A CASE OF GIANUlURTICARIA; 
By A. IL Ohmann-Dumesnil, A. M., M. D., of St. Louis. 
A. J aged twenty, five feet, eight inches high, weigh- 
ing 130 pounds has always been in good health. September 5th, 
he ate some crackers and watermelon and sometime after had a 
sensation of uneasiness in his stomach. The same evening he 
drank a bottle of Uunjadi Janos water, which acted but very 
slightly. The next morning I was cdled and found him with a 
hot and dry skin, intense thirst, rapid and full pulse, abdominal 
pains and constantly vomiting, with intense nausea. He com- 
plained of feeling a lump in his bowels. I prescribed small 
doses of soda-water to allay the irritability of the stomach 
together with powders containing very little morphia with 
some subnitrate of bismuth. 
Upon examining the skin it was found covered with minute 
papules, and macules and beginning to itch slightly. 
In the evening the irritability of the stomach had subsided to 
some extent as also the abdominal pains. 
The next morning, Sept. 7, I prescribed a mercurial to be 
followed by a saline cathartic five hours later. It was then that 
the skin presented a most unusual sight. The patient was cov- 
ered from head to foot with the characteristic wheals of urticaria. 
Their size varied from a large pin-head to half the size of the 
palm and could be found even upon the scalp. The face was 
swollen, and an intense pruritus was present all over the body. 
Frictions with whiskey were ordered to allay the itching. 
The cathartic that had been ordered acted well and the 
patient's bowels were thoroughly emptied that night. 
At noon the next day the eruption had nearly all disap- 
peared and the patient ate a full and hearty meal. In a few 
*Read before the Linton District Medical Society, Nov. 15, 1882. 2 
more, days ho was thoroughly well again and about his busi- 
ness. 
The chief points of interest about this case are: 
1. The fact that the cause of the attack was undoubtedly an 
indigestion of the food taken on the 5th of September, by which 
means a derangement of the gastro-intestinal canal was caused, 
and this in its turn was the means of provoking the eruption. 
2. The general disturbance which, as a rule, does not accom- 
pany such attacks. Although there was fever, no headache was 
ever felt. 
3. The amount of-surface invaded by lhe eruption. Gener- 
allv in adults or after puberty the surface is not so largely 
invaded nor accompanied by such strong constitutional symp- 
toms as in infants. 
4. The duration of the attack was also rather prolonged, last- 
ing almost, if not, four days. As a rule, the wheals are ephem- 
eral, appearing suddenly and disappearing in a very short 
period of lime. 
5. The size of the wheals was unusual. The large ones 
were, of course, formed by the fusion of several smaller ones; 
still wheals as large as half a palm-and there were several 
noticed-arc but rarely observed. 
6. Another point was the appearance of the eruption and its 
evolution, beginning as a macule, then becoming a papule 
and a number of these becoming infiltrated and converted into 
a wheal.