Another Person’s Poison: A History of Food Allergy by Matthew Smith (review)

Until recently, historians of medicine have not engaged overly much with issues of food and nutrition, and of those who have, most came in through the back door. Matthew Smith, senior lecturer at the University of Strathclyde, begins his engaging history of food allergy in the United States by noting that he thought he was working on ADHD (p. ix), and I suspect most other historians of food and nutrition could tell a similar tale. Indeed, one of the great strengths of Another Person’s Poison is that Smith characterizes food allergy as a definitional problem—an argument I would extend to food and nutrition as a whole. Food allergy was an explanation for the otherwise unexplained, a key intersection for the development of medical fields such as allergy and psychiatry, and an elusive clinical entity that neither laboratory testing nor patient testimony could truly reveal. “The greatest challenge in the epistemology of food allergy,” Smith argues, “has been simply defining what it was” (p. 8). What marked the “strangest of all maladies” over the course of the twentieth century, in other words, was a nearly continuous struggle to define food allergy (or later “true” food allergy), and thus to determine how to identify it, who could claim it, how prevalent it was, and who should bear responsibility for averting its worst outcomes.

Another Person’s Poison is structured chronologically, but the chapters are organized largely around key developments in the concept of food allergy. “The history of food allergy,” Smith suggests, “is very much a history of how medical knowledge, and particularly controversial medical ideas, has evolved over the course of the twentieth century” (p. 6), and he focuses on key drivers of that evolution. Chapter 1 considers the “prehistory” of food allergy, before “anaphylaxis” and “allergy” entered the theoretical lexicon in the first decade of the twentieth century. Chapter 2 explores the theories most central to the emergence of allergy as a discrete pathophysiological concept, while chapter 3 examines how food allergy became distinct from other allergies because skin tests were unreliable and desensitization therapy was ineffective. In chapter 4, Smith outlines the increasing controversy that surrounded food allergy in the postwar years, as various models—particularly ecological and psychogenic—were put forth to explain a phenomenon that was exceedingly difficult to demonstrate. Chapter 5 reveals how the discovery of IgE in 1966 provided a concrete basis for the determination of “true” food allergy but also marginalized food intolerances or idiosyncrasies that could not be explained by that particular mechanism of the immune system. Last, chapter 6 explores how media coverage and parent advocacy brought national attention to peanut allergy, an especially severe and at times fatal food allergy. Smith thus charts how food allergy evolved from a controversial and largely experiential condition into a biomedical entity that influences the way we produce, market, prepare, regulate, and consume foods.

Smith writes clearly enough for a lay audience without compromising engagement with academic historians—no mean feat, to be sure—and Another Person’s Poison is likely to appeal to a wide range of readers, from allergy sufferers to allergists and from historians of medicine to health policy leaders. The book would be great for undergraduate courses, and graduate students will find no shortage of potential dissertation topics, particularly with respect to the social history of food allergy. That being said, Smith’s discussion of retrospective diagnosis is bizarre and unnecessary, and his account of the prehistory of food allergy (chapter 1) is cursory and rooted in a literary analysis that accounts too little for the philosophical and physiological contexts of the texts discussed. Worse, it contributes little to the argument he ultimately wants to make; much as an epilogue on HIV/AIDS was once de rigueur for almost any history of infectious disease, the homage to classical thought is appended rather than integrated, an unfortunate trend in current publishing.

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