In connection with the issues raised by Wiel1 in regard to angioneurotic edema, namely, the symptomatic character of the affliction, the association of disturbances of the gastrointestinal tract and the consideration of surgical interference which demands the most delicate judgment, the following case, which I was able to observe very closely, is of interest.
The patient, aged 37, has a negative family history with the exception of a slightly neurotic tendency in the mother. He has never suffered from any other sickness with the exception of scarlet fever and chicken-pox in early childhood. Though physically of a hardy and strong development, mentally his make-up is high-mettled, volatile and tense.
Although from the age of 8 he had suffered intensely from chilblains, there were no other vasomotor disturbances until 1904, when, while working under some stress, he suddenly developed a large circumscribed swelling on the lower lip. Thereafter, at irregular intervals