money was available for research.

Yet smell is intimately connected to memory and emotions, perhaps it is a particular function of the area of the brain where olfactory information is received. Davidson recalled how the smell of an old family camping shed “brings back this phenomenal flood of emotions.”

About half a dozen centers in the United States, most on the East Coast, are studying nasal function. According to Davidson, UCSD’s 3-year-old clinic is the only one west of Denver.

“There are some very basic science questions about the sense of smell that are as yet unanswered,” said Claire Murphy, a psychologist who works with Davidson. “And that’s not true about other sensory systems. We still don’t know how it is the olfactory system codes information about the quality of odor. Can you imagine someone in vision saying we don’t know how it is that we tell the difference between red and blue?”

An odor is sensed when volatile molecules are sniffed and enter a person’s nasal passages. There, they meet the mucous-coated epithelium, or lining of the nasal passages. They attach to minute, hairlike cilia, sending impulses through nerve cells to the brain.

That process can be disrupted at any stage — by a blockage in the nasal passage, or damage to the sensitive lining or to the brain. A head injury can shear the olfactory nerves. A virus can destroy the nasal olfactory cells.

At the UCSD Medical Center clinic, the first phase of analysis falls to Murphy, a psychologist who specializes in the psychological response to physical stimuli. Her tools are a set of opaque polyethylene bottles containing 10 everyday scents.

First, Murphy conducts a threshold test, checking a patient’s ability to detect different concentrations of the same odor. Next comes an odor identification test. Scores are calculated for each nostril: 90 to 100 is considered normal, zero to 10 anosmic.

“One common story is that the person had a very bad cold...and that they lost their sense of smell after the cold and it never came back,” Murphy said. Some suffer from phantosmia, or phantom odors, or parosmia, when everything has the same bad smell.

“You present an orange and it has an off-odor,” said Murphy, who said the odor is often a chemical smell. “You might present an orange, an orchid and some gasoline, and all of them would have the same off-odor.”

Across the hall, Alfredo Jalowayski, the team’s respiratory physiologist, seats the patient in an olive-drab dental chair and escalates it to eye level. Jalowayski’s bailiwick is rhinomanometry, measurement of air pressure and flow through the nose.

His tools are instruments for measuring lung physiology, adapted by him to measure nasal function. Patients breathe through small glass tubes attached to a “nasal airway resistance computer” that generates a printout of a person’s “inspiratory and expiratory flow.”

By studying the red lines etched by the computer onto the graph paper, Jalowayski can detect an obstruction on either side of the nose. Applying a decongestant and remeasuring, he can determine whether the blockage is an inflammation or a more permanent problem, like a deviated septum.

Jalowayski also has invented a small plastic scraper, called a Rhino-probe, for taking samples of nasal epithelial cells for analysis. He said that, in the past, doctors studied only secretions, and that studying cells as well can improve diagnosis 90%.

The cell scrapings are stained bluish purple and studied under a microscope, where Jalowayski can detect allergic conditions, viral infections and the presence of bacteria.

Finally, the patients are examined by Davidson, a surgeon who became interested in noses by doing cosmetic nasal surgery. Using telescopic tubing, Davidson is able to see whether the crucial epithelium is normal or whether it has been scarred or destroyed.

If necessary, a CT scan is used to study the sinuses and look for tumors in the nose or brain.

In the study to be published next month, the team found that 41 of the 63 patients studied had either inflammations or viral problems. Trauma, toxins, congenital defects and psychiatric problems accounted for most of the remainder.

In an interview last week, Davidson estimated that his clinic is able to reverse or reduce the smell problem in one-third to one-half of all patients. For the rest, he said an accurate diagnosis of their problem may finally enable them to come to terms with the loss of smell.

The problem is most upsetting to people like Frances Verbest.

“I always had a very acute sense of smell and taste. Ask anybody,” said Verbest, who attended the clinic last summer. “I love to cook and I love to eat. Now I can’t do either. It’s terrible.”

Verbest said her sense of smell had faded periodically. She suspected that the cause was medication, but it had always returned. Then, during the week of Christmas 1985, she felt it disappearing again. Since then, she has smelled and tasted nothing.

Davidson said: “They speak of the tragedy of cooking a Thanksgiving dinner that has been one of the most important family events of their life... All of a sudden, it’s flat. Not only that, they don’t even know when they are burning the pots.”

The loss of smell also is especially troubling to people for whom sex is very important.

“They’re aware that they’ve lost something,” said Davidson, noting that olfaction plays an important role in sex. “Sometimes it’s not as clearly stated and the patient doesn’t have it as clearly defined. But they know it’s gone.”

The replacements for the loss may seem like small consolation.

Davidson and his colleagues encourage their patients to focus on other qualities in food.

They also suggest foods that stimulate the trigeminal nerve, which carries senses like hot, cold and prickliness to the brain. Those include horseradish, pepper, ginger, cloves, spearmint, cinnamon and pimento.

Finally, Davidson and his colleagues urge anosmic patients to get smoke and gas-leak detectors to warn them of dangers they are unable to sense. They advise great care to avoid food that might be spoiled or rotten.

Frances Verbest is one of the unlucky ones.

In the end, she said, she was told that olfactory cells in her nose had been destroyed-an explanation she finds unconvincing. Unwilling to give up searching for help, she plans to consult a nutritionist. She thinks her problem is “a chemical imbalance.”

“I did finally get my sense of humor back,” she mused. “It’s really a miserable experience. But if I have to have something in my ‘Golden Years,’ I suppose I would rather have this than not be able to get around. Otherwise, I have perfect health.”

Then she added, “Yes, I know one gal, she gets hers back. She can taste Scotch.”

Los Angeles Times
March 30, 1987

When Sense of Smell is Lost, So is Taste, Sufferers Find
By Janny Scott

[Note: This article is very similar to the previous article.]

They come here from across the Western United States to have their noses peered into and probed and scraped and scanned.

There are people who haven’t smelled Christmas turkey in years. There are people haunted by phantom odors. And there are people for whom everything smells like chemicals. “Most have lost their sense of smell for anywhere from one to 15 years,” said Dr. Terence Davidson of UC San Diego Medical Center. “They’ve all been to multiple physicians, all of whom have said, ‘Yeah, your smell is gone. Don’t worry about it.’ It’s not done heartlessly,” he said.

“You’ve got to talk to 60 women who can’t smell Thanksgiving dinner. You’ve got to talk to someone who can’t smell their baby any more. And then you start to understand the emotions of this. It’s not like losing a limb. But it is real,” Davidson said.

“I keep thinking I smell something, because I remember it,” said Frances Verbest, a Poway woman who has not tasted anything since a year ago Christmas. “What I have to do is eat and cook by ear. I just have to use my imagination.”

She is a patient at the Nasal Dysfunction Clinic at the University of California at San Diego, one of only a handful of such clinics in the United States that explore the little-understood phenomenon of loss of smell, believed to afflict 2 million people nationwide.

Some suffer from anosmia, or the complete absence of smell. For others, their sensitivity was diminished or distorted or triggered unprovoked. For most, their first warning was what they took for loss of taste: Suddenly, everything seemed bland.

The causes of anosmia include infections, allergies, viruses and trauma, such as a severe blow to the head, according to Davidson. Some lose their smell from exposure to toxins like ammonia, photo-developing chemicals and hair-dressing chemicals. For a few, the problem is congenital.

Only some of the cases can be treated; for example, inflammations are treated with steroid hormones. In many cases, the loss appears to be permanent. In those cases, Davidson said, the aim is to help people accept their fate.

