IT’S 1 TO 2 YOU’VE GOT AN ALLERGY
BY FERGUS CRONIN
These mysterious ailments still baffle doctors. Why can
feathers, pollen, hair tonic, strawberries
fear, husbands, anger, and strangers
make people sniffle, come out in spots, or even die?
ROBABLY everyone knows somebody with an allergy. An aunt who can’t wear nylon stockings, a second cousin who goes to the seashore every summer because of his hay fever, or the friend of a brother whose grandfather is a martyr to asthma. There are people who can’t wear metal-rimmed eyeglasses without getting a rash, and a few not entirely unlucky housewives who have been prescribed “no more housework” because they’re allergic to dust.
Actually, more people suffer from allergy than any other type of ailment. One in every ten of the entire population suffers from an allergy serious enough to require medical attention, and one person in three will at some time suffer from some form of allergy, mild or serious. In other words, the odds are one to two that any individual has an active or latent allergy.
Allergy is not a disease of itself. It is medically defined as hypersensitivity of the body cells to various substances, otherwise normal, which act as irritants on particular individuals. Dr. George Little, a Toronto general practitioner who has encountered many cases of allergy, concludes that, “A person can be allergic to everything under the sun—and even the sun itself.”
Allergies are usually due to the food we eat, particles we breathe or materials we touch. The most common substances to which people are allergic are pollen, eggs, milk, wheat, cats, dogs, tomatoes, strawberries, dust, feathers, tobacco, soap, mustard, hair lotion, smoke, sugar, honey, chocolate, drugs, dandruff, paprika, pork, scratches, fish, corn, cottonseed, celery, chemicals, insecticides, cleansers, tooth paste, grapes, insect bites, cold, heat and light, even water.
In recent years it has been established, too, that many allergies are psychosomatic in nature, that they are caused by emotional disturbances rather than by a physical irritant. This is often the answer to the elusive cause of allergic symptoms. And the symptoms of an allergy caused by anxiety, frustration or tension can be every bit as serious as those from ragweed or wool.
There is a case of a man whose face broke out in disfiguring blotches at the prospect of having to meet a stranger, even on the most casual business or social occasion. At times a victim may suffer from both physical and psychosomatic allergies, like the Montreal man who had had hives for sixteen months and was found to be allergic to eggs, tuna fish and chicken. These were eliminated from his meals, but he still had occasional attacks. Questioning showed that his hives began to sprout around noon on weekdays, but never
on week ends. Conclusion: they were due to nervous tension while playing gin rummy with the boys in the office every lunch period. He stopped playing and his hives disappeared.
Hay fever is the most familiar and prevalent of I he allergies. A mild allergy may produce nothing more than a rash, sniffles or a swelling of the irritated part. But since allergens the irritant which causes the allergic reaction—can affect any group of cells in the body, the malady can produce all the symptoms and harmful effects of asthma, eczema, hives, canker sores, conjunctivitis (inflammation of the eyes), irregularities of the heart beat, contact dermatitis (a skin disease), sinusitis, rhinitis (inflammation of the nasal passages) and certain ulcer conditions. Swelling of the body tissues affected usually accompanies other allergy symptoms, and if the swelling occurs in the bronchial tubes, the symptoms are those of asthma; if in the brain, epilepsy; in the covering of the brain, migraine; in the colon, colitis.
Allergies may show up as a violent pain in the stomach, as itching of all or part of the skin, as indigestion, swelling and hoarseness of the throat, coughing, even convulsions. In case of widespread allergy shock can result and may be fatal unless treated quickly. It has been the cause of acute appendicitis. The extreme symptoms, which include nausea, vomiting and diarrhea, cause distress equal to that caused by any other disease known to medical science.
Since so many things can cause allergic symptoms, the first difficulty in treating the malady is in finding the exact cause. “We’ve got to be detectives,” says Dr. Bram Rose, of Montreal, one of Canada’s foremost allergists.
Take a typical case of medical sleuthing preparatory to treating a case of allergy. The patient was two-year-old Bobby, son of a Westmount, Que, railway employee. Bobby had a recurring and itching rash over most of his body since he was six months old. Bobby’s mother thought it would eventually disappear, but instead it got worse. Bobby slept poorly, his appetite suffered and he became pale and thin. An allergist was consulted.
First, the doctor took a careful history of the family’s medical background. He found that the mother was allergic to cats “I start to sneeze if there’s even one in the room,” she said. The father had long suffered from hay fever.
The doctor decided that Bobby’s rash was probably due to allergy, and that an elaborate skin test was necessary. So, twice in two weeks he injected under the skin of the youngster’s back extracts
of various foods and other suspect
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It's 1 to 2 You've Got an Allergy
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materials. Any substance to which he was allergic should produce a small hive or weal.
