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Rhinitis
Classification and external resources
ICD-10 J00., J30., J31.0
ICD-9 472.0, 477
OMIM 607154
DiseasesDB 26380
MedlinePlus 000813
eMedicine ent/194 med/104, ped/2560
MeSH D012220

Rhinitis (pronounced /raɪˈnaɪtɪs/), commonly known as a runny nose, is the medical term describing irritation and inflammation of some internal areas of the nose. The primary symptom of rhinitis is nasal dripping. It is caused by chronic or acute inflammation of the mucous membrane of the nose due to viruses, bacteria or irritants. The inflammation results in the generating of excessive amounts of mucus, commonly producing the aforementioned runny nose, as well as nasal congestion and post-nasal drip. According to recent studies completed in the United States, more than 50 million Americans are current sufferers. Rhinitis has also been found to adversely affect more than just the nose, throat, and eyes. It has been associated with sleeping problems, ear conditions, and even learning problems.[1] Rhinitis is caused by an increase in histamine. This increase is most often caused by airborne allergens. These allergens may affect an individual's nose, throat, or eyes and cause an increase in fluid production within these areas.

Contents

Types

Rhinitis is categorized into three types: infective rhinitis includes acute and chronic bacterial infections; nonallergic (vasomotor) rhinitis includes autonomic, hormonal, drug-induced, atrophic, and gustatory rhinitis, as well as rhinitis medicamentosa; allergic rhinitis, the mic reaction triggered by pollen, mold, animal dander, dust and other similar inhaled allergens.[2]

Vasomotor rhinitis

Vasomotor rhinitis is better known as nonallergic rhinitis. The distinguishing characteristic leading to a diagnosis of nonallergic rhinitis is the absence of allergic response. Nonallergic rhinitis can be caused by airborne irritants, weather changes, infections, food and drink, medications, hormone changes, or stress, according to the Mayo Clinic.[3]

The pathology of vasomotor rhinitis is in fact not very well-understood and more research is needed. Vasomotor rhinitis appears to be significantly more common in women than men, leading some researchers to believe hormones to play a role. In general, age of onset occurs after 20 years of age, in contrast to allergic rhinitis which generally appears before age 20. Individuals suffering from vasomotor rhinitis typically experience symptoms year-round, though symptoms may exacerbate in the spring and fall when rapid weather changes are more common.

Patients cannot have vasomotor rhinitis and allergic rhinitis simultaneously because vasomotor rhinitis is a diagnosis of exclusion reached after other conditions have been ruled out.[4] An estimated 17 million United States citizens have vasomotor rhinitis.

Allergic rhinitis

When an allergen such as pollen or dust is inhaled by an individual with a sensitized immune system, it triggers antibody production. These antibodies mostly bind to mast cells, which contain histamine. When the mast cells are stimulated by pollen and dust, histamine (and other chemicals) are released. This causes itching, swelling, and mucus production. Symptoms vary in severity between individuals. Very sensitive individuals can experience hives or other rashes. Particulate matter in polluted air and chemicals such as chlorine and detergents, which can normally be tolerated, can greatly aggravate the condition.

Sufferers might also find that cross-reactivity occurs.[5] For example, someone allergic to birch pollen may also find that they have an allergic reaction to the skin of apples or potatoes.[6] A clear sign of this is the occurrence of an itchy throat after eating an apple or sneezing when peeling potatoes or apples. This occurs because of similarities in the proteins of the pollen and the food.[7] There are many cross-reacting substances.

