“What can you do for my hives?” It would seem that there was nothing more that could be done for this twenty-seven-year-old woman's hives. She already had been carefully studied and treated by a succession of doctors, including an allergist, an internist, and a dermatologist. She had even been hospitalized twice. No cause had ever been found and the hives could be controlled only with steroids.

The attacks had begun six years ago. At first they were only occasional visitors, but soon they developed into severe generalized hives which came every day. For the past three years, whenever she scratched her skin, a hive came up.

The salient features in her hive history were: 1) onset after an automobile accident; 2) anaphylactic shock after injection of the drug, ACTH, suggestive of an allergy to pork; 3) no family history of hives; 4) no association of the hives with either the menses or taking aspirin; 5) usually worse in the morning hours.

Thus began a three-year odyssey of study, tests, and therapeutic trials. Routine blood studies, as well as tests for lupus, were repeatedly normal, as were x-rays of her chest and teeth. There were no dental abscesses evident. Biopsy of the skin showed only the local accumulation of fluid, typical of urticaria.

The absence of basophils from her blood, and the presence of dermographism (skin writing) indicated to us that at all times she carried the antigen responsible for her hives. But what was it?