For them, future pleasure in food may depend on spices and hot sauces, which act on the taste buds on the tongue instead of the olfactory receptors in the nose. Davidson encourages them to savor the texture and appearance of food-now that the flavor is out of reach.

For a few, some satisfaction lingers in memories of smells, occasionally filtering back. Oliver Sacks, the British neurologist and author, called it “a veritable osmalgia,” a nostalgic yearning for lost odors powerful enough to seem to bring them back.

The sense of smell is poorly understood because of its complexity and because of the traditional view that it is relatively insignificant. Yet smell is intimately connected to memory and emotions, perhaps because of the area of the brain where olfactory information is received.

Medical educations have included little about the nose, and until the late 1970s little money was available for research.

“There are some very basic science questions about the sense of smell that are as yet unanswered,” said Claire Murphy, a psychologist who works with Davidson. “We still don’t know how it is the olfactory system codes information about the quality of odor. Can you imagine someone in vision saying we don’t know how it is that we tell the difference between red and blue?”

An odor is sensed when volatile molecules are sniffed into a person’s nasal passages. There, they meet the mucus-coated epithelium, or lining of the nasal passages. They attach to minute, hair-like cilia, sending impulses through nerve cells to the brain.

That process can be disrupted at any stage-by a blockage in the nasal passage, or damage to the sensitive lining or damage to the brain. A head injury can shear the olfactory nerves. A virus can destroy the nasal olfactory cells.

In an interview, Davidson estimated that his clinic is able to reverse or reduce the smell dysfunction in one-third to one-half of all patients. For the rest, he said, an accurate diagnosis of their problem may finally enable them to come to terms with the loss of smell.

The problem is most upsetting to people like Verbest.

“I always had a very acute sense of smell and taste. Ask anybody,” said Verbest, who attended the clinic last summer. “I love to cook and I love to eat. Now I can’t do either. It’s terrible.” She has smelled and tasted nothing since December, 1985.

After much examination, Verbest was told that olfactory cells in her nose had been destroyed-an explanation she finds unconvincing. Unwilling to give up searching for help, she now plans to consult a nutritionist.

The Times (London)
August 6, 1987

A most uncommon sense
By Liz Gill

Our sense of smell can control our sex lives and our health. Why is the most basic sensation the least understood?

When Mr. Justice Caulfield described Mary Archer as ‘fragrant’ he was evoking our most primitive and mysterious of senses-the sense of smell.

Smell is so powerful that a single whiff of chalk dust can transport us back to the classroom, a drop of antiseptic re-awaken childish terrors of dentists and hospitals. In ways still not fully understood smell plays a major part in sexual attraction, parent-child bonding and aggressive behaviour. Without it-and its inseparable ally, taste-many of life’s greatest pleasures become meaningless.

Yet thousands of people lose these senses every year-many of them permanently. The phenomenon is known medically as anosmia, the victims anosmics (curiously, despite the fact that smell is our most basic sense, evolved before sight or hearing, there is no common term as there is for the deaf, blind or mute).

Some people are born without a sense of smell, but non-congenital anosmia can have a variety of causes. Damage to the frail nerves just behind the top of the nose by head injuries or viral infections is irreversible.

Where the problem is caused by nasal polyps, sinus trouble, chronic colds, allergies and rhinitus it can usually be tackled either medically or surgically. In rare cases anosmia is a symptom of a brain tumour.

Frequently, the cause remains a mystery. Marian Rudston, a 43-year-old mother of two and former textile designer, realized she had lost her sense of smell and taste after a dinner party.

‘Everyone was saying how awful the goulash had been and I suddenly found I hadn’t tasted a thing.

‘I became a real sensation-seeker-biting lemons, eating brie and lime pickle sandwiches, sniffing onions and bleach, anything to test it. I even licked the soap. That’s when my husband insisted I go to the doctor.’ After a series of taste test which proved inconclusive she was given a course of zinc tablets. A year from the time she lost them, sense and taste began to return but it was never established why they had disappeared.

‘I felt handicapped in all kinds of ways. I’d always loved cooking but it was impossible. I’d either over-season or under-season. Eating out was unbearable because I couldn’t share it,’ she says.

‘I was worried about whether I smelt or the house smelt. I was worried about fire and gas leaks. But I think the worst thing was not being able to smell personal smells. I’d always loved to smell my family, the kids’ heads after a bath. Sexually it was very frustrating. Sex becomes strange when there is no scent.

‘After a while I did learn how to compensate. I can’t explain this properly except to say that I had a recall, a memory of scents, just as if you’d been struck blind you’d remember what a rose looked like. I still have to go very close to something to smell it but I’m so grateful. Life is very sweet, literally.’

Mr Ellis Douek, an ENT consultant at Guy’s Hospital in London, has observed the curious situation where anosmics ‘hallucinate’ smells. ‘It’s like someone with an amputated leg feeling a pain in their big toe.’

He believes there is a great need for more sympathy and understanding. ‘You have to take it very seriously. The majority of sufferers are very distressed and some actually become clinically depressed. They feel they are living in a colourless world. Smell can have a more profound emotional content than people realize.

‘After all Proust produced 13 volumes that changed world literature on the scent of a madeleine dunken in a cup of tea.

‘Because it’s so very basic and ancient it’s not surprising that it plays a role in our emotions that we’re not very aware of.’

Clinical tests show no difference in sensitivity between the sexes but Douek has no doubt that women handled the sense of smell more imaginatively than men.

‘I know men become top wine tasters and all but you never get men saying they could smell their family blindfold in the way that women do.’

Smell is thought to play an important role in mother-child bonding. Certainly the sense is one of the earliest to develop and a baby finds the breast by smell.

In cosmetic houses and laboratories the search is on to isolate key pheromones, chemical messengers which modify our behaviour. It is already thought that they influence the menstrual cycle: for instance closed communities of women, such as prisons or boarding schools, tend to synchronize their periods.

Douek gives another example. ‘It’s been shown that some of the pheromones produced by a human female will arouse male monkeys but when the same pheremones were tried on human males the results were inconsistent. It may be that social conditioning prevails over our innate biological drives.

‘In our crowded society we don’t want to be unduly and overwhelmingly attracted at random. It’s assumed we douse ourselves with scent to attract the opposite sex but it may be to stop the other sex,’ says Douek.

‘In countries where this is not done we feel uneasy because we are not protected by this neutralization. It’s the same with territory. Animals mark theirs by smell. In more primitive cultures a man’s strong body odour and the fact that his room smells of him may be an important and attractive thing. In our over-crowded communities where we’re all pushing for space it’s a drawback.

The introduction of musk into some perfumes is a curiosity in that musk is a male pheromone. So it may be that a woman sprays herself with it in order to stimulate production of her own pheromone. There is also one type of musk that only women of child-bearing age can smell.

‘It’s all a very mysterious business,’ adds Douek. ‘For instance my wife says she cannot bear to be in the same room as a chap we know who exudes a strong personal odour. Yet he has a notorious effect on women. They positively throw themselves at him.’

How we smell as individuals is determined by the number of sweat glands, the amount of body hair and the food we eat. Meat-eaters often smell unpleasant to vegetarians, hirsute Westerners nasty to the smooth Chinese.

There is also a genetic component that makes a person’s body odour as unique as a fingerprint. Work on a machine that can identify them is in progress at the Leeds University department of Forensic medicine under Dr Barbara Sommerville.

The aim would be to take such a device to the scene of a crime to analyse scents which could then be compared with those of suspects.

‘There are between 20 and 300 different components in sweat so there is a lot of work to be done to isolate the genetic one. It sounds like sci-fi and it will be a few years before we have the technology but it’s entirely feasible,’ says Sommerville.