Some disorders may be associated with allergies: Comorbidities include eczema, asthma, depression and migraine.[8]

Allergies are common. Heredity and environmental exposures may contribute to a predisposition to allergies. It is roughly estimated that one in three people have an active allergy at any given time and at least three in four people develop an allergic reaction at least once in their lives. The two categories of allergic rhinitis include:

  • Seasonal – occurs particularly during pollen seasons. Seasonal allergic rhinitis does not usually develop until after 6 years of age.
  • Perennial – occurs throughout the year. This type of allergic rhinitis is commonly seen in younger children.[9]

Allergy testing may reveal the specific allergens an individual is sensitive to. Skin testing is the most common method of allergy testing. This may include intradermal, scratch, patch, or other tests. Less commonly, the suspected allergen is dissolved and dropped onto the lower eyelid as a means of testing for allergies. (This test should only be done by a physician, never the patient, since it can be harmful if done improperly). In some individuals who cannot undergo skin testing (as determined by the doctor), the RAST blood test may be helpful in determining specific allergen sensitivity.

Hay fever

Pollen grains from a variety of common plants can cause hay fever.

Allergic rhinitis triggered by the pollens of specific seasonal plants is commonly known as "hay fever", because it is most prevalent during haying season. However, it is possible to suffer from hay fever throughout the year. The pollen which causes hay fever varies between individuals and from region to region; generally speaking, the tiny, hardly visible pollens of wind-pollinated plants are the predominant cause. Pollens of insect-pollinated plants are too large to remain airborne and pose no risk. Examples of plants commonly responsible for hay fever include:

In addition to individual sensitivity and geographic differences in local plant populations, the amount of pollen in the air can be a factor in whether hay fever symptoms develop. Hot, dry, windy days are more likely to have increased amounts of pollen in the air than cool, damp, rainy days when most pollen is washed to the ground.

The time of year at which hay fever symptoms manifest themselves varies greatly depending on the types of pollen to which an allergic reaction is produced. The pollen count, in general, is highest from mid-spring to early summer. As most pollens are produced at fixed periods in the year, a long-term hay fever sufferer may also be able to anticipate when the symptoms are most likely to begin and end, although this may be complicated by an allergy to dust particles.

Prevention and treatment

The goal of rhinitis treatment is to reduce the symptoms caused by the inflammation of affected tissues. In cases of allergic rhinitis, the most effective way to decrease allergic symptoms is to completely avoid the allergen.[10][11] Vasomotor rhinitis can be brought under a measure of control through avoidance of irritants, though many irritants, such as weather changes, are uncontrollable.

Allergic treatment

Allergic rhinitis can typically be treated much like any other allergic condition.

Eliminating exposure to allergens is the most effective preventive measure, but requires consistent effort.

Many people with pollen allergies reduce their exposure by remaining indoors during hay fever season, particularly in the morning and evening, when outdoor pollen levels are at their highest. Closing all the windows and doors prevents wind-borne pollen from entering the home or office. When traveling in a vehicle, closing all the windows reduces exposure. Air conditioners are reasonably effective filters, and special pollen filters can be fitted to both home and vehicle air conditioning systems.[12]

Because many allergens cling to clothing, skin, and hair, regular cleaning reduces exposure and therefore symptoms. Many people bathe before sleeping, to minimize their exposure to potential allergens that could have stuck to their bodies during the day. Some people use nasal irrigation to physically remove contaminants from their noses.

Frequently cleaning floors and washing bedding can significantly reduce local irritants such as house dust mite, as well as those tracked in by family, pets and visitors.

Several antagonistic drugs are used to block the action of allergic mediators, or to prevent activation of cells and degranulation processes. These include antihistamines, cortisone, dexamethasone, hydrocortisone, epinephrine (adrenaline), theophylline and cromolyn sodium. Anti-leukotrienes, such as Montelukast (Singulair) or Zafirlukast (Accolate), are FDA approved for treatment of allergic diseases.[13] One antihistamine, Azelastine (Astelin), is available as a nasal spray.

More severe cases of allergic rhinitis require immunotherapy (allergy shots) or removal of tissue in the nose (e.g., nasal polyps) or sinuses.

Many allergy medications can have unpleasant side-effects, most notably drowsiness; more serious side-effects such as asthma, sinusitis, and even nasal polyps have also been reported however.

