The relation of gout and rheumatism to Dupuytren's contraction of palmar fascia, with results of treatment by Adams' operation : being a thesis for the M.B. degree at Cambridge University / by Charles Edward Hedges.

  • Hedges, Charles Edward, 1866-
Date:
[1897]
Catalogue details

Licence: Public Domain Mark

Credit: The relation of gout and rheumatism to Dupuytren's contraction of palmar fascia, with results of treatment by Adams' operation : being a thesis for the M.B. degree at Cambridge University / by Charles Edward Hedges. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    gout. No other member of his family was similarly affected. First nodule appeared at age of 13; he attributes its develop- ment to scraping his hands against the wall when playing games at school. It is interesting to note that upon the palm of the left hand, beneath the ring and little fingers, there was an induration and some puckering of the skin, indicating the commencement of Dupuytren’s contraction. As in the first case, the occupation of the patient involved much writing. The remarkable family history of the first patient, and the occurrence of the nodules in several members of his family, suggests a constitutional origin for them, and lends some colour to the idea that they may be connected with a gouty tendency ; but, on the other hand, no one of the three patients had suffered from acute gout. It is further interesting to note the coinci- dence in one case of an early stage of Dupuytren’s contraction of the fingers, and the history of the same affection in the father of the first patient. The influence of injury in determining their formation was in some instances well marked. I consider the pathology and causation of these growths as analogous to the growth and contraction of the palmar fascia in Dupuytren’s disease, and as a further proof of the tendency to the formation of fibrous tissue in abnormal abundance in situa- tions exposed to slight irritation in persons of a certain consti- tutional state. Whether this state is always a tendency to gout or rheumatism I am unable to state ; but that such is very often the case I feel almost confident. Summary of Statistics of Sixty-four Gases collected by myself at four Infirmaries and one Hoqntal. Age stated iu 63 cases— 60 years and over, 22 cases. Between 50 and 60, 17 ,, „ 40 and 50, 11 „ „ 30 and 40, 11 ,, Under 30 . . 2 ,, Thus 50 cases began after 40 years of age, and 61 cases began after 30 years of age. Sex stated in 64 cases— 57 males—7 females. In all the female cases I saw the condition was slightly marked, and only bilateral in one case ; in one instance it was probably congenital.