The Orange County Register
September 30, 1987

Healthful hints from Register news services
By Elaine Tait

The nose knows more than we do about smell .

Imagine, just imagine, that the entire population of Chicago has lost its ability to smell.

Suddenly, you have three million noses that can’t tell the difference between the scent of Jungle Gardenia on a lace hankie and that of “Refrigerator” Perry’s jersey on the day he forgot to roll on Ban before the big game.

Now, consider the consequences.

Dangerous gases slip undetected from industry smokestacks and kitchen ranges, fouling the air and causing catastrophic explosions. Restaurateurs and wine merchants go idle as customers, unable to savor the perfume of steak and onions, garlic and truffles, coffee and fine cognac, stay home to eat and drink joylessly for survival and not pleasure.

Many of those dining at home become ill from eating over-the-hill flounder or too-ripe turkey, which an impaired sense of smell has failed to warn them to avoid.

Businesses devoted to making and selling cat-box filler fold; perfume and aftershave sales slump. Trainloads of deodorants and room and carpet fresheners are shipped to where knowing noses survive.

That every living soul in one of this country’s largest cities might suffer loss of smell-a condition known as anosmia-sounds like the stuff of which science-fiction movies are made.

Yet that many humans-1.2 percent of the U.S. population-pass through this world without ever being able to smell the roses along the way.

This is serious stuff-and we have it on the word of no less an authority than the National Geographic Society.

Last autumn that Washington-based magazine inserted a scratch-and-sniff test in copies mailed to the society’s almost 11 million subscribers throughout the world.

They were asked to scratch six panels containing chemicals and identify the odors: banana, cloves, roses, musk, human sweat and the warning odor in natural gas.

The object of what turned out to be the largest scientific survey ever done was to separate myth from truth and to add to the general knowledge of the least-studied, least-understood of human senses.

Subscribers in the United States, Latin America, the Caribbean, Britain, Europe, Africa and Asia scratched, sniffed and reported back to the society.

When several members of a family or school group wanted to get in on the act, scratch tests were shared and observations recorded on photocopied questionnaires. Men, women, children-including infants and even family pets participated. A California house cat signed the survey form with toothmarks.

A year later, we’re hearing that the test was a roaring success that brought the magazine 29 tons of mail that cost $200,000 and the equivalent of 10 person-years of work time to process.

In addition to determining that a significant proportion of the world’s population suffers from permanent loss of smell, the findings of the survey, conducted by two biopsychologists with Philadelphia’s Monell Chemical Senses Center and released last week, showed that half the population has at least some sort of odor blind spot. (Only 2 percent of Americans have some form of color blindness.) Of the six odors, the bananas, cloves, roses and the warning odor in natural gas were most often detected, but androstenone, a component of human sweat, and galaxolide, a synthetic substitute for musk collected from the Asian musk deer, were difficult for many survey sniffers to detect.

Ahem. Women were found to have a better sense of smell than men.

What women have always suspected is true, says Monell scientist Charles J. Wysocki.

With all six odors, women scored higher than men, both in being able to smell and in correctly identifying the odors on the sniff test.

But women don’t have better noses just because of more experience in the kitchen. “It’s more profound than culture,” says Wysocki, noting that baby girls recognize their mother’s odor at the age of 2 to 3 days, when infant boys still cannot.

Why do women have superior sniffers? Survey scientists concede that they don’t have that answer yet.

Wysocki and Avery N. Gilbert, his partner in the project, agree that much is still to be learned from the survey.

In January, computerized data will be made available through the society to researchers who will continue with what Gilbert and Wysocki have started.

Some results point to possible future action.

For example, the discovery that older respondents showed a surprising lack of negative reaction to the foul smell added to natural gas is already suggesting that this scent, commonly used as a warning of the danger of escaping gas, might be unsuitable for the purpose and should be changed.

We already know, through the survey, that the stronger an odor, the more likely it is to evoke a vivid memory, and that people with allergies can smell as well as people who don’t sneeze at pollens and pets.

If we’re factory workers, we can feel pleased that we identify odors better than our friends who spend their workdays in the open air.

And, finally, if we don’t work at all, we might consider finding employment: Another survey revelation was that joblessness goes hand-in-hand (or nose-in-nose?) with decreased ability to identify life’s Chanel No. 5s.

Los Angeles Times
July 25, 1988

Scientists Trying to Sniff Out Secrets of the Sense of Smell
By Seth Shulman

If you are like most people, you might have a hard time describing just what fresh-brewed coffee, burning rubber or pine needles smell like. But you would have no trouble identifying one of these odors and countless others if they happened to waft your way. Just how we distinguish among them is a question most of us probably would take for granted. But such questions have baffled scientists for centuries and still do to a surprisingly large degree.

Basically, smelling things is believed to involve sensing and analyzing the molecules of odors-a subtle and complex task that is apparently accomplished with ease at extremely low concentrations of molecules.

“Until about two years ago, I used to always say that olfactory science was pre-Galilean. There has been so much happening that perhaps we may have moved up to a stage comparable to Galileo’s time in the understanding of physical phenomena,” said Charles Wysocki, an olfactory scientist at the Monell Chemical Sense Center of Philadelphia. “But still, it is safe to say that olfaction is the least understood of the senses and for researchers is really pretty much virgin territory.”

Yet at the same time, scientists like Wysocki have derived a fair amount of observation-based data about our sense of smell.

Women, for instance, generally have a more acute sense of smell than men. This has even been shown to hold true in 2-day-old infants, lending some credence to the hypothesis that this sense has an innate basis rather than simply being culturally influenced.

It is known that the sense of smell tends to diminish as people age. Yet this observation would seem to fly in the face of the fact that our olfactory neurons-the nerve cells that send the information about aromas in the air from our noses to our brains-are the only nerve cells in our body that regenerate.

Scientists have also discovered that there seems to be a good deal of variation in what people smell and how well they can smell it. Many people have been shown, for instance, to suffer from a condition called specific anosmias, the nasal equivalent of color blindness.

In addition, studies have shown that as many as 45% of all people cannot smell the chemical androstenone-a musky-smelling odor found in underarm sweat and pork products-no matter how strongly it is present. Other people can smell this particular odor when it is present in concentrations as low as two parts per trillion.

John Kauer, a neurobiologist at the New England Medical Center in Boston, is among a small but growing number of researchers trying to unravel the mysteries of how we smell by studying what are known as olfactory neural networks.

As Kauer emphasizes, researchers do not even know exactly what a smell is. Unlike light and sound, the odor quality at the molecular level cannot be characterized easily along a continuum.

“For the olfactory system,” he said, “we don’t have any good idea about what the critical properties are that are being encoded.”

Aside from not knowing exactly what makes a molecule smell the way it does, another related and formidable problem is how the receptors in our nose and olfactory bulb work to make sense of incoming odors.

Each individual olfactory nerve cell seems able to respond to many different types of odors, and yet there appears to be a good deal of specialization among the receptors as well. The way our olfactory neurons work together to categorize the aromatic information is not known with any precision.

Kauer put it this way: “When we smell bananas, how is it that we can immediately recognize their scent? Does it mean that there is some grand banana neuron somewhere in our brain to which the new aroma is compared?”

Kauer’s notion of a “banana neuron” may sound farfetched, but this, essentially, was the working theory of smell-or olfaction-that scientists used until as recently as 20 years ago.

Put simply, the hypothesis was that somehow odorants worked with receptors much like keys open a lock, and that it was just a matter for the given smell to find the receptor that would open to the smell.

Now, the working analogy seems to have switched from keys in locks to keys on a piano, as several olfactory researchers explained it.

