A Lecture on Hay-Fever
Authors: M. Mackenzie
Journal: BMJ (1884)

partly systematic and partly demonstrative.The former portion con- sisted of a brief review of the diseases affecting the pharynx, cesophagus, larynx and trachea, and nose and naso-pharynx.Each of these subjects occupied one session, so that a period of four years was required for the completion of the series.At the conclusion of each lecture, selected cases were brough* forward and demonstrations made on them, full opportunity being also afforded to the members of the class for exam- ining the patients themselves.Dr. Mackenzie then announced that during the present session lie would lecture on diseases of the nose-and naso-pharyngeal region, and that his first subject would be hay-fever.]Hay-fever is a complaint which, though not dangerous to life, causes at certain times suffering of so intense a character as to prevent some people from following their ordinary avocations, and render a still larger number, who are not actually disabled, thoroughly Mniserable during the most agreeable season of the year.The affection has received various names, such as hay-asthma, pollencatarrh, summer-catarrh, and rosecatarrh, according as the most prominent symptoms, or the supposed cause in a particular case, has been made the basis of nomenclature, and I have thought it convenient to make use of the one most commonly employed in this country.The disease may be defined -to be a peculiar-affection of the mucous membrane of the nose, eyes, and air-passages, giving rise to catarrh and asthma, almost invariably caused by the action of the pollen of grasses and flowers, and therefore prevalent only when these are in blQssom.The history of the affection is interesting in many respects, and appears to show either that the complaint, like influenza and cholera did not occur in Europe in the " good old times," or that the disease was entirely overlooked till a' comparatively recent period.The circumstance, already referred to, -that the ailment does not actually kill, and the fact that in its different forms hay-fever resembles some other complaint, tend to support the theory that the older physicians may not ha-e observed this transitory affection; but on the other hand, the fact that it has certainly become more common in the last few years points to the probability that irritating properties have been newly acquired by certain vegetable bodies, and that a peculiar idiosyncrasy has been developed.'The first detailed account of hay-fever was given by Bostockl, who, in 1819, described a "periodical affection of the eyes and-chest," from which he was himself a sufferer.In 18282 this physician published some further observations of the complaint under the-name of "sum- mer catarrh."A short paper on hay-asthma, by Gordon,3 appeared in 1829, and in 1831 Elliotson' gave a brief description of the complaint.A few years later, the same physician' discussed 'the subject lmore fully, and with characteristic sagacity pointed to pollen as the probable cause of the affection.A systematic inquiry into all the circumstances of the disease was-made in 1862 by Phcebus,5 of Giessen, whose own personal observation was, however, confined to a single case.Unlike most of the other writers upon the subject, moreover, he did not himself suffer from the complaint.His method consisted in issuing circulars and advertise- ments inviting medical men all over the world to send him answers to a series of questions so framed as to embrace every possible kind of information about the causes, symptoms, and progress of the disorder; its periods of prevalence, geographical and ethnological distribution; and its prevention and treatment.In this manner, a vast quantity of facts and observations was collected, and from these Phcebus en- deavoured to extract a complete theory of the disease.During the ensuing ten years, pamphlets on hay-fever were published by Abbott