Tuesday, December 25, 2012

1880: The sudden rise of hay fever

Out of the ashes of nothingness, there all of a sudden appeared a disease called hay fever. Almost all the authors on the subject during the 19th century noted that it is a new disease, appearing out of the blue around the turn of the 19th century, and that it also appears to be a disease of the educated class; a disease of the aristocracy.  

Interesting is this theory.  A few years ago I wrote two posts for healthcentral.com: one about the hygiene hypothesis and another about the microflora hypothesis.  Both of these theories are relatively new, and both speculate that modern civilization is the cause of asthma and allergies.  

Of interest is that we think of these theories as new.  Yet as we read the works of those physicians who wrote about hay fever in the 19th century, we learn that this idea that civilization causes asthma is nothing new.  Dr. Morrill Wyman made it obvious by providing statistics, and he and Dr. Charles Blackley wrote about it extensively.  

Dr. Blackley mentions that upon Dr. Wyman interviewing 55 hay fever sufferers, 49 admitted to having an education.  Of his own patients with hay fever, Blackley notes the following:
  • Six are clergymen
  • Three are relations of clergymen
  • Four are medical men
  • One is the son of medical man
  • Three are military officers
  • One is the widow of military officer
  • One is a school inspector
  • Two are lawyers
  • One is a professor of music
  • Four are merchants
  • Five are manufacturers
  • One is the son of manufacturer
  • One is a farmer
  • Five are engaged in mercantile pursuits which cannot be referred to any of the above classes. 
  • The remainder cannot be distinctly classified, but all belong more or less to the educated class.
So you can see why it was easy to deduce that hay fever was not only a modern disease, it was a disease of the educated; the aristocracy.  It brought upon theories such as this by Blackley: 
These statistics of the occupations of hay-fever patients bring out prominently the very curious circumstance that the persons who are most subjected to the action of pollen belong to a class which furnishes the fewest cases of the disorder, namely, the farming class. This remarkable fact may be accounted for in two different ways: it may, on the one hand, be due to the absence of the predisposition which mental culture generates; or, on the other hand, it may be that in this disease there is a possibility of a patient being rendered insusceptible to the action of pollen by continued exposure to its influence. If this latter hypothesis be correct, it shows that, in one case at least, the enjoyment of health does not merely depend upon a high state of vitality, but also, to some extent, upon the acquisition of a certain degree of insusceptibility to the action of the exciting cause of the disease. In this instance I believe that the immunity enjoyed is as much due to the latter influence as it is to the absence of that predisposition which education brings.
Hay Fever is a disease only prevalent in the United States and England, and the reason for it, or so Blackley surmises is the modern way of living.  He makes light of the fact there were a lot of changes in the way people in England lived over the past 5-600 years.  While most people used to live mainly on farms, many people now live in cities, are better educated, and have jobs that require a lot of thought and stress.  (1, page 189)

Hundreds of years ago the majority of people, including most of the aristocracy, were not educated.  By the 19th century there was an increasing number of people involved in industry and manufacturing, and these folks were receiving an education.  Book learning was essential in order to receive an adequate education for  doing industrial work.  Plus, training and "book learning" were essential to "reach certain positions in the social scale than it formerly did." (1, page 194)

The added stress of work required to live in the city provides a predisposition to developing hay fever. Once hay fever is developed, exposure to certain pollen causes hay fever symptoms.  Adding to this dilemma is the increase in hay production in and near the city to meet demand of the increasing population, and so there will be more pollen per square mile in the city as compared to the country.

Blackley further notes that: (1, page 197)
Taking all these circumstances into account, it is highly probable that hay-fever was at one time altogether unknown, and it is tolerably certain that it has not only been much more frequent of late, but that, as population increases and as civilisation and education advance, the disorder will become more common than it is at the present time.
And thus was the theory of why the sudden spike of hay fever sufferer in the 19th century.  It's eerily similar to our modern theories.  So, as Paul Harvey always said, now you know the rest of the story.

References:
  1. Blackley, Charles, "Hay fever: it's causes, treatment, and effective prevention," 1880, London, 



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