There is perhaps no disease in which there has been more speculation
concerning the etiology than in hay fever, and while osteopathy has
accomplished a wonderful advance in the treatment of this disease, I am
not sure that the cause or causes are yet thoroughly understood.
=Etiology.=—The theoretic causes of this disease may be expressed in
the various names which have been given to it as follows: The term Hay
Fever suggests that it is a febrile condition caused by hay pollen
irritation. Peach cold, Rose cold, Rose fever, Rose catarrh, Rye fever
and Ragweed fever suggest similar specific causes. Idiosyncratic coryza
means nothing and this probably expresses what the theorists know about
its cause better than any other name. Hysteric rhinitis suggests a
probable psychic cause, which certainly does exist in some cases. If I
may be pardoned, and I know I never will be, let me suggest just one
more name—“Respiratory Reflex Inefficiency.”
=Intoxications.=—Auto-intoxication from focal infections or from
gastro-intestinal perversions certainly have an important influence
either directly or as predisposing factors and should always be
carefully considered in treatment.
=Osteopathic Lesions.=—Osteopathic lesions, such as interosseous,
muscular and ligamentous, seem to function as predisposing causes by
their general effects upon the system. It seems probable that their
effects upon the organs of metabolism and elimination are of greater
importance than any direct or specific effect in causing the immediate
symptoms. In practically all cases lesions of the upper thoracic
vertebræ and ribs and of the cervical region are present. It is my
opinion that such lesions are more often secondary than primary.
=Respiratory Reflex Inefficiency.=—Measurement of nerve force in these
cases shows that none are really possessed with “an excess of nerve
force,” but that practically all vary from two-thirds to four-fifths
normal, showing that probably all cases are deficient in nerve force.
This instability of the nervous system can be explained, I believe, in
the theory of peripheral reflex insufficiency. As evidence of this the
following facts may be cited:
1. It is known that peripheral irritation of almost any nature, to the
mucous membranes of the nasopharyngeal tract, will excite an attack in
susceptible individuals.
2. That any treatment which tends to increase the resistance of these
membranes will prevent or relieve an attack.
3. That peripheral inhibition to these surfaces will temporarily
relieve an attack.
4. That complete normalization of these membranes will make the patient
resistive to the so-called specific irritants, such as pollen, dust,
etc.
5. That the mucous membranes of the entire respiratory and
gastro-intestinal tract react to irritants to bring about “the hay
fever state” and that any treatment which tends to normalize these
membranes, renders the patient more resistive to hay fever attacks.
=Exciting Causes.=—There is no doubt that various air-borne irritants,
such as pollen, dust, chemical fumes, emanations from animals, etc.,
act as exciting causes of acute attacks, and yet there are cases that
develop acute attacks out of season or at a time when it seems that
there could be no air-borne irritation. From evidence which will be
offered later (see prognosis) I am led to believe that probably all
susceptible cases can be made entirely resistive to the air-borne
irritants.