Hay fever: An irritating history

 By Carys Brown (@HistoryCarys)

‘About the beginning or middle of June in every year the following symptoms make their appearance, with a greater or less degree of violence. A sensation of heat and fulness is experienced in the eyes…until the sensation becomes converted into what may be characterized as a combination of the most acute itching and smarting…a general fulness is experienced in the head, and particularly about the fore part; to this suceeds irritation of the nose, producing sneezing, which occurs in fits of extreme violence, coming on at uncertain intervals’ – John Bostock, ‘Case of a periodical affection of the eyes and chest’, 16 March 1819.

If, like me, this summer has reduced you to Googling ‘why is my hay fever so bad this year?’ and ‘when will it stop?’ then the above symptoms may sound familiar. Partly because of the recent dry, warm, and windy weather, this year’s hay fever season is set to be the worst in twelve years, and many of us are suffering for it. Unable to find a contemporary cure for this affliction, I sought distraction by looking at how people had dealt with it in the past. 

To add mental irritation to my physical malaise, however, I found that this is by no means an easy task. Hay-fever-like symptoms were not described as a part of specific condition until the physician John Bostock produced the above-quoted paper in 1819. Furthermore, the term “hay fever” was not coined until surgeon William Gordon used it in the London Medical Gazette in 1829, and pollen was only identified as the causes of these symptoms in 1831.^[1] Given this, I was curious to find out how people described their seasonal sneezes before the nineteenth century, and to what they attributed them.

Although the term “hay fever” was not in use in the seventeenth and eighteenth centuries, medical writers related a general propensity to produce phlegm in the summer to the prevalence of particular diseases in that season. Théophile Bonet’s 1686 A guide to the practical physician, for instance, describes how ‘Siriasis, or, Head-moldshottenness…usually takes Children in the heat of Summer, because of pituitous bloud, or phlegm it self putrefying about the membranes of the Brain, and inflaming the Spirits in the Arteries with a gentle Fever’.^[2] The English physician John Floyer related the summer season to a worsening of asthma, writing ‘I observ’d, that in the Winter were sixteen [asthmatic] Fits, but in the Summer-Months I had twenty fits, and in the summer the fits were more sharp and longer, and that I spit more digested Phlegm then’.^[3]

However, without a specific label for the condition we now call hay fever, its prevalence or recognition in this period is much harder to trace. One of the key difficulties in looking for mentions of a seasonal affliction in early modern medical writing, is that physicians were already working within a theory of how the seasons affected the balance of the body. The theory of the four humors, which was central to the teaching of the Greek physician Galen, and continued to be the basis of medical practice in Europe into the nineteenth century, associated the summer with hot, dry conditions that produced ‘yellow bile’— quite the opposite to the cool, wet conditions that produced phlegm in the winter. It is therefore difficult to pick out descriptions of genuinely seasonal diseases from the frequent attribution of disease to the seasonal nature of humoral balance.

This is illustrative of one of the problems faced by historians of medicine and disease. The way we describe illness and its causes is culturally constituted, and basic ideas about what constitutes health and disease have vastly differed across time and place. Many historians are therefore highly cautious about speculating about the identity of diseases in the past.^[4] However, there are some ways around this. By treating “illness” (the experience of suffering symptoms) from as separate from “disease” (an identified cause of suffering), historians are able to navigate some of the difficulties in dealing with changing nomenclature over time.^[5] Furthermore, treating diseases as, in some senses, socially constructed can help to use the history of specific diseases to tell us about societal values and attitudes to health across the global past.^[6]

^[1] Karen Reid, ‘The story of an allergy: coming to understand hay fever’, Royal College of Physicians, 19 August 2016 – https://www.rcplondon.ac.uk/news/story-allergy-coming-understand-hay-fever.

^[2] Théophile Bonet, A guide to the practical physician shewing (London: 1686), p. 334.

^[3] John Floyer, A treatise of the asthma (London: 1726), pp. 12-13.

^[4] Mark Harrison, ‘A global perspective: Reframing the history of health, medicine, and disease’, Bulletin of the History of Medicine, 89 (2015), pp. 639-689, online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898657/.

^[5] Carsten Timmermann, ‘Chronic Illness and Disease History’ in Mark Jackson, ed., The Oxford Handbook of the History of Medicine (Oxford: Oxford University Press, 2011), p. 393.

^[6] Edmund Ramsden, ‘Science and medicine in the United States of America’ in Mark Jackson, ed., A global history of medicine (Oxford and New York: Oxford University Press, 2018), p. 164.

Cover image: Woman with a hay fever. License: CC0 Public Domain https://www.publicdomainpictures.net/en/view-image.php?image=249198&picture=woman-with-a-hay-fever