All About Allergies: Everything You Need to Know About Asthma, Food Allergies, Hay Fever, and More

PART ONE

THE BACKGROUND

CHAPTER 1

THE HISTORY OF ALLERGIES

— Titus Lucretius Carus (circa 98-55 BC), De Rerum Natura

When I helped my dad start Dr. Rubin's Mini Medical School, geared toward high school students, he and I created a curriculum that started with the history of medicine. My dad felt that even though many medical schools do not routinely teach the history of medicine, it is crucial to understand where medicine came from so that we have a better understanding of where we go from here. When I was growing up, when my family went on trips outside Illinois, he would take us to medical history museums if they were nearby. I became fascinated with how medicine has evolved so quickly. For example, the first recorded vaccine was given on May 14, 1796, by Edward Jenner to James Phipps, an eight-year-old boy, to protect against smallpox. That was less than 250 years ago!

Allergic diseases are nothing new—they have been around for thousands of years. However, over the past several decades, there has been a dramatic increase in the number of people suffering from these diseases. It is not clear why this is happening. While many people believe these diseases did not exist in the past, there is ample evidence that people have suffered from several conditions, such as food allergies and asthma, since antiquity.

Throughout history, allergies have puzzled and afflicted humanity, shaping our daily lives in ways that are often overlooked. This chapter will focus on the evolution of our understanding of allergies throughout time across the globe. Important historical figures in the field of allergy and immunology will be covered as well. I hope this chapter will spark a curiosity in you that will excite you to learn more about allergic diseases.

ALLERGIES DURING ANCIENT TIMES

The earliest writings in human history are found in ancient Mesopotamia, the area between the rivers Euphrates and Tigris, which is in modern-day Iraq. The Mesopotamians developed a writing system called cuneiform around 3200 BC. They had writings about breathing: When the patient suffers from cough, he should drink a mixture of Lolium and rose powder dissolved in oil and honey. Afterwards he should eat a broth of pork meat. When he has to defecate, a fire should be lighted where he should direct his anus. Then he will be cured.

Some of the earliest physicians documented in human history came from ancient Egypt. The first is usually considered to be Imhotep during the 3rd dynasty at around 2600 BC. Two hundred years later, Ni-Ankh-Sekhmet was a physician to King Sahura during the 5th dynasty and is considered to be the first documented allergist. There is a stone at the tomb of the Pharaoh with the inscription "he cured the noses of the kings." One of the oldest Egyptian medical texts, the Papyrus Ebers, was written around 1550 BC and contains twenty-one prescriptions for cough or difficulty breathing (i.e., dyspnea). Some of the ingredients listed include honey, dates, incense, juniper, and beer. A lot of the treatments described may have been used to treat asthma. Honey has been proven to help relieve a cough, but most of these remedies were ineffective for asthma treatment.

Ancient Chinese medicine used various plants to treat airway diseases, including wolfsbane and jimsonweed. A text titled Su Wen (meaning "Open Questions") discussed through dialogue between the Yellow Emperor Huangdi and his minister Qi Po a disease that may have been asthma. One passage described how it was helpful to "avoid eating and drinking cold things and one should not wear chilly clothing." We know today that one of the most common triggers for asthma symptoms is cold temperatures. One of the earliest descriptions of food allergy came from China. In the text Shi Jin-Jing (meaning "Interdictions Concerning Food"), the Chinese emperors Shen Nong and Huangdi advised pregnant women to avoid foods such as shrimp and meat. Individuals with certain skin lesions that may have been eczema were also advised to avoid certain foods. One of the earliest descriptions of urticaria, also known as hives, is more than two thousand years old and comes from China, where it was referred to as Feng Yin Zheng (wind-type concealed rash), which is similar to one of today's traditional Chinese medical terms, Feng Sao Yin Zhen (wind itch concealed rash). Wind in traditional Chinese medicine is considered to be a major factor for developing urticaria, so other names for urticaria are Feng Zhen Kuai (wind rash lumps) and Feng Zhen (wind rash).