Theodore Muysenberg came to me with a suspected dust allergy. He was treated with extracts of house dust, a procedure commonly employed to desensitize patients to this source of allergic reaction. Soon after receiving his injection, however, he would be overcome with headache and fatigue and would have to lie down in my office until the reaction wore off.
Since some patients react to the chemical preservative used in the preparation of house-dust extract, Muysenberg was given a chemical-free preparation. Again, however, he became acutely ill. On the next visit the dose was reduced, on the theory that the amount given, although very small, may have been the source of the reaction. Again, he became ill.
Since he lived outside the city, these trips to Chicago were becoming a burden for him, but in an effort to get to the bottom of his reaction, he continued to come. Nothing seemed to work, or rather, everything seemed to bring on these distressing symptoms.
As a control test, Muysenberg was given an injection of preservative-free normal saline solution, which generally has no effect on the body at all. Again, however, he suffered his characteristic fatigue and headaches. After a few hours, he was given another appointment and sent home. The next time, he was jabbed in the arm with a dry needle. This time, too, he became tired, headachey, and had to lie down. The next time he came, he was given no injection at all: he was simply sent home without any treatment and told to watch for symptoms. A few hours later he called and said that he had developed the familiar symptoms on the trip back.
At this point, of course, many doctors would have referred this patient to a psychiatrist or attributed his symptoms to the strain of his intellectually demanding job. Having been alerted by the experience of other patients, however, I thought to ask Muysenberg what means of transportation he used to get to my office and to return home. The bus, he answered. I therefore “prescribed” the elevated train for his next trip into town.
This time there was no headache, exhaustion, or any untoward reaction at all. Muysenberg was able to take his dust-allergy injections with impunity and to return home with no problem, provided that he used the “El.” Whenever he attempted to ride the diesel-powered bus for any length of time, however, the same distressing symptoms returned—symptoms which, in other circumstances, might have landed him on a psychiatrist’s couch.
Another patient got abdominal cramps and diarrhea whenever she attempted to ride a few blocks on a diesel bus but was able to ride several miles on a propane-fueled bus before the same symptoms came on. Sleepiness and mental confusion are reactions which are also often seen among chemically susceptible bus riders.
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