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August 19, 1950, Vol 143, No. 16 >
Other Articles | August 19, 1950

PATHOGENESIS OF URTICARIA: Title and subTitle BreakExperimental Study of Life Situations, Emotions and Cutaneous Vascular Reactions

DAVID T. GRAHAM, M.D.; STEWART WOLF, M.D.
[+] Author Affiliations

Read before the Association for Research in Nervous and Mental Diseases, Dec. 3, 1949, New York. To be printed in full with case reports as part of the Proceedings of that association.


New York

From the New York Hospital and the Department of Medicine of Cornell University Medical College.


JAMA. 1950;143(16):1396-1402. doi:10.1001/jama.1950.02910510014003
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References

The association of urticaria with stressful life situations has been observed by numerous authors,1 but there are few available data concerning the mechanisms involved. Grant, Pearson and Comeau,1b who studied the urticaria that occurs with exercise, warming of the body and "emotion," found that parasympathomimetic drugs produced urticaria in susceptible persons. Hopkins, Kesten and Hazel1c confirmed these observations. They inferred that urticaria in their patients represented an allergic reaction to acetylcholine released at nerve endings during the resulting vasodilatation.

Lewis2 demonstrated the importance of cutaneous vascular changes in the production of wheals. Accordingly, in our investigation measurements of blood vessel function were correlated with changes in the life situation, attitude and feeling state in 30 patients with chronic urticaria. Three procedures were employed: Life history material was correlated with the appearance and subsidence of symptoms; material thought to be symptom provoking was deliberately introduced during interviews

REFERENCES

1 +
Dunbar, F.: Emotions and Bodily Changes: A Survey of Literature on Psychosomatic Interrelationships, 1910-1945 , ed. 3, New York, Columbia University Press, 1947;.
2 +
Grant, R. T.; Pearson, R. S. B., and Comeau, W. J.:  Observations on Urticaria Provoked by Emotions, by Exercise and by Warming the Body , Clin. Sci. 2:253-272, 1936;.
3 +
Hopkins, J. G.; Kesten, B. M., and Hazel, O. G.:  Urticaria Provoked by Heat or Psychic Stimuli , Arch. Dermat. & Syph. 38:679-691 ( (Nov.) ) 1938;.
4 +
Saul, L. J., and Bernstein, C., Jr.:  The Emotional Settings of Some Attacks of Urticaria , Psychosom. Med. 3: 349-369, 1941;.
5 +
Stokes, J. H.; Kulchar, G. V., and Pillsbury, D. M.:  Effect on the Skin of Emotional and Nervous States: Etiologic Background of Urticaria with Special Reference to Psychoneurogenous Factor , Arch. Dermat. & Syph. 31:470-499 ( (April) ) 1935;.
6 +
Lewis, T.: The Blood Vessels of the Human Skin and Their Responses , London, Shaw and Sons, Ltd., 1927;.
7 +
Edwards, E. A., and Duntley, S. Q.:  The Pigments and Color of Living Human Skin , Am. J. Anat. 65:1-33, 1939;.
8 +
Lewis.2 Weiss, S.; Robb, G. P., and Ellis, L. B.:  The Systemic Effects of Histamine in Man with Special Reference to the Responses of the Cardiovascular System , Arch. Int. Med. 49:360-396 ( (June) ) 1932;.
9 +
Ponder, E.:  The Capillaries and the Lymphatics , in Howell's Text-book of Physiology , edited by John Fulton and others, ed. 15, Philadelphia and London, W. B. Saunders Company, 1949;.
10 +
Hardy, J. D., and Soderstrom, C. F.:  An Improved Apparatus for Measuring Surface and Body Temperature , Rev. Scient. Instruments 8: 419-422, 1937;.
11 +
Di Palma, J. R.; Reynolds, S. R. M., and Foster, F. S.:  Quantitative Measurement of Reactive Hyperemia in Human Skin , Am. Heart J. 23:377-389, 1942;.
12 +
Graham, D. T.:  The Pathogenesis of Hives , Proc. A. Research Nerv. & Ment. Dis. 29:1950;, to be published.
13 +
Weiss, S.:  The Interaction Between Emotional States and the Cardiovascular System in Health and Disease , in Contributions to the Medical Sciences in Honor of Dr. Emanuel Libman , by His Pupils, Friends and Colleagues, New York, International Press, 1932;, vol. 3, pp. 1181-1198.
14 +
Schroeder, H. A., and Goldman, M. L.:  Test for the Presence of the Hypertensive Diencephalic Syndrome Using Histamine , Am. J. Med. 6: 102-167, 1949;.
15 +
Graham, D. T.; Goodell, H., and Wolff, H. G.: To be published.

