400 B.C.: Did Hippocrates recognize allergies?

While hay fever was not mentioned until the 19th century, and allergies not defined until the 20th century, the signs and symptoms of allergies were well known to physicians of the ancient world.  Perhaps the first allusion to this was by Hippocrates during the 5th century.

Claude Lenfantt, in his introduction to the book "The Immunological Basis of Asthma, quotes Hippocrates as saying: 

Cheese does not harm all men alike, some can eat their fill of it without the slightest hurt, nay, those it agrees with are wonderfully strengthened thereby.  Others come off badly.  So the constitution of these men differ, and the difference lies in the constituent of the body which is hostile to cheese, and is roused and stirred to action under its influence. (1, page introduction)

Since Hippocrates probably obtained his medical wisdom from his ancestors, who were probably teachers at the Asclepion at Cos, we can probably surmise that physicians going back to the early ancient world observed the symptoms of allergies.

Surely allergies caused grief and suffering for those afflicted with it, this would have been minor compared to all the diseases that plagued the ancient world.  So allergies, even more so than asthma, was essentially ignored by the medical community.  The symptoms were probably recognized and brushed aside as catarrh, or the common cold.

References:

1. Lenfant, Claude, author of introduction, Bart Lambrecht, Henk Hoogsteden, Zuzana Diamant, editors, "The Immunological Basis of Asthma," Lung Biology of Health and Disease, Volume 174, Claude Lenfant, executive editor, 2003, New York, Marcel Dekker, Inc. 

Asthma History: Introduction

According to my mother I was diagnosed with asthma at the age of two, which would be in the year 1972.  Considering she said I was sniffling, sneezing and wheezing even before that, chances are I developed asthma and allergies close to my birth on January 4, 1970.  Despite the claims of my doctors, I never outgrew my asthma.

When I was about ten-years-old, which would be in 1980, my asthma, already bad enough, took a turn for the worse.  While other kids were able to run around and have fun during recess, I was forced to sit on the bench.  While other kids were living normal lives, I was asking the Principal to call my mom because I couldn't breathe.

I remember my mother taking me to many unscheduled visits to Dr. Gunderson, and many more to the emergency room, and most of these for asthma.  Sometime in 1980 Dr. Gunderson introduced me to a small, pocket-sized device that gave me my breath back instantly.  It was an inhaler.  I quickly became great friends with this new object, taking it with me wherever I went.

One day as I was puffing on my inhaler I wondered what life would be like for asthmatics prior to modern medicine.  As I started to investigate this, I ended up on a journey that took me all the way back to the beginning of human existence 2.5 million years ago, and then all the way back to the current world.

I learned that for most of history (perhaps 99.9 percent of it) the asthmatic had to choice but to suffer through an attack.  Once I realized this I likewise realized how privileged I was to have been born in 1970, as compared with 1870 or, worse, 1870 B.C.

I also quickly learned that, as with the warpath of mankind, the path of disease can be traced back to the beginning of human existence.  In fact, disease may go back farther than war itself, as diseases exists regardless of the desires of mankind.  Although, as we learn from the Biblical Cain, fighting began early enough in a quest for selfish gain.

So while most histories follow the path of war, this history follows the path of health and healing, with an emphasis on asthma.  In order to organize this history I will use the following definitions:

• Prehistory (prehistoric):  Time prior to the first written language, or recorded history, which is generally considered to be around 2700 B.C. 
• Ancient:  Time after written language, or time with recorded history.  This period lasted from around 2700 B.C. until the fall of Rome in 476 A.D. 
• Time:  After the birth of Christ people developed a need to keep track of time, and so the birth of Jesus was chosen as the date to begin time.  The date of his birth was estimated and this was chosen as 1 A.D. When a child is born we usually refer to the first year as zero.  With time the first 100 years is considered the first century, and therefore the years 100-199 were referred to as the 2nd century.  It's for this reason why the years 1900 to 1999 were referred to as the 20th century.  This is just how it is.  

This system was created to help people study history and keep track of dates and time.  Whether accurate or not, this is how history is recorded.  I will use this system to categorize this history of asthma:

• Beginning to 5000 B.C.: Prehistoric people (prehistory)
• 5000-2700 B.C.: Ancient Societies (Before History and Time)
• 2700 B.C.-1 A.D.: Ancient Societies (During History, Before Time)
• 1 A.D.-276 A.D.:  Ancient Societies (Beginning of Time)
• 276 -1600 A.D.: Middle Ages (The Dark Ages of Medicine)
• 1600-1800:  Age of Reason (The Age of Enlightenment)
• 1800-1900:  The Scientific Revolution (the Age of Progress)
• 1900-2000: The Age of Results
• 21st Century:  The presents
• My asthma story

Each chapter in this history is one blog post, and each will focus on one thought.  In this way I am able to keep each chapter pithy and, therefore, easy to read.  While I have done some of my own research, I try to tell this history through the eyes of those who lived it, or those who spent hours studying it.  This will, I think, give you a more complete picture of the history of asthma.  

However, considering the vastness of our history, and the brief time each person lived among it, this history is but a small glimpse of the past.  Most of our history is told by the select few privileged to be able to read and write, so it is nearly impossible to impress upon what life was like among the common folk.

Still, there was just enough evidence to draw a picture of what life must have been like for those who suffered from asthma over the years.

So what was it like to live with asthma in fill in location and year?  To best answer this question, I make a gallant effort to describe the the various cultures.  This, I think, should should allow us to gain a more complete understanding what it would be like to be sick if you lived among them.  

However, I would like you to consider the following quote from historian Henry E. Sigerist:

"We have no evidence whatsoever of any paleolithic medicine." (1, page 107)

I say this because there will be times throughout this history when we must use our imaginations to gain an understanding of what it was like to live with asthma in fill in the year and place.

