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Allergy is the sixth leading cause of chronic illness in the United States. More than fifty million Americans suffer from allergies, and they spend an estimated $18 billion coping with them. Yet despite advances in biomedicine and enormous investment in research over the past fifty years, the burden of allergic disease continues to grow. Why have we failed to reverse this trend?
Breathing Space offers an intimate portrait of how allergic disease has shaped American culture, landscape, and life. Drawing on environmental, medical, and cultural history and the life stories of people, plants, and insects, Mitman traces how America’s changing environment from the late 1800s to the present day has led to the epidemic growth of allergic disease. We have seen a never-ending stream of solutions to combat allergies, from hay fever resorts, herbicides, and air-conditioned homes to numerous potions and pills. But, as Mitman shows, despite the quest for a magic bullet, none of the attempted solutions has succeeded. Until we address how our changing environment—physical, biological, social, and economic—has helped to create America’s allergic landscape, that hoped-for success will continue to elude us.
Hay Fever to-day is an American specialty.... In no other country does Hay Fever give so much employment or cause so much prosperity. -William Hard, 1911
August was Edwin Atkins's least favorite time of year; it was when his annual debilitating cold always appeared. But in the summer of 1869, when he was nineteen years old, the young Mr. Atkins tried something different. Some years earlier, Edwin's father, Elisha, had built a summer estate ten miles outside Boston in the newly fashionable suburb of Belmont, far removed from the stresses of city life and the mental strain of the family's thriving merchant business in the Cuban sugar and molasses trade. But the house on Wellington Hill, overlooking the nearby orchards and farms, offered Edwin little relief from the malady that was sure to arrive as the apples, pears, and other fruits ripened in the hot sun. Two months that Edwin spent largely prostrate indoors, his body overcome by a deluge of tears, throat irritations, limpid nasal fluids, and coughing spells, was more than he cared to endure again.
This year,wealth combined with yet another advantage to offer Edwin hope of escape. Edwin's father had recently been elected to the board of directors of the Union Pacific Railroad, which just three months earlier had joined its tracks with those of the Central Pacific to unite the United States' eastern and western shores. On 13 August 1869, Edwin left Boston on a Union Pacific train bound for Sacramento. Riding on the rails of a company his father helped finance and in the luxurious comfort of a Pullman car, Edwin was leaving his family, and with any luck his annual affliction, behind. As the train sped across Pennsylvania into the western parts of Indiana and on to Iowa, Edwin reported in his travel journal a slight cold in the head and throat, a typical early sign of the seasonal paroxysms and misery that would normally follow. But as the train reached the uncultivated prairies of Nebraska, the illness seemed to leave his body. He remained quite well during his two-month sojourn, at least until the journey home. As he crossed the Mississippi River on 22 September, the "unmistakable symptoms of [his] Autumnal Catarrh appeared."
Catarrh, an inflammation of the nose and throat with an increased production of mucus, can be the common cold. But autumnal catarrh is a seasonal affliction and can also be, as Edwin discovered, subject to regional effects. Endemic to some regions, absent in others, the disease that plagued Edwin each summer and fall appeared mysteriously linked to geography and place. To the average tourist speeding across the continent, changes in altitude and temperature, soil type and vegetation, or sunlight and dust were of little consequence. But to Edwin, they were prominent features of the landscape and somehow tied to his health. He was, in the words of the nineteenth-century Boston physician Morrill Wyman, a catarrhoscope, with a body so sensitive as to detect even slight seasonal-and, as Edwin discovered, locational-changes. Edwin didn't know exactly why his body reacted so vehemently when he crossed the Mississippi. But he did know that if he continued traveling directly east, the symptoms of his catarrh would become more severe. He changed his route, booking a ticket on the Great Western Railway of Canada, and headed north in hopes of skirting around the region where he knew sickness would prevail. The invigorating air of the northern Great Lakes region offered the palliative Edwin sought. He arrived in Boston on 25 September, having suffered but one sharp attack of the catarrh. All in all, it had been a most successful hay fever holiday.
