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RECENT DISCOVERIES ON THE CAUSATION AND TREATMENT OF HAY FEVER.
COUNTY COUNCILS AND ISOLATION HOSPITALS.
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old objection that lessened risk means lowered wages has still some force. The society aims at finding a respirator which shall be simple in construction, light, cheap, and sightly, one which can be worn for hours without interference with respiration, and one which will not permit expired air to be breathed again. An apparatus satisfy- ’ ing all these requirements would have a certain sphere of usefulness, but we are a little doubtful whether the
The psychical element is, concludes an attack. Dr. Wallace, a factor of growing importance in many diseases and in hay f ever it plays an important part. Dr. Dunbar, the physician in charge of the Institute of Hygiene at Hamburg, states in the Deutsche Medicinische Wochenschrift, No. 9, 1903, that he has succeeded in isolating the toxic substance from the pollen of grasses which is capable of producing hay fever in predisposed persons. He was thus society is working on the right lines. Even supposing able to reproduce attacks of the disease in winter by subThis that a thoroughly efficient respirator impermeable to dust cutaneous injection of a minute dose of the same. toxic substance is not the ethereal or oily constituent of the were devised we fear that the difficulty of getting workpeople to wear it would not be easily overcome. Even if pollen grains but is apparently, adds Dr Dunbar, an alkaworn it would afford no protection against poisonous vapours loidal body. The attack of hay fever produced by it is and while it might limit the field of pneumonokoniosis intense. An attempt was made to produce an antitoxic and enterokoniosis it would have no application to the im- serum from the blood of animals inoculated with this toxin. portant group of lesions included under the term dermato- After some trials this was successfully effected and in the koniosis. The plan of carrying on the work before an upcast course of his experiments he inoculated eight patients with shaft so that dust and vapours are at once borne away hay fever by instilling into the eye finely-ground pollen by a current of air seems rather the one deserving of grains suspended in water. In every case the physical and encouragement. subjective symptoms of hay fever were reproduced in varying degrees of intensity. The new serum was then tested by RECENT DISCOVERIES ON THE CAUSATION AND mixing some of it with the pollen and applying the mixture to the eye. "The eye itched slightly and appeared conTREATMENT OF HAY FEVER. but these symptoms disappeared in less than 30 gested," THREE interesting contributions to the subject of the minutes. The serum was equally effective against the pollen causation and treatment of hay fever have been recently of various cereals. published. In the Berliner Klinische Wochenschrift, of March 2nd Dr. G. Rosenfeld of Berlin refers to the question COUNTY COUNCILS AND ISOLATION HOSPITALS. of hay fever as caused by the pollen of certain flowers and THE E,sex county council is apparently the first to take adds to the list a plant hitherto unrecognised as a causeviz., the plantus occidentalis which is found in bloom in the advantage of the Isolation Hospital Acts and to make grants neighbourhood of Stuttgart from the middle of May to the systematically to the authorities which have provided isolaend of June, during which time hay fever is prevalent in that tion hospitals. Prior to the recent amending Act grants could locality. The symptoms of hay fever caused by it are of the only be made to hospitals erected under the Act of 1893, usual type and can be reproduced by experimental insuffla- now grants can be made to any hospital, but the sanction of tion of the pollen into the nostrils. In the -zVeTv York the Local Government Board is necessary if the hospital Medical Record of March 28th Dr. Raymond Wallace is erected out of current rates and therefore without the emphasises the fact that a neurotic predisposition to the plans having received the approval of that Board. At the affection exists in persons who develop hay fever. Persons commencement of this year the Essex county council who are "naturally highly strung, excitable, irritable, announced that it was prepared to make grants towards neurasthenic, havingnerves ’ which are literallyon the the maintenance of isolation hospitals and that applicasurface,’ are those who are more liable to this affection than tions were to be made before a given date. Applications " are the more phlegmatic types." The element of periodicity were received from 17 out of the 19 authorities in the county which is generally observed in attacks indicates that a which had provided hospitals. All these hospitals have been psychical factor is concerned in the etiology of hay fever examined and reported upon by the county medical officer of as exemplified in the case of a patient who has had attacks health and the marks awarded range from 55 to 100, the on August 15th of one year and who began to suffer in latter being the maximum. In awarding the marks every subsequent years on the same date. A