So what was life like for asthmatics 2.5 million years ago?  Let's go!

Reference:

1. Sigerist, Henry E "History of Medicine," volume I: Primitive and Archaic Medicine, 1951, New York, Oxford University Press

2640 B.C.-1820 A.D.:First descriptions of hay fever

Like asthma, allergies were probably prevalent early in human history.  Yet the symptoms of a runny nose, sniffly, sneezes and wheezes, along with red and watery eyes, were probably confused with other maladies, such as asthma or influenza. So there were only random mentions of the malady before it was formally defined by the medical community in 1819.  

About 2,640 years before the birth of Christ, King Menses of Egypt was reported to have died after being stung by a wasp. As far as historians are aware, this is the first account of an allergic reaction.  So it's evident allergies go all the way back to the ancient world.   

Right around this time a Middle Eastern Physician named El-Razi observed redness and swelling of the nasal passages in some of his patients.  He described what we might consider allergic rhinitis or hay fever.  Yet those terms weren't used until the 19th and 20th centuries.

Arnoldo Cantani, in his book, "Pediatric Allergy, Asthma and Immunology," describes how Caesar Augustus suffered from asthma and seasonal rhinitis (allergies/ hay fever).  Caesar is also believed to have suffered from asthma. (1)

Roman Emperor Claudius (10-13 B.C to 54 A.D) is believed to have suffered from allergy symptoms, and his son Brittanicus (41?-55 A.D.) is believed to have suffered from an allergy to horses. Historical reports have it that when exposed to horses his eyes would swell up and he'd develop a rash.

Princes Nero and Brittanicus

Brittanicus was heir apparent to the throne.  Yet due to his allergies he was limited in what he could do.  And when his mother died, Claudius remarried to Agrippina the Younger.  She had a son named Nero, and Claudius adapted him.  Nero almost immediately won the favor of the public, and Nero ultimately eclipsed his younger brother and was named Emperor in 54 A.D.

Nero would ultimately become famous for throwing Christians to the Lions.  Yet within only a few months of his reign, he is believed to have poisoned his weaker, older brother Brittanicus to death.

Paul M. Ehrlich and Elizabeth Shimer Bowers, in their 2008 book "Living with Allergies," note that it was an Ancient Roman Physician who was the first to describe allergies.  The authors quote Lucretius, who lived from 99-55 B.C., as saying, "What is good for some may be fierce poisons for others." (2, page 4)

Physicians around  850 A.D. observed many of their patients developed sneezing, nasal stuffiness and runny noses when the roses were blooming.  Upon further examination they observed redness and swelling in the nasal passages that resulted in the runny nose, and they referred to this condition as rose fever.

The medical term catarrh was first used to describe the miserable condition that result in a runny nose around 1350 and 1400 A.D, according to dictionary.com.  The term catarrh comes from the Greek word katarrous which means "literally down-flowing."  So the term catarrh refers to the redness and swelling of the nasal passages that results in nasal drainage regardless of the cause.  It was a term commonly used by physicians through the 19th century.

King Richard III

Ehrlich and Bowers mention how legend has it that King Richard III (1452-1485) knew he had an allergy to strawberries and he used this knowledge to kill Lord Hastings.  The King purposely ate some strawberries and blamed his allergic reaction on a curse from Lord Hastings.  Lord Hasting's was beheaded as punishment, and his head was served on a platter.

In 1656 a French doctor named Pierre Borel suspected one of his patients developed a rash when this patient ate eggs.  So one day he attempted to test his theory by placing some egg particles on the patient's skin.  When blisters developed on the patient's skin the physician knew he had made the correct diagnosis.

Dr. Morell Mackenzie writes that In 1565 Dr. Botallus (the man who's name is applied to the foramen ovale in the heart) recognized that many of his patients developed sniffling, sneezing and facial irritation when they smelled roses.  The condition was thus dubbed rose cold or rose fever.  (3, page 18) (6, page 93)(8)

Mackenzie notes that "This observer, therefore, came very near the mark to the real cause of the disease, to which he applied the term coryza a rosarum odore.'

Jan Baptise van Helmont (1579-1644), who helped define asthma, also noted the symptoms of hay fever.  (3, page 18)  Vanhelmont noted that in some of his patients "sweet smelling causing headache, and in some cases difficulty breathing." (6, page 93)

In 1673 I.N Binningerus wrote that he was informed several times by professor James A. Brun of the University of Bastle that is wife, Ursula Falcisin, "suffered from coryza for several weeks every year during the rose season."  (6, page 93)

In 1691 I. Constant Rebecque described how "for thirteen years he had been afflicted with coryza during the rose season...  At first he attributed his sufferings to heat, but in the year 1685, when the summer was exceptionally hot and there were hardly any roses on account of caterpillars, he was struck by the fact his annual disorder did not trouble him.  The symptoms came on at once, however, after inadvertently plucking a rose toward the end of the season.  He concludes that something flows from roses which stings the nose" (7, page 93)

Seventeenth century physician John Floyer noted, in 1698, that asthma symptoms lasted longer and were more "acute" in summer than in the winter.  (3, page 18)  Eighteenth century physician William Cullen may have been referring to hay fever when he wrote that "in some persons asthmatic fits are more frequent in summer, and more particularly during the dog-days, than at other colder seasons of the year," wrote Charle's Blackley in 1873 (I'll write more about him later). (4)

William Heberden (1710-1801) wrote on the subject of catarrh: "I have known it (catarrh) to return in four or five persons annually in the months of April, May, June and July, and last a month with great violence." Heberden's book was published posthumously in 1802 and edited by his son.  (5, page 14)

Mackenzie explains that Heberden made a connection between "rose catarrh of the seventeenth century and the hay fever of the nineteenth, for though this physician does not seem to have been at all aware that the complaint had any connection with flowering plants, he mentions casually that five of his patients suffered from catarrh for a month every summer, while another was similarly affected during the whole of that season."

