Nasal and Bronchial Allergy in Childhood

Abstract

The frequency of nasal and bronchial allergy in childhood needs constant emphasis in the minds of all physicians. Pediatricians have long realized this fact since the epochal work of O. M. Schloss,1 who was the first to demonstrate the clinical value of the skin reaction, and whose other contributions on allergy in childhood up to 1920 laid the basis of much of the present knowledge of this subject.Of general interest is the realization that the statistics on the frequency of allergy in the general population must be changed. Thus, my analysis carried out on two thousand students at the University of California showed a personal history of allergy in 33 per cent and a family history of allergy in 35 per cent. When Vaughan 2 included migraine, gastrointestinal allergy and food idiosyncrasies with urticaria, eczema, hay fever and asthma, he found evidence of personal allergy in 60 per cent of the total population in a small community of five hundred and eight persons. Some pediatricians believe that most children show some minor or major allergic manifestations sooner or later, and Vaughan and I conclude that this is also true of adults.Pediatricians and rhinologists are constantly forced to decide whether sensitization or infection is responsible for acute and chronic rhinitis, sinusitis, tracheitis, laryngitis and bronchitis. Typical acute rhinitis and paranasal sinusitis, with hyperemic membranes and mucopurulent secretions, malaise and fever, are invariably due to infection. Recurrent acute involvements or chronic congestions with or without evidences of definite infection may be primarily allergic in origin. In favor of allergy is the definite presence of the condition in question in the personal or family history. The pale, edematous nasal mucous membrane with abundant mucoid secretion is present during the activity of allergy but may be absent in the quiescent periods. Of special diagnostic value is the microscopic examination of the nasal and bronchial secretions for eosinophils. The eosinophilic infiltration in allergic bronchial and nasal mucous membranes accounts for the presence of such cells in the secre-Read by invitation before the western division of the American Academy of