THE INFLUENCE OF CLIMATIC CONDITIONS UPON HAY-FEVER.

BY J. HENRY HALLOCK, M.D., SARANAC LAKE, N. Y.

Whether a better name than hay fever can be given to the disease which is now known to be largely a neurosis, I will not argue. All sorts of names and many kinds of treatment are proposed. Some still believe it is entirely due to some abnormality in the nasal organ, and in support of this we have all seen brilliant results after removing some exostosis or cauterizing some nerve ending. Then again we have obtained these results by sprays, etc., to the nasal mucous membrane, and we were inclined to herald a great discovery, but as a specialist in respiratory diseases, and coming in contact with a large number, I am frequently forced to admit that the results of treament are far from satisfactory; and as the annual time arrives for the patient to expect its appearance we think of a change of climate, and rightly too, for most cases are entirely relieved by a change, and it is not always necessary to send our patients far from home. I have known a change of a few miles to do all that was desired. Then again it may be necessary to make a number of trials before the right place is discovered, but after once finding it, a few weeks spent there each year may entirely ward off an attack.

There are plenty of people who annually visit our Adirondacks for the relief of hay fever or asthma, and it is seldom that one is disappointed Patients frequently move to the place that gives them relief, and frequently find that after eight or ten years they have worn out" the climate and must suffer as before or move on.

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This could easily happen in a disease having such a neurotic habit as to have been excited by an artificial rose, or, as in one of Mackenzie's patients, by gazing upon a picture of a field of hay. Hay fever seems to be prevalent throughout all the United States, with the exception of a few elevated regions. The Adirondacks are exceptionally free from the disease. During a residence of ten years in these mountains I have not met with a case among the natives or old residents here, but have known several who, for eight or nine years after moving here, having been entirely free from all symptoms of the disease, gradually lapse back into their old habits. Perhaps this more frequently happens in asthma than in hay fever. This change of climate which usually gives the patient complete relief as long as he remains, is not often curative, for the disease often returns as before if he moves back to his old home. Just how this change of climate brings relief, or why one climate produces hay fever and another does not, I have never been able to answer satisfactorily.

The different kinds of pollen may be less numerous in some places than others, but our mountains are covered with golden rod and other weeds and grasses the pollen of which is supposed to be a causative factor. The effect and tonic action of a pure and ozone-ladened air must be one agent; the effect upon the mind in going to a place unanimously heralded as a panacea is, certainly, an aid. We often see this illustrated in our tubercular patients.

For weeks before leaving home they may have been barely able to walk about the house, but on arriving at Saranac Lake, they at once feel so good that they decide to put off seeing their physician and are seized with the desire to benefit by using their newly acquired strength by long and fatiguing walks, all the while congratulating themselves upon their sudden recovery(?). Of course this is purely mental and is usually paid for by a sickness in bed, but the hay fever patient being well, aside from his malady, may use his new strength as he sees fit without danger of relapse, and when his resources will permit there is no treatment like this change to give him entire relief after the attack is established, or to prevent its recurrence.

HINTS FOR MEDICAL TREATMENT OF HAY FEVER. BY WILLIAM K. KNOWLES, M.D.

The list of medicines recommended for the homoeopathic treatment of hay fever is not extensive, only some fifty in number.

As this is the season of the year when this affliction prevails, the indications for the use of these remedies are briefly given, in the hope that they may prove helpful to some physician who may be called upon to give relief for this distressing malady.

Ailanthus glandulosa.-Eyes feel irritated as from wind or dust. Burning and smarting. Lachrymation in the open air, or in bright light. Eyes affected by light. Conjunctivitis, which may be accompanied with purulent discharge. From nose a copious, thin, ichorous discharge without fetor. Nostrils raw, nose and upper lip covered with scabs. Sneezing, loss of smell; lips cracked. Thick, whitish coat on tongue. The throat may be affected; dry choky feeling, redness, soreness. Severe or dull frontal headache, confusion, mental labor difficult or impossible. There may be asthmatic respira-, tion with aching and soreness in lungs. Tired feeling in lungs making it an effort to breathe. Aggravation in evening or at night.

Ambrosia artemisiaefolia.-(Ragweed). It is to be regretted

that there is so slight a proving of this remedy, for it would doubtless be of great service in the treatment of this disease if we knew just when it was indicated. It has been prescribed empirically with good success in some cases. Professor Dunbar of Hamburg, Germany, and others in Europe and this country. have been experimenting with an antitoxin made by passing an extract prepared from the pollen of ragweed and other plants, grains and grasses, through the horse. It is claimed that a number of cases have been successfully treated with this antitoxin. How much easier and better to take this pollen and potentize it in accordance with the Homœopathic Pharmacopeia! Then if properly proven it might be a most useful remedy.

Aralia racemosa.-Frequent sneezing; copious, watery, acrid discharge, excoriating nasal passages; smarting soreness of the nostrils; suffocative catarrh with extreme sensitiveness to a draught, sneezing from the least current of air; dry, wheezing breathing, worse when lying down. Hay fever with asthmatic attacks and whistling respiration; must sit up.

Arsenicum.-Frequently prescribed. Thin, watery, excoriating discharge from nose; sneezing without relief. When characteristic symptoms of arsenic are present.

Arsenicum iodide. Often gives better results than the white arsenic. Symptoms similar but without the characteristic thirst and fear of death.

Arundo mauritanica.-An unproved remedy, but it has been used with benefit in some cases. Sneezing, burning and itching of the palate and thirst are said to be prominent symptoms. Pain at root of nose, coryza, excoriating discharge.

