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Monday, September 29, 2014

1872: Wyman tries to prevent hay fever

Dr. Morrill Wyman, late Hersey Professor adjunct of the theory and practice of medicine in Harvard University and hay fever sufferer, said there was no truly effective medicine for hay fever.  So instead of recommending medicine, he recommended getting away from the things that caused hay fever symptoms.

"Fortunately," he said, "the study of the natural history of the disease has shown us a remedy which brings material relief in all its periods, — a removal to a non-catarrhal region."  The region he was referring to were mountainous areas where hay fever resorts had been set up, such as the White Mountain Resorts. "This is the great, almost unfailing remedy." (1, page 81, 160)

Realistically, he was aware that most hard working Americans were not fortunate enough to have the finances nor the time for such vacations, and so he listed a variety of other options that might help prevent hay fever symptoms.

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.  Bitartrate o potash (cream of tartar):

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
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