A case-control study found "symptomatic allergic rhinitis and rhinitis medication use are associated with a significantly increased risk of unexpectedly dropping a grade in summer examinations".[14]

Nasal treatments

Systemic Glucocorticoids such as Triamcinolone or Prednisone are effective at reducing nasal inflammation, but their use is limited by their short duration of effect and the side effects of prolonged steroid therapy. Steroid nasal sprays are effective and safe, and may be effective without oral antihistamines. These medications include, in order of potency: beclomethasone (Beconase), budesonide (Rhinocort, Noex), flunisolide (Syntaris), mometasone (Nasonex), fluticasone (Flonase, Flixonase), triamcinolone (Nasacort AQ). They take several days to act and so need be taken continually for several weeks as their therapeutic effect builds up with time.

Topical decongestants: may also be helpful in reducing symptoms such as nasal congestion, but should not be used for long periods as stopping them after protracted use can lead to a rebound nasal congestion (Rhinitis medicamentosa).

Saltwater sprays, rinses or steam: this removes dust, secretions and allergenic molecules from the mucosa, as they are all instant water soluble.

For some patients, especially those with severe non-allergenic rhinitis which at times can produce large amounts of thick mucous, rinsing is the preferred treatment. The nasal passages and sinuses are flooded with warm salty water. The solution should be pH balanced. It should contain Sodium Chloride and Sodium Bicarbonate. There are commercially available preparations which speed the rinsing process as patients may need to repeate the rinse many times during a day.

Rinsing is very often recommend as part of the healing process after sinus or nasal surgery. For this rinse, boiled or distilled water is only necessary during recovery from surgery, as the entire contents of the bottle is used..[15]

Alternative treatments

A large number of over-the-counter treatments are sold, including herbs like eyebright (Euphrasia officinalis), nettle (Urtica dioica), and bayberry (Myrica cerifera), which have not been shown to reduce the symptoms of nasal-pharynx congestion. In addition, feverfew (Tanacetum parthenium) and turmeric (Curcuma longa) has been shown to inhibit phospholipase A2, the enzyme which releases the inflammatory precursor arachidonic acid from the bi-layer membrane of mast cells (the main cells which respond to respiratory allergens and lead to inflammation) but this is only in test tubes and it is not established as anti-inflammatory in humans.

It has been claimed that homeopathy provides relief free of side-effects. However, this is strongly disputed by the medical profession on the grounds that there is no valid evidence to support this claim.[16]

Therapeutic efficacy of complementary-alternative treatments for rhinitis and asthma is not supported by currently available evidence.[17][18]

Nevertheless, there have been some attempts with controlled trials[19] to show that acupuncture is more effective than antihistamine drugs in treatment of hay fever. Complementary-alternative medicines such as acupuncture are extensively offered in the treatment of allergic rhinitis by non-physicians but evidence-based recommendations are lacking. The methodology of clinical trials with complementary-alternative medicine is frequently inadequate. Meta-analyses provides no clear evidence for the efficacy of acupuncture in rhinitis (or asthma). Currently, evidence-based recommendations for acupuncture or homeopathy cannot be made in the treatment of allergic rhinitis.

Eating locally produced unfiltered honey is believed by many to be a treatment for hayfever, supposedly by introducing manageable amounts of pollen to the body. Clinical studies have not provided any evidence for this belief.[20] However, the 2002 study, widely cited as evidence against the efficacy of honey treated patients, was conducted strictly during the pollen season while advocates of honey recommend beginning treatment well before the season begins, or even year round. [21]

