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.

Waite KJ. Blackley and the Development of Hay Fever as a Disease of Civilization in the Nineteenth Century, Medical History, 1995, 39: 186-196 [[PDF] (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/1F138AE7218B012E36AC55B0DF280638/S0025727300059834a.pdf/blackley-and-the-development-of-hay-fever-as-a-disease-of-civilization-in-the-nineteenth-century.pdf)].

 

 

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.

Waite KJ. Blackley and the Development of Hay Fever as a Disease of Civilization in the Nineteenth Century, Medical History, 1995, 39: 186-196 [[PDF] (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/1F138AE7218B012E36AC55B0DF280638/S0025727300059834a.pdf/blackley-and-the-development-of-hay-fever-as-a-disease-of-civilization-in-the-nineteenth-century.pdf)].

 

 

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.

BBC News. [John Bostock: The man who 'discovered' hay fever] (https://www.bbc.co.uk/news/magazine-28038630), 1 July 2014.

 

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.

Ramachandran M, Aronson JK. John Bostock's first description of hayfever, J R Soc Med  2011;104:237-240 [[full text](https://doi.org/10.1258%2Fjrsm.2010.10k056)].

 

 

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.

Waite KJ. Blackley and the Development of Hay Fever as a Disease of Civilization in the Nineteenth Century, Medical History, 1995, 39: 186-196 [[PDF] (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/1F138AE7218B012E36AC55B0DF280638/S0025727300059834a.pdf/blackley-and-the-development-of-hay-fever-as-a-disease-of-civilization-in-the-nineteenth-century.pdf)].

 

 

By 1829, John Bostock had gathered 28 case studies and dubbed the condition "catarrhus aestivus" - a summer cold.

Waite KJ. Blackley and the Development of Hay Fever as a Disease of Civilization in the Nineteenth Century, Medical History, 1995, 39: 186-196 [[PDF] (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/1F138AE7218B012E36AC55B0DF280638/S0025727300059834a.pdf/blackley-and-the-development-of-hay-fever-as-a-disease-of-civilization-in-the-nineteenth-century.pdf)].

 

 

 

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".

Waite KJ. Blackley and the Development of Hay Fever as a Disease of Civilization in the Nineteenth Century, Medical History, 1995, 39: 186-196 [[PDF] (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/1F138AE7218B012E36AC55B0DF280638/S0025727300059834a.pdf/blackley-and-the-development-of-hay-fever-as-a-disease-of-civilization-in-the-nineteenth-century.pdf)].

 

 

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.

On Health. [Allergies: Myths and Facts About Seasonal Allergies](https://www.onhealth.com/content/1/facts_seasonal_allergies_myths). Accessed 8 December 2021.

 

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."

The Guardian. [Allergies: the scourge of modern life?](https://www.theguardian.com/society/2018/oct/20/allergies-the-scourge-of-modern-living-hay-fever-ashtma-eczema-food-peanuts-dairy-eggs-penicillin) 20 October 2018.

 

 

In the US, they took this further, with associations of hay fever sufferers forming in the 1870s.

History Extra. [6 facts about the history of hay fever](https://www.historyextra.com/period/general-history/facts-history-hay-fever/), 2 July 2018.

 

They became known as 'hayfeverites' and celebrated their "aristocratic disease".

On Health. [Allergies: Myths and Facts About Seasonal Allergies](https://www.onhealth.com/content/1/facts_seasonal_allergies_myths). Accessed 8 December 2021.

 

 

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."

Waite KJ. Blackley and the Development of Hay Fever as a Disease of Civilization in the Nineteenth Century, Medical History, 1995, 39: 186-196 [[PDF] (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/1F138AE7218B012E36AC55B0DF280638/S0025727300059834a.pdf/blackley-and-the-development-of-hay-fever-as-a-disease-of-civilization-in-the-nineteenth-century.pdf)].

 

Hay fever became thought of as “one of the consequences of higher civilization".

Waite KJ. Blackley and the Development of Hay Fever as a Disease of Civilization in the Nineteenth Century, Medical History, 1995, 39: 186-196 [[PDF] (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/1F138AE7218B012E36AC55B0DF280638/S0025727300059834a.pdf/blackley-and-the-development-of-hay-fever-as-a-disease-of-civilization-in-the-nineteenth-century.pdf)].

 

 

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".

History Extra. [6 facts about the history of hay fever](https://www.historyextra.com/period/general-history/facts-history-hay-fever/), 2 July 2018.

 

 

 

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.

Waite KJ. Blackley and the Development of Hay Fever as a Disease of Civilization in the Nineteenth Century, Medical History, 1995, 39: 186-196 [[PDF] (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/1F138AE7218B012E36AC55B0DF280638/S0025727300059834a.pdf/blackley-and-the-development-of-hay-fever-as-a-disease-of-civilization-in-the-nineteenth-century.pdf)].

 

 

He methodically exposed himself to several substances thought to cause hayfever, at different times of the year, even performing controls.

Waite KJ. Blackley and the Development of Hay Fever as a Disease of Civilization in the Nineteenth Century, Medical History, 1995, 39: 186-196 [[PDF] (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/1F138AE7218B012E36AC55B0DF280638/S0025727300059834a.pdf/blackley-and-the-development-of-hay-fever-as-a-disease-of-civilization-in-the-nineteenth-century.pdf)].

 

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".

Waite KJ. Blackley and the Development of Hay Fever as a Disease of Civilization in the Nineteenth Century, Medical History, 1995, 39: 186-196 [[PDF] (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/1F138AE7218B012E36AC55B0DF280638/S0025727300059834a.pdf/blackley-and-the-development-of-hay-fever-as-a-disease-of-civilization-in-the-nineteenth-century.pdf)].

 

 

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.

The Guardian. [Allergies: the scourge of modern life?](https://www.theguardian.com/society/2018/oct/20/allergies-the-scourge-of-modern-living-hay-fever-ashtma-eczema-food-peanuts-dairy-eggs-penicillin) 20 October 2018.

 

 

 

An ordinary condition?

 

There are plenty of theories; excessive hygiene making the body more vulnerable, or a steady increase in air pollution since the industrial revolution.

BBC News. [John Bostock: The man who 'discovered' hay fever] (https://www.bbc.co.uk/news/magazine-28038630), 1 July 2014.

 

Ramachandran M, Aronson JK. John Bostock's first description of hayfever, J R Soc Med  2011;104:237-240 [[full text](https://doi.org/10.1258%2Fjrsm.2010.10k056)].

 

 

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.

Medium. [Hay Fever Was Unknown Before the 19th century](https://medium.com/illumination-curated/hay-fever-was-unknown-before-the-19th-century-4c1873c5896e), 7 April 2021.

 

Despite being a condition identified only 200 years ago, it has seen a global rise with a predicted 400 million affected worldwide.

Medium. [Hay Fever Was Unknown Before the 19th century](https://medium.com/illumination-curated/hay-fever-was-unknown-before-the-19th-century-4c1873c5896e), 7 April 2021.

 

It seems unlikely it will ever become 'fashionable' again, though.