Did you know that hay fever was once considered an affliction of the upper classes? Or that it was originally termed ‘rose catarrh’? Yes, the poor innocent rose was blamed for the miserable symptoms of hay fever up until the early 1800s. Thankfully, it was let off the hook when a physician called John Bostock, who suffered from hay fever himself, documented that, in fact, many airborne irritants and odours could be responsible. It took a while longer to prove it was not a disease solely of the upper classes. It was a Dr. Wyman in the U.S. in the mid 1800s who proved this, when he showed that he could produce a reaction to ragweed in himself by inhaling it. Also around this time, Charles Harrison Blackley discovered that loose pollen collected by his children caused an allergic reaction. A dedicated physician, he even went a step further and used himself as a guinea pig, carrying out the original skin test by putting pollen in small cuts in his own skin. They didn’t call this reaction an allergy of course as that word had yet to be introduced. Descriptions of allergies of all types – rashes, swelling, red and itchy eyes, wheeze- have been found in ancient documents from China, Rome, Egypt and Greece but neither the cause nor the actual word itself were known until much later.
In 1906, Clemens von Pirquet coined the word allergy and put forward his theory on the mechanism of allergies. From his observations of what happened after vaccinations and during infectious diseases, he suggested that the immune system was responsible for allergic reactions. Interestingly, this wasn’t well received at all. The immune system had only fairly recently been described and the proud physicians responsible for that found it difficult to believe that it could be the amazing immune system going awry that could be responsible for what is essentially a self-destructive attack.
In actual fact, when he used the word allergy, von Pirquet was describing the reaction of our immune system – good or bad– to a threat. Von Pirquet never intended the word to only describe the hypersensitivity of the immune system. There followed over the next decade a lot of confusion over the terminology and definition of allergy. Indeed the term allergy was nearly confined to the bin as many scientists preferred alternative terminology. Around the same time a French physiologist called Charles Richet was doing research with dogs – injecting them with marine toxins and discovering that after a second dose many would suffer a severe reaction. He named this reaction anaphylaxis, a phenomenon we know today as a severe whole body allergic reaction which can result in death in as little as 15 minutes. He went on to receive the Nobel Prize for his work.
By the 1930s though, the word allergy had been widely adopted to describe hypersensitivity reactions and the first allergy clinics were already up and running. In 1929 the Journal of Allergy was founded. In the ensuing decades the role of histamine in an allergic reaction started to become clear, as well as the genetic or familial component . The discovery of mast cells(1953) and IgE(1963) helped us understand the chain of events that occurs once an allergic reaction begins. Mast cells contain hordes of chemicals that can be released in response to foreign toxins and IgE is crucial in allergic reactions. It is the antibody that is produced in disproportionate amounts in response to an allergen. The IgE remain dormant in the body until the allergen is detected again and it is this time that they can go berserk and trigger the out of control immune response or allergy. In the 1980s Professor Samuelson won the Nobel Prize for his work in discovering the role of leukotrienes in the inflammatory process.
The treatment of allergies began with the use of antihistamines, first introduced in the 1930s. These first generation antihistamines were hugely sedative so really until the 1980s and the development of non-drowsy antihistamines, it was often a case of choosing sleep or allergy. Not ideal. The modern concept of immunotherapy, which is building up the immune system through the administration of injections to help people cope with their allergies, was introduced in 1914 but the principle of immunotherapy has a much earlier precursor in history dating back to when King Mithridates from Pontos tried to protect himself against poisoning. According to Plinius, King Mithridates (132–63 B.C) used increasing doses of snake venom to make himself immune against the toxin. It is not clear whether this therapy was successful but we do know that he died by the sword and not from an allergy!
In 1948 corticosteroids were first used to treat asthma and allergic reactions. They work by reducing the inflammation that is caused by the allergens. The first EpiPen was approved by the FDA in 1987. The autoinjector concept had been originally developed for nerve gas antidotes and would prove to be a true life saver over the years.
The 1950 and 60s saw the first anti-allergy products – non-bio washing powder, specially designed pillows and duvets for example – and a new awareness that our home environment could be responsible for triggering allergies. To this day despite intensive research there is no cure for allergies so a key part of treatment is avoidance of allergens. Healthy homes are crucial to minimise exposure to harmful triggers as we spend the vast majority of our lives indoors. Our indoor air quality has declined as our homes are getting more airtight. Allergic conditions are the most common health problems affecting children in the U.S. and more than 50 million Americans experience an allergy of some type each year. Today, allergies are the sixth leading cause of chronic illness in the United States, costing around $18 billion a year. Research is ongoing but a cure is not in sight so until then we must be vigilant regarding triggers, avoid allergens as much as possible and ensure we surround ourselves with a safe environment by creating a healthy home.
About Dr. Anna O’Donovan – Medical & Lifestyle Author
Anna is a mum of three children, one with allergies, and she suffers from allergies and asthma herself. She is a qualified doctor and worked as a General Practitioner and as a dentist for a number of years. She is also an award-winning author.
Allergies, asthma, hay fever, immune system, healthy homes, indoor air quality.
References and further reading
A brief history of allergies, National Geographic, Click Here
The Allergy Epidemics: 1870–2010, Thomas A.E. Platts-Mills, J Allergy Clin Immunol. 2015 Jul; 136(1): 3–13. Click Here
A History of Allergies, Part Three: The 16th Century To The 20th Century, AchooAllergy, Click Here
The Fascinating History and Discovery of Allergies, Home Air Quality Guides, Click Here
The History of Allergies, Health Beat, Click Here
The history of allergies, The Irish Times, Click Here
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