Saturday, August 1, 2015

1400-1800: Physicians learn about allergies

King Richard III
Physicians around 850 A.D, about the time of Rhazes, 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 noses around 1350 and 1400 A.D, according to  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.

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.

  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

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