neurotic young point in connexion with the position, construction, and woman, aged 25 years, known to Dr. Wallace, suffers administration of the hospitals was taken into account, regularly from three attacks per diem on certain days. together with the adequacy of the accommodation for the The sanitary committee has adopted Thus upon arising from bed she always anticipates an districts served. attack and it always comes on unless she can abort it by these marks as the basis upon which the grant shall be made firm pressure upon the upper lip. In the afternoon at the and recommended that each authority should receive 2s. per The lunch hour a second attack follows and at night on retiring mark per bed for the year ending March 31st, 1903. to her bedroom the third attack occurs. Another case was best hospitals will therefore receive a grant of £10 per bed It is probable, however, that that of a young man, aged 30 years and of neurotic con- and the worst £510s. stitution. He suffers from hay fever in a regular and periodic next year some other basis will be adopted, as the differfashion. Under medical treatment he does not have more ence between the various hospitals is not sufficiently well than four or five attacks during the day. When at work in marked to encourage the improvements and reforms which his office he is seldom troubled with an attack. But if he the county council wishes to see carried out. Of the is spending the evening in society his mind dwells upon 17 hospitals to which grants have been allotted six were the possibility of an attack and of the embarrassment erected out of current rates and therefore the approval of likely to be caused. He then has two or three attacks the Local Government Board will be necessary before the and is compelled to leave the room. Dr. Wallace has found grants can be paid. These hospitals are all wood and iron that strong sunlight will in some persons provoke an attack structures of a so-called "temporary" character and it of hay fever with its attendant symptoms of sneezing, vaso- remains to be seen whether the Board will sanction grants to motor congestion of the nostrils, and coryza, the attack such hospitals. The possibility of a refusal is evidently being caused reflexly by excitation of the vaso-motor recognised, as the sanitary committee recommends, if the centres through the optic nerve, and in the same way it Board’s sanction is withheld, that no grant should be made has been observed that dust, pollen, and certain odours to any hospital. The table prepared by the county medical may act through the trigeminal and olfactory nerves and officer contains a mass of interesting information. Amongst
provoke
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1462
old objection that lessened risk means lowered wages has still some force. The society aims at finding a respirator which shall be simple in construction, light, cheap, and sightly, one which can be worn for hours without interference with respiration, and one which will not permit expired air to be breathed again. An apparatus satisfy- ’ ing all these requirements would have a certain sphere of usefulness, but we are a little doubtful whether the
The psychical element is, concludes an attack. Dr. Wallace, a factor of growing importance in many diseases and in hay f ever it plays an important part. Dr. Dunbar, the physician in charge of the Institute of Hygiene at Hamburg, states in the Deutsche Medicinische Wochenschrift, No. 9, 1903, that he has succeeded in isolating the toxic substance from the pollen of grasses which is capable of producing hay fever in predisposed persons. He was thus society is working on the right lines. Even supposing able to reproduce attacks of the disease in winter by subThis that a thoroughly efficient respirator impermeable to dust cutaneous injection of a minute dose of the same. toxic substance is not the ethereal or oily constituent of the were devised we fear that the difficulty of getting workpeople to wear it would not be easily overcome. Even if pollen grains but is apparently, adds Dr Dunbar, an alkaworn it would afford no protection against poisonous vapours loidal body. The attack of hay fever produced by it is and while it might limit the field of pneumonokoniosis intense. An attempt was made to produce an antitoxic and enterokoniosis it would have no application to the im- serum from the blood of animals inoculated with this toxin. portant group of lesions included under the term dermato- After some trials this was successfully effected and in the koniosis. The plan of carrying on the work before an upcast course of his experiments he inoculated eight patients with shaft so that dust and vapours are at once borne away hay fever by instilling into the eye finely-ground pollen by a current of air seems rather the one deserving of grains suspended in water. In every case the physical and encouragement. subjective symptoms of hay fever were reproduced in varying degrees of intensity. The new serum was then tested by RECENT DISCOVERIES ON THE CAUSATION AND mixing some of it with the pollen and applying the mixture to the eye. "The eye itched slightly and appeared conTREATMENT OF HAY FEVER. but these symptoms