Edwin's travels were the beginning of a fashionable trend. By the 1880s, hay fever had become the pride of America's leisure class and the basis for a substantial tourist economy that catered to a culture of escape. For example, the Reverend Henry Ward Beecher, "archbishop of American Liberal Protestantism"-whom Sinclair Lewis once described as a combination of St. Augustine, Barnum, and John Barrymore-found the White Mountains of New Hampshire to be an ideal retreat. His summer cold plagued him each year with such regularity that he was able to time his six-week vacation away from Brooklyn and his congregation at Plymouth Church by it. "I have never spent a summer in the city, and shall never, if I can help myself," boasted Beecher. "I had rather have 'Hay Fever,'" he said, finding the illness a convenient excuse for his need to escape. Another sufferer, Henry W. King, Chicago's most prominent wholesale and retail clothing merchant, found Mackinac Island, located in the straits where Lake Michigan and Lake Huron meet, a "delightful place of summer resort." It also offered immunity from the "peculiar disease" that visited him each August.
Seeking refuge from the watery eyes, flowing nose, sneezing fits, and asthma attacks that appeared with the "regularity of a previously calculated eclipse," these "accomplished tourists" also sought a holiday from the "desk, the pulpit, and the counting room" of the city. Many physicians believed a nervous predisposition to be a necessary precondition for the development of the ailment, and it was thought that in urban spaces, just such a nervous tendency prevailed. Hay fever, in the opinion of American physician George Beard, was a functional nervous disease that bore a close relation to the much-celebrated American malady Beard did much to promote in the late nineteenth century: neurasthenia-that is, nervous exhaustion. In his widely popular 1881 book, American Nervousness, Beard pointed to modern civilization, and particularly American civilization, as the source of nervous exhaustion, which included among its many symptoms sensitivity to climatic change and "special idiosyncrasies in regard to food, medicines, and external irritants." An extremely sensitive nervous system, coupled with the depressing influences of heat, Beard believed, made a particular class of individuals susceptible during the dog days of summer to a host of external irritants, including dust, sunlight, and plant pollens. In the absence of effective drugs, removing oneself from the cause to a so-called exempt place became the preferred remedy among the country's afflicted bourgeoisie.
Hay fever holidays enjoyed by America's well-to-do were part of an expanding nineteenth-century tourist trade. Leisure had become both a popular pastime and a marketable commodity after the Civil War. And, as noted in the introduction, hay fever began as an illness that only the wealthy could afford to treat. In the White Mountains of New Hampshire and along the northern shores of Lake Michigan, as well as many other places, hay fever catalyzed a lucrative recreational and tourist industry patronized largely by wealthy urbanites. In leisure and nature, not to mention the pleasantries of fine society on holiday, they sought an antidote to the hustle and bustle of the city that left their minds and bodies fatigued and susceptible to this modern malady. By the late nineteenth century, the forests of Michigan, New Hampshire, and other regions had been heavily logged and were largely exhausted. It would take a disease to bring new life to these worn lands. Hay fever tourism not only reinvigorated weary bodies and landscapes but also reinvented nature into an economic resource for health and pleasure. Like axe and plow, hay fever left a mark upon the landscape, visible to this day.
Hay fever first became medically prominent, not in America, but in Great Britain. In 1819, Dr. John Bostock delivered a paper to the London Medico-Chirurgical Society, describing his own condition of a catarrhal inflammation of the eyes and chest that appeared regularly each year during the early summer season. After reporting on twenty-eight additional cases and spending nine more miserable summers, Bostock in 1828 named the disease "Catarrhus Aestivus," or "Summer Catarrh." Other physicians in England, France, Germany, and Switzerland began to report similar cases, in which they or their patients suffered symptoms resembling those of catarrh or the more debilitating effects of wheezing associated with asthma during particular times of year. By the 1860s, "hay fever" or "hay asthma" had become a commonplace term used to describe the recurrent symptoms of swollen eyes, frequent sneezing, and laborious breathing most noticeable in England and other European countries during the hay-making season.
The type of individual affected by this strange new malady was anything but ordinary. The Manchester physician Charles H. Blackley observed in his seminal 1873 treatise on hay fever that among his hay fever patients the overwhelming majority were clergy and doctors. Many physicians shared Blackley's opinion that hay fever was an "aristocratic disease"; if it was not "almost wholly confined to the upper classes of society, it was rarely, if ever, met with but among the educated." Nineteenth-century doctors theorized that among the wealthy and educated, a nervous temperament prevailed, "fostered and perpetuated with the progress of civilization and with the advance of culture and refinement." Its effects could be observed especially among the "brain-working population" in a host of disorders including dyspepsia, neuralgia, insomnia, and nervous exhaustion. Hay fever was yet another "condition of the nervous system which mental training generates."
