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April 1985, Volume 35, Issue 4

Special Communication

Nasal Allergy: Milestones in Understanding the Disease.

M.H.A. Beg  ( ENT Department, K.V.S.S. Site Hospital Karachi-16. )

Nasal Allergy is not a modern disease as is generally known. Two of the contributions by Razi and Mckenzie are described as they stand out as distinct mile-stones in understanding the disease
The first ever known case of nasal allergy was described by Mohanimad Ibn Zakaria Al Razi. This fact is not well known in Medical circles. A few details are worth recording.
Razi (850 923AD) was a physician who was born in Ray, which is few miles from Tehran in Iran.1 He was an excellent clinician, a keen observer and prolific writer. The number of his writings were between 150 to 2002 He was also a very widely travelled person and always associated himself with books and writings. The best known of his contributions are Kitabul Hawi which is an encyclopaedia of medicine.
Kitabul Mansuri is another book of medicine which he wrote for Mansoor Bin Ismail, the Governor of Khorasan. Anoth!r well known contribution is Kitabul Gudari wal Hasba a book in which he has differenciated between Small Pox and Measles.
Razi’s contribution to Nasal ALlergy was not known as it was not presented as independent writing but included in Al-Fusal-al-muhimna fi Tabbul-Umma, which is written by Sarabion Ibn Ibrahim. This thesis is present in Oxford Codex Huntingtonins 461 Pages 78 80 b (3). Alberuni compiled a list of writing of Razi (1048 A.D) which includes information about the above thesis. Ibn Abi Usaiba (1270 A.D) in his work Uyunuianba-fi-Tabqat-ul Attiba also mentions about the case reporting of Razi on Nasal Allergy. The index of Razi’s writting written by Alberuni was translated in Germany in 1926 by Julis Ruska. Cyril Elgood picked this fact and later mentioned it in his persian Science. Hans Schadewalt another German also accepted this fact and mentioned it in his thesis (1961). Friedun R Hau (1975) wrote an article compiling these facts and confirming the story in Journal of history of Medicine in German language3
Razi’s patient was a famous muslimS geographer by the name of Abu Zaid Ahmad Ibn Sahi Al Balkhi. He was also from Khorasan, studied philosophy, astrology, astronomy, medicine and natural sciences. He is mainly known for his works Savar ui-A qalim, Ai-Jstakhri and ibn Haikal, which form the foundation for classical school of Arabic Geography. Abu Zaid Al Balkhi used to suffer from coryza every spring, when roses give forth their scent. Razi picked up this fact that coryza only occured when Abuzaid smelt roses. Razi described this and also has mentioned treatment of the allergy which includes a long list of preventive factors which he thought will help in avoiding the malady.
There are a few isolated reports of cases of nasal allergy during 16, 17, and 18th centuries. Oscar Beschornes described Hay fever followed by Sir Morrell Mackenzie in in England and John Noland Mackenzie in U.S.A.3
Sir Morrell Mackenzie was a physician in Throat Hospital and London Hospital. He delivered a lecture in London Hospital Medical College which appeared in British Medical Journal and later was published in the form of a booklet in l884.4 He is also one of the founding editors of Journal of Laryngology and Otology. In this small booklet he has described Nasal allergy, in the commonest form it presents in England, as Hayfever. This book also contained an appendix on Rose allergy which he rightly thought to be much less. He contributed Hayfever to “the enterance into the eyes and air channels of those predisposed to the ailment, of minute particles of vegetable matter from grasses, plants and flower”. He also described the increased frequency disease more in intellectuals. “Higher we rise in the intellectual scale, the more is the tendency to develop Hayfever”. He was rather sarcastic and showed his arrogance by describing that the frequency of Nasal allergy in the English nation is “a proof of our superiority to other races” and “our superiority to less favoured peoples in culture and civilization”4 “the influence of race is seen in the fact that it is the English and American who are almost the Only sufferers from the complaint”. “In Asia and Africa also it is only the English who suffer” without knowing that the disease has already been well described nine hundred years ago in Islamic people, by Mohammad Ibn Zakaria Al-Razi.

Acknowledgement

I am most grateful to Dr. Fatema Jawad for translating Dr. F. R. Hau’s paper from German language.

References

1. IBN Nadim, Alfehrist (Urdu Translation) 1969 Adara-e-Saqafat Islamia Lahore page 688.
2. Sharif, M. Musalmano-Ke-Afkar, 1963, Majlis Taraqqi-e-Adab, Lahore page 72.
3. Hau, F.R. Razis gutachten uber rosen schnupfen, Medizin historiches journal 1975, 10, 94-104.
4. Mackenzie, M., Hay Fever, Fourth Edition 1887, J.A. Churchill London page 9, 10, 29.

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