Hay fever

“ While hay fever is not strictly a catarrhal inflammation, the cure of hay fever by curing a coexisting catarrhal rhinitis or conjunctivitis seems easily possible. The surgeons taught us long ago that some cases of "hay fever" need nothing but good drainage of the nose, which they secured by freeing the nose from obstruction. ”

“ Any patient who can get rid of the annoying symptoms of hay fever by such simple means of diet and bathing should be urged to try it, whether he believes or disbelieves in the "uric acid poisoning" on which the treatment is based. My own experience leads me to believe that most hay fever patients require something more than dietary regulation to control the disease. ”

“ The first step in the development of hay fever is supposed to be a disturbance in this digestion of protein in the eyes and nose, by which larger amounts of poison are formed and absorbed by the mucous membrane, producing the first poisoning, which, like the first injection into the dog, sensitizes the mucous membrane to other doses of the same poison. ”

“ Some physicians have long insisted that they could relieve hay fever by diet. For instance, I once asked a physician of large general practice what he did for hay fever. He smiled in an incredulous way that I have noticed before among people who never had hay fever and replied, "I find that [Pg 114] if people will stop eating strawberries and not eat too much meat, they soon get rid of their hay fever." This answer surprised me for I knew that in his long practice, he must have seen many cases of hay fever and my experience had been that diet had no influence on the symptoms. ”

“ The fundamental error in all the literature on hay fever is the teaching that the lesion is a peculiar kind of catarrhal inflammation; whereas it is not an inflammation at all, catarrhal or any other kind. The symptoms of hay fever resemble those of catarrhal inflammation, but the resemblance is only superficial. ”

“ Because we can immunize successfully against one disease, it does not follow that the same methods will immunize against another disease. Each disease is a problem in itself and may require its own methods. Nor because we can immunize the guinea-pig in the laboratory, does it follow that the same methods are applicable in the human patient. The only proof that we can immunize against hay fever is to immunize against hay fever. ”

“ The first man to attempt to apply the methods of modern immunity to hay fever was Dunbar, of Hamburg, in 1903, with this pollantin. He attempted to duplicate in hay fever the triumph of antitoxin in diphtheria by injecting a horse with increasing doses of pollen until the horse became immune to large doses of pollen and his blood full of antibodies. Dunbar expected to confer passive immunity on the hay fever patient by transferring to him this horse serum with its antibodies. There is no better example of the rule that each disease requires its own methods of immunity. ”

“ Let her follow the advice we gave to Josephine last week. If this proves successful so much the better. But hay fever is a ticklish thing to treat, and but rarely does the first treatment tried effect a cure. Snuffs of various kinds are often used for this ailment. We have seen better results from snuffs containing menthol or aristol than from others. Very often a trivial surgical manœuvre, such as destroying a sensitive spot with a prick of the electric needle will permanently cure hay fever. Sometimes nothing seems to do any good. ”

“ When you have established hay fever as anaphylaxis or lowered resistance to a specific proteid, you may be sure that the immunologist will seize the patient as his own, carry him off to the laboratory, and there attempt to raise his resistance or develop immunity to the attacking proteid by giving minute doses of the poison gradually increased. ”

“ Hay fever is incorrect, because hay is only a cause in a limited number of cases, and fever is by no means a prominent symptom. Hay asthma should be discarded, for asthma is far from being a constant accompaniment of the affection. Autumnal catarrh or early spring catarrh only serves to designate the time at which the two forms usually appear, but conveys no idea of the disease in its entirety; while the term pollen catarrh or pollen fever is objectionable on the ground that, although the disease is most frequently produced by that agent, there are causes other than pollen which may excite it. ”

“ Now, there may well be cases of hay fever as there are known to be cases of that other anaphylaxis, asthma, that are pure examples of food anaphylaxis. In such a case, detecting the irritating food and removing it from the diet is the proper path to cure. The error in our former practice was to divide foods into good and bad for certain diseases. We should rather think of foods as good or bad for a particular patient. ”

“ HAY FEVER, Hay Asthma, or Summer Catarrh, a catarrhal affection of the mucous membrane of the upper respiratory tract, due to the action of the pollen of certain grasses. It is often associated with asthmatic attacks. The disease affects certain families, and is hereditary in about one-third of the cases. It is more common among women than men, city than country dwellers, and the educated and highly nervous than the lower classes. ”

“ If injected beneath the skin or rubbed into a deep scratch, the food proteins, like the pollen proteins, may be dangerous. If they are absorbed rapidly into the circulation of a patient who happens to have been sensitized to any of them, there is serious danger of anaphylactic shock.
If these observations prove reliable, here is a method of selecting a diet for the individual patient that surpasses in accuracy anything that we have ever known. If hay fever is ever a food anaphylaxis, this method of testing the food sensitiveness of the individual patient promises much ”

“ Besides recognizing the urticarial nature of the lesion, de Mussy sought the underlying cause of hay fever and thought to find it in the gouty diathesis. He notes the occurrence of hay fever in gouty families, its periodicity, its association with urticaria, eczema, granular pharyngitis and asthma, all characteristics of gout or arthritism. ”

“ The pollen of rag weed and other plants is supposed to be the cause of hay fever. But we also have something far more important in the germs of certain classes of vegetation. The effects are familiar. If food is put away, it becomes mouldy. ”

“ Undoubtedly the large amount of attention given to hay fever, the gathering of these patients in particular localities, the repetition of the story of their symptoms to each other, the body of literature that has gathered around hay fever and is read with such avidity by those who are pleased to call themselves its victims, adds to the unfavorable suggestions and inveterates the symptoms, exaggerates the nasal hyperemia and makes the general condition worse. ”

