"My nose has been a mess for three days," said Dr. William Howard, who has a nose that knows.

For Howard, like one of every five Washingtonians knows gentle April breezes do not carry promises of warm spring afternoons. They carry millions of grains of pollen and runny noses, itchy watery eyes, swollen red eyes and headaches.

"Everybody is sneezing and snorting. This is the busy season," said Howard, who is chairman of the department of allergies at Children's Hospital National Medical Center. "I had to get a shot myself this morning," he said. "I practice what I preach."

"The trees are budding like mad out there," he said. "The tree pollens have been with us for weeks."

An estimated 30 million to 50 million Americans suffer from allergies of one sort or another. "It's a very important cause of illness and days lost from work and school," said Dr. Joseph Bellanti, director of the International Center for the Interdisciplinary Study of Immunology, at Georgetown.

"The allergic reactions can range from a mild nuisance to life threatening and severe asthma, from the tip of the nose to "the most hidden recess of the lungs.

The cause of the reaction may range from the family dog or cat to a feather pillow, a dish of strawberries or chocolate pudding or the pollen in the spring air. It is the pollen that makes this the busy season for allergists all over the country.

"What's causing a problem now are the tree pollens," said Dr. Robert Scanlon, a pediatric allergist in private practice in Maryland. It's not giving major trouble, but mostly upper respiratory problems - runny nose, itchy eyes - and in some people it's aggravating asthma. Things aren't full-blown yet because the grasses aren't pollinating. They will in a few weeks.

"The best treatment for allergy," said Scanlon, "is to eliminate the allergen. So if somebody's allergic to a food, the best treatment isn't allergy shots, but to eliminate the food."

The reason individuals have allergic reactions to substances is that their bodies have antibodies that set off a reaction when the allergen is introduced into the system.

When, for example, pollen enters the nose of an individual allergic to pollen, a so-called mast cell releases chemicals called histamines, which in turn cause the allergic reactions like watery eyes and a runny nose.

In more serious cases the reaction can involve the swelling of blood vessels in the lining of the lungs and the secretion of heavy mucus, both of which make breathing difficult for the asthma patient.

"It's something we inherit," said Scanlon. "If one parent is allergic the chances are about 40 percent that the child will be allergic and if both parents are allergic the chances are about 80 percent that the child will be allergic."

For the mildest cases of so-called "hay fever," which really refers to any allergy to airborn pollen, just using a handkerchief and coughing it out is the best treatment.[TEXT OMITTED FROM SOURCE] is to try one of the over-the-counter antihistamines, which will help dry up the runny nose and eyes and stop the swelling.

If that does not work, the next step doctor, who may, or may not, prescribe shots to build up antibodies to block the reaction of the antibodies already causing the allergy.

Washington is sometimes referred to - particularly by spring time snifflers - as the "allergy capital of the world," a title allergists say it probably does not deserve. It's not that Washington is better than any place else, it's just that it's not particularly worse.

"Everybody always seems to think this place is worse," said William Howard, "but I have friends all over the country making a living from allergies."

Whether or not this is the worst spot for the allergic, every night William Howard checks his own special pollen counter - the glass topped table on the screen porch at his home. "I haven't seen that heavy yellow film on it yet," he said, "but I will." Which is small comfort to the afflicted.