Various other physicians made references to hay fever or rose fever, such as by C.L. Parry in London in 1801 and 1809.  Or by Elliotson in 1821 who "tells of a patient who had had hay-fever since 1789, and another who was sixty-six years of age and who had had the disease since his seventh year, i.e. since 1755, and of a third who had been afflicted for many years. (3, page 18-19)

Finally, in 1819, the condition would be recognized by the medical community.  By that time the term hay-fever had been around for many years, although there is no evidence as to who created the term, where, and when is a mystery.

References:

1. Cantani, "Pediatric Allergy, Asthma and Immunology," 2000, New York, page 724
2. Ehrlich, Paul M., Elizabeth Shimer Bowers, "Living with Allergies," 2008
3. Hollopeter, William Clarence, "Hay-fever and its successful treatment," 1898, Philadelphia, P. Blakiston's Son & Co.
4. Blackely, Charles Harrison, "Hay-fever: its causes, treatment, and effective prevention," 1873, 1880 2nd edition, London, Bailliere
5. Smith, William Abbotts, "On Hay-Fever, Hay-Asthma, or Summer Catarrh," 1867, London, Henry Renshaw
6. Mackenzie, Morell Sir, "Hay fever and paroxysmal sneezing," 5th edition, 1889, London, J&A Churchill, also see Morell Mackenzie, "On Hay Fever and Rose Fever," The Medical Record, New York, August, 1884, vol. 26. no. 9, page 225
7. Mackenzie, Morell, ibid, Sir Mackenzie notes here that "This observer, therefore, came very near the mark to the real cause of the disease, to which he applied the term coryza a rosarum odore.'
8. Koessler, Karl K., "The Specific Treatment of hay fever (pollen disease)," page 665, of "Forchheimer's Therapeusis of Internal diseases," Frederick Forchheimer, edited by Frank Billings and Ernest E. Irons, Volume V, 1920, New York and London, D. Appleton and Company

x1909: Pituitrin tried for asthma and hay fever

Pituitrini was an extract of bovine pituitary gland.  Along with other uses,
it was trialed for asthma by various physicians, and with success, around
1909 and 1910. The medicine was provided by Park-Davis & Co. out
of Detroit, Michigan in one ounce glass stopper bottles and glaseptic
  ampoules (ready for immediate hypodermic injetion) as seen here. (2)

Another medicine that was trialed for asthmatics around the 1910s was a medicine called Pituitrin.  It was an extract of bovine pituitary gland containing oxytocin and vasopressin, and being a relatively new medicine it garnered much attention among the medical community. As with other new medicines, it was trialed for various purposes, including asthma. 

The medicine "has been somewhat extensively used for the past two or three years," by European physicians for its oxycotin effect on some pregnant women to help strengthen labor and reduce bleeding.  (1) It does this by constricting blood vessels.  It also is a bronchodilator, and for this reason it was trialed on asthmatics.

In 1919 the Therapeutic Notes reported the following:

The fact that Pituitrin has an Adrenalin-like action, and the fact that this action is more prolonged than that of the suprarenal active principle, has suggested its utility in the treatment of asthma and hay-fever. It has been tested clinically by leading practitioners, who pronounce it a valuable drug in these diseases. Some opinions are here given:

 "One of my asthmatic patients has experienced great relief from the use of Pituitrin.""I have used Pituitrin in two cases of hay-fever with satisfactory results. While ischemia is accomplished less slowly it seems to last much longer; one patient who experienced great irritation from the use of Adrenalin says that the Pituitrin is almost without any irritating effect.'' 

"I have one case of asthma which was relieved by the use of Pituitrin; it is also of a great deal of use in the treatment of hay-fever." 

"A case of hay-fever treated with Pituitrin in normal salt solution (1:3) showed decided relief. I found that its. action was slower, more prolonged and less irritating than Adrenalin, and no after-congestion resulted as in the case of the latter." 

"I used Pituitrin daily in one case of hay-fever, employing the undiluted solution so as to give the hardest possible test as to its irritation. There was no irritation and the relief was perfect.'
"When used in a 10-per-cent normal saline solution the results were very satisfactory."

 It's very common throughout human history to find a medicine experimented with in this fashion, and this continues to this day.  Also, in the 1970s a medicine called terbutaline was approved for asthma as a rescue medicine, and it was ultimately more commonly used to delay pregnancies.

Probably due to the success of adrenaline, pituitrin never caught on as an asthma medicine.  Yet it provided another option for physicians and asthmatis when such an option was necessary.

References:

1. "Pituitin in difficult parturition," Medial Review, June, 1912, Volume 61, Issue 6, Picture is from an advertisement that follows the article paid for by Park-Davis & Co.
2. "Pituitrin in Hay fever and asthma," Therapeutic Notes, Volumes 17 and 18, Park-Davis & Co., 1909 and 1910, page 70.

Further reading: 

1. rticle on polen and hay fever

1876: Many names for hay-fever x

Prior to John Bostock defining hay fever for the medical community in 1819, hay fever seemed not to exist.  However, from our own history we know it probably did exist and was misdiagnosed as a cold, flu or some other such ailment.  Still, the term hay fever evolved as a term long before 1819, to the point that even Bostock himself labeled "hay fever" as an inapropriate name.  Yet it stuck nonetheless.

