I have no personal experience with the vaccines in the treatment of hay fever, though I know their value in ordinary catarrhal conditions. As remarked in the chapter on Pollens, I have succeeded with the milder methods of rosin-weed, faradism and ichthyol. However, bacterial vaccines are much safer than pollen extracts, the technique of their use is not as complicated and they are well worthy of trial in refractory cases if bacteria are demonstrated in the eyes and nose. I might remark here that this demonstration will seldom fail; for you can get a culture of the staphylococcus from almost any nose.
The Word Vaccine. Used in connection with the treatment of hay fever, the word vaccine is confusing, for it has been applied to two totally different kinds of medicine, the bacterial vaccines and the pollen extracts. Physicians intending to use vaccines in the treatment of hay fever should make sure which they are using; for the methods and dosage of the one are quite different from those of the other. Sir Almroth Wright, to whom the whole world is indebted for his work in preventive medicine, started the trouble by calling his killed bacteria vaccines, having in mind the prevention of bacterial diseases as the familiar vaccine prevented small-pox. Now, vacca is Latin for cow, vaccinia is properly cow-pox and the virus of cow-pox that we use in vaccination against small-pox is properly called vaccine. With a paucity of vocabulary unexpected in an Irishman, Wright called his killed bacteria vaccines because he used them to prevent disease, using the word as synonymous with preventive. As cow-pox vaccine is the greatest preventive we know, the word vaccine might be justified when applied to the bacterial cultures or to the pollens or to any preventative of disease. But when you leave pure prevention and apply these remedies to the cure of disease, the word vaccine loses even this shadow of justification and the present confusion results. One American house makes a laudable attempt at a more exact terminology by calling the killed cultures of bacteria bacterins. Still, the word vaccine for killed bacterial cultures has been advertised so deeply into the medical mind that it is firmly rooted there and not likely to be disturbed by mere considerations of etymology. As for the pollen extracts, they are yet young and impressionable. It would be better to leave off the word vaccine as applied to them and call them what they are, pollen extracts.
CHAPTER XIII
DIET
Until recently, diet in hay fever was a matter of avoiding meat and strawberries and the result was usually unsatisfactory. With the conception of hay fever as an anaphylaxis and the recent studies in food anaphylaxis, the subject of diet in hay fever assumes a new and inviting aspect.
This new view of diet in hay fever begins with Schloss's masterly study of a case of food anaphylaxis reported in the American Journal on Diseases of Children, 1912, No. 6. A good review of the subject with references to the literature will be found in the special Hay Fever and Anaphylaxis number of the Boston Medical and Surgical Journal, August 10, 1916, especially the article by Talbot.
Some physicians have long insisted that they could relieve hay fever by diet. For instance, I once asked a physician of large general practice what he did for hay fever. He smiled in an incredulous way that I have noticed before among people who never had hay fever and replied, "I find that if people will stop eating strawberries and not eat too much meat, they soon get rid of their hay fever." This answer surprised me for I knew that in his long practice, he must have seen many cases of hay fever and my experience had been that diet had no influence on the symptoms.
Then, there is Professor Dunn, already quoted in Chapter IX, who believes in the uric acid theory and says that, in his opinion, "hay fever is the result of improper eating and living." He has been able to prevent the annual attacks by using cold baths and excluding meat, tea, coffee and alcohol from the diet.
Any patient who can get rid of the annoying symptoms of hay fever by such simple means of diet and bathing should be urged to try it, whether he believes or disbelieves in the "uric acid poisoning" on which the treatment is based. My own experience leads me to believe that most hay fever patients require something more than dietary regulation to control the disease. For instance, in my own case, the disease appeared at an age when I had never taken tea, coffee or alcohol, during the summer vacation when I was living a hygienic out-door life, playing ball, cycling and swimming every day in the salt water. I remember one summer in camp by a lake among the pines, in which I lived Dr. Dunn's hygienic life for many weeks, drinking no tea, coffee or alcohol, eating chiefly fresh fish and green vegetables and swimming daily. My experience can be paralleled by many hay fever patients that as long as I remained among the pines, I was in perfect health but on going down into the valley, one breath of fragrant wind blowing over the fields would cause instant itching and swelling of eyes and nose and all the previous hygienic life up at the lake was no protection against the disorder. I have seen the hereditary form develop in three children of one family while they were at the seashore, bathing daily in salt water and living a care-free, active, out-door life, never taking tea, coffee or alcohol and not much meat.