Adventures in Science: Interview with Leone N. Claman

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Watson Davis: Our Adventures in Science guest today is Dr. Leone N. Claman,

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Watson Davis: Attending Physician in charge of allergy at the New York Infirmary.

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Watson Davis: Dr. Claman is talking on this program as a member of the American Foundation for Allergic Diseases.

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Watson Davis: Now, first of all, I think Dr. Claman, we better find out what allergies are.

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Watson Davis: I know there's a lot of things I'm allergic to.

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Watson Davis: But that's not exactly what you mean when -- by allergic diseases, is it?

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Leone N. Claman: No, it isn't. The word allergy actually by definition means an altered reactivity.

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Leone N. Claman: In other words, some people sneeze when lots of other people don't when they inhale certain things that are in the air.

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Leone N. Claman: Other people get hives. In other words, their skin or their noses or their lungs behave in an abnormal fashion.

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Watson Davis: Well, are there very many other people that have allergies, Dr Claman?

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Leone N. Claman: Well I regret to say that there are about one in every ten in this country who are allergic in some way or other.

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Watson Davis: About 17 million or thereabouts?

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Leone N. Claman: Just about.

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Watson Davis: Well no wonder people are worried about it, 'cause it does affect a lot of people,

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Watson Davis: and it certainly has gotten into the language, this matter of being allergic to things,

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Watson Davis: perhaps we had better ask you what can we do about some of these things?

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Watson Davis: Can we do anything?

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Leone N. Claman: Yes we can very definitely do something about them. The first thing is, to recognize an allergic condition, the diagnosis of an allergic disease must be made, and made early.

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Leone N. Claman: There are ways by which the diagnosis can be confirmed.

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Leone N. Claman: The history of the illness, the family history, the appearance of symptoms sometimes during certain seasons or when in contact with certain animals or fabrics or drugs or foods is a very important thing.

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Watson Davis: Well, Dr. Claman, you mentioned that you got to catch it early. Actually children are very subject to allergies, aren't they?

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Leone N. Claman: Well, I think that's one way of putting it. I think another way of --

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Leone N. Claman: "Expressing it would be that the first manifestations of allergic disease often appear in very early childhood or infancy. And our feeling is that if they can be recognized, diagnosed, and treated at that time before there were any complications, that a great deal will have been accomplished. In that way, the child can develop as normally as possible and not go on piling one complication upon another upon the basic allergic condition."

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Watson Davis: " Well, you mean to say that if a person does have an allergy when a child, it doesn't necessarily have to have it all the years of his life.
Leone N. Claman:

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" No, he doesn't, but one of the unhappy things about allergic disease is that they have a certain
[SILENCE] progression. The first manifestation of allergic disease in early childhood is usually eczema or "ex-ee-ma" if you prefer to pronounce it that way. It's a skin rash which itches. At a later date, the next manifestation which often appears is that of rhinitis or hay fever, sneezing, itching eyes and nose, running eyes and nose. The next thing in the progress, the allergic progression, is the appearance of asthma. And at any time in between, hives will appear. In other words, if an individual has eczema as an infant, is untreated, has hay fever as a young or middle-aged child, and is untreated, will probably develop asthma.

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Watson Davis: " Well, uh, the fact that they can be treated and, uh, get some relief is rather encouraging but I think it's a little discouraging, isn't it, that you're not, don't have the same kind of, uh, allergy throughout life. You may have this progression. I didn't know that, that's very interesting.

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Leone N. Claman: " Well, it sounds a little pessimistic. That is the sort of thing which happens when people aren't treated. But if you can get that baby when the eczema appears, if you can find out what causes the eczema. Whether its food or something in contact with the skin as soap or a fabric, or a woolen blanket

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Leone N. Claman: find out what causes the eczema, whether it's a food or something in contact with the skin: a soap or a fabric, a woolen blanket, or a rayon comforter, or something of that sort.

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If you can find what foods are causing it, and if you can help the baby to recover from the eczema at that time, then watch carefully, uh..being aware of the things that may happen, you may be able to do a very good prophylactic job, and prevent this progression of events from becoming inevitable.

