This is a singular variety of Catarrh, produced by a peculiar local cause, which, although not of serious consequence, requires a short notice. Dr. Bostock, in the "Medico-Chirurgical Transactions," gives an account of this complaint as it was apt to attack himself. In Dr. Elliotson's lectures also, there is a good deal of curious information upon this malady, contained in letters addressed to him from practitioners in various parts of the country. Dr. Elliotson speaks of it as a combination of Catarrh and Asthma. It consists in excessive irritation of the eyes, nose, and the whole of the air passages; producing in succession, itching of the eyes and nose, much sneezing occurring in paroxysms, with a copious running from the nostrils; pricking sensations in the throat; cough, tightness of the chest, and difficulty of breathing, with or without considerable mucous expectoration. This complaint affects certain persons only, and in them it always takes place at the same period of the year, in the latter end of May or in June, when the grass comes into blossom or when the spring hay-making is going on. It seems, in fact, to be produced by some kind of emanation from certain of the grasses that are in flower at that season, of the irritating qualities of which emanations some persons only-and a very few persons in comparison with the entire community-are susceptible. The disorder happens only at that one particular season; and it then attacks persons who are not remarkably subject to Catarrh at other times, nor from the ordinary causes of Catarrh; and, if they avoid meadows and hay-fields, and the neighbourhood of haystacks, they escape the malady. Hence, going to the sea-coast, and especially to those parts of the coast that are barren of grass, offers a means of protection: and when this cannot be done, such persons obtain refuge, in some measure, from the cause of the irritation, by remaining within doors, and shutting out, as much as possible, the external air, during the hay crop. One lady, who suffered annually from this strange affection, stated that a paroxysm has been brought on by the approach of her children, who had been in a hay-field; and once this happened when the hay harvest had been over for some time, upon their joining her at tea, after playing in a barn in which the hay of that year had been deposited. She was in the habit of flying to Harwich, or some other part of the coast, as the dangerous season came on. On one occasion, while walking on the shore at Harwich, she was suddenly attacked by the complaint, to her great surprise, as she was not aware of any grass being in the neighbourhood; but the next day she discovered that hay-making was in progress upon the top of the cliff, at the time when she was walking under it. In another year, she being at Cromer, and an attack that she had suffered having quite subsided, and all the haymaking thereabouts being over, she was suddenly visited by the well-known symptoms, and on going into her bed-chamber perceived that they were building a large stack of hay in the yard near the house, having transferred it from a field five miles distant.

Dr. Watson says: "I was asked by Mr. Cheyne to see with him the wife of a stable-keeper near Regent Street. I found her suffering under what is called a "crying cold:" pain in the forehead, streaming eyes, sneezing and running from the nostrils, and shortness of breathing, which was accompanied by loud wheezing. Symptoms of this kind had come on suddenly, some days before: and her distress was then so great, that her husband proposed to drive her in a gig to consult a medical friend of his, who lived in Islington. On their way thither, every symptom disappeared, and she felt at once quite well. She subsequently stayed a night or two, in comfort, with some relations in the city. Immediately upon her return home, the same symptoms returned, with all their former severity, and resisted the means adopted for their relief by Mr. Cheyne, who had now been called in. He was soon led to suspect the cause of the attack, and of its obstinacy. There was a strong odour of hay in the house. The husband told him that his lofts were filled with a lot of hay which had recently arrived, and which had an unusually powerful smell. We learned that our patient was always worse at night, when the house was shut up; and better in the morning, when a free current of air blew through the open windows. We advised a temporary change of residence, but our advice was not followed until two days afterwards, the disorder meanwhile continuing, and increasing in intensity when the patient removed to lodgings not one hundred yards distant; and immediately all the Catarrh and distress again ceased, and she passed a perfectly tranquil night. Afterwards she went into the country, and did not return until the odoriferous parcel of hay had been consumed, and a new stock laid in. She was, however, revisited by some slight cough and occasional difficulty of breathing, neither of which troubled her much or long.

Treatment

Of course the best remedy for this disorder is to get away from the cause; but as every one can not conveniently do that, it is necessary to try and find some means to counteract its influence.

Mr. Gordon, of Weldon, in Yorkshire, communicated some interesting observations to the profession on this subject before those of Dr. Elliotson were published. He supposes that the aroma of the sweet-scented vernal grass, the anthoxanthum odoratum, is the principal exciting cause of the complaint. He found the symptoms more speedily and effectually removed by the tincture of Lobelia Inflata, than by anything else that he had tried at that time; and he recommended the cold shower bath as the best preservative against the attack. But, in a subsequent communication to Dr. Elliotson, he states that the Sulphates of Quinine and Iron, given in combination, had proved completely successful in emancipating from their tormenting disorder, the two patients, from whose cases he had principally drawn up his account: although they had, in spite of all previous treatment, Buffered an annual return of it for fifteen or twenty years. The Tincture of Lobelia may be taken in one-dram doses three times a day; and the Sulphate of Quinine and Sulphate of Iron may be taken, two grains of each three times a day, either in water, or made up into pills. Probably the Citrate of Iron and Quinine would be found equally effectual: it may be taken in five grain doses.

There is another vegetable substance which produces in some persons symptoms very similar to those caused by the hay effluvia; this is powdered Ipecacuanha Root. Sir Thomas Watson says: "I recollect a servant employed in the laboratory of St. Bartholomew's Hospital, when I was a pupil there, who had the peculiar ill-luck to be liable to this infection. Whenever that drug was under preparation, he was obliged to fly the place. This peculiarity is not very uncommon. A very small quantity of the Ipecacuanha is sufficient, in such persons, to bring on a paroxysm of extreme difficulty of breathing, wheezing and cough, with singular anxiety and great weakness. The distress usually terminates by a copious expectoration of mucus."

I recollect a medical friend in England who suffered so much from the effluvium of Ipecacuanha, that he was compelled to tie a handkerchief over his mouth and nose whenever he had occasion to use it.