Tuesday, November 05, 2013

1860-1870: Dr. Beard teaches about hay fever

George Miller Beard was president of the United States Hay Fever Association. He wrote a book about hay fever called "Observations on the Nature, Cause, and Treatment of Hay-Asthma" and he dedicated it to all the members of the association. He wanted the members to have an understanding of the condition they suffered from.

He said that in 1867 Dr. Pirrie postulated that there may be other symptoms of Hay Fever besides the usually runny nose, stuffy nose, itchy eyes and throat, and sneezing.  The other symptoms are (1, page 18):
  • Languor (lack of energy)
  • Malaise
  • Insomnia
  • Irritability
Pirrie, as with most of the other physicians who studied hay fever, believed the affection to be hereditary, and that it was caused by a nervous temperament.  He recommended the following as remedies (5, page 18):
  • Quinine tonic
  • Arsenic tonic
  • Iron tonic
  • Strychnine tonic
  • Sedatives (as a palliative)
  • Antispasmodics (belladonna, cannabis indica, camphor, stramonium, and the inhalation of chloroform)
  • A resort to the seaside
  • Carefulness in diet
  • Avoidance of exhausting influences
  • Keeping clear of hay, grass, flowering plants, and vegetation generally.
Beard said that Pirrie...
...admitted that the tonic treatment had often failed; but explained the failures in part by the fact that the patients had delayed until the beginning of an attack, and he distinctly advised preventive treatment in the intervals of the attacks."
Beard also said that in 1869, Dr. C. Binz of Bonn, Germany, published an essay on quinine, in Virchow's Archives, where he described a letter sent to him by Helmholz (who was not a physician)...:
...recommending the local application of sulphate of quinine in hay-fever.  Helmholtz stated that he had suffered since 1847 from what the English called "hay-fever;" that the disease came on about the 20th of May, and lasted till the end of June, and that the symptoms were aggravated by exposure to heat and sunshine. Helmholtz further stated that he had found in the nasal secretion at that time "certain vibrio-like bodies" (infusoria), very delicate and small, and which could only be seen with a very good Hartneck's microscope; and on becoming acquainted with the experiments of Binz, in which the poisonous action of quinine on infusoria was demonstrated, he resolved to test the treatment of his hay-fever by this method. Accordingly, in 1867, he injected a solution of quinine into his nostrils, lying on his back and moving his head to and fro, so that all parts might be affected. There was immediate relief; and this treatment repeated three times daily served to keep the disease at bay, and the vibrios disappeared from the secretion. After a few days of this treatment the symptoms entirely ceased, but if the applications were omitted the disease returned. (2, page 19)
In 1868 Helmholtz began this treatment early, with the very first appearance of the disease, and succeeded in keeping it off entirely. These vibrios were figured and described in this letter; and it was remarked that they did not come out of the nose with the drops of secretion, but only after sneezing, and from this Helmholtz argued that they were lodged in the deep recesses of the nasal passages. 
 (2, page 19-20)
This theory of Helmholtz has obtained in this country a wide popularity, in the profession and out of the profession. At the time I took up the investigation it was, so far as I could learn, the dominant theory among those medical men whose attention had been called to it. (2, page 20)
By the 1870s it the most sought after treatment for hay fever was to seek refuge in an area where people did not suffer from hay fever.  This started the era of the Hay Fever Resort or the Hay Fever Vacation.

References:
  1. Beard, George, "Hay-Fever; or Summer Catarrh: It's Nature And Treatment," 1876, New York, Harper & Brothers
  2. Beard, ibid, page 19.  The reference used by Beard was C. Binz, of Bonn, Germany, published in Virchow's Archives (Part I, February) an essay on quinine, under the title "Pharmakologische Studien iiber Chinin"
Further Reading:
  1. Mittman, Gregg, "Breathing Space," 2007, New Haven and London, Yale University Press
  2. Taylor, C.F., editor, "The Medical World," volume 16, 1898, Philadelphia, 
  3. Fry, John, "The Natural History of Hay Fever," J. Coll. Gen. Practi1, 1963, 6, page 260
  4. Ehrlich, Paul M., Elizabeth Shimer Bowers, "Living with Allergies," 2008
  5. Beard, George, "Hay-Fever; or Summer Catarrh: It's Nature And Treatment," 1876, New York, Harper & Brothers
  6. Beard, ibid, pages 12 and 13, referenced by Beard from Dr. Mr. W. Gordon's paper "Observations on the Nature, Cause, and Treatment of Hay-Asthma," London Medical Gazette, 1829, vol. iv, page p. 266
  7. Beard, ibid, pages 13 and 14, referenced from "On the use of Nux Vomica as a Remedy in Hay Fever, Lancet1850, vol. 1, page 692

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