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1 +
Dunbar, F.: Emotions and Bodily Changes: A Survey of Literature on Psychosomatic Interrelationships, 1910-1945 , ed. 3, New York, Columbia University Press, 1947;.
2 +
Grant, R. T.; Pearson, R. S. B., and Comeau, W. J.:  Observations on Urticaria Provoked by Emotions, by Exercise and by Warming the Body , Clin. Sci. 2:253-272, 1936;.
3 +
Hopkins, J. G.; Kesten, B. M., and Hazel, O. G.:  Urticaria Provoked by Heat or Psychic Stimuli , Arch. Dermat. & Syph. 38:679-691 ( (Nov.) ) 1938;.
4 +
Saul, L. J., and Bernstein, C., Jr.:  The Emotional Settings of Some Attacks of Urticaria , Psychosom. Med. 3: 349-369, 1941;.
5 +
Stokes, J. H.; Kulchar, G. V., and Pillsbury, D. M.:  Effect on the Skin of Emotional and Nervous States: Etiologic Background of Urticaria with Special Reference to Psychoneurogenous Factor , Arch. Dermat. & Syph. 31:470-499 ( (April) ) 1935;.
6 +
Lewis, T.: The Blood Vessels of the Human Skin and Their Responses , London, Shaw and Sons, Ltd., 1927;.
7 +
Edwards, E. A., and Duntley, S. Q.:  The Pigments and Color of Living Human Skin , Am. J. Anat. 65:1-33, 1939;.
8 +
Lewis.2 Weiss, S.; Robb, G. P., and Ellis, L. B.:  The Systemic Effects of Histamine in Man with Special Reference to the Responses of the Cardiovascular System , Arch. Int. Med. 49:360-396 ( (June) ) 1932;.
9 +
Ponder, E.:  The Capillaries and the Lymphatics , in Howell's Text-book of Physiology , edited by John Fulton and others, ed. 15, Philadelphia and London, W. B. Saunders Company, 1949;.
10 +
Hardy, J. D., and Soderstrom, C. F.:  An Improved Apparatus for Measuring Surface and Body Temperature , Rev. Scient. Instruments 8: 419-422, 1937;.
11 +
Di Palma, J. R.; Reynolds, S. R. M., and Foster, F. S.:  Quantitative Measurement of Reactive Hyperemia in Human Skin , Am. Heart J. 23:377-389, 1942;.
12 +
Graham, D. T.:  The Pathogenesis of Hives , Proc. A. Research Nerv. & Ment. Dis. 29:1950;, to be published.
13 +
Weiss, S.:  The Interaction Between Emotional States and the Cardiovascular System in Health and Disease , in Contributions to the Medical Sciences in Honor of Dr. Emanuel Libman , by His Pupils, Friends and Colleagues, New York, International Press, 1932;, vol. 3, pp. 1181-1198.
14 +
Schroeder, H. A., and Goldman, M. L.:  Test for the Presence of the Hypertensive Diencephalic Syndrome Using Histamine , Am. J. Med. 6: 102-167, 1949;.
15 +
Graham, D. T.; Goodell, H., and Wolff, H. G.: To be published.

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