“ If unable to visit any of the exempt localities, a sufferer may secure a certain degree of comfort by exposing himself as little as possible to the exciting causes of hay fever. As it is well known that heat and dust aggravate the symptoms, the windows of the apartment occupied [p. 224] by the patient should be so arranged as to exclude the sunlight and every precaution taken to avoid the presence of dust. He should eat good, nutritious food, avoiding the use of all stimulants, except perhaps a little light wine at dinner. ”

“ I have no personal experience with the vaccines in the treatment of hay fever, though I know their value in ordinary catarrhal conditions. As remarked in the chapter on Pollens, I have succeeded with the milder methods of rosin-weed, faradism and ichthyol. However, bacterial vaccines are much safer than pollen extracts, the [Pg 111] technique of their use is not as complicated and they are well worthy of trial in refractory cases if bacteria are demonstrated in the eyes and nose. I might remark here that this demonstration will seldom fail ”

“ This process is called parenteral digestion or digestion outside of the intestines; and this theory of the parenteral digestion of protein is the foundation of the anaphylaxis theory of hay fever.
During the growing months of the year the air is full of pollen that is blown in everybody's eyes and nose. In that pollen is a proteid that is digested by the secretion of those mucous membranes, proceeding exactly as food is digested in the stomach and intestines, splitting up the complex proteid molecule into simpler groups, and forming both poisonous and non-poisonous substances. ”

“ The prevalence of autumnal hay fever appears to coincide with the blooming of the ragweed, and conforms to the geographical distribution of that plant, which grows wherever the disease prevails, while in exempted localities it is seldom found or never seen. ”

“ The advantage of the skin reaction over the eye reaction is that it permits testing many pollens at the same time and [Pg 100] does not distress the patient as does a sharp eye reaction.
While Noon and Freeman selected the one typical pollen of spring, the timothy grass pollen, and Koessler selected the typical fall pollen of the American hay fever, rag weed, for all cases of that season, later workers, using the skin reaction, go to the extreme of injecting the patient with each and every pollen to which his skin reacts. ”

“ Next, it was learned that anaphylaxis may persist through life and be transmitted to the offspring of rabbits and guinea-pigs, illustrating the cases in human families where sensitiveness to a certain food or drug runs down through several generations. Then the dermatologist brought in a list of skin eruptions, urticaria in the lead, as examples of anaphylaxis to certain foods or to poisons generated within the body, especially in the intestines. Then asthma was included among the anaphylactic reactions and, finally, Wolff-Eisner pointed out that the lesion of hay fever is an anaphylaxis. ”

“ The moral order of the world runs aground on hay fever. Of what use is it? Why was it invented? Cancer and hydrophobia, at least, may be defended on the ground that they kill. Killing may have some benign purpose, some esoteric significance, some cosmic use. But hay fever never kills; it merely tortures. No man ever died of it. ”

“ Then there are the regular hay-fever patients whose affection occurs principally in haying time, during August and September, though most of them have not been near hay pollen, and the disease is an affection of dwellers in cities rather than in the country, of indoor livers more than of farming people, who might be expected to suffer most from the supposed cause, hay pollen. ”

“ Did you ever see a catarrhal conjunctivitis that acted in this way or a cold in the head in which the patient could be cured and catch a fresh cold twenty times a day? I think you never did. A true inflammation requires time, a few hours, for its development, and when an inflammatory exudate oozes into the meshes of the tissue, it requires some days or at least some hours to be absorbed. This one point of rapid appearance and rapid disappearance would forbid our calling the lesion of hay fever a catarrhal inflammation. ”

“ One thinks of the gouty patient who cannot take iron or digitalis because it aggravates the gouty pain and of the attack of gout that is brought on by a glass of champagne or a piece of beef or a few strawberries that the majority of mankind can take freely without harm. Now, if urticaria, eczema, arthritis, asthma and hay fever form a picture of anaphylaxis, and if these symptoms also form the picture of the gouty diathesis, is it not probable that one of these pictures can be explained in the terms of the other? ”

“ The ocean itself affords complete exemption, and a sea-voyage is the surest means of avoiding the disease. It is true that persons have been known to be affected with hay fever even in mid-ocean, but in such cases it is more than probable that the cause of the attack could have been traced to the cargo. A case of this character came under the writer's observation during a voyage from New York to Charleston during the month of September, and was evidently caused by hay, a number of bales of which were stowed on the forward deck of the vessel. ”

“ After all, just the same story is told about consumption and its many remedies as of hay fever and its many "cures." However, the most important therapeutic element so far discovered for the treatment of hay fever is evidently suggestion. If the patient's mind can only be brought to a favorable attitude in which the discouragement incident to imperfect oxidation can be greatly lessened, then relief of many of the symptoms will be afforded and under favorable conditions the patient will deem himself cured. ”

“ With the former the patient is affected with every change of the weather, any sudden draught, puff of wind, or even the air from a fan will sometimes bring on an attack. Spasmodic asthma comes often from a severe cold. It is better known to many people as hay fever, simply because it is very prevalent at the harvesting season, the fine dust from the dry hay causing it, by choking the bronchial tubes and air passages to the lungs. People liable to these sudden attacks should never, if possible, mix dry linseed, mustard, or any fine meal at all ”

“ As the patient reader of the chapter on Pollens will remember, the anaphylaxis or sensitiveness of the patient to particular pollens is tested by rubbing a speck of different pollens into scratches on the skin. This skin reaction as a test of anaphylaxis was used by Schloss with different foods before it was adopted in hay fever; and it has been taken up by the dermatologist also. The dermatologist has long suspected that certain skin diseases, as urticaria, and eczema, are aggravated or produced by certain foods but he has been unable to demonstrate just what foods were at fault. ”