ANOTHER PERSON'S POISON

A scholarly history of food allergy.

Smith (Health and Healthcare/Univ. of Strathclyde; Hyperactive: The Controversial History of ADHD, 2012, etc.) writes that food allergy has been riven by ideological controversy since the word “allergy” was coined in 1906. Sure, the ancients knew that some foods made people sick. However, at the turn of the 20th century, little was known about the immune system, and all doctors could go by was patient reports of headaches or upset stomachs when they ate certain foods. Moreover, the skin tests used to diagnose hay fever or asthma were unreliable in detecting food allergies. So practitioners split into two camps: orthodox allergists believed that few food allergies existed; others saw a cornucopia of problematic foods, which after World War II, grew to include food dyes and other additives. Some became “clinical ecologists” who added the dangers of modern environments and developed elaborate toxicity tests and elimination diets. By the 1960s, the discovery of the immune system molecules responsible for allergic reactions led orthodox allergists to increase their limited roster of allergy-causing foods. Then came the peanut. In the 1990s, there was a rash of sensational stories of children dying within minutes of unwittingly imbibing traces of peanut or even food cooked in peanut oil. The resulting paranoia led to today’s bans on serving peanuts on airplanes and in other public places, along with educational alerts. But how do we account for the rise in peanut and other food allergies and autoimmune diseases? It’s frustratingly elusive, writes the author, who cites popular theories like the hygiene hypothesis as well as the hope for peanut desensitization therapies. But as a historian, he is more interested in a century’s lack of medical research to find answers than in defending old dogmas and definitions, a situation he finds parallel to the history of psychiatry.

While Smith’s text sometimes reads like a doctoral dissertation, all that meticulousness adds weight and authority to the evidence of the serious shortcomings of a medical specialty.