See also

References

  1. ^ "Rhinitis and quality of life". http://www.stallergenes.com/en/sciences-innovation/the-respiratory-allergens/rhinitis-asthma-and-quality-of-life.html.  
  2. ^ Allergic
  3. ^ "Nonallergic rhinitis". http://www.mayoclinic.com/health/nonallergic-rhinitis/DS00809/DSECTION=causes.  
  4. ^ Patricia W. Wheeler, M.D. and Stephen F. Wheeler, M.D.. ""Vasomotor Rhinitis" American Family Physician". http://www.aafp.org/afp/20050915/1057.html. Retrieved 2009-03-10.  
  5. ^ Czaja-Bulsa G, Bachórska J (1998). "[Food allergy in children with pollinosis in the Western sea coast region]". Pol Merkur Lekarski 5 (30): 338–40. PMID 10101519.  
  6. ^ Yamamoto T, Asakura K, Shirasaki H, Himi T, Ogasawara H, Narita S, Kataura A (2005). "[Relationship between pollen allergy and oral allergy syndrome]". Nippon Jibiinkoka Gakkai Kaiho 108 (10): 971–9. PMID 16285612.  
  7. ^ Malandain H (2003). "[Allergies associated with both food and pollen]". Allerg Immunol (Paris) 35 (7): 253–6. PMID 14626714.  
  8. ^ "Allergists Explore Rising Prevalence and Unmet Needs Attributed to Allergic Rhinitis". ACAAI. November 12, 2006. http://www.acaai.org/public/linkpages/NR+Rising+Prevalence+and+Unmet+Needs+of+Allergic+Rhinitis.htm. Retrieved 2008-10-01.  
  9. ^ "Rush University Medical Center". http://www.rush.edu/rumc/page-1098987384061.html. Retrieved 2008-03-05.  
  10. ^ "The Facts about Hay Fever". Healthlink. University of Wisconsin. http://healthlink.mcw.edu/article/1031002426.html. Retrieved 2007-06-19.  
  11. ^ "NHS advice on hayfever". http://www.nhs.uk/Conditions/Hay-fever/Pages/Prevention.aspx?url=Pages/Lifestyle.aspx.  
  12. ^ Steven Jay Weiss. "Seasonal Allergic Rhinitis". http://www.suggestadoctor.com/health_article_28.htm. Retrieved 2009-01-28.  
  13. ^ eMedicine Health Hay Fever Causes, Symptoms, and Treatment on eMedicineHealth.com
  14. ^ Walker S, Khan-Wasti S, Fletcher M, Cullinan P, Harris J, Sheikh A (2007). "Seasonal allergic rhinitis is associated with a detrimental effect on examination performance in United Kingdom teenagers: case-control study". J. Allergy Clin. Immunol. 120 (2): 381–7. doi:10.1016/j.jaci.2007.03.034. PMID 17560637.  
  15. ^ | Australian Society of Clinical Immunology and Allergy
  16. ^ Susan O'Meara, Paul Wilson, Chris Bridle, Jos Kleijnen and Kath Wright (2002). "Effective Health Care: Homeopathy" (PDF). NHS Centre for Reviews and Dissemination. http://www.york.ac.uk/inst/crd/EHC/ehc73.pdf. Retrieved 2007-06-10. "There are currently insufficient data ... to recommend homeopathy as a treatment for any specific condition"  
  17. ^ Passalacqua G, Bousquet PJ, Carlsen KH, Kemp J, Lockey RF, Niggemann B, Pawankar R, Price D, Bousquet J (2006). "ARIA update: I--Systematic review of complementary and alternative medicine for rhinitis and asthma". J. Allergy Clin. Immunol. 117 (5): 1054–62. doi:10.1016/j.jaci.2005.12.1308. PMID 16675332.  
  18. ^ Terr A (2004). "Unproven and controversial forms of immunotherapy". Clin Allergy Immunol. 18 (1): 703–10. PMID 15042943.  
  19. ^ World Health Organisation (2002). Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials. Geneva: WHO. 87. ISBN 9789241545433.  
  20. ^ (Furthermore, it should be noted that honeybees visit precisely those plants that are not pollinated by the wind and are, therefore, less likely to cause allergic rhinitis.) TV Rajan, H Tennen, RL Lindquist, L Cohen, J Clive (February 2002). "Effect of ingestion of honey on symptoms of rhinoconjunctivitis". Annals of allergy, asthma & immunology 88 (2): 198–203. ISSN 1081-1206. PMID 11868925. "This study does not confirm the widely held belief that honey relieves the symptoms of allergic rhinoconjunctivitis".  
  21. ^ Jardine, Cassandra. "Honey: the sweetest cure for hayfever". http://www.telegraph.co.uk/health/5135837/Honey-the-sweetest-cure-for-hayfever.html. Retrieved 2009-05-06.  