The idea is that there seems to be some large but finite number of receptors that look for a particular piece of a molecule as it is sniffed in through the nose. Out of these, a tremendously large variation of “chords” can be discerned by matching together the information over arrays of receptors.

The important change is that researchers have come to hypothesize that our identification and recognition of a smell happen only from a “chord” or pattern of information across thousands or even millions of nerve cells. But how many distinct keys are on the piano-whether there are 10 different types of receptors or 1,000-remains a mystery.

Contrast this to research into vision, for example, where scientists have discerned two major types of receptors in the retina: rods and cones, which take in all the information needed to enable us to see.

Using video cameras and image-enhancement techniques developed in the space program for satellite reconnaissance, Kauer has recorded what actually happens to the nerve cells in the olfactory bulb of live salamanders when an odor passes their way.

What Kauer and others have demonstrated is that one odorant, say, the smell of bananas, excites certain neurons, forming a distinct pattern over time, while another, like coffee, makes a distinct and different pattern.

Interestingly, however, a familiar smell seems to make a different pattern after multiple exposures, suggesting that even at this stage of processing, some recognition or even memory is taking place.

Kauer’s work fits in neatly with theoretical work by other researchers on information-processing in neural networks. Some of this work comes from computer scientists who are trying to model neural networks as examples of what they call “parallel processing”-systems where information is processed by many individual components simultaneously. By contrast, most standard computers have many-thousand bits of memory but only one processor.

Because the research by Kauer and others has shown that recognition of a smell comes only through a group of receptors working together at once to encode the information, it is a good candidate for this type of modeling.

One such ingenious model comes via a collaboration between neurobiologist Gary Lynch and computer scientist Richard Granger at UC Irvine. Lynch and Granger have designed a computer simulation model that is based on the workings of olfactory receptors in rats.

Simulating individual odors as bar codes (much like those used at the supermarket), these researchers found that the system seems to use the cells closest to the entrance of the nose to look for similarities between molecules and the cells farther downstream in the system to tease out the more subtle differences between the odor inputs.

Kauer said the work by Lynch and Granger shows promise, but that it is still too simplified. But he also acknowledges the importance of the theoretical models like Lynch and Granger’s.

“Without them,” he said, “it is a little like having a radio and trying to understand how it works by sticking a probe into it and listening to what you hear from each little transistor. The real understanding comes from the connectivity of the parts.”

Newsday (New York)
April 17, 1990

How the Nose Knows; A picture is emerging of how the sense of smell works-and doesn’t
By Earl Lane

FOR 16 YEARS, Mary Brooks endured attacks in which she smelled a foul, overpowering odor through her left nostril. The odor so nauseated Brooks that she was unable to carry on her normal life.

Only after vomiting or prolonged crying would the mysterious odor, for which there was no apparent cause, subside.

Brooks, 37, a Philadelphia housewife, visited numerous doctors. Many told her the problem was psychosomatic-all in her head. But a psychiatrist concluded the cause must be physical. Toward the end, Brooks said recently, she felt increasingly suicidal. The odor came as often as 30 times a day. She called Richard Doty, the director of the University of Pennsylvania’s Smell and Taste Center. Doty had seen Brooks over the years and, like other specialists, had been puzzled by her case.

“I told him I could no longer live like this,” Brooks said. “I went nowhere. I was trying to raise a little baby. I was just going out of my mind.”

Fortunately, Doty had just read a new medical journal article about a woman in North Carolina with complaints identical to those of Brooks. Surgeons had solved the problem by removing the woman’s olfactory bulbs, two small structures in the brain that receive smell “messages” from the nose.

And so two years ago, surgeons performed the same procedure on Brooks. By choice, she accepted what many other Americans suffer involuntarily-loss of the sense of smell. “It’s wonderful,” says Brooks.

Her case is a dramatic example of what can happen when the least understood of the senses goes haywire. Researchers do not know what causes such false signals to occur. Nor do they understand well the much more common problems of partial or total loss of smell that afflicts millions of people like Max Bowman.

Bowman, 63, the owner of a small computer firm in Lansdale, Pa., lost his sense of smell after being knocked out in a 1987 traffic accident. Doctors attribute his loss of smell to damaged olfactory nerves.

Bowman said he misses the spring fragrance of the hyacinths outside his front door and “the aroma of a nice roast turkey.” Most upsetting, he said, is his inability to sense dangerous odors such as the whiff of gas or smoke. “My worry is the smell of things that aren’t good for you.”

Researchers estimate that about 1 percent of the population-or 2.5 million Americans-have major loss of smell. The condition is called anosmia. According to Doty, the common causes include upper respiratory infections, head trauma, nasal and sinus diseases and allergies. In all, at least 30 different diseases are implicated.

Of interest has been the finding that 90 percent of patients with early symptoms of Parkinson’s disease have fairly substantial loss of smell. A better understanding of the pathways of smell, researchers say, might provide some insight into the onset of Parkinson’s disease, a brain disorder that reduces muscle control. Researchers hope that certain deficits in smell perception eventually may be shown to be early warning signs for disease. Olfactory problems also have been noted in patients with other brain diseases, including Alzheimer’s.

Beyond those with serious difficulties, virtually all humans have an inability to smell at least some odors. In most cases, Doty said, people are not even aware of these specific anosmias-the nasal equivalent of color blindness.

For some substances, nearly half the population may be “smell blind.” For example, as many as 45 percent of Americans cannot detect androstenone-a musky-smelling substance found in human sweat, boar saliva and some foods, including celery and truffles. Yet, some who can smell it are able to do so with great sensitivity - at levels below one part per billion in a volume of air.

Research suggests that women, in general, have a better sense of smell. It also shows that odor detection declines with age. Where 1 percent of the population under 65 may have major loss of smell, Doty said, about half of those between ages 65 and 80 have major deficiencies in the sense of smell. Doty said the sensory membrane in the nose appears more easily damaged by respiratory infections in the elderly.

The mysteries of smell have long puzzled research scientists and physicians alike. Only within the past decade have molecular biologists started to provide a glimpse at the subtle and complex molecular pathways that allow us to tell the difference between a banana and an apple, a field of wildflowers and a barn full of hay.

As the picture develops, the interplay between the clinicians who deal with patients and the molecular biologists is likely to increase. Already, the well-documented presence of specific anosmias reinforces the view of many researchers that there are individual smell receptors in the sensory tissue of the nose. When one or more of these receptors is missing, they suggest, a deficit in the ability to smell results.

The research challenge has been to identify these receptors and how they cope with hundreds of thousands of odorant molecules. “It’s totally phenomenal what the olfactory system can do,” says Charles Wysocki, a specialist on smell at the Monell Chemical Senses Center in Philadelphia. Chemists create several hundred thousand new substances in laboratories every year. “Many of these brand new molecules-that never before have existed-we can smell,” Wysocki says. “How can that be? It’s clear we weren’t endowed with receptors for every specific molecule.”

Doron Lancet of Israel’s Weizmann Institute of Science suggests there may be several hundred kinds of receptors on the surface of nerve endings in mucous-lined tissue at the top of the nasal cavity called the olfactory epithelium. These olfactory receptors, acting in concert, may be able to process a nearly infinite number of different smell messages to the brain.

The picture is further complicated by smell’s connection with other sensations. Special pain-sensing nerves in the nose respond to the jolt of ammonia or the fire of chili peppers. And the subtle flavor and aromas of food are a result of the marriage of taste and smell. Receptors on the tongue distinguish only bitter, sour, sweet and salty tastes (although Japanese researchers say there is a fifth receptor for the taste of monosodium glutamate). Perceptions of flavors in food or the bouquet of a wine are produced principally by the nose, not the tongue.

