Each case of hay fever some symptoms in common, but not every case present the same grouping of symptoms, or all of the symptoms, that go to make up the classical hay fever syndrome. Almost every case presents some atypical symptoms or concomitants that individualize the case to a degree never considered in the textbook delineations.
There is always a hypersensitive state of some one or more of the mucous surfaces: eyes, ears, nose, nose, roof of mouth, uvula, tongue, throat, bronchi. This irritability usually manifests itself in congestion, inflammation, itching, and normally in increased mucous secretions. Occasionally we find the surfaces dry and burning with the congestion, especially if sprays or other local applications of a suppressive nature have been used.
This hypersensitivity is always potential in certain individuals, but it is detonated, as it were, by combinations of predisposing circumstances, such as irritating substances plus favorable thermic, atmospheric and seasonal conditions. Hay fever belongs to the class of so-called allergic diseases, which manifest local symptoms of the disturbed equilibrium of health apparently as the direct result of contact with these irritating substances, such as certain pollen, odors, foods, etc.
Theses allergic conditions are often regarded as local or restricted manifestations, and their popular treatment if frequently based on the assumption that suppression of the annoying symptoms (which are largely localized) will cure the condition. Careful analysis of hay fever cases who have undergone a series of suppressive treatment of any nature demonstrates that this form of treatment never cures, although it may seemingly clear the annoying symptoms.
The condition is merely driven from the surface manifestation to deeper and more profound action upon the constitution. Ephedrine and narcotic applications to the mucous surfaces tend to lessen the congestion by drying and shrinking the parts, but the patient is fortunate if the result is only that of adding to the local discomfort.
Another popular method of treating these conditions is by inoculation. This method at least recognizes that the local manifestations are to some extent the outcropping of a constitutional condition, and the method of treatment is a crude imitation of homoeopathic methods. However, these patients, if observed over a period of a few years, almost invariably develop pathology of grave type of deep-seated dysfunction.
Considerable numbers of people suffer annually form hay fever and other allergic conditions, but we do not find that a majority of the people in any given community suffer from hay fever, and certainly not at the same time. Although all are subjected to the same air-borne pollens, only a comparatively small percentage of the community suffers from the same irritating substance. In other words, susceptibility is present in a certain percentage of individuals, while in the majority of people there is an immunity against these irritating substances.
Let us ask ourselves why some individuals are immune while others are extremely susceptible. It is true that we occasionally find the hay fever picture actively exhibited in an otherwise apparently healthy person, but upon inquiry we are often able to trace the course of certain suppressions from early childhood; and back of that we usually find an inherited tendency (the stigmatic or miasmatic disease tendencies).
Thus we find as the basis for hay fever a background of inheritance usually sycotic, although it may be so far removed from the active stages that we can trace its presence only by the disease tendencies- infiltrative in nature-exhibited at different periods of life. This is often found in enlarged tonsils and glands in child life; appendicitis, ovarian cysts, fibroid tumors; other infiltrations and / or thickening of the tissues and deposits as the individual passes on through life. The eczematous conditions of early childhood are a manifestation of the dyscrasia, thrown outward by the psoric influence and the activity of natural exfoliative tendencies in the rapidly developing life.
Careful case taking becomes the master key that unlocks the gates of the patients diseases-barricade, in hay fever conditions as in all other manifestations, particularly chronic manifestations.
In careful case taking, then, we almost invariably find a history of an eruptive skin lesion, usually in early childhood; or there has been surgical procedure (very often removal of the tonsils) when the cause of the condition should have been corrected by medication instead of lopping off the results; or there have been inoculations or vaccinations against typhoid, diphtheria, tetanus, small-pox, or any one of several other eruptive or septic conditions, either in the way of prophylaxis or antitoxic action; or offensive perspiration, of the body or feet, had incited the patient to the use of suppressive measures; or perhaps long-continued emotional strain has inhibited the natural eliminative powers, or sudden emotional shock has been followed by an outbreak of susceptibility to certain substances, with the resulting train of symptoms.
If there is any class of patients which needs careful individualization, because of the peculiar susceptibility of one individual to certain substances and circumstances that have no effect upon the other sufferers, it is these hay fever patients. In other words, we almost always find that individual susceptibility must be the keynote of the individual case. In considering a case of hay fever, we immediately visualize a syndrome composed of sneezing, lachrymation, red nose, watery coryza. So frequently do we see this picture that we too often tend to note “hay fever” as a single symptom one our case record. Because of this tendency let us analyze our case records.
When does your patient sneeze? You will find that some suffer from this symptom only occasionally, while with others it is frequent and extremely distressing. Some sneeze only in the open air; or in the house; or in wet weather; or in dry weather; or when it is cool; or when it is very hot; or when he gets up in the morning; or when he lies down at night; in the sun; or in the dark; or in a bright light; or when reading; or when looking at distant objects.
In other words, one is aggravated by circumstances and conditions that relieve another.
Let us analyze still further: further: WHY is the patient better or worse when he first rises in the morning? Is it the change of position, the beginning of motion, of the change of temperature from the warmth of the bed to the cold floor?.
There is a fine differentiation necessary even between the symptoms of location; not all patients have an irritated conjunctiva. neither has every patient swollen lids or congestion of the canthi. some people are driven nearly frantic with itching eyelids which swell and almost obscure their vision; others complain bitterly of an itching throat, or tip of the nose, or itching from the ear to the tonsil.
Not all patients complain of the same sensations: in most patients there is some sensation of itching, but smarting, excoriation, burning, are among several sensations from which they suffer, and which should make a different in your consideration of the prescription.
No cure can be made without the similimum; and no case can be analyzed with the Boenninghausen repertory method without the four-square basis of symptoms the locations, the sensations, the conditions of aggravation and amelioration, and the concomitants.
Having considered the locations manifesting symptoms in each individual patient, and the sensations of which he complains, and having considered carefully all the conditions of aggravation and amelioration, let us examine the most frequently expressed concomitant symptoms.
What are concomitant symptoms? Concomitant symptoms are those symptoms, often seemingly unrelated, that appear coexistently with the syndrome under consideration, or in some definite relation of time to that group.
We frequently find in these cases an eruption on the fingers and toes, appearing at about the same time as the hay fever symptoms; unusual mental and emotional manifestations; circulatory disturbances; menstrual dysfunctions; these are among the most common coexistent symptom groups.
It is because of the ever-varying array of symptoms that the only sure approach toward curing these suffers lies in individual study of the case, and the most accurate method of analysis seems to be the repertory study. This is tedious method, but quite feasible with trained assistance. Moreover, it is the method that demands the least possible amount of the physicians own time, for the technician can be trained to lay before the physician just those details for which he might search for some time.
The results of the Boenninghausen analysis in these cases seen to be superior to those of the Kent method. This is unquestionably due to the relative importance Boenninghausen attaches to the conditions of aggravation and amelioration and concomitance to those we regard as the classical symptoms. The construction of Boenninghausens Therapeutic Pocket Book demands proper consideration of these modalities and concomitants.
