Thursday, May 29, 2014

1872: Wyman's tips to escape the hay fever season

Dr. Wyman interviewed patients who noted they had no symptoms
of hay fever while vacationing at resorts in the White Mounntains.
Partly due to Wyman writing about it in his 1872 book "Autumnal
Catarrh," the White Mountains became an elite hay fever resort area.
Victims of hay fever realized early on that severity of the disease was directly proportional to certain geographic regions. And for this reason one of the original remedies recommended by hay fever physicians was to vacation during the offending season.  One physician to do extensive studies on the geographic effects of hay fever was Dr. Morill Wyman.

Wyman became particularly interested in the disease in 1833 when he first had a severe attack of hay fever, the same ailment his father, siblings, and later his son suffered.  So he had ample reason to partake in a study of the aliment and, ultimately, publish his book.  Apparently his father gathered some data prior to his interest in it was developed, so he had a good place to start. (1, page 174)(2, page 18)

In fact, it was partially, if not significantly, because of his studies that the White Mountains became one of the most sought after vacation spots for hay fever sufferers, especially those with money.  After performing extensive research, he concluded, as hay fever sufferers already suspected, that hay fever is both seasonal and geographical.  

Wyman provided this map of the White Mountain region.
 The uncolored space represents those parts believed to be safe from Catarrh.
This is also true of the different types of hay fever as noted in this post (published date).  People who suffer from hay fever in May in the United States may have no symptoms while vacationing during May in Britain, and vice versal.  This is evidence that different geographic regions have unique causes.  So a vacation to the opposite country may actually provide a remedy for the hay fever. (1, page 58-61, see also pages 1-6)

Wyman concludes: 
It may be assumed, therefore, with a good degree of certainty, that the Autumnal Catarrh of the northern portion of the United States does not exist in Great Britain, nor in those countries on the Continent above mentioned. To this we may add, that although Dr. Phoebus1 makes mention of asthmatic and catarrhal attacks occuring in these countries annually, at other seasons than early summer, he makes no mention of a regularly recurring catarrh in September. He gives the average duration of the June Cold as about eight weeks. (1, page 61)
 Wyman also observes that hay fever "does not exist over the whole United States. It is a matter of difficulty to give the exact limits, the number of cases not being sufficient for that purpose. We can, however, arrive at proximate results which further observations may render more definite. We have no other evidence of its non-existence in the indicated places than this, that certain persons who have suffered elsewhere have ceased to suffer on removing to them."

After performing studies of hay fever sufferers across the United States, Wyman proceeds to list the areas of the United States that are most affected by hay fever, and the areas where hay fever appears not to exist.  He even provides maps so that a hay fever sufferer knows where the  afe places are, as so he or she may escape to one of these regions during the hay fever season.  (You can view the maps here, click and scroll up one or two pages).

The following places the disease does not exist.  Vacationing in these areas may end an attack within 24 hous, and living or vacationing may prevent hay fever symptoms altogether: (1, page 73)

  1. Along the shores of Lake Michigan
  2. Canada
  3. Latitude 35°
  4. Extreme east of the continent
  5. Pacific coast.
  6. In the sea
So, the following is how to escape the hay fever season:
  1. Sea voyage: symptoms do not seem to occur out at sea (1, page 73-4)
  2. Sea side:  Sea air seems to provide relief from hay fever symptoms.  If symptoms occur they are generally milder, and the cooler air is soothing and provides better ability to deal with symptoms. (1, page 74-9)
  3. Islands: They are protected by sea air, which seems to provide relief (1, page 74-9)
  4. City residence: It provides relief, but it is never complete, especially if there are fields nearby, or if there is a wind.  Although, for the most part, there is less vegetation in the city.(1, page 80) 
  5. Mountains:   Generally, the disease does not exist in places that are 800 feet above sea level. (1, page 81-95)
The only time the above may result in hay fever symptoms is when the wind is blowing.  When this occurs pollen from fields may blow to the region to which you are vacationing, and this may result in hay fever symptoms.  This is noted by the following by quoting previous hay fever experts:
 Dr. Phoebus says: "Moist air brings to many, probably to most, great relief. Many praise the sea air. It brings a quick and lasting amelioration during the whole attack, even without sea bathing, which is also useful. Dr. Bostock proved this in his own case. Many reside at the sea-shore, or cruise about in yachts during the critical period. The asthma is immediately relieved at the sea-coast; but if the wind blows from the land, even for a single hour, the disease immediately returns."
As far as mountains are concerned, Dr. Wyman is not the first to propose the benefits of mountainous air in the treatment of disease, although he may be among the first to suggest such a thing for the sufferers of hay fever.  It must be noted, however, that many sufferers, by default, had already realized the benefits, and it was mainly from questioning many of these folks that Wyman came to his conclusions.

