Book Review

Allergy: The History of a Modern Malady

N Engl J Med 2006; 355:855-856August 24, 2006

Article

Allergy: The History of a Modern Malady
By Mark Jackson. 288 pp., illustrated. London, Reaktion Books, 2006. $39.95. ISBN: 1-86189-271-3

In Allergy, Mark Jackson examines an array of scientific, socioeconomic, environmental, and political factors that have shaped allergy — both as an ailment and as a field of scientific research — from 1906 to the present. The result is not a tale of rational and orderly scientific discoveries leading to a satisfying mechanistic explanation for allergy. Rather, this story, like most scientific progress, is fraught with controversy, ambiguity, and emotion.

Jackson's history begins in 1906, with the introduction of the term “allergy” into the scientific lexicon by the Austrian pediatrician Clemens von Pirquet. The term was meant to encompass a variety of immunologic hyperreactions, including serum sickness, food intolerance, adverse reactions to bee stings, and the death of laboratory animals injected with foreign proteins, and it was met with considerable opposition, ranging from skepticism to outright hostility. Perhaps its most vehement detractor was the French physiologist Charles Richet, who regarded this new term as redundant in light of his own term, “anaphylaxis.”

The theories about the cause of allergy were as controversial as those regarding its meaning. Hay fever, as we learn in this book, was considered by many to be a disease of the elite, primarily attacking people of Anglo-Saxon descent and sparing the poor and uneducated. Others thought the root of allergy was nervous or hormonal. Throughout his descriptions of these controversies, Jackson weaves the shifting concepts of immunity, disease, and the nature of antibody–antigen reactions. Indeed, von Pirquet was among the first to suggest that the immune response itself could cause disease, an idea that formed the basis of his theory of allergy.

Jackson later delves into the economics of allergy, exploring the extent to which pharmaceutical, cleaning, and food companies have benefited from — and perhaps exploited and fueled — a growing fear of allergies to generate and sustain multibillion-dollar industries. He also examines the extent to which allergies reflect industrialization and urbanization, which have resulted in an ever-increasing release of pollutants and toxins into the environment.

Jackson's writing is precise and scholarly, and although I occasionally felt bogged down by the dizzying cast of characters, it is clear that the author is a consummate historian. Although Allergy is perhaps best for those readers with at least a rudimentary knowledge of medicine and immunology, it provides a rich medical and social narrative, suitable for anyone with a penchant for medical history and curiosity about the roots of this still enigmatic modern-day scourge.

Heather L. Van Epps, Ph.D.
, New York, NY 10021
hvanepps@rockefeller.edu