URTICARIA HIVES OR NETTLE RASH


A colored woman in her early twenties, presented a case of urticaria, in which great welts appeared on her back and chest, also on the hips. These lesions had persisted for some months and were particularly annoying at the regular menstrual periods, together with serious cramping of muscles of the back. After a short course of Apis mel. 30th, the welts disappeared. A few days each month of B & Ts Thyroid and Ovarian in potency, rendered the periods painless.


This is a mild, to severe, inflammation of the skin. The condition, acute to sub-acute, manifests itself by an intense itching of the skin, with the sudden appearance on the skin, of wheals, rings, ridges or welts. There is much stinging and burning and the patient gets no relief from scratching. In rare cases are found nodes, papules, bullae or blebs.

At the beginning, the skin irritation may be the only symptom; however, if the condition is quite generalized, there may be some malaise, moderate headache, and some gastro- intestinal disturbance with coated tongue. The systemic symptoms, as a rule, are not troublesome, but the burning, stinging, pricking and itching sensation of the skin, cause the patient great discomfort, especially if the individual be of the nervous, high strung type; he is almost beside himself. Then he attempts to show his friends where his lesions are, and behold there is nothing to be seen. The spot he last rubbed, or scratched, shows not a trace of weld of wheal, which is very like the moss-grown railroad story told on Pat Finnigin, section boss on the Northern Pacific.

Pat was accustomed to write a lengthy report after every train wreck he cleared up, and send it to the main office of the road. As wrecks were fairly numerous, the superintendent grew weary reading Pats long epistles, so one day he called Pat up on the carpet and admonished him to make his reports more brief. The very next day, there was another wreck, and the superintendent received the following telegram: “Off again; on again; gone again, Finnigin.” So with the hives, the more one scratches, the more itching there is, but the wheal is often not to be found. This sudden itching, with its raised section of skin, which when looked for again is not there, is very diagnostic of nettle rash.

Urticaria as a rule, appears with no warning; so the question as to its cause is purely an individual one. In general, some indiscretions in diet; an overloaded alimentary tract; an idiosyncrasy to certain articles of food, among which the more common are seafood, especially shellfish, pork and its products, certain acid fruits, as strawberries, or raspberries; mushrooms; drugs, such as salicylic acid, quinine, arsenic, coal tar products; antitoxic sera injection; any one may the cause for the appearance of the rash.

Again, urticaria does not present itself to all persons. It generally manifests itself upon the so-called thin skinned individual; on one who is sensitive to outward impressions; on the nervous, easily startled person; on the man or woman easily annoyed or made irritable by trifles; upon the individual whole elimination of waste products daily, is slightly less than the daily production, hence he is always a little toxic.

Therefore, a patient suffering from an attack of hives, requires careful individualization and carefully, to learn if the patient knows of any article of food or drink, which may possible cause his distress; to ask as to character of stool and condition of urine; to learn whether the perspiration is much, little or none; number of hours of restful sleep, per twenty-four hours; to discover the eating habits of the patient, whether the food is well masticated; the amount of fluids drunk at meals. It will also be wise to learn if stimulants, drugs, or narcotics are frequently used.

A correction in any of errors, made by the patient, which the above examination may show, will be a great aid in effecting a cure. The length of time that the rash has been bothering the patient may be an aid in giving the prognosis.

For the relief of the itching, the parts may be bathed in alcohol, hot normal saline, hot five per cent soda-bicarbonate solution, potassium permanganate, cold 1-5,000 solution. The whole body may be given a hot tub bath, at time, with the addition of a liberal supply of sea salt to the water, or one- quarter pound of washing soda to each 20 gallons of water. Olive oil pain, or with phenol five drops to the ounce, rubbed well in will often give relief to an itching part.

At least but by no means least, the well indicated remedy will be necessary to effect a cure, for although urticaria is a simple rash, it generally caused by some dyscrasia in the individual and the appropriate remedy is necessary to set right the body mechanism. The following remedies come most frequently to mind:

Aconite: Early in the rash, in the plethoric, active person.

Belladonna: Also acute stage, with flushed face, dilated pupils, nervous, slight temperature, moist neck and hands.

Anacardium: Patient angry at the condition, apt to sweat at the stings; dreads to go to his job; patients looks rheumatic.

Apis: Rash apt to be in welts, instead of wheals; general puffiness; sluggish type of individual.

Arsenicum: If history of eating shell fish, or indications of any spoiled food as the exciting cause.

Cimicifuga: If patients is a woman, nervous, subject to neuralgic pains; apt to be irritable, or easily offended.

Calcarea carb.: Patient fat, blonde, craves sweets, rash very fleeting in its stay.

Dulcamara : Itching worse during cold or wet weather. Sour eructations together with the rash.

Pulsatilla: Women or blonde girls; weak and weeping; condition and rash brought on by eating rich food.

Sulphur: Terrible itching; worse at night; apt to be a careless person; dreads water, either to drink or bathe.

Urtica urens: Much stinging in the lesions; wheals pronounced;. urine shows uric acid; sub-acute stage.

The following cases illustrate the simplicity of curing such conditions.

CASE I.

A young married woman, mother of one four year old boy, came into the office, as a new patient, for advice as to what to do for a cold for herself and her boy. In taking her history it was learned that for the past 16 months she had been on “a wheat free diet.” Curious as to the cause, she said she had had an attack if hives, which had bothered her. Her skin had been tested and she was told that if she would drop all wheat from her diet her hives would leave. She did and never ate wheat bread, bun or cereal, from that day on for 16 months. Innocently, I remarked, “No more hives; diet cured?” “It did not. The diet made no impression, whatsoever, and I still have my hives” she replied.

A return to a full wheat diet and a few doses of Urtica urens within ten days wiped the hives off her calendar.

CASE II.

A colored woman in her early twenties, presented a case of urticaria, in which great welts appeared on her back and chest, also on the hips. These lesions had persisted for some months and were particularly annoying at the regular menstrual periods, together with serious cramping of muscles of the back. After a short course of Apis mel. 30th, the welts disappeared. A few days each month of B & Ts Thyroid and Ovarian in potency, rendered the periods painless.

CASE III.

Miss J., aet. 19, a blonde, weight 140 pounds, very fond of cakes, pastry, candy and ice cream, suddenly developed a case of hives, in which the itching was quite pronounced, the lesions largely wheals and confined chiefly to arms and shoulders. She was advised to omit sweets largely from her diet and add salads and meat. She was given some ointments to rub on the lesions and ordered to go to the country for a month. When I saw her on her return she was a sight. Very little of her skin was free of the developing lesions, many of the other lesions were excoriated, some scaling and some covered with scabs.

A milk and vegetable diet was prescribed, with frequent olive oil rubs, together with Sulphur 200th. By the end of a week, most of the old lesions had healed but plenty of new ones had appeared. She then had Calcarea carb. 30th in tablets and in a month her urticaria had cleared and she has remained free since, but she has never returned to her excessive carbohydrate diet.

Thus it seems that the finding of an indicated remedy is very largely responsible for the cure of urticaria.

MONTCLAIR, N.J.

I L Farr