“I don't have a skin problem … but I was told you might help. A few months ago I woke up smelling smoke. But there was no smoke and ever since then everything has smelled like burnt toast,” was our introduction to a seventy-one-year-old woman. She went on to explain that this perception of the aroma of burnt toast was continuous, twenty-four hours a day, week in and week out. It seriously depressed her appetite. She no longer enjoyed food, although her sense of taste was perfectly normal. She had already lost 10 pounds in weight.

It wasn't that she had lost the sense of smell, but instead was a case of misidentification of odors. Even as people are color blind, she was odor blind. All stimuli of smell evoked only the smell of burnt toast, including coffee, onions and cantaloupe. The more powerful the stimulus the more intense the odor of burnt toast. Her medical diagnosis was dysosmia, or as some prefer to call it, parosmia.

The diagnosis was easy, but what caused this sudden malfunction of an organ which, in its own way, is as exquisitely specialized as the eye? The organ of olfaction is located in a patch of specialized mucosa high in each nostril. It is truly remarkable, for there, totally hidden from view, are over 10 million separate bare nerve endings. They are actually outside the body, unlike any other nerve.