And, sure enough, some of them did. Bobby was found to be allergic to whole milk, cod-liver oil, feathers and house dust. Bobby’s mother noticed that when the oil furnace in their home was running Bobby showed allergy symptoms. So oil fumes were added to the list of the boy’s allergies.
For treatment, Bobby was switched from cow’s milk to a substitute made from soybeans. Instead of cod-liver oil he got a synthetic vitamin preparation. The furnace had to be converted to coal. The feathers in his pillow and mattress were replaced by foam rubber. The drapes and stuffed furniture in his room were removed, his stuffed toys must be discarded for plastic ones, Bobby’s father had to buy a humidifier to help eliminate dust.
At present, the effect of these measures on Bobby’s health is being watched. If the precautions are not enough, the doctor has informed the child’s parents that a series of small injections of extracts of feathers and dust may be necessary. This often builds up a certain tolerance or resistance to the irritants, and may eventually eliminate an allergy. In the case of foods, a similar tolerance to allergvcausing items may be induced by feeding the sufferer gradually increasing quantities of them, beginning with minute quantities.
One of the factors which sometimes makes it difficult to detect the cause of an allergy is that incredibly small quantities of the irritant may be enough to affect the sufferer. Infants highly sensitive to egg can be made ill by the quantity of egg received from the kiss of a person who has recently eaten an egg. A Winnipeg child was so sensitive he would break out with an attack of [fives if an egg was opened in the same room with him.
The problem of finding a child’s allergy is, however, simple compared to that of an adult whose activities are more varied and more difficult to trace. The allergist must not only find out what an adult eats, but what he does with his entire time, where he goes, details of his occupation, even his hobbies.
Dr. Rose tells of one of his men patients who, after a long and frenzied search, was found to be allergic to the glue on the back of postage stamps
and he was an ardent collector, until he accepted the fact that he had to give up his hobby. Another grew mushrooms in his basement—until he was found to be allergic to a mold which grew on them.
When all known methods failed to find one woman’s allergy her doctor asked to see her husband. He showed up with a waxed mustache. In a flash of inspiration, the doctor scratched the wife’s arm and rubbed in a bit of the wax. Her skin reacted almost immediately. So the husband trimmed his mustache, forswore the wax and the wife had no further trouble.
A man who had a rash on his face, hands and arms for about six months finally visited a doctor when he was about to be married. Skin tests with woolens and other materials he handled in his clothing store were negative, but a carefully kept history of his ailment showed that his rash became worse during his week ends, and that he spent most of his free time with his fiancee. A new tack in the detective work
showed that he reacted strongly to her perfume and face powder. She changed her brands and his skin cleared in a week.
Like the stamp collector who had to give up his hobby, many persons with allergies find their chosen careers affected by “occupational” irritants. After his first year in Canada an emigrant farmer from Holland found himself stricken with violent asthma and bronchitis. The attacks coincided with the rye harvest, and aided by this clue, his doctor was able to establish that dust from the rye was the cause. The
remedy was simple—the farmer turned to other crops.
Some persons sensitive to sunlight have to use protective skin creams or wear broad-brimmed hats to be able to take jobs which require going out in daylight, even to travel back and forth to work. But sunlight allergy can be so severe that victims must take night jobs and stay out of the sun forever.
In the cast1 of children with persistent allergies, doctors may advise parents to guide the sufferers away from occupations which would expose
them to the irritants to which they are sensitive—farming, working as bakers, furriers, upholsterers, florists, in grain mills or around animals.
In one notable instance, however, Dr. E. A. Brown, of Boston, reported the case of an allergy sufferer who remained steadfast to his calling despite his suffering. The patient was a thirtyone-year-old Roman Catholic priest who for six years had had periodic attacks of sneezing and coughing which once or twice a day would develop into a two-minute tit of choking. He sought medical attention when he began to get
bumps and itching over most of his body.
A number of measures were tried, Lnit his condition just got worse. Then it was noticed that his coughing was most distressing about ten minutes after Mass each morning. As a routine test, he refrained from holding Mass for several days. All symptoms cleared up in less than three days. To verify a suspicion, the doctor gave him a drink of wine, and the symptoms returned in fifteen minutes and lasted for three days.
The small quantity of sacramental wine which the priest drank at Mass every morning was at the root of his allergy. All attempts to give him a tolerance for wine failed. At last word he was still saying Mass and suffering, while the doctor continued to seek a drug which would give him relief.
Allergies may dictate the climate in which its victims must live if they wish to be comfortable, since some people are allergic to cold and others to heat. A man in Moncton, N.R., has a case of asthma which is aggravated by the slightest change in temperature. He spends his evenings sitting in one chair in his home, afraid to move to another part of the house even a few feet away because a change in temperature of one degree will start an attack.
