On local asphyxia and symmetrical gangrene of the extremities / by Maurice Raynaud ; translated by Thomas Barlow.

  • Raynaud, Maurice R., 1834-1881.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: On local asphyxia and symmetrical gangrene of the extremities / by Maurice Raynaud ; translated by Thomas Barlow. Source: Wellcome Collection.

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    tlie base, there arrives a moment wbeu the slougli is fouml sepa- rated from tbe living parts by a groove of a few millimétrés widtb. Cicatrisation takes place proportionally, and to remove tbe slougli it is only necessary to eut througb along tbe edge ot tbe growing nail. Nevertbeless tbe growtb of tbe nails bas uot been continued ; it is completely suspended, and tbeir lengtb remains stationary during ail tbe time tbat tbe great pains of mortification last. Tben tbey recommence to grow, and présent at tbeir surface a trausverse dejjression, wbicb indicates tbus tbe period of arrest in tbeir nutrition. Tbe black colour wbicb tbey présent is a simple cftect ot transparence ; at a later period it is replaced by a greenisb colour. Some may fall eutirely, otbers, not finding auy furtber support at tbeir extremity, curve round more or less irregularly, and remaiu permanently deformed. I bave no need to insist on tbe lowering of température wbicb accompauies tbe production of gangrené in tbese cases, as in ail otbers. I will only mention tbat I bave noted at tbe same time a sligbt increase of beat over tbe wrists and on tbe palms. Since I bave made tbis observation À\I. Broca bas generalised tbe fact, wbilst sbowing tbat in senile gangrené tbere is always exaggeration of beat in tbe upper part of tbe diseased limb ; be tbinks tbat tbis pbenomenon is due to a supplemeutary capillary circulation.* Tbe nose and tbe external ears are sometimes more or less attacked ; but I am not aware tbat in tbese situations complété mortification bas been observed. Tbe lobule and tbe alæ uasi présent, it is true, a black colour, livid marblings extend to tbe cbeek, but tbis coloration disappears on pressure, to reappear subsequently. Tbe parts become reanimated little by little, witbout even passing tbrougb tbe period of desquamation. IV. In tbe description of general symptoms we must carefully distiuguisb tbose wbicb belong strictly to tbe malady wbicb now concerns us, from tbose wbicb are allied eitber to an antécédent malady or to a concomitant diatbetic state. Tbe symptom wbicb first attracts attention is pain. Tbis is sometimes tbe primary pbenomenon, and geuerally it rapidly takes on a truly frigbtful intensity ; it is not limited to tbe * Comptes rcinhis de la Société de Chirurgie, 1861.