288 THE INTERNAL SECRETIONS 1920 



constriction of the same vessels, with secondary sup- 

 port and prolongation by adrenal hyperactivity, which 

 vasoconstriction limits the blood supply to the affected 

 part and for a continued period prevents the reabsorp- 

 tion of exuded serum. 



Foreign protein in the blood stream appears to be 

 the exciting cause of thyroid activity and vasodilator 

 irritability and near-fatigue ; nervous shock, continued 

 strain and fatigue appear to be the exciting causes of 

 adrenal hyperactivity. The latter are absent in simple 

 urticaria, hence adrenal hyperactivity is absent and 

 wheal persistence is slight ; in angioneurotic edema any 

 or all are present, hence adrenal hyperactivity is pres- 

 ent, and wheal persistence is great. In both types of 

 urticaria foreign protein absorption manifestations are 

 marked. 



Being of thyroid and adrenal origin, and not a dis- 

 sease of the nervous system, angioneurotic edema 

 should be known as Thyro- Adrenal Urticaria. 



BIBLIOGRAPHY 



1. Osier (Sir. Wm.) : "The Principles and Practice of 



Medicine," D. Appleton & Co. (New York), 1901, 

 p. 1140. 



2. Ibid., p. 1141. 



3. Hare (H. A.) : "Practical Therapeutics," Lea & Febi- 



ger (Philadelphia), 1918, p. 166. 



4. Schalek (A.) : "Diseases of the Skin," Lea Brothers 



& Co. (Philadelphia), 1902, p. 214. 



3. Bandler (S. W.) : "Medical Gynecology," W. B. Saun- 

 ders Co. (Philadelphia), 1915, p. 200. 



6. Besredka (A.) : Theories of immunity and anaphy- 



laxis, Lancet (London), 1913, ii, 462. 



7. Rogers (J.) : Fatigue disease as exemplified in func- 



tional disorders of the stomach and thyroid gland, 

 Arch. Int. Med. (Chicago), 1919, xxiii, 498. 



8. Bandler (S. W.) : "Medical Gynecology," W. B. Saun- 



ders Co. (Philadelphia), 1915, p. 160. 



9. Besredka (A.) : Theories of immunity and anaphy- 



laxis, Lancet (London), 1913, ii, 462. 