Why had hay fever, unknown prior to the nineteenth century, become more common? Blackley turned to the economic and environmental history of Great Britain to account for its apparent rise among urban professionals. Before the Industrial Revolution, he argued, a large portion of the population in England was exposed to the atmospheric conditions of country life, either through the cultivation of the soil or the production of woolen, linen, and cotton goods, largely in rural villages and towns. As England's population increased, large numbers of people moved from the "country to the workshops and mills of towns." In doing so, they removed themselves from pollen and other exacerbating factors to which agricultural laborers were continually exposed. At the same time, the influx of population into the cities, where greater educational opportunities, wealth, and luxury prevailed, created circumstances "favorable to the development of the pre-disposition to hay fever." The frenzied pace of urban life, the mental demands of modern business, and the removal from nature, which could fortify the body and calm the hurried mind, had strained the nervous systems of the city's educated and well-to-do classes. "As population increases and as civilization and education advance," Blackley warned, hay fever "will become more common."
In the United States too the increasing differentiation-physical and social-between urban and rural life created conditions in which hay fever flourished. Morrell Mackenzie, a physician at the London Hospital in the late 1800s, may have prided himself that the "national proclivity to hay fever" in Britain offered "proof of our superiority to other races." But by the 1870s physicians and sufferers in the United States were making similar claims. Hay fever, political journalist William Hard boasted, had become an "American specialty ... the English compete with us no longer." "In no other country are summer resorts built up on Hay Fever patronage," remarked this hay fever sufferer and friend of Theodore Roosevelt. "In no other country is the Hay Fever travel toward certain regions so thick that railways serving those regions might well enter Hay Fever with the Interstate Commerce Commission as the basis for part of their capitalization. In no other country does Hay Fever give so much employment or cause so much prosperity. It has come to deserve to be a plank in the national platform of the Republican party."
Like many hay fever sufferers, Hard employed humor and hyperbole to great effect. But his claims were not completely facetious. Although hay fever never became the center of Republican politics, it did find a place in Whig Party affairs. Daniel Webster, prominent Massachusetts senator, Whig Party leader, and twice secretary of state, was the most celebrated hay fever sufferer in nineteenth-century America. Webster dated his first attack to 1832, when he was fifty years old. His annual cold commenced about 23 August, accompanied by fits of sneezing and profuse discharges from the nose. On 15 August 1849, he wrote, "In seven days I shall begin to sneeze and blow my nose; and the first week the catarrh is usually most severe." His eyes became progressively swollen, preventing him from reading and limiting the stroke of his pen to signatures. By the middle of September, Webster's disease would move into its last recognizable stage-asthmatic. In the fall of 1850, Webster wrote to President Millard Fillmore that given the "annual occurrence of his illness" and his long absences from Washington, perhaps he ought to consider himself unfit for the holding of public office. Two years later, Webster resigned his post as secretary of state for health reasons.
One of the nation's most highly paid lawyers, branded by his political adversaries as a friend of the rich, Webster adopted a lifestyle in keeping with those of his clients and political supporters. Hay fever was another bond that linked him to America's leisure class. Like his British counterparts, Webster found the "bracing air of the ocean beneficial" in offering at least partial respite from his annual symptoms. Fleeing the heat and mental strain of the nation's capital, Webster often retired in summer to his eighteen-hundred-acre coastal estate in Marshfield, Massachusetts, eleven miles north of Plymouth. The severity of the hay fever season at Webster's farm depended greatly upon the weather. A northwesterly wind blowing across the land and out to sea spelled misery. But a day on the ocean aboard one of his seven yachts, when he fished for cod or haddock or shot coots near shore, replenished Webster's worn nerves and fortified his body against an attack that would leave him depressed and fatigued. Webster's friend Samuel Lyman remarked how a morning of outdoor sport at the Marshfield retreat did more to "repair the inroads upon one's health, made by too much application to books, business, or mental labor ... than by the idle monotony of a dozen days spent at Saratoga, or any other mere watering place." According to Lyman, the rigors of outdoor life, for which Webster, who had grown up on a New Hampshire farm, had acquired a fondness, had transformed the once frail and sickly child into a man with a robust constitution. Not surprisingly, Webster turned to outdoor recreation in nature as a tonic to strengthen him against his enfeebling seasonal disease.
Excerpted from Breathing Space by GREGG MITMAN Copyright © 2007 by Gregg Mitman. Excerpted by permission.
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