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.

    14/206 (page 8)
    pose to (lemonstrate tbat tbere exists a variety of dry gangrené affecting tbe extremities wbicb it is impossible to explain by a vascular oblitération—a variety cbaractei-ised especially by a remarkable tendency to symmetry, so tbat it always affects similar parts, tbe two upper or lower limbs, or tbe four at tbe same time ; furtber, in certain cases, tbe nose and tbe ears ; and I bope to prove tbat tbis kind of gangrené bas its cause in a vice of innervation of tbe capillary vessels wbicb it remains for me to define. As may be seen, it is a very limited corner of tbe general bistory of gangrenés tbat I propose to consider. Tbat bistory I sball avoid even approacbing ; it would be an immense task, and I cannot forget Horace’s line, “ Quid ferre récusent quid valeant bumeri.” I wisb to state at tbe beginning tbat I do not prétend in any way to attack tbe tbeory generally admitted, of gangrené by oblitération ; I believe it to be perfectly establisbed in tbe majority of cases. At least, in presence of tbe innumerable difîiculties wbicb eneumber Science, let us know bow to respect tbe facts wbicb are irrevocably acquired by ber ! Few Works bave been undertaken up to tbis time from my own point of view, It is truc tbat many autbors bave maintained, ratber on tbeoretical grounds tban on tbe basis of exact observa- tions, tbe possibility of a gangrené occurring from tbe very fact of a nervous lésion ; innervation baving according to tbem an influence upon tbe pbcnomena of nutrition at least equal to tbat of circulation. One of tbe most interesting memoirs in tbis sense is tbe tbesis of M. Zambaco, wbicb bears tbis significant title : “ Spontaneous gangrené produced by nervous perturbation.” But M. Zambaco is wrong, in my judgment, in generalising tbe cause too mucb and not precisely stating tbe mecbanism. He admits tbe direct and primitive influence of tbe nerves on nutrition, wbicb is far from being demonstrated by pbysiology , consequently be believes tbat tbe nervous System disturbed or damaged in its fonctions can by itself alone détermine gan- grené witbout any lésion of tbe vessels. He goes so far as to maintain tbat tbe nervous element prédominâtes in ail gangrenés, wbicb is inadmissible. Tbe gi'cater part of tbe facts gatbered by bim relate to lunatics, and especially to patients affectcd witb