Allergy: The History Of A Modern Malady by Mark Jackson

A tale of medical failure that's not something to be sneezed at

Each age has its defining disease. In the late 19th century, people claimed to be a "a little bit consumptive". In the late 20th, people regarded themselves - even proudly - as a little bit allergic. The label denoted someone who not only had a clinical condition but was sensitive, civilised and responsive to progressive ecological imbalances. Allergy became, like hysteria and neurasthenia before, an archetypal disease of modern civilisation.

The term was first used in a German medical journal in 1906, signifying altered biological reactivity. From the start, there was disagreement about the roles of mind and body - which persists. Hypersensitivity to foreign substances such as pollen was clearly implicated. But many specialists stressed the nervous origins of asthma and hay fever. Hay fever had become increasingly common during the Victorian period and was thought to affect a better class of person - the educated before the ignorant. Symptoms only struck those with the requisite constitution. By the 1940s, specialists such as the psychoanalyst Helen Dunbar were arguing that a predisposition to asthma was linked to a lack of mother love - or an excess, as in "smother love".

As the numbers affected rose, such theories lost their grip. The scale of the problem is extraordinary. In 1955, just over five GP consultations in 1,000 were for hay fever in England and Wales. By 1971, the number had doubled and a decade later it doubled again. This increase was occurring as pollen counts were falling, owing to the cutback in agricultural land.

What lay behind the rise? No one is sure. The hygiene hypothesis is favoured: that, as we lead cleaner, germ-free lives and are exposed to fewer illnesses in childhood, our immune systems are underdeveloped. But this does not account for extraordinary increases in townships in Tanzania, on Tristan da Cunha, and in other parts remote from Western civilisation.

Mark Jackson's book is meticulously researched and written, and of undoubted value to the academic. The general reader, however, will struggle to find enlightenment. The story of allergy is of medicine's failure - either to curb its rise or to treat it effectively. Indeed, the rise in deaths from asthma in the 1980s was almost certainly triggered by drugs that lulled sufferers into a false sense of security. The old adage bears repeating: the treatment can be worse than the disease.