How to treat hay fever?

Hay feverThis is hay fever season (if you’re reading this in the northern hemisphere, at least) – the time of year when airborne pollen makes life a misery for anybody unlucky enough to be allergic to the stuff. The condition is incurable, but a range of drugs including antihistamines can reduce the symptoms significantly. No such luck in the nineteenth century, when those affected just had to suffer. In the summer of 1864 The Lancet printed a series of letters from physicians comparing notes on various methods of alleviating the symptoms. They were, well, varied. One letter came from a Dr Chambers of Warwick Square in London:

I am at the present time attending a lady residing at Clapham, who has suffered periodically from this troublesome disease for six years, coming on with her first menstruation. The irritation of the mucous membrane first commences about the end of May, just as the grass approaches maturity, and about the first week in June the attack comes on in good earnest, and lasts, with more or less severity, till the hay harvest is over; little or no difference being noticed whether the patient keeps her room or takes outdoor exercise. In addition to the usual irritation of the mucous membranes of the fauces, nose, eyes, &c., this patient is much distressed by frequent and violent fits of sneezing, by far the most annoying and depressing part of the attack. 

Not much danger of the hay harvest affecting a resident of Clapham these days, but in 1864 a South Londoner was never far from a hay field.

During the past six years various kinds of treatment have been (by myself and others) adopted, but with little or no benefit. I saw this lady for the first time this season in the first week of the present month (June). I found her in much the same condition as on former occasions. I ordered two grains of quinine to be taken three times a day in a glass of good port wine or claret; in addition to this, I advised her to inhale ammoniated steam twice a day, or oftener if necessary.

The idea of inhaling ammonia has, perhaps unsurprisingly, since fallen from medical favour. Also contributing to the discussion was a Dr Jones of Kentish Town:

Herewith I forward a synopsis of the opinions of a few of the most eminent men in various countries that I have consulted… I have been a sufferer for the last twenty years, and to such an extent last year as to doubt recovery. I have, however, this year been enabled to keep down the most severe symptoms by continuous small doses (five minims) of the tincture of opium. I would suggest to those who, like myself, have no time to spare, the above remedy as one enabling them to pursue their duties in  tolerable comfort.

Again, medical science has (for some reason) abandoned the use of opium as a treatment for hay fever. Dr Jones appends a helpful table of the various diagnoses he had been offered by Europe’s leading doctors, and the treatments they had prescribed. One doctor believed his streaming eyes and congested airways were caused by inhaling iodine; another suggested it was ‘inflammation of the Schneiderian membrane’ (the lining of the sinuses).  One suggested that he stay indoors from 11 am to 6 pm; another agreed, but desired him also to drink port and wear blue glasses. One notable diagnosis was ‘disease of the caruncula’ – the caruncula being the pink nodule at the corner of the eye – the only time I can remember any reference to this anatomical feature in the medical literature.

The sheer variety of treatments, and Dr Jones’s dry comments on them (‘Useful to those who have unlimited time’) are worth reproducing in full – see below:

hay fever table
Dr Jones’s treatment table (click to enlarge)

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