The Best Guide to Allergy
NATHAN D. SCHULTZ, MD ALLAN V. GIANNINI, MD TERRANCE T. CHANG, MD AND DIANE C. WONG I THIRD EDITION I * SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Dedication We dedicate this book to our teachers WILLIAM C. DEAMER, MD OSCAR L. FRICK, MD NOTICE: The authors and publisher ofthis book have, as far as it is possible to do so, taken care to make certain that recommendations regarding treatment and use of drugs are correct and compatible with the standards generally accepted at the time ofpublication. However, knowledge in allergy is constantly changing. As new information becomes available, changes in treatment and in the use of drugs may become necessary. The reader is urged to consult his or her physician for professional advice in dealing with any serious or potentially serious allergic problem. Illustrated by Diana Reiss 1994 by Springer Science+Business Media New York Originally published by Humana Press Inc. in 1994 Softcover reprint of the hardcover 3rd edition 1994 AII rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without written permission of the publisher. Photocopy Authorization Policy: Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Springer Science+Business Media, LLC, provided that the base fee of US $3.00 per copy, plus US $00.20 per page, is paid directly to the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA 01923. Forthose organizations that have been granted a photocopy license from the CCC, a separate system of payment has been arranged and is acceptable to Springer Science+Business Media, LLC. The lee code for users of the Transactional Reporting Service is: [0-89603 283-3194 $3.00 + $00.20). Library of Congress Cataloging-in-Publication Data The Best guide to aliergy / Nathan D. Schultz... [et al.]. -- 3rd ed. p. cm. Includes index. ISBN 978-0-89603-325-2 ISBN 978-1-4612-0307-0 (ebook) DOI 10.1007/978-1-4612-0307-0 1. Previous ed. published: New York: Appleton-Century-Croits, 1981. 2. Allergy--Popular works. 1. Schultz, Nathan D. RCS84.B45 1994 616.97--dc20 94-11376 CIP
Preface This is a new and completely updated edition of The Best Guide to Allergy. We hope and believe that in its pages we have successfully provided clear directions through the often dense forest of information about allergies and asthma. New data generated by the powerful techniques of modern biomedical research springs up rapidly, and much has changed since the previous edition. The Best Guide to Allergy will help you through this wealth of information, providing perspectives that will allow you, the allergy sufferer, to safely navigate the complex maze offreeways and byways that characterize most allergic disease manifestations. Everyone suffering from allergies and asthma very much needs to be well-informed in order to make correct and rational decisions about the optimal care of his or her health. The answers you will find here are our very best responses to those questions about allergy and asthma most frequently asked of us by our patients, our families, and our friends. The health care information we offer in The Best Guide to Allergy largely emerges from the research carried out in university medical schools in the United States and around the world. In every era full and clear knowledge has dispelled mystery and puzzlement-after all, we know that despots hold on to their power by keeping entire populations enslaved in ignorance. We are thus confident you will gain real control over your allergies and their symptoms as you read and understand our book. In all that we write here, we have carefully endeavored to avoid the traps of fads and of overly simplified cure-all explanations, benefiting from the examples afforded by some of the eminent physicians who taught us years ago at the University of California at San Francisco. Thus, we are particularly grateful for our training in the scientific method to the world renowned and brilliant Dr. Oscar L. Frick, and in the artfully quizzical approach of Dr. William C. Deamer, who was suspicious of those healers who marched on "unhampered" by knowledge. Though the u
vi Preface language we employ is largely nontechnical, the medical concepts we advance are well-founded in established scientific principles. In addition to our strong adherence to the principles of scientific medicine, we have not hesitated to include information on new self-help approaches and to revive appropriate ideas and methods from certain ancient healing arts, including such mindfulness exercises as meditation, yoga, and tai-chi, where these have been shown to be helpful to patients. The word "doctor" has common linguistic origins with "teacher"; with mindful vision and participation, we believe that you, the patient, can also become a teacher. We, the physicians, know that we are always learning much more from you than you imagine. Clearly, we must continue to listen carefully-and you must insist on this. But beyond that, we strongly recommend that you become an activist in behalf of your own health and its best care. Make demands. Don't be satisfied and quieted by statements without explanations. Trust your own inner intuitions. In short, we have striven, in The Best Guide to Allergy, to help you avoid becoming a victim of your allergy and asthma, or even of the medical system from which you seek help. To sum up: The Best Guide to Allergy offers a practical, everyday approach to alleviating your allergy and asthma. We feel we have put together a body of hard scientific knowledge that, together with your intuitive understanding, can truly constitute a caring guide to the usually basic, but sometimes difficult, regimens that are necessary to sustain you in good health. We hope to help you and those you care for conquer your allergies completely, and so lead a fuller and more enjoyable life. ACKNOWLEDGMENTS: Special thanks to our patients, to our publisher, Tom Lanigan, and to Betsy Savery, RN, whose expertise was invaluable in the preparation of this new edition. Betsy worked with the individual personalities and writing styles of the several authors, who truly appreciate her bright and energetic assistance. Through the long and often intense periods of preparation needed to create this work, we experienced a mutual exchange of love and closeness among our four different families. This was a special gift for which we are all deeply grateful.
Contents Preface... v CH. 1. What Is Allergy?... 1 CH. 2. Hay Fever... 21 CH. 3. Asthma... 49 CH. 4. Skin Allergy... 87 CH. 5. Food Allergy... 111 CH. 6. Insect Allergy... 137 CH.7. Allergy Shots... 149 CH. 8. Drug Allergies... 163 CH.9. New and Controversial Issues: Behavioral and Body Systems... 179 CH. 10. Where Do I Go from Here?... 197 Glossary... 211 Index... 215 vii