A system of practical medicine. By American authors. Vol. 3 — Themes and Context

in the form of a paper, "Case of a Periodical Affection of the Eyes and Chest," which he read before the Medico-Chirurgical Society in London in 1819.[2] This was a description of his own case. Nine years later he gave the details of 18 additional cases and mentioned 10 others.[3] In the second paper, having noticed that the disease as known to him, the American rose or June cold, prevailed only in the late spring and early summer, he styled it catarrhus æstivus. Rejecting the popular theory, that hay asthma is due to the emanations from hay, flowers, etc., he maintained that heat was the real cause of the disease.

[Footnote 2: _Medico-Chirurgical Transactions_, London, 1819, pp. 161-165.]

[Footnote 3: _Ibid._, London, 1828, pp. 437-446.]

It appears singular, in view of its frequency at the present time, that notwithstanding the attention which had been directed to it only 18 cases should have been collected during the nine years which intervened between the publication of the first and second articles by Bostock, and tends to prove that in those days the disease could not have been as common as at present. That this was indeed the case is rendered all the more probable by the indisputable fact that, owing to the more general education of the people and to the requirements of a so-called advanced civilization, other nervous diseases are certainly much more frequent than they were formerly. The great prevalence of hay asthma among the educated is a further proof of the correctness {211} of this conclusion. It must, however, be remembered that diagnosis did not then occupy the position it now does, and it is not unlikely that it was often overlooked or confounded with other diseases.

During the five years which succeeded the publication of Bostock's second paper no less than five treatises on hay asthma appeared in England, some of them by the most prominent medical men of that period. They are remarkable as showing the great diversity of opinion entertained at that early date as to the etiology of the disease. Thus, Macculloch[4] (1828) attributed it to the air of hot-houses and green-houses, while Gordon[5] (1829) attributed it to the flowers of grasses, particularly those of the Anthroxanthum odoratum, and suggested that grass asthma would be a more appropriate name than hay asthma.

[Footnote 4: _An Essay on the Remittent and Intermittent Diseases_, London, 1828, vol. i. pp. 394-397.]

[Footnote 5: _London Medical Gazette_, 1829, vol. iv. pp. 266-269.]

Even as late as 1859 the disease appears to have been scarcely known in Germany, for Phoebus, who has since published a most excellent work on the subject, on being consulted by a colleague suffering from hay asthma frankly confessed that he was unacquainted even with the name of the disease. This incident, and the belief that he had before him a comparatively unworked field, stimulated him to investigate the disease. By addressing circulars to the various medical societies and hospitals, not only in his native country, but also in other parts of Europe, as well as by personal interviews with patients and by publishing requests for information in the various medical journals, he collected a large number of cases and gained much valuable information concerning the disease. The results of his assiduous and painstaking labors were published in 1862 in the form of a valuable work,[6] which, although over twenty years old, is still regarded the best authority on the spring variety of hay fever.

[Footnote 6: P. Phoebus, _Der Typische Freuhsommer Katarrh_, Geissen, 1862.]

Previous to the year 1859, when Phoebus's circulars directed attention to it, hay asthma seems to have been almost unknown in France, as, with the exception of a single case by Cazenave of Bordeaux (1837), who described it as a new disease, we find previous to that date no mention of it in French literature.

The first case of hay asthma published in America, a typical one of the autumnal form of the disease, is recorded by Drake in his work, _The Principal Diseases of the Interior Valley of North America_, p. 803, published in 1854.

It will be seen by this brief summary of the history of hay asthma that the disease was first recognized in England in 1819, where in 1828 it became generally known, and that at the time of the publication of Phoebus's work (1862), with the exception of one or two isolated cases in France and the United States, England was the only country in which it was generally known and understood. Since the publication of Phoebus's valuable work numerous additions have been made to the literature of the disease, but with the limited space at my disposal I can only refer to a few of the most important that have appeared in the last two decades.