THESE CONDITIONS are essentially the same, except that urticaria, or small hives, is on the surface of the skin and angioedema, or giant hives, involves the deeper layers of the skin, the mucous membranes and the joints. If the swelling occurs in the throat or larynx, there can be asphyxiation unless help is promptly obtained. An injection of adrenalin is needed at this time.
The two conditions may be present in the same person and are often due to the same allergens. It is accepted and known by scientists in this field that certain foods, inhaled substances and drugs will cause urticaria and angioedema. There are many cases in which the condition will persist for many years and the cause is subtle and difficult to find. We have found in a number of such individuals hidden foci of infection in the teeth, gall bladder and bowels. When the infection cleared, the person recovered. The nervous system has been strongly implicated and the removal of a stressing emotional problem seems to have helped overcome some of these problems. This is still open to considerable question, as no scientific evidence appears sufficiently conclusive in this regard. Intestinal worms can also be a cause.
It must be clear to the reader that the usual thorough and complete examination and exhaustive laboratory studies are necessary, if this troublesome and often serious problem is to be solved.
A Hives Fish Story
Four-year-old Danny C. was considerably put out about the whole matter. Daddy C. shrugged his shoulders and protested against the barrage of accusations pouring from his wife.
“I knew it! I told you so!” she kept repeating. “The right kind of a father would keep at least one eye on his child when he takes him fishing!”
“I’m telling you I did keep an eye on him,” protested the father. “I kept both eyes on him, and I’m sure he didn’t leave my side the whole afternoon.”
“The boy’s probably poisoned, that’s what,” exclaimed Mrs. C. as she turned little Danny’s face down on the bed for the tenth time. The left half of the child’s backside had swollen to three times its normal size.
“It can’t be poisoning,” retorted the father. “I’ve fished that river for nearly 10 years, and I know there isn’t a sign of poison ivy or poison oak for miles.”
The family doctor looked at the inflamed region, then pressed it gently while the owner of the region indicated his disapproval.
“It’s poisoning; I just know it is,” said Mrs. C.
“I don’t think so,” ventured the doctor after a brief hesitation.
“Couldn’t be a snake bite, could it, Doctor?” asked Mr. C.
“I’m sure it isn’t that,” replied the doctor. “Tell me—did anything unusual happen to the boy while he was with you? Did he do anything at all outside of sitting beside you?”
Mr. C. reflected. “Not that I remember.”
At that moment, Danny flipped around to rest upon the unaffected portion of his backside and muttered something about being bitten by a fish. Daddy and mother were perfectly willing to pass it off as insignificant, but the doctor was interested.
“What do you mean, Danny?” inquired the physician.
“I spill itty fishes all over,” he said cryptically.
“Oh, I know what he’s talking about now,” chuckled the father. “One time I asked him to push the minnow pail closer to me. He was so anxious that he pushed it over.”
“Did any of the minnows spill out?” asked the doctor.
“Huh, just about every one of them,” said the father.
“Did manage to salvage a few, though.”
The physician pieced the story together, made close examinations and smiled.
“Well, the boy has neither been poisoned nor bitten by a snake.”
“Then what did happen to him?” the parents asked simultaneously.
“He sat on a minnow,” replied the doctor. “He what?” exclaimed the parents.
“Yes, he sat on a minnow,” the doctor repeated. “You’ll recall that, when Danny was still nursing, I had to eliminate fish from your diet, Mrs. C? Well, it seems that the child hasn’t outgrown that sensitivity to fish. When he sat on that minnow, the glue on the scales worked its way into his pores, causing the reaction you see.”
This “fish story” came to a happy ending when the swelling subsided, and the parents bent all their efforts toward keeping Danny away from fish in any form.
For those of you who are inclined toward practical joking, there is a sound lesson to be learned from the following episode in the life of a certain young lady.
Helen F. would have made a perfect hypochondriac except for the fact that the ailments she constantly complained of actually existed.
When Helen said she had a pain in her side, she really had one. When she complained of a heart murmur or of a sudden loss of breath, there was a genuine foundation for the complaint. Her greatest fault was that she persisted in voicing her ailments to her friends. Even her best friends tired of it. Her friends tried ineffectually to talk her out of her complaints, but, when Helen said that a certain food was not good for her, she meant it. The gravity of the situation somehow did not impress others.
Helen belonged to a bridge club which met weekly. The girls had always respected Helen’s request to eliminate certain foods from the luncheons they prepared.
One week, one of the girls was in the mood for practical joking.
“I’ll bet it’s all in her head,” she told another member of the club. “I’ll bet we could feed her crab meat, tell her it was tuna fish and she’d never know the difference.”
“Why don’t you try it?” suggested the other.
“That’s exactly what I’m going to do. Won’t Helen feel silly after we have told her that she has eaten crab meat?”
The girls arrived for their weekly meeting. As the luncheon was served several pairs of eyes focused with inconspicuous anxiety upon the unsuspecting Helen as she raised the first forkful of crab meat, alias tuna fish, to her lips. Since there was no immediate reaction, the girls believed that, for once, they were right.
Another mouthful and another, and suddenly Helen dropped her fork. The color left her cheeks as her lips turned blue. A terrified glassiness appeared in her eyes and, for a moment, silence hung over the room.
Soon Helen went into convulsions. She could not breathe. First aid was administered until a physician arrived. After an hour or so, Helen began to show indications of returning to normal. Only the use of adrenalin had kept the girl’s heart beating.
Angioedema of the Larynx and Death – Hives
Mrs. Avis R., a patient of ours with bronchial asthma, tells us of her daughter’s death at sixteen years of age. The story was substantiated by an autopsy report she furnished us. Her daughter had since two and a half years of age suffered from periodic swellings of a foot, a hand or the face following the eating of pork. One day at noon when she was sixteen years of age she ate some hot dogs in a restaurant. She was baby sitting and called her mother at 3:00 P.M. at which time she complained of laryngitis (hoarseness). At 9:00 P.M. that night she ran to a neighboring house dying of suffocation.
Before medical attention could be obtained the youngster passed on. The autopsy report proved the death to be the result of asphyxiation due to swelling of the larynx caused by an allergic reaction. No doubt this was precipitated by pork which was contained in the hot dogs eaten at noon. Her mother knew that she ate nothing else between noon and the 3:00 P.M. telephone call. This tragedy might have been averted if the true nature of this girl’s allergic problem had been understood and allergic medical consultation had been given many years earlier. Written By: Jack A. Rudolph, M.D. & Burton M. Rudolph. M.D., Continue Reading: Digestive Allergy