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Friday, December 12, 2014

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, sniffy, 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 notations describing the malady before it was formally defined by the medical community in 1819.  

About 2,640 years before the birth of Christ, King Menes 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.   
King Menes (circa 2925 B.C.)

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," described 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 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 (1452-1485)
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 explained 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. (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
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