disappeared in less than 30 gested," THREE interesting contributions to the subject of the minutes. The serum was equally effective against the pollen causation and treatment of hay fever have been recently of various cereals. published. In the Berliner Klinische Wochenschrift, of March 2nd Dr. G. Rosenfeld of Berlin refers to the question COUNTY COUNCILS AND ISOLATION HOSPITALS. of hay fever as caused by the pollen of certain flowers and THE E,sex county council is apparently the first to take adds to the list a plant hitherto unrecognised as a causeviz., the plantus occidentalis which is found in bloom in the advantage of the Isolation Hospital Acts and to make grants neighbourhood of Stuttgart from the middle of May to the systematically to the authorities which have provided isolaend of June, during which time hay fever is prevalent in that tion hospitals. Prior to the recent amending Act grants could locality. The symptoms of hay fever caused by it are of the only be made to hospitals erected under the Act of 1893, usual type and can be reproduced by experimental insuffla- now grants can be made to any hospital, but the sanction of tion of the pollen into the nostrils. In the -zVeTv York the Local Government Board is necessary if the hospital Medical Record of March 28th Dr. Raymond Wallace is erected out of current rates and therefore without the emphasises the fact that a neurotic predisposition to the plans having received the approval of that Board. At the affection exists in persons who develop hay fever. Persons commencement of this year the Essex county council who are "naturally highly strung, excitable, irritable, announced that it was prepared to make grants towards neurasthenic, havingnerves ’ which are literallyon the the maintenance of isolation hospitals and that applicasurface,’ are those who are more liable to this affection than tions were to be made before a given date. Applications " are the more phlegmatic types." The element of periodicity were received from 17 out of the 19 authorities in the county which is generally observed in attacks indicates that a which had provided hospitals. All these hospitals have been psychical factor is concerned in the etiology of hay fever examined and reported upon by the county medical officer of as exemplified in the case of a patient who has had attacks health and the marks awarded range from 55 to 100, the on August 15th of one year and who began to suffer in latter being the maximum. In awarding the marks every subsequent years on the same date. A neurotic young point in connexion with the position, construction, and woman, aged 25 years, known to Dr. Wallace, suffers administration of the hospitals was taken into account, regularly from three attacks per diem on certain days. together with the adequacy of the accommodation for the The sanitary committee has adopted Thus upon arising from bed she always anticipates an districts served. attack and it always comes on unless she can abort it by these marks as the basis upon which the grant shall be made firm pressure upon the upper lip. In the afternoon at the and recommended that each authority should receive 2s. per The lunch hour a second attack follows and at night on retiring mark per bed for the year ending March 31st, 1903. to her bedroom the third attack occurs. Another case was best hospitals will therefore receive a grant of £10 per bed It is probable, however, that that of a young man, aged 30 years and of neurotic con- and the worst £510s. stitution. He suffers from hay fever in a regular and periodic next year some other basis will be adopted, as the differfashion. Under medical treatment he does not have more ence between the various hospitals is not sufficiently well than four or five attacks during the day. When at work in marked to encourage the improvements and reforms which his office he is seldom troubled with an attack. But if he the county council wishes to see carried out. Of the is spending the evening in society his mind dwells upon 17 hospitals to which grants have been allotted six were the possibility of an attack and of the embarrassment erected out of current rates and therefore the approval of likely to be caused. He then has two or three attacks the Local Government Board will be necessary before the and is compelled to leave the room. Dr. Wallace has found grants can be paid. These hospitals are all wood and iron that strong sunlight will in some persons provoke an attack structures of a so-called "temporary" character and it of hay fever with its attendant symptoms of sneezing, vaso- remains to be seen whether the Board will sanction grants to motor congestion of the nostrils, and coryza, the attack such hospitals. The possibility of a refusal is evidently being caused reflexly by excitation of the vaso-motor recognised, as the sanitary committee recommends, if the centres through the optic nerve, and in the same way it Board’s sanction is withheld, that no grant should be made has been observed that dust, pollen, and certain odours to any hospital. The table prepared by the county medical may act through the trigeminal and olfactory nerves and officer contains a mass of interesting information. Amongst
provoke
-
____