“Coffee contains over a hundred active compounds,” Wysocki said. “If you take one out, it is no longer the good coffee you experience.”

The sense of smell is thought to involve a complex recognition system akin to that of the body’s immune system, Lancet said. “If you have a lock that you need to open and you come in equipped with two-thousand different keys of the right size, chances are that one of those keys will open the lock,” Lancet said. “Did you know the configuration of the lock ahead of time? No, you just try one key after another until you open the lock.”

The immune system relies on such a recognition system to identify and disable invading viruses and other toxins that it has never seen before. “We speculate that this type of evolutionary tool also exists for the olfactory system,” Lancet said. Thus far, however, no one has been able to isolate individual smell receptors.

Researchers have had some luck identifying receptors in other body systems by tagging a molecule of interest with radioactivity and watching whether it “lights up” a specific location in the cells. Such methods have been useful, for example, in locating receptor sites in the brain that bind a specific drug or compound.

The olfactory system has proved much less amenable to such direct attack, researchers say, because of the complex interactions at work. Wysocki prefers the analogy of the piano: A particular odor molecule may have regions that are recognized by hypothetical receptors 1, 5 and 9. Another molecule may hit receptors number 1, 3 and 7. If the right notes and chords are struck, the brain recognizes the odor as “banana.”

The recognition of a single odorant, thus, may involve dozens of different molecules and receptors acting in concert within the olfactory epithelium. “It’s like having a hundred drug receptors all mixed together and needing to work out what they bind and what they don’t,” Lancet said.

Lancet and his colleagues also have been asking why the nose is not overwhelmed by the smelly chemicals that assault it constantly.

Lancet and his colleagues have isolated a pair of detoxification enzymes in the olfactory epithelium. Both of the enzymes are of a class also found in the liver, gut and other tissues exposed to toxins. An odor molecule can be converted by the two enzymes to a water-soluble molecule that can be quickly cleared from the sensory tissue, Lancet said.

That would allow the nose to pick up on the subtle changes from moment to moment in its surroundings. It also would explain how a dog or other animal can sniff the trail of a prey and determine whether the intensity of the smell is changing from moment to moment, Lancet said. (A dog’s olfactory tissues are similar to ours, but a dog has perhaps 100 million cells in its olfactory epithelium, compared to less than 10 million for a human. Dogs also have a larger portion of the brain devoted to processing of smell signals, Lancet said.)

The presence of detoxification enzymes in the nose also may play a role in modifying potentially dangerous chemicals, Lancet said. Some odor chemicals and other airborne molecules, if not disarmed, may have an ability to travel up the olfactory nerve and directly into the brain, Lancet said. “This battery of enzymes we are working on may be related to the long-term protection of the olfactory epithelium as well as the brain,” Lancet said.

Getting The Scent

Researchers offer this theory for how smell occurs. Organic molecules float into nasal passages and are carried by a special protein through the mucous fluid to the presumed receptors lining the olfactory epithelium, or tissue layer, at the back of the nose.

These receptors are thought to be located on hairlike cilia that extend from olfactory nerve cells in the epithelium.

After a smelly molecule attaches to a receptor, researchers believe, it “turns on” a series of chemical events. A molecular amplifer called G protein and an enzyme called adenylate cyclase, or AC, are activated within the cilium. AC generates a soluble messenger molecule called cyclic AMP that triggers the opening of a channel at the surface of the cilium. The passage of electrically charged ions-calcium and sodium-through this channel triggers electrical signals along the length of the olfactory nerve and into the olfactory bulbs in the brain. All these events occur within about one second.

Chicago Tribune
May 3, 1990

Lost scents: When age or disease rob us of the sweet ability to smell, food becomes a bitter pill
By Elaine Markoutsas

Lilacs were the first clue. She no longer could soak in the perfume of their blossoms. Then she noticed the aroma of bread baking in the oven was missing. Food began to fade to blandness.

As time went by, everything seemed to smell like roast chicken, an odor that persisted no matter what was cooking. Chocolate, which she once craved, tasted spoiled. Bananas seemed to her to have the flavor of rotten garbage. Jell-O was like fish gone bad. Soft drinks lost their sweet fizz.

The 65-year-old was understandably depressed. Smell deprivation had affected her ability to perceive flavors, indeed, to enjoy eating. The woman, a patient at the Smell & Taste Treatment and Research Foundation Ltd. in Chicago, is but one of a growing segment of the American population faced with what to date has been an irreversible affliction associated with the process of aging: a gradual but often dramatic decline in the ability to smell, ergo taste.

“As much as 80 percent of what we call ‘taste’ actually is aroma,” explains Dr. Susan Schiffman, professor of medical psychology at Duke University Medical Center. Schiffman, who also is a senior fellow in the Center for the Study of Aging and Human Development, has done extensive research on the physiology and chemistry of taste and smell.

“When we chew and swallow food, air is forced up through the back of the throat into the nose. Perhaps 94 percent of the aromas in food stimulate the olfactory receptors in this way,” Dr. Schiffman says.

The tongue and taste receptors discern sweet, salt, sour and bitter flavors, among others. “There are other components such as hot and spicy, temperature sensations and pain sensations for carbonation,” says Dr. Gary Beauchamp (pronounced beecham), assistant director of Monell Chemical Senses Center in Philadelphia. “All of these, plus odor, give you the subtleties of flavor.

“So when someone says something tastes good, the perception is a combination of taste, smell, texture, temperature, even color and shape.” A total sensory impression.

But something happens to our capacity to sniff as we age.

“We lose it,” says Dr. Richard Doty at the Smell & Taste Center of the University of Pennsylvania. “About half of those between the ages of 65 to 80, and three-quarters of those over 80 have a major loss.”

“For some, it happens as early as the 40s,” says Schiffman. “It might be subtle. They might not be able to distinguish differences among wines and beers. Or among (flavors such as) strawberry, raspberry and grape.

The condition is called hyposmia (diminished ability to smell) or anosmia (inability to smell). Physiological deterioration is evident in a microscopic study of a cross section of the olfactory bulb. “It looks moth-eaten,” says Schiffman.

One way to measure olfactory loss is through some kind of smell identification test. The University of Pennsylvania’s test consists of 40 items. “Young people generally score 37 out of 40,” says Doty. “People with no sense of smell score between 10 and 12; older people 19 or below.”

Women, on the average, appear to be more sensitive to both taste and smell although researchers disagree about the reasons. Some feel there is a gender difference; others suggest that women simply have a wider vocabulary to describe flavors and odors. Whether or not women hold on to their sense of smell longer than men is debatable.

And just as some people never may experience vision or hearing problems, there are those who won’t suffer any loss of taste or smell either. There’s nothing to support the idea that those with an acute sense of smell or taste retain them longer. Nor does heredity seem to play a role.

As our population is aging, with 15.7 percent reaching 65 years and older in 1980 (by 2030 that category will include about 50 million), the degeneration of smell and/or taste is a growing concern.

At least four kinds of taste-related losses have been identified in the elderly. There’s a diminishment of absolute sensitivity or how many molecules are needed to detect a taste or smell, which is measured by threshholds. A threshhold is the concentration at which an ingredient can be detected.

“Higher concentrations often are required for older people to perceive the presence of a particular aroma or taste” says Schiffman. Many foods, such as beans or corn, now are fortified with nutrients such as amino acids. The elderly may not detect the difference; younger people might pick up a slightly bitter taste. As an example, unpleasant odors in retirement homes often go unnoticed by the elderly while younger people find them offensive.

But the most profound effect of this increased detection threshold is the impaired perception of sweetness and saltiness as well as certain food aromas. “Two-and-a-half times as many molecules are required for an older person to detect the presence of a sweetener,” says Schiffman, “and 30 times as many molecules to distinguish other flavors and as many as 50 times more to detect smell.”