In the 1876 edition of his book, Morill Wyman noted that "at the time of the publication of the first edition (in 1872) of this Essay, the "June " or " Rose Cold " was the only form of annual catarrh generally known. Since then, the number of sufferers from the autumnal disease has apparently greatly increased, until they seem greatly to outnumber the others. That this apparent increase is in no small degree due to the greater knowledge, may be admitted. Still, there is reason to think that the disease is on the increase, and it may be that the cause of this increase is to be found in the change of condition and habits of the people of the northern section of the United States, and more particularly of New England, which seems to be the home of the disease." (1 page 101)

As the occurance of the disease rose, various names were used depending on the the season involved and the suspected exciting cause.  Edmund Holmes listed several of those names in his 1876 essay, "Summer Catarrh," and they were as follows: (2, page 200)

• Hay-Fever
• Summer-Fever
• Rag-Weed Fever
• Snow-Fever
• Hay- Asthma
• Rye-Asthma
• Pollen-Asthma
• PollenPoisoning
• Pollen-Catarrh
• Bostorck's Catarrh
• Catarrhus iEstivus
• Summer Catarrh
• Summer Catarrh from Idiosyncrasy
• Typical Early Summer Catarrh
• Autumnal Catarrh
• Summer Bronchitis
• Rose-Cold
• Peach Cold
• Harvest Cold
• June Cold
• July Cold.

Chances are, as we read through the various books and articles on hay fever we'll come across enough unique names to double this list.  It must be considered that this was the beginning of knowledge of a disease that we now simply refer to as allergies. 

References:

1. Wyman, Morill, "Summer Catarrh," 1876 (first edition was published in 1872), New York, Hurd and Houghton
2. Holmes, Edmund W., "Hay Fever," Philadelphia County Medical Society: Proceedeings," volume XVII, session of 1897, Augustus and

1872: Wyman's remedies for hay fever

Morill Wyman wrote in 1872 (and again in 1876) that there is not one true medicinal remedy that works for hay fever, that the only "unfailing remedy" is removal of the exciting cause of the hay fever, or the removal of the person from the exciting cause, with the later being the easiest solution.  (1, page 52-3)

So in his book he doesn't give medicinal remedies as other physicians do in their respective books.  However, he does note there are some things that can be done in order to prevent hay fever from occurring, such as:

1.  Use good hygiene:  The better the overall condition of the body upon "meeting the enemy" the greater the chance of preventing it from causing the symptoms. In this sense, "Hygienic measures... are of more value than medicines."

2.  Avoid great heat and direct sunrays:

3.  Avoid smoke and dust of railways:

4.  Prepare the bedroom:  "The sleeping-room should have an open fire-place, should not be exposed to the afternoon sun, and after being well aired for an hour in the early morning, should have the windows and doors closed, and kept closed, so that the air shall be as still as possible until the following morning; any movement in the air is annoying. We think the still air allows the injurious particles to subside; but whether this be so or not we are satisfied that this course has given us a good night's sleep and a better condition in the morning.

5.  The diet should be nourishing:  "Abstinence from animal food reduces the strength and aggravates the symptoms. Alcoholic stimulants do not defer the attack, and, so far as my own observations extend, are rather a detriment. Various experiments have been made on the quantity of liquids drank, on the supposition that it may modify the flow from the nose and eyes. Abstinence for many days in succession did not diminish it, nor was it increased by an excessive use of liquids.

6.  Cold bath or shower:  Might help to lessen the sensitiveness of the skin

7.  Warm clothing: Flannel next the skin during the month of August, and increased while the disease is in progress, is of great importance. It protects from sudden changes of temperature to which the skin is peculiarly sensitive, and with which the nervous system at this time has a close sympathy. Rubbing with a flesh brush is also of service.

8.  The application of sweet oil to the whole surface, after it has been thoroughly washed in a solution of soda or pearlash, or other alkaline carbonate, is reported to have been useful. This also protects the skin from change of temperature.

9.  Camphor on the pillow is said to relieve

10. Galvanism has been recommended.

11.  A compress wrung from cold water, applied to the whole front of the chest and covered with a dry flannel, has given relief.

12.  Holding your face over boiling water.

13.  Hot cup of tea or coffee in a warm room

14.  Whiskey to relieve difficulty of breathing

15.  Eat a generous diet

16.  The bowels should be moved daily. Gentle laxatives, like Congress water, Rochelle powders, citrate of magnesia, or a rhubarb pill, are useful. Violent purging should be avoided.

17.  If the secretions of the kidneys are deficient in quantity, or dark colored, the occasional use of bitartrate of potash (cream of tartar), as a drink, is advisable.

18.  Do not itch eyes.  If they are irritated, cover them with a cold cloth, and, if necessary, "some relief to the irritated conjunctiva is obtained from washing the eyes in an infusion of camomile tea, or by the use of a mild sedative solution of biborate of soda (borax), five or six grains to an ounce of camphor water, a popular remedy with oculists."

19.  Take care of the nose:  "The discharge from the nostrils may be relieved by the "head bath ;" holding the head over a bowl of very hot milk and water, or hot water alone, while the head and shoulders are covered with a thick shawl; it produces a copious perspiration. The "Turkish Bath" has given relief. Blowing the nose should be avoided as much as possible; it increases the obstruction and discomfort. Let the limpid fluid be wiped away with a soft handkerchief; it will then sooner cease. In railway traveling, considerable protection is given by small pieces of sponge dipped in water and placed just within the nostrils; they exclude dust and smoke, and interfere but little with breathing. A veil of Swiss muslin, wet with water, is a still more complete protection to the whole face.

20.  Medicine for the nose: Hot whiskey and water, before leaving the bed in the morning, is said to prevent attacks of sneezing and closed nostrils. Various irritants have been recommended for the relief of the nostrils; camphor and sugar, or cayenne pepper, finely powdered, and used as snuff ; or water of ammonia, held under the nose, and the vapor inhaled.

