Wyman is of the opinion that females are attacked later in life than males.
Without knowing the numerical proportion which the various professions and occupations bear to each other, it is impossible, even with the aid of statistics, to determine which of them is most subject to hay asthma; but the annexed table shows conclusively that those who do brain-work are much more frequently attacked than those who earn their living by manual labor:
| Wyman. | My Own. | Total. | |
| Statesmen Clergymen Jurists and lawyers Physicians and medical teachers Dentists Pharmacists School-teachers Students Military officers Authors, editors, etc. Mechanical engineers Bankers Bank officers Merchants Brokers Manufacturers Clerks Artisans Farmers and gardeners Butchers Laborers | 1 6 6 8 1 0 3 6 3 0 0 3 2 11 0 12 1 1 4 1 0 | 0 3 2 4 0 1 0 1 0 1 1 1 1 7 1 3 1 1 211 0 1 | 1 9 8 12 1 1 3 7 3 1 1 4 3 18 1 15 2 2 6 1 1 |
It will be seen by the above that of 100 cases, only 12 were engaged in outdoor pursuits, and that the remaining 88 followed occupations necessitating confinement within doors and entailing more or less intellectual effort; which proves conclusively that the earlier writers on hay asthma were correct in regarding it as a disease of the more cultured classes of society. The writer agrees with Wyman that the large increase in the number of hay-fever sufferers may in a great measure be attributed to the circumstance that many who were formerly pursuing agricultural and mechanical pursuits are now engaged in occupations which require more or less intellectual effort.
11 One of these was an amateur and highly educated.
To determine the value of temperament I have followed Beard's example, and in my circular of inquiry propounded two questions: 1st, the temperament of the patient's family; 2d, his own temperament. To the first query I obtained replies which showed that the nervous temperament predominated in 28 out of 37 cases; or, in other words, the family temperament was more or less nervous in two-thirds of the cases. As regards the patients themselves the temperament was as follows:
| My Own. | Beard. | Total. | |
| Sanguine Nervo-bilious Nervous Nervo-sanguine Nervo-lymphatic Lymphatic Sanguino-bilious Bilious Sanguino-lymphatic Bilio-lymphatic | 8 5 23 9 0 3 4 7 0 0 | 18 23 67 27 3 0 5 29 1 1 | 26 28 90 36 3 3 9 36 1 1 |
It thus appears that the nervous element predominates in no less than 157 out of 233 cases.
Other diseases do not appear to predispose to hay asthma, nor, on the other hand, is that affection a cause of any other disease. The question whether naso-pharyngeal catarrh is more common among hay-fever subjects has, after careful investigation, been decided in the negative.
Exciting Causes.—It is generally conceded that the suggestion of a large number of remedies in the treatment of a disease is good evidence that no effective curative agent has as yet been discovered. This observation regarding therapeutics equally applies to etiology, a long array of causes usually developing the fact that great uncertainty exists as to the real causative agent. Hay fever affords a most striking proof of the truth of this remark. The simple enumeration of the various agents which have been accused of causing the attacks would cover several pages. An example of the multiplicity of its supposed causes is afforded by the replies to the question in Beard's circular, "What is the cause of your attacks?" no less than thirty-three agents being accused of causing the disease. Of these I propose to confine myself to a few of the most prominent.