In addition to threshold changes, the perceived intensity of specific ingredients may decline. So a mixture of ingredients often tastes different to an older person because the pattern of the intensity of the components is different from that of a young person.

“Taste is a mix of molecules,” says Schiffman. “When one declines more than others, the mix can appear distorted. It’s as if when you lose one note, the chord is a little off, so the overall sound is different.”

The ability to identify flavors also declines with age. “Vegetables and meats suffer the most, when we rely on taste and odor alone without the additional cues of texture,” says Schiffman. The loss is least apparent with fruits.

Finally, as in the case of those who might suddenly have trouble identifying strawberry versus raspberry, discriminating among various tastes and aromas is lost.

How those changes show up varies considerably, as researchers are discovering in patient interviews.

A 76-year-old woman says that foods all have a moldy smell. The only odor she feels she can discern is that of ammonia. She has to force herself to eat.

Because the taste process is so complex, losing just one receptor might alter the balance and affect the overall flavor. Take coffee, for example. “Almost all of coffee is aroma,” says neurologist Alan Hirsch, who also is a psychiatrist and medical director of the Smell & Taste Treatment and Research Foundation. “Smell is perceived in a more pleasurable way than taste. Coffee has a bitter taste. When the ability to smell drops, bitter is what is left.”

The same is true of green peppers. When the sweet smell is wiped out, only the bitterness remains.

“With some vegetables the astringent taste becomes more salient,” says Schiffman.

“Tasting onions is a two-dimensional experience,” says Hirsh, “part olfactory, part trigeminal. The latter may take your breath away (because of the pungency). But when you lose the olfactory component, an onion and apple will taste just the same. Because all you’re picking up is the crunch, the texture.” [For the record, I’ve had people claim that I can’t differentiate between an apple and an onion, and I will swear to my dying day that this is NOT true!! -JB]

Perhaps a most distressing example is that of something deliciously dulcet like chocolate. “Almost all the taste of chocolate is smell,” says Hirsh. “If you eat a chocolate bar while holding your nose, it might seem like chalk.”

In one experiment, a blindfolded patient was given a wad of wax paper to chew on, while he was exposed to a chocolate-enhanced odor. He insisted he was munching on chocolate.

Besides the obvious frustration that accompanies loss of smell, there may be other serious consequences. Oversalting food to compensate for its apparent lack of taste may lead to hypertension. Oversweetening may lead to obesity, if calorie intake goes out of control.

Selecting foods according to one’s perception of taste may cause some to neglect daily dietetic requirements, resulting in constipation, diarrhea or nutritional deficiencies.

People who no longer relish food also may lose interest in it. That in turn, may lead to anorexia, even death.

Then, too, there well may be a physiological depression related to the diminished ability to smell. “When you lose your sense of smell, the hippocampus and amygdala, the parts of the brain that have to do with emotions, are not stimulated,” says Schiffman. “You may actually feel depressed.”

“There also is a tremendous, potentially life-threatening implication,” says Hirsh. “About 70 percent of those who are asphyxiated from gas leaks are over the age of 65. It happens because they can’t smell.”

Nobody really knows for sure why smell and taste may become less robust with age. There currently are several theories, some of which are interelated.

One theory holds that something interferes with the routine regeneration process of the olfactory neurons (nerve fibers on either side of the nasal cavity).

Related is a theory about what happens to the brain itself as we age. Neurotransmitters, chemicals that allow different neurons or cells to talk to one another, tend to fade out. It could be that when certain parts of the brain deteriorate, the numbers of transmitters also decline, hence inhibiting the communication and ultimately the ability to smell.

“We know, for example, that those with senile dementia, Alzheimers and Parkinsons disease early on experience a reduced ability to smell,” says Hirsch. “It could be that people with those diseases have a deficiency in certain neurotransmitters.”

Traumas to the head may sever the neurons going through the cribriform plate, a small bonelike structure at the top of the nose with small holes. Receptors for smell in the top of the nose go through the plate to connect with the olfactory bulb. “Boxers, football players, people who have been in car accidents have experienced such damage,” says Shiffman.

Recurrent viral or bacterial infections may have a cumulative and ultimately damaging effect on the olfactory nerve. When you have a cold, things don’t smell the same, don’t taste the same. Eventually, the recurrence may trigger a permanent response.

In the same way, environmental insults to the membrane at the top of the nose wear down the smelling process. “One of the reasons the olfactory system evolved as one that regenerates,” says Beauchamp, “is that it’s exposed to many things in the air and has to have a way to repair itself. But eventually pollutants or other causal agents might break everything down.” Airborne molecules also may be implicated in finding a cause for Alzheimer’s and Parkinson’s disease. Researchers at the University of Pennsylvania perhaps are within a year of major understandings regarding the role of olfaction and these diseases.

Allergies seem to affect smell because epithelial tissues swell to constrict the opening that allow odorants to reach the olfactory receptacles.

Growths such as polyps interfere with airflow to receptors, hence the ability to smell and taste. Medication or surgical removal alleviate the problem.

Estrogen and testosterone levels may affect the turnover of smell and taste cells (or tastebuds). Taste cells turn over every 10 days, smell every 30 days. When hormone levels decline, as in menopause, burning mouth syndrome is one common result. “We think it has to do with the thinning of epithelial cells,” says Schiffman. “So free nerve endings are more accessible to irritants, resulting in a burning sensation and hypersensitivity.”

Drugs interfere with taste and smell. “Some older people may be on 7 to 9 different medications,” says Schiffman. “Captopril, an antihypertensive drug, and D-Penicyllamine, an antiarthritic, are among hundreds of drugs that impede the taste-smell process.”

Current research is focused on pinpointing cause as well as what to do about it.

“There are some ways of opening the taste channels (on the tongue in its cells),” says Schiffman. Adding charged nitrogen to food can do that.”

Curiously, caffeine may work as a flavor enhancer “because it revs up taste smells,” according to Schiffman. “It triggers the release of a compound that enhances the response to taste.” Adding molecules can modify the way we smell. That’s the basis of flavor enhancers such as the powders developed by Schiffman and marketed by NutriSystem.

Whether or not certain foods can alter neurotransmitters in the brain, as drugs such as antidepressants may do, is up for debate.

November 26, 1990

Sniff! An Ode to the Odorous
By Sylvaine Rouy Neves

A FEW DAYS AGO I recovered my sense of smell.

The loss had been gradual, almost unnoticeable. I had convinced myself that the aroma of American carnations and American roses was not as sweet as that of the French ones that had perfumed my youth. Sometimes, on days when the air was crisp, I could smell hot bread, fresh out of the oven, or Italian sausages imbued with garlic. But most of the time, when my friends griped about the fumes of oil refineries drifting across the Hudson river, or the stench of the city’s sewers, I smiled and nodded, blissfully unaware of what they were complaining about.

When I was growing up, the sense of smell seemed to me the least important of the five senses. To a petite gourmande like me, losing my sense of taste would have been a real tragedy. Imagine never being able to taste Madame de Sevigne’s chocolates! My Nanny’s Easter bread! A ripe apricot! A pissaladiere! Life would barely have been worth living.

And if I had lost my sense of hearing, I would never have heard the bells of the cathedral on an Easter Sunday, or my kitten’s contented purring. The birds would have greeted a new morning with silence and I wouldn’t have been able to hear a boy’s admiring whistle. Inconceivable!

And what if I had lost my sense of touch? What if I couldn’t feel the softness of my mother’s silk dresses, the roughness of my father’s unshaven beard? The smooth skin of an apple, the blades of grass tickling the soles of my bare feet? A cold pebble on a beach, the warm sand?