21.  Medicines that may provide relief are:

• Quinine (most successful of all the medicines.  Two grains should be taken before each meal, starting  a fortnight prior to the hay fever season, and continue through the season)
• Iron
• Arsenic
• Srychnine
• Nux vomica
• Iodide of potassium
• Bromide of potassium
• Hydrocyanic acid
• Wild cherry bark infusion.
• Mophine (5-10of Dover's powder, or the equivalent in laudanum or morphine, at bed-time, will render the night much more comfortable)
• Oxygen or other gases at a spring house (to treat symptoms)
• Gargling the throat with a solution of a teaspoonful of chlorate of potassa in a pint of cold water, and the chewing of cubeb peppers, relieves the itching.
• Mild narcotics, extract of hyoscyamus, and tincture of Indian hemp, various household demulcents (for cough) (demulcants include flax-seed tea, gum arabic solution, or bits of the gum dissolved in the mouth)
• Smoking stramonium leaves, salpetre, Espic cigarettes, arsenical cigarettes, inhalation of sulphuric ether, carbolic acid (for asthma)
• Saltpetre paper is a popular remedy. The paper is dipped in a half-saturated solution of saltpetre, dried, and rolled into cigarettes, and smoked or burned in the room.
• The inhalation of the vapor of water of ammonia through the mouth, with the nostrils closed, frequently succeeds. A teaspoonful should be poured into a bowl, and the face held a foot or two above it; the inhalation to be continued a quarter of an hour.
• A quarter of a teaspoonful of spirits of camphor allowed to trickle down the throat, sometimes relieves.
• Arsenical cigarettes, to be found at the apothecaries, are frequently smoked with relief. They should be used with care, a few puffs at a time.
• The inhalation of sulphuric ether and chloroform give relief to some; in such cases the relief is usually immediate; it should not be pushed to insensibility. The inhalation of carbolic acid has been useful.

Regarding the medicine, Wyman notes, "It is very difficult to determine the value of any of these substances; the number of cases in which each has been tried is too small to draw any definite conclusion. This much, however, may be said, that few persons are so well satisfied with the results of any one treatment as to repeat it from year to year."

While Wyman believes medicine doesn't do much for hay fever, he does note this: 

"By one or another many remedies are praised as sure cures for the various symptoms. This, like other diseases, has many alleged specifics. Indeed, they are in such number that, as Rousseau said, it is sheer malice in people to be sick while the means of cure are so numerous and certain. The natural remissions of the disease are such that even the wary and experienced are often deceived into the hope, not destined to be realized, that it is really taking its leave; while the sanguine are happy in the belief that the last new remedy has achieved a victory. Still, a certain degree of relief is obtained by remedies."

Palliative remedies, however, are basically reserved for the symptoms.  For instance,

---

The Espic cigarettes are often used; each cigarette contains the following substances: —

Belladonna leaves 4-J- grains.

Hyoscyamus leaves 2j grains.

Stramonium leaves 2J grains.

Phellandrium aquaticum leaves \ grain.

Opium grain.

Mix. These are powdered, carefully mixed, and rolled up in paper. Only two cigarettes should be smoked during a single attack; used to excess they cease to give relief.

---

References:

1. Wyman, Morill, "Summer Catarrh," 1876 (first edition was published in 1872), New York, Hurd and Houghton

x1898: Hollopeter's remedies for hay fever

By the late 19th century there was an increase in the number of patients calling their physician with complaints like, "I feel miserable. My face, throat and eyes feel like I want to scratch the heck out of them.  I feel like I'm going to explode.  I will do anything to feel better."

So physicians eager to help such "desperate" patients were willing to try just about anything in their pharmacopoeia, according to W.C. Hollopeter's 1898 book "Hay fever and it's successful treatment."  Some of the things tried were: (1, page 101);

• Antiseptics: Substance that prevents growth of microorganizms
• Antispasmotics:  Substances that relieves spasms, such as bronchospasms (i.e. atropine)
• Escharotics: Substances that causes scabs or burns on the skin
• Astrigents:  Shrinks body tissues

Dr. William Hollopeter says he himself tried everything under the sun. Then, finally, "during the last ten years I have had under my care over 200 well marked cases of hay fever, of which I possess, in nearly all, complete histories, and I have not failed to relieve a single patient who has persisted in the treatment."

The following is the treatment regimen that worked for him, and that he recommends to his faithful readers:

A.  Simple Local Treatment:

1.  Removal from the source of irritation:  The more wealthy among us have the luxury of vacationing to an area that is not conducive to causing hay fever.  This is the same remedy that pretty much every other physician has recommended since John Bostock made light of the ailment in his 1819 lectures.  This has been proven to be the best prophylactic means available at this time, although not always practical for sufferers who do not have the finances and, or, cannot leave their work. (1, page 105) Morril Wyman notes that the only true "unfailing remedy" for hay fever is removal of the source, or removal of the person from the source -- i.e., vacationing to the mountainous regions, or the sea shore, or an island, etc. (2, page 160-1)

2.  Daily Sterilization:  It was a technique established by Joseph Lister that entails antiseptics or surgical cleanliness to cleanse out the nose and throat.  By doing this daily, this will allow the person to live a normal life, even when surrounded by exciting causes such as dust or blooming flowers without fear of having symptoms. This will wipe out any and all offending matter that harbors in these passages. (1, page 102-5)  (Read more about this in my post to be published 11/22/13)

3.  Stay indoors during season:  Morell Mackenzie recommends for those who cannot "flee to the mountains or the mid ocean they should remain indoors." (1, page 105)

4.  Nose Plugs when go outdoors:  Again, Mackenzie recommends that when you have to go outside during hay fever season that you plug your nose with cotton wool and wear "spectacles with large frames.".  This will keep exciting causes (pollen, dust, etc.) from entering the air passages and eyes. (1, page 105)  Many patients had been employing this technique, or something similar, for years.

