Seasonal allergic rhinitis and asthma initially referred to (incorrectly) as rose catarrh was ill understood and still the subject of case reports less than 200 years ago (1). In his famous treatise in 1873, Charles Blackley clearly identified pollen as at least one cause of allergic airway symptoms (2). Subsequent studies led to the development of allergen skin testing (3), allergen injection therapy (4), passive transfer of sensitization by serum (5), and the eventual discovery that the serum factor previously termed reagin was a newly recognized immunoglobulin called immunoglobulin E (IgE)(6). In subjects who appear equally allergic, allergen exposure may induce allergic rhinitis (nose and eye symptoms primarily), allergic rhinitis and asthma, or infrequently asthma alone. These discrepancies led to the concept that there must be a difference or a susceptibility in the so-called shock organ that led to some subjects developing asthma and others rhinitis (7).