Hay Fever - Theories Of Basic Causes
( Originally Published 1943 )
THE underlying cause of hay fever is unknown. "What about the information on pollens and heredity?" you ask.
"Very valuable," we say, "but not explanatory enough." For instance, a hay fever patient challenges us to explain his ailment and he starts out by asking, "Why do I sneeze, itch, and otherwise suffer during the summer only?" We answer this question by explaining that the pollens to which he is sensitive are present in abundance at this time.
"Why do these pollens pick on me and neglect other people?" he asks.
"Because you inherited the tendency to become sensitive," we reply.
This persevering patient isn't satisfied by the mere statement of heredity because he is probably mechanically minded. As a child he took clocks apart to see what makes them tick. And so he asks the $64 question, "Just what did I inherit in my body make-up to give me this sensitivity?"
To answer this stickler we try to satisfy him with the theory that he has inherited weak "shock organs" which determine what kind of an allergy he will have. That is, if the weakness centers in the membranes of the nose and eyes, the ailment will be hay fever, if the weakness locates in the breathing apparatus the ailment will be asthma and so on through the other allergic complaints.
But this patient is rio dope, he knows he has stumped the experts and wants his set of encyclopedias. He carries the attack home and asks, "What is there about these `shock organs' to make them go out of kilter in such a peculiar manner when they are exposed to ordinarily harmless pollens?"
Since we are intellectually honest we give the patient his set of encyclopedias and say, "We don't know the answer, but there are some theories, would you like to hear them?" This sufferer says, "Yes," because we have decided to include the theories in this book. Some of the theories hold water, while others leak like a sieve.
In a popular treatise, a review of what are merely theories about the basic cause of hay fever symptoms may seem far afield to some readers and critics. Nevertheless, we cannot help but feel that readers whose quest for knowledge would lead them to secure this book are of the same turn of mind as our prize winning interlocutor.
In judging these theories we must expect them to ex-plain satisfactorily what there is in a person's make-up to account for the conditions which result from that individual's contact with the responsible substances.
AUTONOMIC NERVOUS SYSTEM
One popular theory holds that hay fever and other allergies are due to a defect in the lower functions of the nervous system. That is, those branches of nerves which control your involuntary actions such as breathing, circulation, digestion, sneezing, coughing, vomiting and other reflexes. The approach along these lines has been to test for differences in pulse rate, blood pressure, and reflex movements between allergics and non-allergics. As yet, no conclusive evidence has been found.
Another group believes that sensitivities are due to endocrine gland defects. Among the glands suspected is the thymus gland in the chest which normally shrinks by the time puberty is reached. But in some asthmatic children x-rays have disclosed an enlarged thymus gland. Under-secretion of the adrenal gland has also been suspected be-cause it is well known that adrenalin acts to counteract the symptoms experienced in hay fever, asthma and urticaria (condition of hives). However, it has been pointed out that there are many instances of persons suffering from a lack of secretion of adrenalin who do not show allergic symptoms. The thyroid, pituitary and sex glands have also been considered as factors. Especially from the point of view of their relationship to the onset of puberty and the secondary sex characteristics which frequently bring in their wake an appearance or disappearance of one or more of the allergic ailments.
Insufficiency of certain minerals or body chemicals was an early theory which has been recently revived. Calcium was one of the first minerals to be thought lacking. More recently there arose the hypotheses of phosphorus, potas.
sium and sodium deficiencies. But supplying hay fever patients with these chemicals has shown no definite success as yet. Other such substances that have been recommended and found wanting as a cure for hay fever include iodides, iron and sulphur.
Nasal obstructions and nasal defects as a cause of hay fever is a theory that flourished in an earlier day and still has its adherents today. But time and again it has been shown that there are numerous persons with severe defects of their nasal structures who do not suffer from hay fever. It is true that in some persons, removal of nasal obstructions has caused a reduction in complaints similar to hay fever symptoms. However, thousands of hay fever cases who have had abnormal nasal conditions corrected, continue to have their hay fever.
ACIDOSIS AND ALKALOSIS
A variety of hypotheses have been offered in terms of the body chemistry of the hay fever patient. One group has argued that the symptoms are due to over acidity while another group has blamed the condition on alkalosis. Each recommends counteracting alkalies or acids. One of them must be wrong.
At the present writing, the theory that has gained favor with most, is that hay fever or any other allergic reaction is a protective one. That is, it is an attempt by the body to protect itself from the unfavorable reaction caused by the ingestion of a protein substance. This theory involves Histamine or some H-substance. It seems that the irritating pollens, or antigens as any allergic excitant is called, cause the sensitized cells (those of the shock organs) to release the H-substance for protection. But something goes wrong with the protection for it is not coordinated or properly directed and allergic symptoms appear as a result of the presence of this H-substance.
The H-substance has been shown to be able to cause blood vessels to dilate and become more permeable, permitting excess fluids to escape. This is used to explain the tearing eyes, dripping nose, skin rednesses, hives and wheals which are symptomatic of allergies. The H-substance has also been indicated as having the ability to make certain types of muscles contract. These muscles are smooth muscles which function on an involuntary basis. This action is supposed to account for the contractual spasms of the air passages which occur in asthma.
According to the theory the more irritating the substance to which one is exposed, the greater the amount of H-substance liberated. One of the flaws pointed out in this theory, is that there are known counteractants to the effect of this isolated H-substance, the application of which, has not as yet been successful in the cure of hay fever or asthma.
The last theory to which we shall give attention is that which claims hay fever to be due to a neurosis. This idea has been so popularized and so frequently dealt with by modern psychologists and psychiatrists that we shall consider it at greater length. A further consideration that impels us to review this theory in detail is the fact that the writer feels exceptionally well qualified to do so.