External links


Hay Fever is a comic play written by Noël Coward in 1924 and first produced in 1925 with Marie Tempest as the first Judith Bliss. Best described as a cross between high farce and a comedy of manners, the play is set in an English country house in the 1920s, and deals with the four eccentric members of the Bliss family and their outlandish behaviour when they each invite a guest to spend the weekend. The self-centred behaviour of the hosts finally drives their guests to flee while the Blisses are so engaged in a family row that they do not notice their guests' furtive departure.

Some writers have seen elements of Mrs. Astley Cooper[1] and her set in the characters of the Bliss family.[2] Coward said that the actress Laurette Taylor was the main model.[3] Coward introduces one of his signature theatrical devices at the end of the play, where the four guests tiptoe out as the curtain falls, leaving disorder behind them – a device that he also used in various forms in Present Laughter, Private Lives and Blithe Spirit.

Contents

History

In 1921, Coward first visited New York City, hoping that American producers would embrace his plays. During that summer, he befriended the playwright Hartley Manners and his wife, the eccentric actress Laurette Taylor. Their "over-the-top theatrical lifestyle" later inspired him in writing Hay Fever.[4]

Coward wrote the play in three days in 1924, intending the lead role of Judith Bliss for the actress Marie Tempest, "whom I revered and adored".[5] Though she found it amusing, she thought it not substantial enough for a whole evening, but changed her mind after the success of Coward's The Vortex later in 1924. Hay Fever opened at the Ambassadors Theatre on 8 June 1925 and transferred to the larger Criterion Theatre on 7 September 1925 and ran for 337 performances.[6][7] Coward remembered in 1964 that the notices "were amiable and well-disposed although far from effusive. It was noted, as indeed it has been today, that the play had no plot and that there were few if any 'witty' lines."[8]

The original cast was as follows:

  • Sorel Bliss – Helen Spencer
  • Simon Bliss – Robert Andrews
  • Clara – Minnie Rayner
  • Judith Bliss – Marie Tempest
  • David Bliss – W Graham Browne
  • Sandy Tyrell – Patrick Susands
  • Myra Arundel – Hilda Moore
  • Richard Greatham – Athole Stewart
  • Jackie Coryton – Ann Trevor

Plot

The action is set in the Hall of David Bliss's house at Cookham, Berkshire, by the River Thames.

Act I

A Saturday afternoon in June

Sorel and Simon Bliss, a brother and sister, exchange artistic and bohemian dialogue. Judith, their mother, displays the absent-minded theatricality of a retired star actress, and David, their father, a novelist, is concentrating on finishing his latest book. Each of the four members of the Bliss family, without consulting the others, has invited a guest for the weekend. Judith announces that she has decided to return to the stage in one of her old hits, Love's Whirlwind. She and Sorel and Simon amuse themselves acting out a melodramatic passage from the play beginning, "Is this a game?" "Yes, and a game that must be played to the finish!" They are interrupted by the ringing of the doorbell.

Clara, Judith's former dresser and now her housekeeper, opens the door to the first of the four guests, Sandy Tyrell, a sporty fan of Judith's. The next arrival is the vampish Myra Arundel, whom Simon has invited. The other two guests arrive together, Richard Greatham, a diplomat, and Jackie Coryton a brainless but good-hearted young flapper. Tea is served. Conversation is stilted and eventually grinds to a halt. The scene ends in total and awkward silence.