When I was 11, I thought being blind would be romantic. One of my favorite movies that year had been a sad, violin-drenched film called “La Symphonie Pastorale” in which a blind Michele Morgan eventually stumbles into Pierre Blanchard’s arms. I spent hours with my eyes closed, my hands stretched dramatically in front of me, groping helplessly for a familiar object. If I were blind, wouldn’t everyone love me, and be kind and forgiving? The cold quarry tiles felt colder when I was blind, and my kitten’s hair softer. The birds’ songs sounded lovelier then. But when I opened my eyes, I would happily notice how blue the sky was, how pink the cherry blossoms were.

Poems and novels have been written about the blind and the deaf, but where was the hero, or the heroine, who had lost his or her sense of smell? I didn’t even know if a specific word existed for one who suffered such an affliction (it’s called anosmia). And even though I enjoyed the smell of a chocolate cake baking in the oven, I enjoyed its taste even more. Weren’t orchids and other odorless flowers just as beautiful as fragrant ones?

I had adjusted quite easily to my loss until the day I read that it could be an early symptom of Alzheimer’s disease. Then I panicked. Random memory lapses were already worrying me. I spent the next few days testing myself, smelling as many objects as I could. I sniffed and inhaled like a pig searching for truffles. The Koreans at the greengrocers must have thought me unusually eccentric as I bent down, eyes closed, and tried to identify the various blooms by their odor. In restaurants, I couldn’t enjoy a meal unless I had discovered which spices seasoned which dishes. I spent a whole morning on Bloomingdale’s main floor trying to detect my own perfume among the thousands on display. I couldn’t find it. It was really time to see a doctor. But would he be able to help me, or was it already too late?

It wasn’t. After assuring me that my loss of smell had nothing to do with Alzheimer’s disease, he prescribed medication to shrink the polyps that must have been clogging my sinuses for decades.

Now I have recovered my missing sense. Does anyone truly appreciate the sweet smell of a cucumber? It smells better than it tastes. Or the woody mustiness of a mushroom? American white roses are just as fragrant as French ones, I discovered, but American raspberries still do not smell or taste as sweet as the ones from my youth. I can smell gasoline when I fill up my car, cookies baking in the oven, and my own perfume, even in a diluted lotion form. Is it my imagination, or does every season have its own aroma?

On clear, breezy evenings, I can smell the roses in my neighbor’s garden and chicken roasting in an oven. Of course, now, the smell of oil refineries and the city’s sewers are not foreign to my nostrils anymore. But what a small price to pay for the recovery of that most valuable sense.

The Independent (London)
May 5, 1992

Can you smell anything? I wish I could
By Laura Croker

IN A FAMOUS early scene in Marcel Proust’s A La Recherche Du Temps Perdu, he dips a madeleine into his tea and drinks a spoonful of the sweetened liquid. He is overwhelmed by the physical and emotional reactions evoked by the smell and flavour of the tea.

“When from a long-distant past nothing subsists ... the smell and taste of things remain poised a long time, like souls, ready to remind us, waiting and hoping for their moment, amid the ruins of all the rest; and bear unfaltering, in the tiny and almost impalpable drop of their essence, the vast structure of recollection.”

For myself, and others who suffer from a loss of the sense of smell, we have lost this key to the past, and to many more immediate pleasures that others take for granted; a tint in our emotional spectrum is missing. I yearn to bury my face in hyacinths and enjoy memories of spring sunshine. I long to tiptoe into my children’s bedrooms and inhale the warm sleeping smell in their hair, or to savour chocolate as a perfume and not just as a soft sweet lump on the tongue; to enjoy the smell of baking as it suffuses the house-and to know when food is cooked before the smoke alarm tells me. My olfactory loss, as it is known, began last year after a particularly nasty bout of flu. Complete olfactory loss, or anosmia, which follows a viral infection, is very rare, while hyposmia, partial olfactory loss, can occur for many reasons, according to Ellis Douek, consultant otologist (ear specialist) at Guy’s Hospital, London.

The most common causes of temporary loss of smell are nasal allergies. “Patients sometimes come with what they think is a post-viral olfactory loss when it is the lining of the nose that is affected,” says Mr Douek. “Changes have taken place in the nasal lining that have ‘masked’ the organs of smell.” Obstructions in the nasal passages, the result of polyps, sinusitis, allergic inflammation or anatomical obstruction, can also lead to a loss of smell.

Olfaction, or smelling, occurs when odorant molecules are brought into the nasal cavity, mainly during inhalation. They pass through the narrow, wet, mucus-lined upper nasal airways, about 1mm wide, to meet the olfactory receptors at the top and both sides of the nasal cavity. There, the molecules are dissolved in mucus and “engage” with the receptors that lie underneath.

Individual receptors engage with particular molecules in a lock and key fashion depending on their size and shape. It is believed that we differentiate between smells according to the size and shape of the odorant molecules. This triggers an electrical signal that travels along olfactory nerve fibres into the brain and so we smell.

Mr Douek has examined tissue samples taken from the noses of patients with post-viral anosmia. He has shown that when a virus has attacked the organ of smell, it leaves an interwoven mesh of scar tissue, which destroys sensory tissue. Tissue samples from patients with problems caused by allergies or inflammation show normal sensory fibres.

“It can be compared with the retina of someone who has a cataract,” Mr Douek says. “If you remove the cataract he can see, but the person who has damaged a retina will not see even when a cataract has been removed.”

Olfaction is not impaired as long as the nerves are undamaged, and once an obstruction is removed, sense of smell is restored. Mr Douek says that this can even happen after decades.

But removing the obstruction is not always easy. Dr Glenis Scadding, a consultant immunologist and allergist at the Royal National Throat, Nose and Ear Hospital in London, and Valerie Lund, a consultant ear, nose and throat surgeon, see many patients who have been referred with olfactory loss due to inflammation or obstruction of the nasal passages. They see less than one patient a month with post-viral anosmia.

Initially, the degree of olfactory loss is assessed using “scratch and sniff” tests. This is followed by medical treatment such as intra-nasal steroids, or a short course of oral steroids which suppress inflammation. Antibiotics may be simultaneously prescribed if the inflammation is the result of infection. If this gives no improvement, surgery may be recommended. An obstruction is removed from the nasal passages by a technique known as functional endoscopic sinus surgery (Fess), using rigid rods which are inserted up the nose.

A patient will first undergo a CT scan, a precise type of computerised X-ray that shows the soft tissue and bone changes, and allows the surgeon to build up a map which is essential for such precise surgery. The tissue is then removed from a critical point in the nasal passages.

“There is tremendous individual anatomical variation in the nose and sinuses, so this map is critical. The work we do here has shown that you can improve the sense of smell in the nose and the way in which the nasal lining works,” Miss Lund says.

However, most patients who come for this surgery say that their problems with smell are secondary: their primary and more troublesome conditions are related to general chronic rhinosinusitis or allergies. Fess, of which Miss Lund performs at least four operations per week, is more successful in treating the primary symptoms than the secondary olfactory problem.

“The majority of the patients with specific olfactory disorders as their primary problems are not improvable,” Miss Lund says. “And patients who have lost their sense of smell following a flu-like virus cannot be helped by surgery.”

So my prognosis is not a good one. Will I ever regain my sense of smell? My intuition-now of course, my fifth sense-tells me that I might. I take some consolation in being unperturbed by all the “pongs” that are associated with bringing up young children, and by halitosis, flatulence and body odour. I am now quite relaxed about the neighbours’ bonfires that used to irritate me so much. But I would gladly suffer them again if only I could lay my head on my daughter’s pillow and be jolted by the fragrant sensation of her presence.


