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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    It is to be noted tbat we bave here not a passive congestion, but ratber a momentary absence of local circulation, just as syncope is a suspension of tbe general circulation. When tbis state is repeated up to tbe point of becomiug almost continuons, it may at lengtb lead to profound troubles in tbe nutrition of tbe parts wbicb are subjeot to it. Cbilblains become to some extent establisbed, and tbe adipose tissue ultimately becomes over-developed, as in ail organs whicb perform tbeir functions incompletely. Tbis is wbat took place in tbe following case. Case II.*—Habituai Local Syncope with Lésions of Nutrition. X., 25 years, a young lady of small build, and of a very clear, ligbt complexion ; menstruation faulty during many years, but régulai* since 24 ; sligbtly icteric ; bas bad several attacks of “ nerves,” witb loss of consciousness, globus, tears, and iu- voluntary laugbter. b'rom tbe âge of 14 to 18 years sbe suffered mucb from cbilblains, wbicb kept ber laid up during tbree montbs of tbe winter. Sbe bas for a long time suffered from dead Angers. Tbese were constantly becoming absolutely cold, pallid, and insensitive. Tbe retum of tbe catamenia bas not modified tbis condition. Tbe Angers présent a conformation wbicb is quite remarkable— tbey are extremely gross and soft ; tbe bands tbemselves seem œdematous, and tbis contraste in a striking manner witb tbe wrists and very slender forearms. Tbe nails are not clubbed. Tbe puise is quite perceptible. Tbe feet présent tbe same appearance as tbe bands ; tbey seem as tbougb tbey were made up entirely of skin and cellulo-adipose tissue. Tbis young woman died recently of a bydatid cyst of tbe liver. Up to tbis point we bave bad to do witb sligbt forme of local syncope ; it may acquire enougb gi*avity to become disquieting. Everybody knows tbe curions fact recounted by Lamotte {Traité Complet de Chirurgie, 3rd Edit., T. ii., p. 317). A billiard marker received a stroke from a stick on tbe outer part of bis rigbt arm. Tbere was severe pain, tbe band became pale, cold, insensible ; tbe moming after, Lamotte made many cuts witb a lancet witbout tbe patient perceiving it ; be even crossed tbe band witbout a drop of blood escaping. Tbis band remained in tbe same state during ten days. At tbe end ♦ Communicated by Dr. Marey.