Dyspnoea and Diminished Vital Capacity as a Symptom and a Sign in Hay Fever

¹ Physician-in-Chief, Department of Allergy, New England Medical Center, Boston, Massachusetts.
² Assistant, Department of Allergy, New England Medical Center, Boston, Massachusetts.
³ Massachusetts Institute of Technology, Cambridge, Massachusetts.

From these studies we may tentatively conclude that:

1. Patients with uncomplicated hay fever and no history of bronchial asthma may frequently demonstrate a diminished vital capacity during their pollen seasons.

2. In the majority of cases, such diminished vital capacity will be associated with little benefit from injection therapy.

3. The patients with coincidental inhalant sensitivities show greater variation in vital capacity measurement than those in whom there is a single causative agent.

4. Intercurrent nasal or pulmonary infection will also affect the vital capacity.

5. Patients with bronchial asthma due to pollen sensitivity, either alone or associated with other inhalant sensitivities, showed decreased vital capacity when exposed to their causative allergens, although clinically they may not complain of bronchial asthma.

6. In the small series studied, variation of vital capacity was not an index of prognosis.

7. The studies suggest that in three out of four patients the respiratory tract reacts as a single organ irrespective of the seat of the majority of the symptoms of which the patient complains.

8. Patients suffering from nasal pollenosis should be questioned regarding dyspnoea which may be the earliest sign of bronchial involvement. Studies with larger groups of patients, for longer periods of time, may finally prove how quickly this may be associated with a latent bronchial asthma in both treated and untreated pollen and other inhalant sensitive patients.

Similar studies are now in progress concerning the relationship of other forms of nasal allergy, and direct or reflex diminution in lung capacity.