5.  Identify anything that might irritate nasal mucosa:  This would include things that might make the mucosa hyper-responsive to exciting factors by causing a "permanent turgescence (swelling) of the whole nasal chamber," such as: (1, page 106)

• Germs
• Polypi 
• Deviated Septums 
• Hypertrophies (enlarged tissue)
• Chronic rhinitis (nasal infection)
• Any other marked defects

These irritations also make it easy for irritating matter and germs to become trapped inside the nasal passages, and they make sterilization "difficult if not impossible. So they must be remedied as best as possible, and weakens the normal resistence of the mucus membrane, thus inviting periodic infection." (1, page 106) 

Removal of polypi, hypertrophies and deviated septums cause too much pain and inflammation for the patient, so he simply recommended daily sterilization and nasal washes as noted in this post. (see above link)  Treatment may take a while, although over time the hay fever should be resolved. (1, page 106)

References:

1. Hollopeter, William Clarence, "Hay-fever and its successful treatment," 1898, Philadelphia, P. Blakiston's Son and Co.
2. Wyman, Morill, "Summer Catarrh," 1876 (first edition was published in 1872), New York, Hurd and Houghton

1898: How to diagnose hay fever

So a patient presents with itchy, water eyes, scratchy throat, sneezes, wheezes and shortness of breath.  How does a physician in 1898 diagnose this as hay fever as compared with asthma, bronchitis or some other ailment?  The answer is: it isn't easy.

William Hollopeter states that "Hay-fever may be distinguished from asthma, common catarrh, bronchitis, acute rhinitis, remittent fever, and catarrhal conjunctivitis. The salient feature of hay-fever is its periodicity or annual recurrence. This is part of its very nature, is the central point of diagnosis, is its chief characteristic, and to its elucidation, Holmes says, all existing theories tend."

According to Hollopeter, Beard lists the following as similarities between hay fever and asthma:

1. It is hereditary;

2. It is more or less periodic;

3. It is paroxysmal;

4. It is correlated to other functional nervous affections;

5. The paroxysms are excited by great variety of irritants; persons being differently affected;

6. It is singularly obstinate and is relieved by the same remedies.

Likewise, Hollopeter quotes Bosworth as considering "hay-fever dependent upon":

1. A neurotic habit;

2. Pollen in the atmosphere;

3. A disordered condition of the nasal passages.

While asthma is dependent upon:

1. A general neurotic condition;

2. Obscure conditions of the atmosphere;

3. Diseased bronchial (not nasal) mucous membranes.

So the many similarities between the two diseases were well known. Other similarities are:

1. Sudden onset
2. Sudden end
3. Violent paroxysms
4. Inflammation (hyperaemia)

Asthma differs from hay fever in that hay fever causes violent sneezing and discharge of the nasal passages, while hay fever presents with inflammation and redness of the upper respiratory tract and eyes, while asthma presents with inflammation of the air passages.  

Hay fevermay also be mistaken for other diseases, as Holopeter notes:

The first attacks are likely to be mistaken for ordinary coryza, but here the abrupt onset, the characteristic edematous puffiness of the eyelids, the absence of constitutional symptoms will indicate the difference. In children, moreover, attacks of hay-fever are most liable to be mistaken for acute colds or rhinitis,—but here, again, the above points may serve to distinguish, together with the sequence of the symptoms, the time of year, and the physical signs of an acute bronchitis, if it extends so far. The approach of cold weather and the coincident departure of the symptoms will make clear a diagnosis, while the history of previous attacks at the season of the year most favorable tohay-fever, the presence of certain irritants, and the general condition of the bodily symptoms may be of aid in distinguishing the affection."

The best way to differentiate between simple coryza, catahrr, asthma, colds, and other ailments is the timing of the disease; that it occurs at the same time every year, or when exposed to the same exciting cause.

Note:  For a differential diagnosis between hay fever and colds and other similar ailments, click here and then scroll down one or two pages (Morill Wyman, 1876, "Autumnal Catarrh," page 153-154).

References:

1. Hollopeter, William Clarence, "Hay-fever and its successful treatment," 1898, Philadelphia, P. Blakiston's Son and Co., page 94-97

x1898: What causes one to develop hay fever?

According to William Holopeter in his 1898 book "Hay-fever and its successful treatment, there were essentially two causes of hay fever: (1, page 47)

1. An exciting cause (heat, pollen, dust, sunlight, etc.)
2. A preexisting, underlying condition 

Provided statistics of the era, Holopeter states that relatively few people have hay fever, which verifies that some "underlying condition, predisposition, or idiosyncrasy can hardly be doubted. Exactly what this is, or on what it depends, is unknown." (1, page 47)

Holopeter notes that the first person to talk about a predisposition to developing hay fever was Dr. Abbots Smith in 1865.  Likewise, Holopeter notes: (1, page 47)

This predisposition or idiosyncrasy has generally suddenly developed without apparent reason. It has been argued that it is systematic or central, and that it is due to some local abnormality of the mucous membrane, the capillaries, or the periphery of nerves. Once acquired, however, it is seldom lost, and it apparently increases with each successive year.

