Thursday, June 19, 2014

1898: What is the prognosis of hay fever victims?

One you are diagnosed with hay fever in 1898, what is your prognosis?  Based on evidence at the time, the following are believed to be true:

1.  The prognosis is invariably good as to life. Sufferers often live to advanced ages. Hay-fever is no bar to life-insurance.  George Beard states the disease has no effect on longevity, according to Hollopeter (1, page 98)  Morril Wyman seems to concur with this, noting that "the interest of longevity is of interest to the life insurance companies.  To them a cough is a serious matter, and asthma usually brings with it an increased premium, whatever be its cause; so also, of a constant and recurring catarrh." Yet he provides several examples of hay fever sufferers who lived to ripe old ages (Daniel Webster died at 70, and Chief Justice died at 80) Wynman notes: The history of the disease, while it affords a pretty good prospect of a life-long periodical suffering, promises, for the intervals, good health, and gives the comfortable assurance that it does not materially shorten life." (3, page 157)

2.  Unless rationally treated the chances of permanent cure are very small. There are few exceptions to the rule that the tendency is, when once established, to an annual recurrence, unless the predisposing causes are removed, or there is removal of or away from the exciting cause. (1, page 98)

3. Hay fever may act as a kind of safety-valve for the nervous diathesis, preventing other and more serious disorders, and thus becoming the friend rather than the enemy of life. (1, page 98)

4.  When once attacked, unless properly treated, escape is rare in any subsequent year. Even changes in constitution in extreme age are no bar or protection. (1, page 98)

5.  The disease rarely skips a year, provided locality and influence are the same. Absolute immunity is only obtainable at the price of temporary exile. (1, page 98)

6.  There is no proof that hay-fever is generally milder or severer in certain years all over the world or over a country, yet evidence is satisfactory that in certain localities it varies greatly in different years. (1, page 98)

7.  Occasionally the disease becomes milder with advanced age, and can be outgrown. In 1885, F.H. Bosworth observed that the younger hay fever is, the better the chance of outgrowing it. (1, page 99) Wyman, however, notes that he never knew of a patient who, once diagnosed, "escaped the tendency to it." (3, page 97-9, 156)

8.  The reason hay fever appears to be more prevalent among the wealthy is because "with this class there is a higher intelligence and closer attention to ailments, and the fact that once having discerned the actual condition they, in many instances, take professional advice, or go to a place of refuge, thus drawing notice to themselves, all of which things are denied to the lower (poorer) classes."  The truth is other people get it, and the prognosis is the same. (2. page 201)

9.  As far as prognosis of each individual attack, the prognosis is very good.  Generally the symptoms cease as soon as the hay fever season has ended. The symptoms also cease when you remove the cause, or cessat effectus, cessat cuasa (remove the cause, remove the effect).  (1, page 100)

10.  W.W. Bulette of Colorado says, in 1896, according to Hollopeter, "that more than eighty percent of hay fever sufferers can be permanently and effectually cured.  Thorough examination of the patient and elimination of every possible source of irritation and pathologic condition is necessary." (1, page 100)

11.  According the the Hay Fever Association that meets in Bethlehem, N.H., each year, about 200,000 people are suspected of having hay fever, although Holmes suspect these are mainly the wealthy, and that there are many more cases that remain anonymous among the poor and middle class. (2, page?)

References:

  1. Hollopeter, William Clarence, "Hay-fever and its successful treatment," 1898, Philadelphia, P. Blakiston's Son and Co.
  2. Holmes, Edmund W., "Hay Fever," Philadelphia County Medical Society: Proceedeings," volumes 18 and 19, 1897, 
  3. Wyman, Morill, "Summer Catarrh," 1876 (first edition was published in 1872), New York, Hurd and Houghton

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