'Hayfeverites': Seasonal allergies as a fashionable fad
Key Takeaways
Hay fever, or allergic rhinitis, was only properly identified in the 1800s, with Dr. John Bostock presenting a study describing his own symptoms. The term "hay fever" was first used in medical literature in 1828.
Hay fever was initially associated with the middle and upper classes, with doctors connecting it to wealth, refinement, and education.
Dr. Charles Harrison Blackley's experiments in the mid-1800s connected hay fever to pollen exposure.
Today we know hay fever as a common, often frustrating allergy. But it was only properly identified in the 1800s when, bizarrely, it became seen as a trendy condition to have.
For those of us who begin sneezing as soon as summer sets in, allergic rhinitis - or hay fever as it is usually known - is most likely seen as a routine annoyance. Though, it can in the most severe cases become a detriment to everyday life.
But while it is common in the 21st Century, it has been medically understood only relatively recently - and the story of how it came to be recognized is far from ordinary.
The discovery of hay fever
Apart from a 10th Century Arabic text by the physician Rhazes, On the reasons why the heads of people swell at the time of roses and produce catarrh, it mostly escaped medical notice until 1819.[]
English physician Dr. John Bostock found himself suffering from "a periodical affection of the eyes and chest" every June for more than 20 years - all throughout his time studying at medicine in Edinburgh and working in Liverpool and London.[]
As a result, he presented a study to the Medical and Chirurgical Society called Case of a Periodical Affection of the Eyes and Chest, describing his own symptoms.[] At first the medical establishment dismissed the idea that seasonal catarrh - a general term referring to any discharge from the eyes and nose - was its own condition.[]
But the idea began to catch on, especially in the public imagination, appearing in newspaper reports every year. The term hay fever itself was first used in medical literature in 1828 and quickly became the most common way of referring to it.[]
By 1829, John Bostock had gathered 28 case studies and dubbed the condition "catarrhus aestivus" - a summer cold.[]
However, the reasons for hay fever remained a mystery for many decades. In fact, the understanding of 'allergy' - and even the word itself - was only first used in 1906.
A condition of culture
Contemporary doctors began to speculate about the possible reasons for this.
John Bostock had theorised that it was connected to moisture, heat, light or dust. However, he also noted that he had only seen cases of hay fever among "middle or upper classes of society, some indeed of high rank".[]
This became the persistent idea: hay fever was seen as a mark of superiority.
The inherent bias of doctors was mostly ignored - they were much more likely to regularly treat wealthier patients, so therefore persistent conditions were more likely to be noted in this group.
Instead, wealth, refinement and education all became linked to hay fever with certain jobs - including medicine - being thought to lead to hay fever.[] British doctor Sir Morell Mackenzie said: "Summer sneezing goes hand-in-hand with culture, we may, perhaps, infer that the higher we rise in the intellectual scale, the more is the tendency developed."[]
In the US, they took this further, with associations of hay fever sufferers forming in the 1870s.[] They became known as 'hayfeverites' and celebrated their "aristocratic disease".[]
However, the concept of hay fever as a mark of superiority became connected with contemporary racism. Most reported cases were in white British patients, leading Mackenzie to state: "National proclivity to hay fever may be taken as a proof of our superiority to other races."[] Hay fever became thought of as “one of the consequences of higher civilization".[]
In 1885, Scottish physician Dr. Andrew Clark summarized that hay fever affected "the man before the woman, the educated before the ignorant, the gentle before the rude, the courtier before the clown".[]
Identifying the cause
Similarly to Dr. Bostock, Dr. Charles Harrison Blackley, a GP in the mid-1800s, was a hay fever sufferer. He decided to figure out what was the actual cause and mechanism of catarrhus aestivus, so began experimenting on himself in 1859.[]
He methodically exposed himself to several substances thought to cause hayfever, at different times of the year, even performing controls.[] Eventually, he found that pollen seemed to be the main cause.
He went on to try 35 different types of pollen, including performing a preliminary version of patch testing on himself. In 1873, he published Experimental Researches on the Causes and Nature of Catarrhus aestivus: a book that The Lancet described as “one of the most interesting that it has been our fortune to read".[]
This discovery, combined with the discovery of allergic mechanisms in 1906, meant that the perception of allergic rhinitis as a mark of superiority slowly faded.[]
An ordinary condition?
The understanding of allergic rhinitis - and allergies in general - is still developing. It is unclear exactly why people are affected by pollen, and whether it is primarily genetic or environmental in origin.[]
There are plenty of theories; excessive hygiene making the body more vulnerable, or a steady increase in air pollution since the industrial revolution.[][]
But hay fever’s bizarre history is an important reminder of the importance of well-conducted medical research; the social ideas which surrounded it strongly impacted the way it was researched and treated.
The number of people affected by hay fever has grown drastically since 1829, when Dr. Bostock only identified 28 other cases. Instead, it affects around 16 million people each year in the UK.[] Despite being a condition identified only 200 years ago, it has seen a global rise with a predicted 400 million affected worldwide.[] It seems unlikely it will ever become 'fashionable' again, though.