This case is reported because of its unique interest and for the further support which it brings to the accumulated evidence that in cases of thrombo-angiitis obliterans there is a constitutional sensitivity to tobacco.
A man aged 44, American born and a lawyer, first seen Dec. 30, 1936, gave a history of attacks of angioneurotic edema for eight years. These attacks at first were rare but gradually became more frequent and for some weeks had occurred almost daily. They involved chiefly the lips and eyelids but had occurred also in other parts of the body. He had no history of urticaria, hay fever, asthma or cutaneous eruptions. His grandfather had asthma. No other members of the family were subject to allergic manifestations. He had been to numerous skin specialists and had been given tests for protein sensitivity. Elimination of various substances from his diet or environment, however, brought no relief