The Magazine

Scratch 'n' Sniff

When the body overreacts, all hell breaks loose.

Dec 17, 2007, Vol. 13, No. 14 • By KEVIN R. KOSAR
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American business saw the opportunities in aiding the afflicted. Vacations to posh clean-air resorts were marketed to eager sufferers, such as the well-heeled members of the United States Hay Fever Association. Industry -ballyhooed to the common man air conditioning, air purifiers, vacuum cleaners, hypoallergenic pillows, and chemical fixes like Dust-Seal, which was supposed to reduce airborne dust in the home by making it stick to carpets where it had been applied.

And obviously, there were drugs: antihistamines in the form of pills and corticosteroids delivered via inhalers. If you could not escape the allergens, you could inoculate yourself against them, at least temporarily.

To a great degree, Gregg Mitman's version of the fight against allergies is a tale of futility and foolishness. As land was cleared for railroad tracks, leading to pollen-free towns, ragweed took root in the loose soil and followed. Weed-killing chemicals might have some utility in eradicating allergenic menaces like ragweed. But municipalities' habit of blasting gallons of it along their roads wreaked environmental havoc--and did nothing to address the pollens produced by the lush green lawns its citizens coaxed forth and the ornamental plants they tended.

Drugs have alleviated the suffering of millions, but have come with their costs, not least overreliance upon them, and addiction. (Witness the case of the asthmatic woman who lived with "two very heavy smokers" and did nothing to help herself beyond sucking on "an isoproterenol inhaler every few minutes.") Quite sensibly, Mitman notes that we have been hampered in our response by grasping for the magic bullet, for failing to see that we can make our allergies better or worse by manipulating our environment.

Although sometimes enlightening and amusing, Breathing Space is, ultimately, a rather messy book. Mitman is a historian of science; yet throughout the book, science takes a back seat to storytelling and cultural criticism. A detailed explanation of the biomechanics of allergic and asthmatic reactions does not appear until the sixth chapter. Often Mitman recounts medical disputes but then leaves them unsettled. We read, for example, that asthma-related mortality rose at the same time that the use of a certain type of inhaler increased. But Mitman does not bother to tell us why: "Whatever the cause of the apparent increase in death rates. .  .  ." Death, schmeath--whatever.

Mitman derides municipal efforts to reduce asthma suffering by cutting down ragweed in empty lots, but does not provide a convincing explanation to counter any reader's commonsensical intuition that a reduction in pollen-emitters would lead to less pollinated air. Oddly, Mitman often treats asthma sufferance as a proxy for allergy sufferance, which is not quite accurate. Asthma, an inflammation of the air passages, is caused in many cases by allergens, but may also be triggered by cold air, emotional stress, or viral infections.

Breathing Space reads as if it was written by a leftist literary wannabe. For one, it is phantasmagoric and ill-defined. There are six chapters, but they do not provide individual theses that add up to a coherent argument. Frequently, the reader finds himself sucked into lengthy asides that cannot be related to the chapter's point. While this is supposed to be about allergies, you read little about atopic dermatitis, the reaction of the skin to allergens or irritants, or allergic reactions caused by food, medicine, mold, or bee stings.

Additionally, Breathing Space is replete with staid rhetorical frameworks, clumsily employed. Mitman runs the old city/country opposition, writing of the early 20th century: "With the shift in medical understanding of hay fever as a disease of the immune rather than nervous system, treatment also shifted and expanded from the therapeutic wilderness to urban clinics." The reader is not sure how to square this thesis with Mitman's lengthy description of the building of an allergy clinic in the Arizona desert at the same time. Enraptured with spatial imagery, he describes the story of allergies as involving man's quest for "breathing spaces," and the movement of allergies "across the boundaries of geography, class, and gender."