The relief obtained by resorting to an exempt locality after the attack has begun is very prompt, all symptoms of the disease disappearing within a few days after the arrival of the patient. While residing at Bethlehem, N.H., I was called one evening to see a German who had just arrived on the train from Fall River. His condition was most pitiable: his eyes were fiery red, the nose and face were terribly swollen, while the water streamed from both eyes and nose. The asthma was at its height, and his struggles for breath were fearful in the extreme. A quarter of a grain of morphia was injected into the arm, and after providing other means for his comfort I left him for the night. The next morning, while preparing to pay him an early visit, the patient himself appeared at my office, bright and cheerful, and so much changed that I at first failed to recognize him. A single night had served to dissipate all traces of his hay fever.
Unfortunately, a journey to the mountains, and a residence there of six or eight weeks, are not within the reach of every one afflicted with the disease; and for these unfortunates something must be done to relieve, or at least mitigate, their sufferings. If unable to visit any of the exempt localities, a sufferer may secure a certain degree of comfort by exposing himself as little as possible to the exciting causes of hay fever. As it is well known that heat and dust aggravate the symptoms, the windows of the apartment occupied by the patient should be so arranged as to exclude the sunlight and every precaution taken to avoid the presence of dust. He should eat good, nutritious food, avoiding the use of all stimulants, except perhaps a little light wine at dinner. Anything which induces dyspepsia must be carefully guarded against, and care taken to keep the bowels regular.
Blackley18 advises as a surer method of excluding the irritant (pollen) the hanging of a curtain of thin calico before the door and fitting into the lower portion of one of the windows a screen made of two layers of thin black muslin enclosed in a square frame. When in use both curtain and screen should be moistened with a solution of carbolic acid, ten grains of the acid to one pint of water. For those who are compelled to go out he has devised a very ingenious respirator. Having taken an exact cast of the nasal passages from the margins of the alæ and septum to the inferior turbinated bones, he constructed with the aid of these, by means of the galvano-plastic process, cases of silver fitting exactly all the folds and depressions of the cavity. Several layers of platinum wire, 0.001" to 0.007", were arranged in the cases. The sieve thus formed was moistened before using with a 1/10 per cent. solution of carbolic acid. To prevent the pollen from coming in contact with the eyes, they were protected with spectacles provided with accurately-fitting gauze guards. The result of wearing this apparatus was an almost perfect freedom from unpleasant symptoms.
18 Op. cit., p. 267.
In the absence of any specific, the medicinal treatment of hay fever is necessarily confined to palliative measures. Debility being one of the prominent symptoms, tonics are indicated, and in this way quinine, at times regarded almost as a specific, may be of use. It should be given in doses of one or two grains three times a day before and during the attack. Thus administered, it is undoubtedly of great utility in many cases. Arsenic, whether in the form of Fowler's solution or the iodide of arsenic, as suggested by Blackley, may also be used with advantage. Galvanism, which was used successfully by Hutchinson of Rhode Island, is strongly recommended by the late Beard. He advises that the negative pole be placed at the epigastrium "and the positive applied a moment over the forehead and on top of the moistened head, then over the front and back of the neck, and down the upper and middle of the spine." The current used should be mild and the sittings short. The writer has had no personal experience with this method of treatment, nor has it been generally adopted.
The injection into the nostrils of a saturated solution of quinine by Helmholtz, although apparently useful in his case, has not met with like success in the hands of others.
The troublesome itching and burning of the eyes and face are most readily relieved by bathing the parts at first in tepid and then in cold water, repeated several times a day, and with mild astringent collyria, such as a strong infusion of tea or of one or two grains of sulphate of zinc to an ounce of rosewater. If the lids be much inflamed and the skin excoriated, the following ointment may be applied:
| Rx. | Bismuth. subnit. | drachm ss; |
| Ungt. simpl. | ounce j. | |
| M. Ft. ungt. | ||
The pharyngeal symptoms are best controlled by chlorate of potassium as a gargle, or, better still, in the form of the compressed tablets now prepared by many of our druggists. The treatment of the asthmatic symptoms differs in no way from that which we have recommended for the paroxysms of [BRONCHIAL ASTHMA], the details of which were fully described in the preceding article.
In 1880, Harrison Allen of Philadelphia published an article19 directing the attention of the profession to the fact that many cases of chronic nasal catarrh which had resisted the ordinary methods of treatment could be readily cured by restoring the permeability of the nasal passages.