M.D.'s or LL.D.'s, though bespattered with all the letters of the alphabet.

Of all the foolish things that scientific men quarrel about, one of the most foolish is the question of priority of discovery. A scientist who will welcome the opinion of another scientist agreeing with him the day after he announces his discovery will fight like a cat against evidence that the same man agreed with him the day before. It seems to me that if another human being confirms your work, it does not make any difference whether he does it the century before or after your transient existence. In fact, you should be more pleased to have it "confirmed" the century before, because then you will have a chance to know about it.

Besides recognizing the urticarial nature of the lesion, de Mussy sought the underlying cause of hay fever and thought to find it in the gouty diathesis. He notes the occurrence of hay fever in gouty families, its periodicity, its association with urticaria, eczema, granular pharyngitis and asthma, all characteristics of gout or arthritism.

As de Mussy's lecture is not readily available, I quote from the Boston Journal some of his conclusions.

"I have dwelt at length on the constitutional condition in order to show in what diathetic conditions spasmodic catarrh has developed. The direct and collateral hereditary tendency appears to indicate a diathetic origin. The two sisters belong to a gouty stock. Chronic urticaria and granular pharyngitis are not rare in gouty families.

"Periodicity is characteristic of many arthritic affections. The spring-time periodicity is especially common to them. The periodicity of this coryza places it in the same category as the arthritic affections which generally manifest themselves by regular or irregular paroxysms.

"If hay fever has been more often noticed in England than France, can this be due to the greater frequency of gout in the former country?

"Continuing the study of these analogies which, if not enough to prove a common origin, are enough to justify further study of the question, I find in one of my patients a morbid condition due to an arthritic source, i.e., an urticaria alternating with asthmatic coryza (hay fever), the latter appearing with symptoms such as injection and itching and tumefaction of the eyes which recall the cutaneous affection to which it had succeeded." (Italics mine. Here is my urticaria theory expressed in 1868. G. F. L.)

"Behind a vast number of nervous troubles, behind a vast number of bizarre functional anomalies stamped with a nervous imprint, we find arthritism." (Italics mine. Here is my pet theory of the gouty origin of neurasthenia and perhaps Beard's neurotic constitution, beloved of rhinologists. G. F. L.)

"As to analogies between summer catarrh and urticaria, I wish to draw no conclusions from them. If it be admitted that both are due to arthritism, their succession and the analogy in their local development can be understood." (My urticarial nature of the lesion again. G. F. L.)

I might add that de Mussy reports success in preventing the appearance of the symptoms by the use of quinine for seven or eight days before the expected attack. During the attack he used sulphur and arsenic for the catarrh.

In the next chapter we will consider the fate of de Mussy's theory of gout as the underlying cause of hay fever.

CHAPTER VIII

HAY FEVER AS GOUT

In the last chapter we read that the theory of a gouty diathesis as the constitutional basis for hay fever originated with Dr. Gueneau de Mussy, in 1868, on account of the many resemblances that he found between the symptoms of gout and the symptoms of hay fever. We have now to consider the fate of the de Mussy doctrine in those countries where hay fever is best known and has been most closely studied, Great Britain and America, Germany and France.

De Mussy in Great Britain and America. If any specialist on the nose and throat in England or America ever heard of de Mussy and his theory that hay fever is rooted in a gouty diathesis, he is keeping the secret well, for it does not appear in any of the books that he writes; but in every book I find the disease attributed to the neurotic constitution first suggested by Beard. In this statement I do not include several references to "uric acid poisoning" which is not the same thing as gout, as will be explained in Chapter IX, on the Uric Acid Theory.

After reading de Mussy's argument for the dependence of hay fever on a gouty diathesis, I turned first to the English books. For centuries, England has been famous as the home of gout and, since the Englishman, Bostock's, account of his own case, hay fever, too, like parliamentary government and gout, has been recognized as an inheritance of the Anglo-Saxon race. As British physicians see more gout than any other physicians in the world and as, for many years, they have had the best opportunities for the study of hay fever, I turned first to the English books, thinking that if there was any truth in the gouty theory, the British physicians would have found it out long ago. To my surprise I searched book after book by both British and American authors, but in not one instance did I find hay fever associated with gout. These books included Allbutt's System of Medicine, F. T. Robert's Practice, Lennox Browne, Morell Mackenzie in England and, in this country, Ballenger, Bosworth, Coakley, Kyle, Solis-Cohen, Ivins and Vehslage and Hallett.

No one is more saturated with the traditions of British medicine than Sir William Osler, but, in his Practice of Medicine, in discussing the constitutional causes of hay fever, he seems to know nothing of the gouty theory.

Besides the article on hay fever in his Diseases of the Nose and Throat, Sir Morell Mackenzie wrote a comprehensive work on Hay Fever and Paroxysmal Sneezing that ran through five editions and bears on the flyleaf the admiring comment of the London Lancet that it "must be regarded as one of the most complete expositions of our knowledge of this curious complaint in our language." It is a wicked joy to catch such a scholarly writer as Mackenzie napping. In a footnote he even refers to the de Mussy lecture in the Gazette hebdomadaire, Jan. 5, 1872, as calling the disease spasmodic rhinobronchitis, with which name the disease is still known in France. One suspects that the learned Doctor was very busy that day and that the footnotes were looked up by somebody else; for, though he gives "the most complete exposition in our language," as the Lancet puts it, of the constitutional causes underlying hay fever, there is never a word of de Mussy's theory of gout.

In Osler and McCrae's Modern Medicine the article on Hay Fever is written by Professor Dunbar, of Hamburg, deviser of pollantin. Here at last we get away from British insularity, for, in spite of his Scotch name, Dunbar is a German. On page 863 he writes:

"For a long time it has been believed that the predisposition to hay fever rests on a gouty diathesis. This view is not on the face of it inconsistent with the pollen theory. Inquiries, however, have shown that gouty persons form only a small portion of hay fever patients."

Finally, in the great Edinburgh Encyclopædia Medica, 1900, Volume 4, Greville MacDonald, of London, in the article on Hay Fever, seems to know nothing of the gouty theory and says innocently at the end of the article, "No special dietary is indicated, seeing that these