Urticaria, or hives, often constitutes an annoyingly difficult problem to the general practictioner and the specialist alike. In the aggravated form of angioneurotic edema it may even threaten life. Usually the attacks are self limited and easily controlled by abstinence from foods to which the patient is allergic, by employment of cathartics, alkalis and calcium by mouth and by the use in emergencies of epinephrine or ephedrine. Occasionally it resists all such measures and plagues the patient intermittently or continuously. In such instances of resistant disease the nervous or psychic element may be so prominent1 as to require psychotherapy or training in muscular relaxation according to Jacobson's method.2
In several of my cases bacteriologic study and treatment have been successful.
Allergens producing urticaria usually enter through the intestinal tract. This manifestation of hypersensitiveness differs from true atopy in not being mediated by a reagin mechanism.3 In the
TRAUT EF. MANAGEMENT OF INTRACTABLE URTICARIA. Arch Derm Syphilol. 1939;40(3):368–373. doi:10.1001/archderm.1939.01490030025002
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