Act II

After dinner that night

The family insists that everyone should join in a parlour game, a variety of charades in which one person must guess the adverb being acted out by the others. The Blisses are in their element, but the guests flounder and the game breaks up. Simon and Jackie exit to the garden, Sorel drags Sandy into the library, and David takes Myra outside.

Left alone with Richard, Judith flirts with him, and when he chastely kisses her she theatrically overreacts as though they were conducting a serious affair. She nonplusses Richard by talking of breaking the news to David. She in turn is nonplussed to discover Sandy and Sorel kissing in the library. That too has been mere flirtation, but both Judith and Sorel enjoy themselves by exaggerating it. Judith gives a performance nobly renouncing her claim on Sandy, and exits. Sorel explains to Sandy that she was just playing the theatrical game for Judith's benefit, as "one always plays up to Mother in this house; it's a sort of unwritten law." They leave.

David and Myra enter. They too indulge in a little light flirtation, at the height of which Judith enters and finds them kissing. She makes a theatrical scene, with which David dutifully plays along. Simon rushes in violently, announcing that he and Jackie are engaged. Sorel and Sandy enter from the library, Judith goes into yet another bout of over-theatrical emoting. In the ensuing uproar, Richard asks "Is this a game?" Judith, Sorel and Simon seize on this cue from Love's Whirlwind and trot out the melodramatic dialogue as they had in Act I. David is overcome with laughter and the uncomprehending guests are dazed and aghast as Judith ends the scene by falling to the floor as if in a faint.

Act III

The next morning

A breakfast table has been laid in the hall. Sandy enters and begins eating nervously. At the sound of someone approaching he escapes into the library. Jackie enters, helps herself to some breakfast and bursts into tears. Sandy comes out and they discuss how uncomfortable they were the night before and how mad the Bliss family are. When they hear people approaching, they both retreat to the library. Myra and Richard now enter and begin breakfast. Their conversation mirrors that of Sandy and Jackie, who emerge from the library to join them. All four decide that they are going to return to London without delay. Sandy agrees to drive them in his motor car. They go upstairs to collect their things.

Judith comes down, asks Clara for the Sunday papers and begins reading aloud what the gossip columns say about her. The rest of her family enter. David proposes to read them the final chapter of his novel. Immediately, a minor detail about the geography of Paris is blown into a full-scale family row, with everyone talking at once about whether the Rue Saint-Honoré does or does not connect with the Place de la Concorde and hurling insults at each other. They are so wrapped up in their private row that they do not notice when the four visitors tiptoe down the stairs and out of the house. The Blisses are only momentarily distracted when the slam of the door alerts them to the flight of their guests. Judith comments, "How very rude!" and David adds, "People really do behave in the most extraordinary manner these days." Then, with no further thought of their four tormented guests, they happily return to David's manuscript and to what passes for their normal family life.

Revivals

The first London revival was in 1933 at the Shaftesbury Theatre with Constance Collier as Judith.[9] Hay Fever has been revived numerous times around the world since then. A 1964 National Theatre production of Hay Fever, starring Edith Evans and Maggie Smith with Coward directing, was part of the revival of interest in his work toward the end of his life. When invited to direct the production, Coward wrote, "I am thrilled and flattered and frankly a little flabbergasted that the National Theatre should have had the curious perceptiveness to choose a very early play of mine and to give it a cast that could play the Albanian telephone directory."[10]

Revival casts

Notable cast members in major revivals include:

New York, Maxine Elliott's Theater, 1925

Sorel Bliss – Frieda Inescort
Simon Bliss – Gavin Muir
Judith Bliss – Laura Hope Crews
David Bliss – Harry Davenport
Sandy Tyrell – Reginald Sheffield
Richard Greatham – George Thorpe

New York, Avon Theater, 1931

Sorel Bliss – Betty Linley
Simon Bliss – Anthony Kemble Cooper
Judith Bliss – Constance Collier
David Bliss – Eric Cowley