The coming of winter brings relief to one type of allergy victims—hayfever sufferers—but means misery to a smaller group who are allergic to cold. If these people merely expose their faces on a chilly day, swelling results. If they breathe cold air they break into fits of coughing. Even on the hottest days of summer they cannot take a cold drink or eat an ice-cream cone for fear of swelling throat and stomach membranes followed by nausea and abdominal pains.
Drownings have been attributed to persons highly sensitive to cold encountering a sudden chilly current while swimming. The resulting shock rendered them helpless. Persons with heat allergies are also unfortunate. Symptoms can be produced by drinking a cup of coffee, and sometimes an attack can be brought on by the body heat generated by the effort of rising from a chair, taking part in a business deal or watching a hockey game.
Insecurity Can Do It
Allergies are as old as the human race. Claudius Galen, one of the fathers of modern medicine, who practiced in Rome eighteen centuries ago, was describing allergies when he coined (or borrowed) the phrase “one man’s food is another man’s poison,” the same meaning contained in today’s often heard mealtime cliche: “1 like it hut
it doesn’t like me.” But the specificstudy of allergies as a branch of medicine is a mere fifty years old. (The 1908 edition of Webster’s International Dictionary does not contain the word “allergy.”)
One of the advances in treating allergies resulted from the discovery that some were psychosomatic and therefore might yield to psychiatrictreatment, or to simple understanding of the cause.
An eight-year-old New York girl had recurrent attacks of asthma, but every time her mother took her away from her brothers and sisters to Florida, the symptoms disappeared. The relatively pollen-free air was apparently just what she needed. Once, however, a sister accompanied them and the attacks continued, even in Florida. An allergist decided that the girl felt insecure, and her mother admitted that she had been an unwanted child. Her first attacks had been brought on by dust and certain foods, hut when
she found her attacks brought her closer to her mother, she began to develop them without such provocation. Doctors believe that psychosomatic allergic reactions can happen without any initial sensitivity to materials.
In a California study of ninety children with asthma, hay fever, hives and eczema, ninety-eight percent were found to have a disturbed and insecure relationship with their parents, usually with their mother. But in a similar group of non-allergic children only twenty-five percent held disturbed relationships.
Dr. Donald H. Williams of Vancouver made a valuable study of fiftythree children with allergic eczema. He divided them into two groups, one to be treated only for eczema, the other for the mother-child relationship. In the first group, only ten percent lost their rashes in fifteen to eighteen months. In the second, nearly half had been cleared up in from three to seven months. Attention to the emotional factor thus proved more than four times as successful in eliminating the symptoms, and in about a quarter of the time.
There is the record of a woman who developed migraine and nausea every time she was asked for a date. It was finally explained by the fact that she had a subconscious fear of marriage.
Perhaps the strangest of all cases of allergy was that of a California girl who was granted a divorce in 1949 because she was allergic to her husband. Joyce Goodman met Nolan Holdridge in 1945 and, while having dates with him, noticed a red rash on her wrists. They were married the following year and the rash spread. He went overseas with the navy, and her rash disappeared, hut when he came back, so did the rash. It finally became unbearable and she sued for divorce on the ground that she was allergic to her husband.
If allergists do not know why one person is immune to allergies and another subject to them, they have developed an increasing volume of information on the factors that accompany allergies, and on methods of preventing and treating the various symptoms.
Most doctors believe that allergy is hereditary, or at least that the capacity to be hypersensitive to allergens is inherited. One survey showed that in more than half the cases of hay fever, asthma or hives flue to physical allergy, there was a family history of allergy.
When both parents were allergic, thirty-six percent of their children developed some kind of allergy before the age of five, only fifteen percent if only one parent is afflicted, comparable to the rate among children of nonallergic parents.
Until recent years there was little that could be done for allergies. Hayfever sufferers who could afford it would spend their summers in pollenfree areas. If the cause was food or a contact substance, the offending material had to be avoided. Now a certain tolerance can be built up for many allergenic substances, and injections of adrenalin and new drugs like ACTH, cortisone and anti-histamines can give substantial if temporary relief.
In an ACTH test for hay-fever sufferers, a night-and-day watch upon those taking the drug showed that their sneezes were cut in the first twenty-four hours from an average of six hundred and forty per person to one hundred and fifty. After two days the patients were completely free of coughs, sniffles and sneezes. In some cases relief lasted for nearly a year.
On the other hand, one of the most suspected causes of allergy is the indis-
criminate use of drugs. Allergy to drugs should be suspected whenever a sick person or convalescent gets a rash.
Dr. Rose warns that drugs like penicillin and some forms of sulfa often sensitize a patient so that their second use can be serious, even fatal. Everyone, especially those with allergy in the family, he says, must be careful of new drug preparations. They should never be taken unless prescribed by a doctor for a serious ailment. “Taking penicillin lozenges for a simple cold is the worst thing in the world,” he says. “It might sensitize you for later when you might badly need penicillin for a major illness.”
