On the study of the hand for indications of local and general disease / by Edward Blake.

  • Blake, Edward T. (Edward Thomas), 1842-1905.
Date:
[1889]
Catalogue details

Licence: Public Domain Mark

Credit: On the study of the hand for indications of local and general disease / by Edward Blake. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    lunule, lies immediately above the nail-fold. It is then known as “ pot-boys’ disease.” These areas of election form a curious exception to the old clinical rule that eczema elects the aspect of flexion, whilst psoriasis prefers the aspect of extension. Psoriasis of the palm, unless produced by arsenic or by traumatism, is often associated with specific infection. It may be roughly said that the dorsal aspect of the hand is the domain of gout and that the palmar side is the area of secondary syphilis. The primary manifestation of syphilis on the hand has no elective site. The chancre is indeed occasionally found on the finger because, with the possible exception of the tongue, that is, next to the external genitalia, the point most exposed to infection. On the finger, a crack in the nail-fold or a hang-nail often decide the site of invasion. We may bear in mind that chancre of the finger pre- sents an entirely different appearance from that with which we are familiar in its more ordinary situation. It begins as a bright red spot, grows quite rapidly, and in a fortnight after its first manifestation it may exceed one centimeter in diameter. It is quite easy to overlook its specific nature. It may be dull or rosy, depending for its tint on the tendency to venous stasis of the person infected. The surface may be very angry-looking during the active stadium, and when the acute stage has subsided, there often remains a typical brown spot which, to the initiated, tells its own story. A ruddy injected line, raised slightly above the surface and bordering the lunular fold, is very suggestive of gout. It is interesting that a similar fold of epithelium, at the labial aspect of the insertion of the teeth, known as “ the gingival organ,” is also an area of election for certain gouty manifestations, for example, pyorrhoea alveolaris or Kigg’s disease. Panaris or Paronychia.—The site of whitlow is the site of primary specific infection of the hand. The washerwoman’s disease has been attributed to poisoning by soda, but the exceedingly valuable provings