From Ambulances to Allergy

When Robert Anderson Cooke was eight he went to live on the family farm at Holmdel, N.J., soon began to suffer severe asthma, especially after a visit to the stables. It got better when he was sent away to school. An M.D. at 24 (his family's fourth-generation physician), Intern Cooke was assigned to ride ambulances for Manhattan's Presbyterian Hospital. After each call he was gasping and choking, needed Adrenalin. Reason: this was 1905-06. the ambulances were horse-drawn, and young Cooke's asthma was caused by horse dandruff.

Last week, 78-year-old Dr. Cooke, as guest of honor at a physicians' dinner in Manhattan, told how he had parlayed his equine asthma into one of medicine's newest, most prosperous specialties: allergy. Though the word had been coined in 1906, the condition had been rated a mere "idiosyncrasy" until Dr. Cooke applied himself to it. Sharpest impetus for his work came in 1908 when, after exposure to a patient's diphtheria, he got a shot of antitoxin that was produced in horse serum. Before the needle was out, Dr. Cooke was in a bad way. It took prompt Adrenalin to save him from death by anaphylactic shock.

Medical opinion at the time held that such reactions came about because the offending substance was poisonous. But Cooke noted that many people had taken horse-serum extracts with no harm; some were sensitive to pollens while others were not; most remarkable, he got patients who broke out in hives whenever they ate certain foods. He welcomed those difficult, sniffling patients for whose distress there was no obvious cause. Dr. Cooke was on the track of sensitization and desensitization.

An early and prime example of his medical detective work: a boy who had been asthmatic while living in Coney Island got relief when the family moved to Manhattan. But he had a severe relapse after his parents got some furniture out of storage. Among the items, Dr. Cooke found, were the boy's favorite heavy pillows. They were filled with rabbit fur from Europe, to which he was sensitive.

In 1918 Allergy Detective Cooke was ready for large-scale practice, opened the world's first asthma and hay-fever clinic for New York Hospital; renamed Institute of Allergy, it is now attached to Roosevelt Hospital. The institute has spawned a total of 71 similar clinics in New York City alone; the U.S. now has 1,500 allergy specialists, as many as the rest of the world.

Celebrating his organization's 40th anniversary last week. Dr. Cooke foresaw a day when current tedious desensitization measures will be abolished. Instead of merely neutralizing allergy reactions, he believes, his successors will be able to switch off the cause of allergy itself. Meanwhile, Dr. Cooke has managed to desensitize himself to horses, enjoys life on his farm in Scobeyville, N.J.

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