One study among children showed eleven percent with typical allergy reactions to the sulfas, seven percent to penicillin. Nearly two percent were allergic to aspirin.
Although an allergy may occur for the first time at any age, allergists have found that the period of greatest danger is before birth, in infancy and in early childhood, particularly during illness
and convalescence. Therefore specialists recommend that precautions be taken with all children, and particularly with those of parents who are both subject to allergies.
Dr. P. A. Ryan, a Toronto allergist, states that during the first year a child’s diet should be controlled under medical advice, since giving an infant full portions of new foods is suspected of causing allergies.
“One trouble,” said Dr. Ryan, “is that every mother wants hers to be the most ‘advanced’ baby in the neighborhood, and eating solid foods ahead of other children is considered a sign of advancement.” Also, it is cheaper and more convenient if the baby can eat what has been prepared for the rest of the family. Foods, however, can be made non-allergenic by thorough cooking. That is one reason why pediatricians advise; stewed fruit, hard - boiled eggs, pre - cooked cereals and evaporated milk for infants.
A child can become allergic before birth, via the expectant mother’s diet. Therefore allergists recommend that mothers-to-be should eat a well-balanced diet without excesses, especially in the so-called allergenic foods such as eggs, fish, nuts, shellfish and raw foods
To parents who wish to take the most effective measures against allergies, doctors make the following recommendations:
1. Permit no stuffed toy animals or dolls in the house, only plastic and wooden toys.
2. Reduce house dust to a minimum. Remove from the child’s room all upholstered furniture, heavy carpets and drapes. Substitute wood, metal or plastic furniture, rubber-filled pillows, plastic-covered mattresses and floor linoleum.
3. To prevent mold, the house and especially the basement should be kept dry.
4. The mother should use cosmetics which are free of orris, the root of the Florentine iris which is a well-known allergen.
5. Before sending a child to summer camp, he should be skin-tested for reaction to pollens.
6. Should any allergy be indicated, immunization shots should be started at an early age to build up tolerance.
There is a growing conviction among allergists, however, that within the limits of those precautions children with allergies should be allowed to lead as normal a life as possible, and should be reassured that they are not different from other children. Until recently allergic children were forbidden to go to a zoo or a circus. Now doctors allow such visits, with the proviso that if an attack occurs after proximity with a certain animal, then the child should be kept away from that animal in future.
The violent allergies leave no doubt of their presence, but many people have mild or obscure types without being aware of it. Some of these can be roughly self-diagnosed as follows: A person who sneezes three times in a row may have an allergy; if one averages more than two colds a year the cause may be allergy. “Summer cold” might be hay fever, the usual culprit too behind a constantly running nose. Usually an allergy is the villain when there is no other explanation for a rash or other symptom. A rash on the hands or face might be caused by a soap, detergent or cosmetic. An allergic symptom recurring on Fridays may point to a sensitivity to fish.
One of the more obscure types of allergy which often eludes diagnosis is known as “allergic toxemia,” a weakness or feeling of tiredness for no apparent reason. A woman of thirtyfive turned up at the outpatients’ department of a Toronto hospital with the complaint that she had been tired all ber life and she felt she needed a tonic. Suspecting an allergy, the doctor eliminated from her diet wheat, milk, eggs and pork, and although at last report he had not vet decided which of these was at fault, the woman’s tiredness had disappeared and she was elated that for the first time in her life her tongue was not coated.
Considerable progress has been made in the few years since allergy first came under serious medical scrutiny, but allergists admit they have a long way to go. Dr. Ryan maintains that allergy is a serious enough problem to warrant an organized attack on it.
“I’d like to see money available for investigation of allergies, particularly asthma, which is the one allergy most likely to incapacitate people and shorten their lives,” said Ryan. “Asthmatics are long overdue for help, and the disease should share the attention now being given to arthritis, diabetes and heart disease.”
At the Royal Victoria Hospital in Montreal, Dr. Bram Rose directs one of the largest projects on the continent in basic allergy research. Rose believes that increased knowledge of allergies may shed light on other diseases which may be in some way connected with the allergic process.
For example, the American College of Allergists was told at a recent convention in Chicago that alcoholism is sometimes a form of food allergy in which the alcoholic is sensitive to certain grains from which liquor is made. The particular food to which he is allergic may not produce a strong reaction like hives bur might give the alcoholic a reaction in the form of a “lift” followed by a letdown. Progressively larger and more frequent doses become necessary for the temporary relief of the hangover.
The present objective of allergy research is a specific prevent ive. If and when it is found, said Dr. Rose, it would be given to all children just as antidotes for tetanus and smallpox are administered today. ★