The following are the major predisposing factors:

1. Race: English and Americans are the most susceptible.  One physician went as far to suspect that sine Americans and English were the most likely to drink tea, that perhaps tea somehow affected the nervous system causing hay fever. Although the Chinese and Japanese drink tea as well, and there's a low incidence of the disease in those nations. 
2. Geographic distribution:  It is rarely found in northern regions, such as Canada, Norway, Sweden and Denmark.  It is most commonly seen in the U.S., Europe, and to some degree New Zealand and Australia. Even in the U.S. and England is is not commonly found along the seashore and at high elevations.  It is difficult to know exactly where it's most likely to occur. (Dr. Wyman published maps for where it's most likely to occur in his 1872 book "Autumnal Catarrh." (1, pages 49-52
3. Heredity:  George Beard was the first to postulate a nervous origin of hay fever, and that it was acquired through inheritance. Various physicians have shown evidence of the malady among the various generations of the family tree (Morill Wyman, F.H. Bosworth, Morell Mackenzie) (1, page 53)  
4. Sex:  Generally, "of the 433 cases cited by Phoebus, Wyman and Beard, only 143, about one-third, were females." So the tendency is that it affects males more so than females.  Morell Mackenzie also noted the trend, noting he had 38 male patients with hay fever, and only 23 females. The theory is that "men are more exposed to the exciting causes such as dust, heat, pollen, etc., although females are more neurotic."(1, page 54)(2, page 96-7)
5. Age: While occasionally occurring in people over the age of 60, it generally first appears in people under the age of 40. (1, page 55)  In many cases of childhood onset hay fever, many cases are regarded as the common cold, unless the parents were also afflicted with it (hence suggesting the hereditary component). 
6. Education: Holopeter notes pretty much the same as every other author on the subject, that: "Most all writers on this subject have observed that the disease attacks the better educated classes and those of fair social position. It is rarely met with among the laboring classes. This would seem to emphasize the view that the disease is essentially a neurosis. From the notes of sixty-one cases of hay-fever in private practice, and the sight of many others of which no record was kept, Morell Mackenzie found all the patients persons of some education, and recalled having seen none among his hospital patients. Of fortyeight cases of Blackley, all were educated, and Wyman made the same observation. Edmund W. Holmes has shown that the ignorant classes are not so likely to recognize the disease as a distinct affection, and apply for medical aid." (1, page 55)(3, page 204)
7. Occupation and Mode of life: The "rustic" and farmers are much more exposed to exciting causes and therefore are less susceptible to developing hay fever. Others suggest it only effects the wealthy because they have a higher intelligence.  (1, page 56)  Wyman observed, among the occupations he observed, those most likely to have hay fever have "indoor jobs requiring but little manual labor," such as merchants and manufacturers. Wyman notes that only three farmers in his little study had hay fever, and this was of interest to him.  He surmised that they probably did have hay fever, "  (2, page 99-100) 

Of this observation regarding the low number of farmers with hay fever and the high number of merchants and manufacturers, Wyman writes the following: (2, page 100)

"It is not a little remarkable that of those who must make up the largest class in the community, so few should be reported as subjects. It may be that the disease with them is light, and therefore overlooked entirely, or not thought of sufficient importance to apply for medical aid. This, to a certain degree, is not improbable, for we find that physicians to whom application is made, do not all recognize it sufficiently to ask whether the disease has recurred annually, nor do the patients think it worth mentioning, even if it has been observed and remembered. It is by no- means infrequent for a person to experience several pretty severe annual attacks before it occurs to him that probably these are returns of one and the same disease. Still, the mechanics and farmers of New England are too intelligent and too well educated to allow the disease to escape their observation entirely. If many applied for treatment at the dispensaries of the large cities, the fact would appear in their annual reports. No such disease is mentioned.

I am inclined to think, therefore, that the disease is less severe or less frequent with those that labor, than with those whose employments are attended with less muscular exertion. The result, perhaps, of a life more in accordance with the rules of health, in this respect, for the mechanics and farmers of New England, as a general rule, are as well housed, clothed, and fed, so far as health is concerned, as those who are among the richer and in some respects more favored classes. This question, however, can only be satisfactorily settled when a knowledge of the disease becomes more general."

The following are theories as to what might cause hay fever:

1.  Pollen Theory:  It is the most generally recognized as the cause of hay fever, and while it was a speculated cause prior to the 1860s, experiments by Dr. Charles Blackley proved it during experiments he performed between 1866 and 1878.  He proved that contact with pollen to the mucus membrane causes inflammation and redness, and hay fever symptoms. He wrote that there is a direct relationship between the amount of pollen in the air and hay fever symptoms. For more on Blackley's pollen theory of hay fever you can click here. 

2.  The Neurotic Theory: Holopeter basically refers to George Beard, who in 1876 postulated the nervous  theory of hay fever, and made light to allay the "misconception" that nervous meant "debility and emaciation." Holopeter notes that Beard explains the truth to be more along the lines that the nervous system is full of full of "great strength and endurane." In those with hay fever, some exciting cause "excites" the nervous system to cause the symptoms of hay fever.  Beard explains that the the disease and the tendency to be transferred from one generation to another was all based on this nervous theory.  No evidence has yet been shown of how the nervous system causes the hay fever symptoms. (You can read more about Beard's Nervous Theory of Hay Fever by clicking here)(1, page 57-60) 

• Vasomotor susceptibility:  Vasomotor refers to the nervous systems ability to regulate dilation and contraction of blood vessels.  In hay fever it has a tendency to cause dilation of the blood vessels lining the respiratory tract and eyes, hence hyperaemia and inflammation (catarrh) and your hay fever symptoms. That this happens "indicates a neurotic tendency." Some suspect it may or may not be due to lesions. A similar event occurs with asthma, only the dilation and hyperaemia occurs in among the air passages of the lungs.  (Hyperaemia refers to increased blood flow to a certain region of the body) Hollopeter notes that "Bosworth is inclined to think a peculiar lack of vasomotor control characterizes the neurotic manifestations." (1, page 57-60)
• Idiosyncracy:  The fact hay fever has idiosyncratic means it's neurotic.  By this, the body of the hay fever sufferer is oversensitive to some exciting cause. 