London, National Theatre (Old Vic), 1964

Sorel Bliss – Louise Purnell
Simon Bliss – Derek Jacobi
Clara – Barbara Hicks
Judith Bliss – Edith Evans
David Bliss – Anthony Nicholls
Sandy Tyrell – Robert Stephens
Myra Arundel – Maggie Smith
Richard Greatham – Robert Lang
Jackie Coryton – Lynn Redgrave

New York, Helen Hayes Theater, 1970

Sorel Bliss – Roberta Maxwell
Simon Bliss – Sam Waterston
Judith Bliss – Shirley Booth
David Bliss – John Williams
Sandy Tyrell – John Tillinger
Myra Arundel – Marian Mercer
Jackie Coryton – Carole Shelley

New York, Music Box Theater, 1985

Sorel Bliss – Mia Dillon
Simon Bliss – Robert Joy
Clara – Barbara Bryne
Judith Bliss – Rosemary Harris
David Bliss – Roy Dotrice
Sandy Tyrell – Campbell Scott
Myra Arundel – Carolyn Seymour
Richard Greatham – Charles Kimbrough
Jackie Coryton – Deborah Rush

London, Albery Theatre, 1992

Sorel Bliss – Abigail Cruttenden
Simon Bliss – Nick Waring
Clara – Maria Charles
Judith Bliss – Maria Aitken
David Bliss – John Standing
Myra Arundel – Carmen Du Sautoy
Richard Greatham – Christopher Godwin
Jackie Coryton – Sara Crowe

London, Savoy Theatre, 1999

Sorel Bliss – Monica Dolan
Simon Bliss – Stephen Mangan
Judith Bliss – Geraldine McEwan
David Bliss – Peter Blythe
Myra Arundel – Sylvestra Le Touzel
Richard Greatham – Malcolm Sinclair
Jackie Coryton – Cathryn Bradshaw

London, Haymarket Theatre, 2006

Sorel Bliss – Kim Medcalf
Simon Bliss – Dan Stevens
Judith Bliss – Judi Dench
David Bliss – Peter Bowles
Sandy Tyrell – Charles Edwards
Myra Arundel – Belinda Lang

A UK tour in early 2007

Sorel Bliss – Madeleine Hutchins
Simon Bliss – William Ellis
Judith Bliss – Stephanie Beacham
David Bliss – Christopher Timothy
Sandy Tyrell – Christopher Naylor
Richard Greatham – Andrew Hall

Manchester, Royal Exchange Theatre, 2008

Sorel Bliss – Fiona Button
Simon Bliss – Chris New
Judith Bliss – Belinda Lang
David Bliss – Ben Keaton
Myra Arundel – Lysette Anthony
Richard Greatham – Simon Treves

Television versions

A UK television production in 1960 featured Edith Evans as Judith Bliss and Maggie Smith as Jackie Coryton. They later played in Hay Fever on stage under the author's direction in the National Theatre revival in 1964 with Smith switching from the ingénue role of Jackie to that of the vampish Myra. Other members of the television cast were Pamela Brown, George Devine, Paul Eddington and Richard Wattis. The Times reviewed this broadcast, calling Hay Fever "Mr Noel Coward’s best play... one of the most perfectly engineered comedies of the century."[11] A further UK television production in 1968 included Lucy Fleming as Sorel, Ian McKellen as Simon, Celia Johnson as Judith, Dennis Price as David, Richard Briers as Sandy, Anna Massey as Myra, Charles Gray as Richard, and Vickery Turner as Jackie.[12]

