To the Editor:—
Dr. Kligman's skepticism is appreciated. Before reporting these cases careful evaluation of data forced us to conclude that Aqua Ivy, AP, was the offending agent. The reactions were so severe that further administration of Aqua Ivy, AP, for absolute proof, was deemed dangerous. Experience has taught us that any complex chemical given as a drug eventually will produce some reactors. Never, before the over-the-counter distribution of Aqua Ivy, AP, has there been such mass exposure to an antigen. Dr. Kligman states that there was no good evidence of kidney damage from the reasonable use of poison ivy extracts, but in the summary of his fine article (A.M.A. Arch. Dermat.77:149 [Feb.] 1958) he states, "The unusual consequence of Rhus dermatitis includes eosinophilia, kidney damage, etc." If we produce ivy dermatitis by oral administration of poison ivy extract, as took place in one of our patients, then