Abstract
In 1911, Drs John Freeman and Leonard Noon published an account of a novel treatment for hay fever. Their method of desensitisation consisted of injecting increasing doses of an extract of pollen subcutaneously until the hypersensitivity reaction was diminished or abolished. Over subsequent decades, desensitisation established itself as the cornerstone of clinical allergy in both England and the United States, at least until the advent of novel pharmaceutical agents in the 1950s and 1960s. Although British allergists such as Noon and Freeman were aware of conceptual developments within European immunology and pathology (such as the identification of anaphylaxis by Richet and Portier or von Pirquet's coining of the term allergy), their approach to hay fever was driven by more immediate pragmatic, and indeed financial, considerations. Freeman's immersion in the problems of hay fever and asthma and his pioneering use of allergen desensitisation or immunotherapy were shaped by his adherence to the convictions and bacteriological practices of his principal at St Mary's Hospital, Almroth Wright, and by the drive to produce commercial vaccines which would help to subsidise the experimental and therapeutic work at St Mary's. The aim of this paper is to explore early twentieth-century approaches to hay fever and other allergic diseases by tracing the intellectual and institutional origins of clinical allergy in Britain.