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.

    13/206 (page 7)
    “ Senile gangrené differs essentially from the preceding (mum- mific gangrené) and from that which we bave described as spon- taneous gangrené. It is quite eiToneous to suppose tbat it is regularly preceded by arterial tbrombosis. I bave bad frequent opportunities of examining it anatomically, and ofteu I bave been unable to find any trace of diminution of tbe calibre of tbe arteries,_ not even above tbe limits of tbe gangrené. Often, it is true, tbe arteries are found diseased, sometimes bardened, some- times atberomatous or calcareous, &c. Nevertbeless I do not consider tbese lésions as a sufficient cause, because it is recog- nised tbat very extensive degenerations of arteries may exist vvitbout gangrené. It is very important to examine at tbe same time tbe condition of tbe muscular fibres of tbe beart ; it may be atropbied, or bave undergone fatty degeneration. Circulation becomes diffiôult in tbe remote vessels, particularly in tbe lower limbs ; nutrition suffers, &c. Senile gangrené is tbere- fore essentially a necrosis from feebleness, and ougbt to be brougbt into proximity witb gangi-ene following upon decubitus, and witb tbose gangi’enes wbicb supervene in tbe ultimate phases of grave fevers, and aô’ect tbe ears, tbe nose, tbe fingers, and tbe toes.”* \\ e see tbat tbe last word bas not yet been said on tbe subject of gangrené, and on dry gangrené in particular. In tbe actual State of our Imowledge, and in order to avoid confounding in a single description facts perbaps very incongnious, it becomes more and more necessary to give up an artificial unity wbicb eau only satisfy minds wbo care little for new researebes ; also it is necessary to establisb in tbe bistory of gangrené divisions based upon patbological anatomy and etiology, and to study separately eacb of tbese varieties, subject to tbe bringing tbem togetber at a later period and discovering tbe bond wbicb unités tbem and tbe law wbicb dominâtes tbem. III. It is to tbis Work of analysis (of wbicb tbe attentive reading of modem works on gangi'ene bas made me strongly feel tbe necessity) tbat I wisb to contribute my part. I pro- * Virchow, Ilandbuch der speciellen Pathologie und Thérapie, T. i., p. 289. There are many réservations to be made to the explanation given by M. Virchow. The degeneration of the heart and that of the vessels seem to me to be inséparable lésions, and it appears to me difScnlt to nnderstand how a permanent and incurable cause, cardi^ atrophy, shonld prodnee effects which are often transient, and also difficult to explain cases which are followed by recovery.