The Glenn house was one of the earliest resorts in the White
Mountain region.  The original hotel was built in 1851, an expansion
 of an old farm house.  The name Glenn House was established in 1852
after the hotel was sold to J.M. Thompson (see this link for more).
Wyman notes in his own biography that he too found that staying
at the Glenn house offered him the most relief.  (1, page 173)
One of the hay fever sufferers he talked to was a lady from Lynn, Massachusetts.  Wyman writes of that:
She had suffered severely, especially in the asthmatic stage. She accidentally noticed, in 1853, while traveling in the White Mountain region, that her catarrh, which for twelve years had commenced in August 20th, had failed to make its appearance. The following year she visited the same region before the usual time of attack, with the hope of escaping it. She did escape it. During the remaining ten years of her life, until 1864, she was at the Franconia Notch, White Mountain Notch, or at the Glen House (a White Mountain resort established in 1851.  You can read about it here), — most of the time at the latter place. 
He also wrote about Jacob Horton:
During this whole period she,obtained complete relief. In 1860, Jacob Horton, Esq. of Newburyport, Mass., who bad suffered so severely that he was verity at each annual return, and I found myself more liable to catarrhal affections at other seasons of the year."
So through accounts of many of his patients, his attention was drawn, as he notes, to mountainous regions as benefiting hay fever sufferers.  Further investigations verified his suspicions.  He particularly recommended regions of the White Mountains as a good place to seek refuge from hay fever.  And, partly thanks to the first edition of his book "Autumnal Catarrh" in 1872, the White Mountains became a prime and prestigious hay fever resort.

Other mountainous regions thought to be safe havens for hay fever sufferers are: (1, pages 85-89)

  1. White Mountains in New Hampshire
  2. Mount Mansfield in Vermont, one of the Green Mountains
  3. Slow Village near the foot of the Green Mountains
  4. Adirondack Mountains in northeastern New York State, including St. Lawrence and Chateaugay ranges
  5. The great Pennsylvania and Ohio plateaus (proves to be a good refuge)
  6. Catskill Mountain House 
  7. Alleghany Holds (only in certain plaes)
  8. Other, including regions not necessarily of high altitude
He concludes this section by writing the following: (1, page 89)
The large number of persons, who have visited these regions successfully, demonstrates their safety. But we have other evidence: persons who have left them before the end of the critical period, have been at once attacked, and the attack has ceased immediately on their return.
He likewise notes (1, page 90)
The change in a sufferer fully under the influence of his malady, on arriving at the mountains is sudden and striking. His first night's sleep is refreshing, and in the morning his most annoying symptoms — the itching and watering of the eyes, the sneezing and nose-blowing, or the asthma — have much diminished. A second night gives still more relief and usually in the course of the following day most of the symptoms disappear. Besides this relief of the local symptoms, a still greater change takes place in the spirits. Activity of mind and body replaces discouragement and weakness, the usual flesh and strength are regained, and the sufferer feels assured that he has at last shaken off his enemy. 
He also notes that it's not just a coincidence certain geographic regions benefit hay fever sufferers: (1, page 91)
The number of cases obtaining this relief in certain regions is too great to be explained by coincidence; the repetition, year after year, of the same relief at the time of arrival in such regions, is conclusive that the relief is connected closely with the arrival; that the causes of the disease, whatever they may be, have ceased to be efficient. We have no evidence that persons, residents of these regions, suffer.1 We have also the still further evidence that it is not dependent upon simple change of residence, for very many of those who are relieved in these regions have tried various other places without success; and yet these places, by their distance from their usual residence, and different physical conditions, should have afforded relief, provided ordinary changes alone were required. They have also tried various kinds of drugs, and different methods of medical treatment, with as little success. 
And he concludes: (1, page 92)
We are forced to the conclusion, then, that the causes of a paroxysm of disease which exist elsewhere, are less active, or entirely wanting in the places above mentioned; and that those who visit these places in due season, are for the much larger part greatly relieved, or entirely free.
So there were a variety of places hay fever sufferers could go to find refuge and treatment for hay fever during the mid 19th century.  Dr. Wyman's book was not the first to note this, yet he was the first to note altitude as a good remedy and treatment for hay fever, and to map out the exact areas on the map that are ideal for this treatment.

Further reading:
  1. 1872: Wyman's two types of hay fever
  2. 1872: Good times for hay fever sufferers

References:
  1. Wyman, Morill, "Autumnal catarrh," 1876 (first edition 1872), New York, Hurd and Houghton
  2. Mitman, Gregg, "Breathing Space," 2007,

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