Arum triphyllum.-Burning, ichorus, watery discharge from nose, excoriating nose and upper lip. Nose obstructed; smarting of eyes; aversion to light; asthmatic breathing. Agg. at night after lying down.

Arum maculatum.-Action similar to A. triphyllum, but it may be useful where the mucous surfaces of nose and throat are less severely affected.

Camphor.-Fluent coryza; nose obstructed; frequent chilli

ness.

Cuprum met.-Nose stopped up, yet there is sometimes fluent coryza, with pain in the frontal sinuses, lachrymation and smarting of eyes.

Cyclamen.-Frequent sneezing, with profuse discharge from nose, diminished smell and taste; pressing pains over nasal bones; itching in ears and much ear wax.

Dulcamara.-Nostrils entirely filled up, preventing breathing; constant sneezing; profuse discharge from nose and eyes, worse in open air, better in closed room. Agg. on awaking and in evening, from cut grass or new mown hay.

Euphorbium.-Sneezing, cough, chilliness and heat alternating; inflamed eyes, agglutinated at night; dryness of mouth and throat; oppression of chest; dry, deep, hollow, hoarse cough, with irritation of larynx; general prostration. Agg. from draught of air or dust.

Euphrasia.-Profuse coryza with smarting, lachrymation and photophobia; flow of acrid tears, discharge from nose mild. Ferrum phos.-A case reported cured of an anæmic young woman who had menstrual troubles, prostration and great dryness of nose and throat. Had almost constant sneezing from a violent itching sensation in the nasal passages which could not be controlled by local treatment.

Gelsemium.-At the beginning. Violent sneezing in the morning. Pharyngeal inflammation with pain on swallowing, shooting up into the ear. Disposition to catch cold with every change of weather.

Grindelia.-Unproven, but has frequently been used with good results, particularly in the asthmatic form. There may be a large accumulation of mucus, tenacious and hard to detach; when it can be raised it brings relief. Fears to go to sleep on account of loss of breath, which awakens him.

Hecla lava. Asthmatic form; oppressed breathing, with sensation as if there were a heavy weight lying on the chest. Agg. when walking through the woods and fields.

Hydrocyanic acid. In asthmatic form where the small bronchial tubes are affected, with puffy face and feeble or violent heart's action; voient attacks of spasmodic suffocative cough with involuntary urination.

Ipecac. When the characteristic symptoms of this remedy are present.

Iodium.-Obstructive coryza, becoming fluent in open air; discharge hot, watery,-sudden, violent, with much sneezing, lachrymation, pain in eyes, then violent cough, difficult respira

tion.

Kali bichromicum.-Sneezing, acrid, fluent discharge, excoriating the mucous membrane from nostrils to throat; this usually soon changes to the tough, tenacious form characteristic of this remedy. There may be wheezing cough, worse from eating and drinking, expectoration of tough, stringy mucus.

Kali iod.-Frequent and prolonged sneezing in morning on rising. Profuse, acrid, watery, excoriating discharge; swelling and redness of nose and eyelids; acrid tears; right and left nostril occluded alternately. Laryngitis, conjunctivitis, cedema of lids, dyspnoea; aching pain between the eyes; violent, suffocative cough.

Kola.-One case has been reported wherein this gave great relief. A doctor who was subject to a violent attack every year, obliging him to leave his business for a month or more,

and go to some place where he could escape it, received so much benefit from the use of this remedy that he was able to stay at home and attend to his practice.

Lachesis.-Nash claims to have had good results from this in cases where there was aggravation, particularly of sneezing, after sleep.

Lobelia.-Asthmatic form with great oppression of the chest. Derangement of the stomach, with a feeling of weakness, or a lump at pit. Constant dyspnea; agg. from the slightest exposure to cold, and from eating.

Mercurius or Merc. cor.-When the characteristic symptoms are present.

Moschus. Attacks of sudden dyspnoea; great collection of mucus, rattling, difficult to expel. Suffocative constriction of

chest, palpitation, great anxiety.

Naja tripudians.-Hay fever, flow of water from the nose, followed by intense sneezing; later feeling of dryness of lungs and great difficulty of breathing, especially when lying down. Suffocative spells after sleeping (Lach).

Naphthalin.-Allen says: "It has been found a valuable remedy for hay fever, many inveterate cases seeming to have been entirely arrested; sneezing, eyes inflamed and painful, head hot; also spasmodic bronchitis and asthma, worse in open air, with soreness in chest and stomach; bloated feeling in stomach, has to loosen clothing." It has been used with some success as a prophylactic.

Natrum carb.--Violent sneezing, profuse discharge of thin, white mucus; worse from the least exposure to air or when removing an article of clothing; discharge through day, stoppage at night. Disposition to catch cold.

Natrum mur.-Hay fever with watery discharge from eyes and nose. Least exposure to sun brings on attack.

Phosphorus. Characteristic symptoms.

Psorinum.-Raue recommends where there is a constitutional taint; the attacks sometimes alternate with eczema.

Pulsatilla. Sometimes indicated.

Ranunculus bulb.-Hay fever with smarting and burning in the eyes, nose stuffed; tingling and crawling in the nostril which the patient cannot remove.

Rhus tor.-Spasmodic sneezing; it lasts all night; tip of nose red and sensitive. Characteristic rhus symptoms. Rosa damascena.-(Rose.) "In the beginning when the eustachian tube is involved, with hardness of hearing and tinintus aurium." Raue.

Sabadilla.-Hay fever with violent spasmodic sneezing; itching and irritation in nose; copious watery discharge from nose and eyes; severe frontal headache.

Sanguinaria can.-Frequent sneezing; watery, acrid dis