BOOKS

Review: ‘Another Person’s Poison,’ Matthew Smith’s Book on Food Allergies

Have to put in a personal note here: I am from a generation (older) of Americans among whom real food allergies were (are) very rare. My sister, who is just seven years younger than me, is a devoted Vegan and has converted her family to the Vegan/Gluten Free Way...I am still an Omnivore and the only thing I watch is not eating too much tuna because of the Mercury problem these days ( advised by my doctor)...my niece, (adopted from China as an infant) has a terrible dust allergy and all her friends who live in very clean, pleasant circumstances in Massachusetts have allergies too. What gives? Does this all come from Diesel fumes or something ( as they suspected of asthma-- Note: Science Daily has reported on NEW findings on origins of asthma...)

MAY 24, 2015

Matthew SmithCreditUniversity of Strathclyde

Books of The Times

By ALEXANDER NAZARYAN

If you grew up food-allergic in the late 20th century, you probably grew up haunted by the ghost of Katherine Brodsky, the Brown University student with a peanut allergy who died in 1986 after eating chili at a restaurant in Providence, R.I. The chili had been thickened with peanut butter. It took two spoonfuls to kill Ms. Brodsky.

The lesson of Ms. Brodsky’s death — repeated by my parents, and, I imagine, many others across the land — was not difficult to grasp: Threats are everywhere, and your vigilance must be mighty to meet them. Ask about the mole poblano and the samosa. Avoid the pad thai. Carry an EpiPen. Cook your own food. In the absence of a cure, constant anxiety will be your savior.

Matthew Smith, a medical historian in Scotland, tells Ms. Brodsky’s story, and those of many other allergy victims, in “Another Person’s Poison,” a cultural history of people eating things that make them sick or kill them. The author of two books on hyperactivity, Mr. Smith acutely grasps that medicine is often informed, or vitiated, by history and culture. He knows, too, that politics is a primary ingredient in most everything we ingest.

While too academic in tone to compete with the romps of a pop-med master like Mary Roach (“Stiff,” “Bonk,” “Gulp”), “Another Person’s Poison” shouldn’t frighten away those who don’t know their varieties of immunoglobulin. The story Mr. Smith tells is fundamentally fascinating, and for the most part he tells it well.

The timing for this book is certainly right. Allergies have been on the rise, with the most deadly food allergy, to peanuts, doubling in incidence from 1997 to 2002 among American children. An estimated 15 million Americans are believed to have a food allergy of some kind. One person may break out in hives from eating shellfish; another may go into anaphylactic shock from eggs. Society no longer ignores food allergies as oddities. There is a gluten-free pizzeria in Manhattan; Fenway Park in Boston has a peanut-free zone for some Red Sox games; and peanuts on airplanes have become nearly as verboten as cigarettes.

Some have speculated that food allergies are “a disease of civilization,” a physiological mutiny against the additives in our diets. “In this age of chemicals and synthetics there is truly no limit as to what substances may be discovered as causes of allergy,” an allergist wrote in 1957. Echoing some autism activists, a few doctors have even linked the rise of the peanut allergy to mass vaccination, in a show of how readily the imagination will supply answers that science cannot.

The Pulitzer Prize-winning author and doctor Siddhartha Mukherjee called his book about cancer “The Emperor of All Maladies”; allergies, conversely, were deemed “the strangest of all maladies” in a 1942 volume, a description with which Mr. Smith explicitly agrees, and for good reason. There are no universal criteria of diagnosis, no standard treatments and plenty of disagreement about the very contours of the battlefield: What are the bounds of aversion, intolerance and allergy? What’s the difference between a psychological reaction and a physiological one? If you declare that you can’t eat mushrooms, who has the right to tell you otherwise?

Because the etiology of allergies proved elusive, those who treated the disorder were accused of practicing “witchcraft,” as one allergist complained in 1956. Mr. Smith makes the distinction between orthodox allergists, steeped in hard-core immunology, and the food allergists who were often seen as renegades because they considered environmental causes and took patients’ complaints seriously, even if those complaints could not always be scientifically confirmed. Mr. Smith writes that throughout much of the 20th century, some in the medical establishment “believed that allergy was not much more than a glorified craft practice rather than a medical science.” Those plagued by food allergies were sometimes maligned as hypochondriacs, the true nature of their suffering suspected to be neurotransmitters, not antibodies.

Where American medicine goes, American business eagerly follows. Mr. Smith quotes an advertisement that sought to capitalize on the late-20th-century push for allergy testing: “GET RICH! BE FIRST in your area to open a very lucrative allergy testing center — an ALL-CASH-UP-FRONT money-maker.” More honest entrepreneurs figured out that riches could be made from allergen-free foods and recipes. As early as 1939, an author was extolling the fact that “in Oakland, California, there is a bakery where counters are filled with nonallergic delicacies” and that, more broadly, the “potentialities of the soybean are being explored.” I, personally, am waiting for New York’s first nut-free Thai restaurant.

The peanut is the complex hero of this book. A killer, yes, but one that “finally gave allergists the scientific legitimacy, public profile, and medical status that they had always desired.” In 2004, Congress passed the Food Allergen Labeling and Consumer Protection Act, mandating that food makers list the presence of any of the eight most common allergens on their labels. And in the fall of 2013, President Obama, whose eldest daughter, Malia, has a peanut allergy, signed a bill that encouraged schools to stock EpiPens, which can arrest anaphylaxis.

Mr. Smith gives an amusing summary of the culture wars raging over the peanut, the consumption of which has become a celebration of personal freedom in the face of suspicious public health goals. His book opens in Edmonton, Canada, where a stadium in 2009 banned peanuts from an AC/DC concert. The outrage was predictable, with one fan complaining that he would “end it all” if forbidden from chomping on peanuts while fist-pumping to “You Shook Me All Night Long.” A Florida school started to use a peanut-sniffing dog in hopes of protecting a 6-year-old girl with a severe allergy. Some parents complained about the classroom time usurped by that school’s anti-peanut measures, protesting in front of the school with signs that proclaimed “Our Children Have Rights Too!”

But despite promising research, the ailing continue to ail. A few years ago, I went to see an allergist on the West Side of Manhattan who I had been told was one of the finest practitioners in the city. As I sat in her office, detailing the tree nut and peanut allergies that had plagued me for three decades, I awaited the moment in which she would reveal an imminent cure that would soon have me scarfing down Reese’s Pieces.

When I was done with the chronicle of my travails — The Dark Night of the Pistachio-Studded Cannoli, etc. — the doctor looked at me with a befuddled expression, as if something obvious was eluding me.

“It’s very simple,” she said. “Just don’t eat any nuts.”