Doctors at the Royal National Throat, Nose and Ear Hospital, London, use scratch-and-sniff tests to assess the degree of olfactory loss. Patients are asked to sniff at 40 smells which are ingrained in the pages of little books and to identify them by selecting from multiple-choice answers.

I sat in a busy waiting room desperately trying to sniff every molecule from each page of the book, as if they contained the Earth’s last dregs of oxygen. But I was disturbed to find that these are American tests-and are based on American smells. I, for one, have no idea what a skunk, or root beer, smells like.

I had to attempt an identification of every smell, even if I had no nasal response whatever. A score of around 12 could be expected if a patient with no sense of smell simply guessed; and zero would also suggest that the patient was cheating, for there are some smells that still provoke a chemical response in the nose even for anosmic patients. My score was 17 out of 40.

The Vancouver Sun
January 21, 1993

The nose knows: Scientists are beginning to understand how smell can evoke powerful primal feelings; SCENTS: Cosmetics get into the smell of things
By Dawn Hanna

GO TO THE FRIDGE, right now, pull out an orange and peel it. Or open the canister that you keep the coffee in. Or, if you’re at work, pull the cap off a big felt pen.

Now close your eyes and just breathe in the aroma (not too closely if you’re doing the felt pen). What images come to mind?

Does the bittersweet tang of the orange bring to mind warm thoughts, maybe of the times that your dad used to peel an orange for you because your fingers were too small to pull apart its rind?

Or does it remind you of lunchtime in Grade 4 when the class bully used to torment you, beaning you with an orange peel to the back of the head?

That’s the thing about smell. We have these visceral, emotional reactions to the odors and aromas that surround us. Smells evoke memories in ways that our other senses don’t.

The irony of smell is that while it affects us so strongly, so emotionally, we also tend to overlook it.

Now, that is starting to change, both in the research lab, as scientists begin to understand why smell has such a potent effect on us and in the marketplace, as companies and entrepreneurs cash in on the primal power of smell.

Barry Beyerstein, a psychology professor at Simon Fraser University, was walking down one of the hallways near his office recently when he had a SEAM-shorthand for smell-evoked autobiographical memory.

“I got a whiff of a combination of smells that produced one of these dramatic memories of my Grade 2 or 3 classroom,” Beyerstein recalled. “It was a combination of a certain kind of cleaning fluid, some orange peels in a trash can and pencil shavings. It was instantaneous. I could recall the classroom and the teacher’s face. It was a pleasant feeling.”

Those kinds of smell memories sparked Beyerstein’s interest in the psychology of smell years ago. Since then he’s become a bit of an expert.

He teaches a course on smell. Graduate students under his supervision conduct research on smell. And Beyerstein has been called as an expert witness to testify on the effects of anosmia-when a person loses their sense of smell, often the result of a head injury.

While we’re still a long way from a complete understanding of our olfactory sense, Beyerstein says there is a probable explanation for why smell affects us the way it does. And it has do with our nosebrain.

Well, actually, it’s called the rhinencephalon; Beyerstein has dubbed it the nosebrain. In humans, the rhinencephalon contains the limbic system, which is associated with emotions such as anger, fear, pleasure, sadness and sexual arousal.

In other mammals, the rhinencephalon is a little more rudimentary, but what we have in common is this: the smells that come through our noses appear to be mostly processed in that same part of the brain. (Sights and sounds, on the other hand, are received and understood by a relatively newer, higher-functioning part of our brain, the cortex.)

“It’s a real primal response. And it’s probably why smells can modulate and affect so many behaviors without our direct awareness of it,” explains Beyerstein.

While our sense of smell is not as acute as that of a dog or a cat, we can detect more than 10,000 different odors. And we can detect those odors in very small concentrations.

In fact, as Beyerstein and other researchers have discovered, our nosebrain can register a smell without us consciously realizing that we have picked up a scent. And in so doing, affect our limbic system - tied to emotion, memory and motivation.

It’s that subtle, subconscious connection that is making smell an even more valuable commodity in the marketplace.

Aside from perfumes, deodorants, air fresheners and other more obvious uses of scent, there’s a new market that focuses on smells as agents of healing, stress-reduction and energy-boosting.

Imagine, for example, that in the place where you work there wafted the aroma of spiced apples. We think it would just make us hungry, but a University of Arizona psychologist reportedly found that it had a relaxing effect on subjects’ brain waves and could reduce their blood pressure.

And at the Shimizu Construction Corp. in Japan, they’ve been pumping fragrances through the office air systems in an attempt to increase productivity and decrease stress among workers.

Researchers claim fewer errors were made when jasmine or lavender scented the air, but lemon was the fragrance of preference. Computer operators reportedly made 55 per cent fewer errors when sniffing lemon compared to no scent.

Aromatherapy has been around for years-3,000 if you count back to the days of ancient Egypt when aromatic oils were used for embalming and treating illness.

In North America, the practice of using so-called essential oils in massage or inhalation therapy started off as a New Age fad a few years back. Now it’s become more mainstream, with aromatherapists working out of beauty salons and spas.

Even cosmetics giant Estee Lauder is getting into the smell of things to come. In the United States, the company has launched a line of herbal concoctions called Origins.

Origins, with its own exclusive boutiques in New York City, offers what it calls sensory therapy in various forms: on-the-spot gels, oils for bath or shower and inhalations.

Our personal favorite is Peace of Mind: “When the world closes in on you and your head feels a size too small ... Just close your eyes and breathe deeply while you massage a tiny dab of Origins’ own mind-clearing formula into the back of your neck, temples and especially your earlobes,” reads an Origins ad in The New York Times Magazine. “You’ll feel pressure, tension, the weight of the world melt away almost instantly.”

Must be some stuff.

Despite his awareness of the power of smell, Barry Beyerstein none the less is a skeptic when it comes to aromatherapy and other scented off-shoots.

Rarely are such treatments tested in a way to see if they are anything more than a placebo, says Beyerstein.

Here’s his take on Peace of Mind: “I could give you essence of cow dung and tell you: ‘This may smart a little when you start it, but boy, are you going to feel good afterward’ and I guarantee that you’ll feel just as good as this sort of stuff.”

While dismissing aromatherapy and related treatments as “classic pseudoscience,” Beyerstein also acknowledges that there may be unintentional benefits.

“As with many drug treatments that are really inert, there’s a placebo effect and if you believe in it, it will probably have somewhat of that effect,” he said.

“The other thing is smells are particularly good at attaching themselves to emotions and memories, so it’s possible that some smells that aromatherapists use may, in the past history of the individual concerned, have some association that way and produce a kind of warm feeling.”

But because each individual would have his or her own individual experience of a scent - his or her own language of smells, so to speak - one scent could have a different meaning for each person.

New York Law Journal
August 2, 1993

$480,000 Settlement For Loss of Smell

A SETTLEMENT of $480,000 was reached recently in the case of a pedestrian who was struck by a parking lot attendant driving a car across a public sidewalk on West 29th Street.

The plaintiff, Daryl L. Yuan, 30, a computer salesperson, was knocked unconscious by the car on April 18, 1991. As a result of the ensuing head trauma, she sustained anosmia, or loss of scent and impairment of taste, according to her attorney, Todd J. Krouner, of Kreindler & Kreindler.

William Ryan of Hayes & Ryan represented Willy Severe, the lot attendant; Ezey Company, the parking lot company and Sal Sapper and Leonard Zigelbaum, the company owners.

Justice Karen Peters, of Ulster County Supreme Court, presided over the three days of trial in New York Supreme Court until July 8 when the parties settled.