3.  Local Disease Theory: Some sort of local disease (polyp, deviated septum, rhinitis, obstructed nasal passages, etc.) may be the cause of the disease. When the polyp is removed, the hay fever may be cured. Hollopeter quotes Mackenzie:  "there exists in the nose a well-defined sensitive area whose stimulation through a local pathologic process, or through an extra irritation, is capable of producing an excitation which finds its expression in a reflex act or in a series of reflected phenomena."  Bosworth suggested these were generally the effect rather than the cause of hay fever. Some physicians propose such local agents cause both hay fever and asthma. (1, page 62-64)

4.  The Uric Acid Theory:   In 1893, Dr. Seth S. Bishop, as quoted by Hollopeter, wrote: "an excess of uric acid in the blood causes hay fever, or nervous catarrh."  Hollopeter notes that excess uric acid in the blood "causes certain disturbances of a vascular and neurotic character. Haig wrote that excess uric acid causes contraction of arterioles and capillaries, and this opinion was verified by Thomas J. Mays. Murchison, Conklin, Ebstein, Quinquad, and others. Bishop in 1894 speculated that regulation of uric acid should be regarded as a treatment for hay fever. Mays believed that while uric acid was the cause, hay fever was still nervous and, therefore, still hereditary. Although Dr. Capp suggests that the presence of excess uric acid may actually cause "a central nervous irritation." This results in "nerve currents" that are uncontrolled by the normal functions of the body, and result in the abnormal response of hay fever.  (1, pages 64-71)

References:

1. Hollopeter, William Clarence, "Hay-fever and its successful treatment," 1898, Philadelphia, P. Blakiston's Son and Co.
2. Wyman, Morill, "Summer Catarrh," 1876 (first edition was published in 1872), New York, Hurd and Houghton
3. Holmes,

1872: Wyman's two types of hay fever

Hay fever was early on determined to be a false name for the disease that causes itchy and watery throat and eyes, and difficulty breathing in many.  Yet the name stuck.  After being diagnosed in 1833 with hay fever, Dr. Morrill Wyman performed extensive studies on the disease and concluded that there were basically two types:

1. Autumnal Catarrh: Often referred to as catarrhus autumnalis and occurs in August and September
2. Summer Catarrh:  Often referred to as Rose cold, June cold and occurs in May and June (1, page 1)

Yet he actually defines a third type, and that would be hay fever that occurs in Europe.  He determines European hay fever, or hay asthma as it's often called, offers it's patients with the same symptoms of the above two types, but the cause must be different.  (1, page 1-6)

The reason he suspects this is because people inflicted with hay fever in the United States aren't bothered when they go to Europe, and those who have hay fever in Europe are fine when they come to the U.S. So it appears, to Wyman, that the two types of hay fever have unique causes.  (1, page 1-6)

After Charles Blackley discovered pollen and cereals to be the cause of hay fever, there still seemed to be a unique cause in European hay fevers as compared to American hay fevers. Yet he did prove that light, heat, dust, hay and roses were not the cause, and the terms hay fever and rose fever were inappropriate. (1, page 1-6)

He also supposed, as other physicians already suspected, that hay fever must not be confused for other ailments, such as bronchitis, chronic catarrh, and asthma.  I also suspect that hay fever may have often been confused for a common cold, but that was probably also diagnosed as bronchitis or catarrh back in Wyman's day.  (1, page 57)

References:

1. Wyman, Morill, "Autumnal catarrh," 1876 (first edition 1872), New York, Hurd and Houghton

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,

1876: Colorado cures hay fever

Dr. George Beard lists the above approximate altitudes above sea level for
various areas of Colorado, stating that such high altitudes benefit people
suffering from hay fever and asthma. 

In the mid 19th century it was discovered, perhaps by mere accident, that higher altitudes present themselves to easier breathing. I already covered how tuberculosis patients benefited from sanatoriums set up in Denver, Colorado, and how later these TB sanatoriums were converted to asthma hospitals.  Yet did you know that hay fever sufferers also found relief in the centennial state.  

Vacationing to the State of Colorado was actually recommended as a remedy for hay fever in an 1876 book "Hay-fever; or, Summer Catarrh," by George Beard, president of the American Hay Fever Association.  He writes that:

In 1873 a pamphlet was issued under the indorsement of the Medical Association of Denver, Colorado, giving details of over one hundred cases of ordinary asthma and hay-fever that had been cured, or more or less benefited, by residence in or near that region. The Committee of Asthmatics, who represented the Asthma Association, state in their report that probably not one half or one quarter of those in Colorado responded to the call for information. They state, furthermore, that the amount of sunshine there is remarkable; from July, 1872, to December 29, 1873, there were but three days (excepting perhaps in June, 1873) when the sun was not seen.

Dr. Henry K. Steele, President of the Medical Association, in a brief report, states that "in the opinion of the above medical association the climate of Colorado, in and about the range of the Rocky Mountains, has a wonderful curative power over asthma; that nearly all such patients coming into this climate are relieved—at least so long as they remain here; and that all, if not entirely relieved, are sooner or later benefited, with the exception of those cases dependent on or complicated with organic disease of the heart or lungs.

 Dr. O. M. Bryan, of Colorado, writes: "I have known a few cases temporarily relieved by visiting Colorado. Persons suffering from hay-asthma are generally relieved soon after crossing the Missouri River. My opinion is that ninetynine cases out of every one hundred would be relieved, or cured for the time being, by visiting the Rocky Mountains.

It's just interesting to note the various studies and reports confirming the benefits of breathing the cool, sunny air of Colorado, or similar places.

Reference:

1.  Beard, George M, "Hay-fever; or, Summer Catarrh," 1876, New York, Harper and Brothers, Publishers, pages 151-153