Notes

  1. ^ Evangeline Julia Marshall, eccentric society hostess (1854–1944), married Clement Paston Astley Cooper, grandson of Sir Astley Paston Cooper, on 10 July 1877. She inherited Hambleton Hall from her brother Walter Marshall on his death in 1899, and there she entertained rising talents in the artistic world, including the painter Philip Streatfeild, the conductor Malcolm Sargent and the writer Charles Scott Moncrieff, as well as the young Coward. See Guardian, 19 April 2006, The Peerage, and Victorian Hotel History
  2. ^ Hoare, Philip. "Coward, Sir Noël Peirce (1899–1973)", Oxford Dictionary of National Biography, Oxford University Press, September 2004; online edn, January 2008, accessed 30 December 2008
  3. ^ Coward (Present Indicative), p. 126
  4. ^ Kenrick, John. "Noel Coward - Biographical Sketch", Coward 101 at Musicals 101: The Cyber Encyclopedia of Musical Theatre, TV and Film, 2000, accessed on 9 March 2009
  5. ^ Coward, p. vii
  6. ^ Gaye, p. 1554
  7. ^ Coward, p. viii
  8. ^ Coward, pp. viii and ix
  9. ^ Coward unnumbered introductory page
  10. ^ Morley, p. 369
  11. ^ The Times, 25 May 1960, p. 6.
  12. ^ "Play of the Month: Hay Fever", tv.com

References

  • Castle, Charles. Noël, W. H. Allen, London, 1972. ISBN 0491005342.
  • Coward, Noël. Hay Fever. Heinemann, London, 1964. ISBN 0 435 20196 4
  • Coward, Noël. Present Indicative. Autobiography to 1931. Heinemann 1937. Methuen reissue, 2004 ISBN 978-0-413-77413-2
  • Lahr, John. Coward the Playwright, Methuen, London, 1982. ISBN 0-413-48050-X
  • Mander, Raymond and Joe Mitchenson. Theatrical Companion to Coward. Updated by Barry Day and Sheridan Morley. Oberon 2000. ISBN 1-84002-054-7.
  • Morley, Sheridan. A Talent to Amuse. Heinemann 1969/Penguin Books, London, 1974, ISBN 0-14-00-3863-9

External links


1911 encyclopedia

Up to date as of January 14, 2010

From LoveToKnow 1911

Medical warning!
This article is from the 1911 Encyclopaedia Britannica. Medical science has made many leaps forward since it has been written. This is not a site for medical advice, when you need information on a medical condition, consult a professional instead.

HAY FEVER, HAY Asthma, or Summer Catarrh, a catarrhal affection of the mucous membrane of the upper respiratory tract, due to the action of the pollen of certain grasses. It is often associated with asthmatic attacks. The disease affects certain families, and is hereditary in about one-third of the cases. It is more common among women than men, city than country dwellers, and the educated and highly nervous than the lower classes. It has no connexion with the coryzas that are produced in nervous people by the odour of cats, &c. The complaint has been investigated by Professor W. P. Dunbar of Hamburg, who has shown that it is due to the pollens of certain grasses (notably rye) and plants, and that the severity of the attack is directly proportional to the amount of pollen in the air. He has isolated an albuminoid poison which, when applied to the nose of a susceptible individual, causes an attack, while there is no result in the case of a normal person. By injecting the poison into animals, he has obtained an anti-toxin, which is capable of aborting an attack of hay fever. The symptoms are those commonly experienced in the case of a severe cold, consisting of headache, violent sneezing and watery discharge from the nostrils and eyes, together with a hard dry cough, and occasionally severe asthmatic paroxysms. The period of liability to infection naturally coincides with the pollen season.

The radical treatment is to avoid vegetation. Local treatment consisting of thorough destruction of the sensitive area of the mucous membrane of the nose often produces good results. There are various drugs, the best of which are cocaine and the extract of the suprarenal body, which, when applied to the nose, are sometimes effectual; in practice, however, it is found that larger and larger doses are required, and that sooner or later they afford no relief. The same remarks apply to a number of patent specifics, of which the principal constituent is one of the above drugs. An additional and stronger objection to the use of cocaine is that a "habit" is often contracted, with the most disastrous results. Finally Dunbar's serum may be applied to the nose and eyes on rising, and on the slightest suggestion of irritation during the day; it will, in the large majority of cases, be found to be quite effectual.


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