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Watson Davis: Well that's very encouraging. Uh...I have heard it said...I've just heard this once, Dr.Claman, that actually it was a case of a husband being allergic to his wife. (laughs) A pretty serious situation I would say. What do you do in a case like that. Or have you ever had cases like that?

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Leone N. Claman: Well yes I have and it wasn't an emotional thing. In a couple of instances, it was cosmetics that the wife was using that were at fault and the husband wasn't allergic to her at all...just to her cosmetics.

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Watson Davis: Well that was promising and encouraging. And she stopped using those particular cosmetics and they lived happily ever after?
Leone N. Claman: Forever and ever.

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Watson Davis: Well that's very nice. How bout dogs. Sometimes dogs are causes of allergies, aren't they?
Leone N. Claman: Yes, uh...dogs, cats, birds, household pets, or the...sometimes people are even allergic to human dander or dandruff or the little scales of skin that come from the scalp.

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Watson Davis: Feathers?
Leone N. Claman: Feathers. And of course parakeets are very popular now and people sometimes people forget that parakeets have feathers, but they do and sometimes people are feather sensitive can't be happy with a parakeet.

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Watson Davis: And dust?
Leone N. Claman: Well dust is a sort of universal thing in that it consists of all the hairs: human, animal, all the bits of feathers, all the bits of fabric, all the cleaning material, cosmetics, anything that's in a home environment eventually finds its way into the dust of that home, so starting off with dust, you start off with a sort of stock mixture of things and

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Leone N. Claman: and try to develop immunity, you see, the actual specific treatment of allergic disease is really an immunizing treatment. The injections of a small dilute amount of the very substance that causes the symptoms, is really, an immunizing treatment. We don't speak of it anymore of it being desensitization it was an ambiguous word. But when you think of it as building up the resistance of the individual. It's truly an immunizing process.

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Watson Davis: Well some of these immunizing agents are more or less standard and you can get them out of the hospital's laboratory but some of them you really have to make from the agent that you really find is causing the trouble.

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Leone N. Claman: Yes, it's not at all uncommon, in fact, it's quite usual, for the doctor to ask the patient to collect his own house dust, and bring it in, and then have it made into an extract that can be used for treatment.

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Watson Davis: And that also applies to some of the pollens and that sort of thing.

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Leone N. Claman: Those are available, yes. Pollens and animal danders and feathers and kapok and cotton seed and the various things that are used in stuffing or upholstery.

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Watson Davis: Actually, years ago I wrote a story about it wasn't the goldenrod that caused hay fever, but ragweed.

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Leone N. Claman: How very good.

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Watson Davis: And well this was very, this was some years ago and believe it or not, the copy desk of the newspaper I was working on, knew so much better than I did that they changed my story and restored goldenrod to my story. Much to my regret, and much to their regret later on.

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Leone N. Claman: Yes.
Watson Davis: But it is true that it is ragweed, in the fall at least, that causes some hay fever.

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Leone N. Claman: Yes. In this part of the country we have a great deal of ragweed and one of the reasons it creates a great many complications and symptoms is that the ragweed pollen is very light. And can travel for over a hundred miles on gust of wind.

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Leone N. Claman: So that in eradicating ragweed, some people have tried to do it,

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Leone N. Claman: it doesn't do very much good just to get it out of your own back yard, or the street on which you live.

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Leone N. Claman: Because the first wind storm can bring in showers and showers of the ragweed pollen.

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Watson Davis: It's almost got to be a regional or national attempt.

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Leone N. Claman: Almost total.

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Watson Davis: reduce the ragweed. Uh air-conditioning is some help I believe isn't it? I mean if...

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Leone N. Claman: Yes air-conditioning is a of a great help, in that you can control the air in which the, uh the room in which the patient sleeps very often

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Leone N. Claman: if they can have a comfortable night's rest they can battle with their symptoms during the day.

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Watson Davis: And then it is true though that these are real difficulties, they are not imaginary at all

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Leone N. Claman: No they are not imaginary, they're very real.
Watson Davis: Not even psychosomatic, are they?

