latter period, and it is quite exceptional that one individual is afflicted during both periods.
The first attack usually begins near the age of puberty and then recurs every year with such regularity that patients are able to forecast quite accurately the date of their coming illness. The duration of the sickness is approximately six weeks.
The symptoms are those of a catarrhal condition of the mucous membrane of the eyes, nose, pharynx and often of the trachea and bronchi. After a preliminary period of one to two weeks, during which there is a moderate irritation of the eyes and nose, associated with a slight discharge, the disease may reach its maximum within a few days or even hours. At this time the eyes are reddened and swollen, and tear secretion is abundant; the nasal mucous membranes are swollen and injected, causing a copious, watery discharge. In addition there are violent, explosive fits of sneezing together with an intolerable itching, and later a soreness of the nose and the eyes. Subsequently nasal breathing becomes impossible and mouth breathing is necessary. Then irritation symptoms of the larynx, trachea and bronchi develop as shown by attacks of coughing. The lung symptoms vary between a mild bronchitis and a severe asthma.
All these symptoms which make life a burden to the hayfever sufferer are caused by the inhalation of certain pollens. As early as 1831 Elliotson advanced this opinion, and later experimental researches by Blackley and especially by Dunbar placed the theory on a safe footing. Dunbar proved that the albumen fraction of certain pollens was the toxic agent by injecting or instilling this substance in predisposed individuals; under proper conditions the typical symptoms were always obtained. The reaction was specific; thus autumn catarrh patients responded typically to the proteids obtained from ragweed and goldenrod, but showed no effect when the pollen proteid of graminaceous plants was used.
Hayfever patients therefore have acquired in some fashion or another a hypersentiveness to the albumin constituent of certain pollens. When plants bearing these pollens are in bloom, the pollen is distributed by the wind, and when inhaled by susceptible individuals, the typical consequences follow. The specificity of the sensitization explains why some suffer in the spring, when pollen from the flowering grasses is in the air, while others suffer in autumn when golden-rod and ragweed distribute their pollen.
Dunbar has produced a therapeutic serum by inoculating horses with the chief pollen proteids which come into consideration. This pollantin has yielded good results when used prophylactically.
Drug Idiosyncrasies.—There are numerous individuals who react with more or less severe symptoms to drugs which cause no obvious effects in the large majority of people. Among these drugs morphine,
