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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    43) the symptoms of local asphyxia of limbs appeared about a fortnigbt after recovery from tertian ague, and the first of bis later cases (p. 155, New Rcsearcbes) bad suffered from ague tbirty years previously. lu the article ou gangreue (p. 679, Dict. de Méd. et de Chir. jirat.) Raynaud says tbat “ altbougb after repeated attacks of interniitteiit lever œderaa ot the limbs, with or witbout tbrom- bosis, may often be observed, no examples are known of gaugrene spécial to the malarial cacbexia.” Siuce the publication of Raynaud’s memoirs several cases of local syncope, local asphyxia, and gangrené bave been recorded as occurring in persons wbo eitber were suflferiug at the time or bad suffered from ague. ïbe most complété review of tbis subject bas been given by Petit and Verneuil {Uev. de Chirimfie, 1883, pp. 1, 161, 432, 699). The cases of gangrené described by tbem are very miscellaneous in cbaracter, some of tbem resembli'ng tbe forra wbicb occurs as a complication of varions exantbemata, and not strictly comparable witb Raynaud’s type, but there are otbers wbicb seem to conform to it in tbat tbe gangrené occurs in young subjects, and is sj-ra- metrical, terminal, dry, and circumseribed. It is also clear tbat in some of tbe cases recorded, botb of local asphyxia and of gan- grené, tbere was a defiuite response to the use of quinine. M. Mourson, in bis second memoir (Arch. de Méd. Nav., 1880, p. 340) 011 tbis subject, places tbe local asphyxias in malarial sub- jects in juxtaposition witb some of tbe anomalous central and peripberal nervous atiections wbicb occur as sequelæ and “larval” forms of ague, and be broacbes tbe tbeory of melan- æmic deposits in tbe vessels of tbe cord, &c., as a possible agent of tbeir production. It is of importance to note tbe evidence wbicb bas been brougbt by Dr. Dickinson and otbers in support of tbe malarial origin of some of the cases of tbe allied affection, intermittent bæmoglobiuuria. lidation to Syphilis.—Two of tbe examples quoted by Raynaud (XVI.,XVII., pp.85,87) were patients wbo bad suffered previously from acquired syphilis. Tbis bas also obtaiiied in some of tbe subsequently reported cases; and in a remarkable instance of symmetrical gaugrene recorded by Dr. Henry Humpbreys, tbe patient was a sypbilitic child. Tbe obvions objection arises tbat in tbese cases tbere may bave been présent some sypbilitic