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Leone N. Claman: Well, I, I'm glad you asked that, I could talk for two, three days about that, if you'd let me, but I'll try and condense it,

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Leone N. Claman: uh you see every patient has a psyche as well as a soma, you can't divorce one from the other

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Leone N. Claman: uh, um medicine, good medicine has always tried to treat the whole patient.

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Leone N. Claman: I, I think that any illness, or any disability

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Leone N. Claman: is uh exaggerated or minimized by the psyche of the patient who has it

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Leone N. Claman: or the temperament, shall we say, or personality

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Leone N. Claman: Some people tend to exaggerate, others tend to, uhm . . . belittle their symptoms.

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Leone N. Claman: Some people tend to use their symptoms as weapons, or as thrones

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Leone N. Claman: and so, uh I think you must be very very careful in distinguishing,

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Leone N. Claman: between the cause of a disease, which is not psychic, or psychogenic

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Leone N. Claman: and and the effects that are superimposed

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Leone N. Claman: by the virtue of the personality, emotion, temperament, or psyche of the individual who has the disease,

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Leone N. Claman: uh I think it's unfortunate that the idea was so firmly seated in many people's minds

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Leone N. Claman: that all allergy was an emotional thing, uh it is not so. Definitely not so.

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Watson Davis: That's one of the reasons why the.

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Watson Davis: ...the practitioner's, the medical men and women, who are treating allergy have gotten together to support along with Claman, this "American Foundation for Allergic Diseases". Actually, it has not been organized very long has it?

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Leone N. Claman: No, it got underway in about 1953. It started its organization, it's really -uh- coming along very well. Would you like to hear the objectives of the foundation?

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Watson Davis: Well, I think it would be, I guess you're against allergy, aren't you? Both: Laugh

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Leone N. Claman: Well-
Watson Davis: What are the objectives Dr. Claman?
Leone N. Claman: Well, there is a very great necessity for basic research in allergic disease and one of the objectives is to stimulate -uh- basic research.

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Leone N. Claman: And then there is a necessity for increased professional training in the medical schools, -uh- there, there must be more, and more thorough, and better teaching of allergic diseases in the medical schools.

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Leone N. Claman: Then, -uh- it is hoped to extend hospital and clinical facilities for allergic patients so that there are more beds set aside for them under controlled conditions of environment too.

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Leone N. Claman: And eventually a home care program some time in the future which will give financial assistance to allergic patients -uh- too.

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Leone N. Claman: And then, and I would not put this last because I think I would put it first, and that is what we are trying to do right now, which is to increase the public fund of knowledge on an accurate basis as far as allergic disease are concerned. To give the public's very definite and accurate information as to what allergic diseases is and what can be done about it.

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Watson Davis: Well that's what we're doing right now, Dr. Claman actually as a part of the program. You, the foundation, isn't allergic to financial contributions is it?

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Leone N. Claman: On the contrary. Both: Laugh

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Watson Davis: Well I think it is very interesting to have this look At allergy. Uh, let me ask you this Dr. Claman, you mentioned asthma and uh,

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Watson Davis: Um Excema(Exceema), Excema(Exuhma)!

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Leone N. Claman: Well we say Excema(Exuhma), most people say Excema(Exceema).

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Watson Davis: Well alright uh... Topical things that you put on or do for them to relieve symptoms are useful, but also there's this problem of the basic cost.

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Leone N. Claman: Yes, uh we can... we can relieve some of the symptoms with various medications or applications, but you don't really treat the individual correctly unless you try to immunize them against whatever is causing his illness.

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Watson Davis: And uh, that's, therefore it's important that a doctor who knows about allergy, really uh have a chance to see these patient's, isn't it?

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Leone N. Claman: Well we think so, yes.

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Watson Davis: And uh, well I hope you do go on and conquer more and more of these rather serious, but very prevalent conditions known as allergies.

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Leone N. Claman: Thank you-
Watson Davis: Our- Our "Adventures in Science," guest today has been Dr. Leone N. Claman: Attending physician in charge of Allergy at New York Infirmary.

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