Strange Malady

> One morning a little girl's mother cooked a new kind of breakfast cereal. The child lifted a spoonful, put it in her mouth. Her lips and tongue swelled like balloons. She fell into a spasm of coughing, began to suffocate, fainted. When the doctor arrived on the run, he saw at once what had happened, injected adrenalin. In a few hours, restored to normal, the little girl was scampering around as though nothing had happened. There was nothing wrong with the cereal except that it contained flaxseed, to which the child was violently allergic.

> A woman had hives only when she was in bed. On testing, she was found allergic to corn. To an allergy specialist, the answer was obvious, for laundry starch is often made from corn. When the patient began sleeping on unstarched sheets, her troubles were over.

These allergy anecdotes and scores of others, culled from hundreds of medical journals, are on display in Strange Malady, a breezily written book published last week by Dr. Warren Taylor Vaughan of Richmond, Va. (Doubleday; $3). Son of the late Dr. Victor Clarence Vaughan, who was not only a pioneer allergist but also the man who brought the first diphtheria antitoxin from Europe to the U. S., Dr. Warren Vaughan tells in his book about all that a layman needs or wants to know about allergy--how "sensitization" takes place, its bodily results, its myriad agents, its treatment. From kapok to camel's hair to cockroach powder to cosmetics, the list of things to which people are allergic is almost endless.

The symptoms of allergy may be asthma, hay fever, edema (swelling), hives, eczema, sick headache, diarrhea, stomachache. Dr. Vaughan estimates that the U. S. has 6,000,000 people with hay fever, 600,000 to 3,500,000 with asthma, 3,000,000 with recurrent sick headaches, 4,000,000 with frequent or occasional hives--that altogether some 60,000,000 of the U. S. population have had, or will have, some major or minor allergic symptom at some time during their lives.

According to the theory of immunity proposed by the great Paul ("Magic Bullet") Ehrlich, when foreign proteins enter the body, they try to enter into harmful chemical union with body cells. The cells sprout invisible, mysterious little things called antibodies which act as chemical grappling hooks. When an invading protein seizes a hook, the cell gets rid of its eneny by loosing the hook. If there are not enough hooks to cope with the invaders, the person falls ill.

In case of a small invasion (e.g., vaccination), the disturbed cells set about manufacturing hooks (antibodies) in great profusion, throw them off into the blood stream. Then, when another protein army comes along, there are enough hooks loose in the blood to deal with the invaders. The person has been immunized.

But occasionally something goes wrong with the detaching mechanism by which the disturbed cells turn loose their hooks. Then, instead of immunity, allergic sensitization is set up. Though sprouted in great numbers, the hooks remain attached to the cell. Now the cell is more attractive to foreign proteins than before. They swarm to its hooks like hungry wolves pouncing on beefsteaks. From then on, the person is allergic to that protein.

Suppose a farmer is stung by a bee. He suffers only a temporary, curseworthy discomfort, forgets it. His blood cells manufacture antibodies against the bee venom. But instead of being turned loose, as they normally should, they may remain attached. The victim is then sensitized instead of protected from bee sting. Six months later he may be stung again. He faints, dies. This is allergic shock.

Milder allergies to foods, pollens, textiles, animal hairs, etc. are produced the same way. Food allergies are often acquired by digestive upsets which allow proteins to get into the blood instead of being broken down in the digestive tract. Some people are born with food allergies, acquired from proteins in the maternal blood during pregnancy.

In treating milder allergies, the first step is to find out what a patient is allergic to, by means of skin tests which result in small reactions to the offending substance. If it is a food or something similar, all the patient has to do is avoid it. If it is a wind-borne pollen that cannot be escaped, the patient may try "desensitization" treatment, which involves injecting very small quantities of the allergenic protein. How or why desensitization works is unknown. The benefits of desensitization are temporary and partial, though the degree of relief may seem wonderful to a sufferer. Treatments must be repeated every year. Sometimes allergies subside spontaneously, but there is no medical cure.

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