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.

    47/206 (page 41)
    In the month of March she bacl several attacks of tertian lever, which disappeared under the influence of a sédative. Towards the middle of April she hecame very impressionahle to cold. Every time that she went out during weather at ail cool, the nose, chin, cheeks, hands, and feet hecame pale ; they passed then to a violet tint, then to a slaty white. It was in this state that she presented herself on the 20th April at the consultation at the Hôtel Dieu (at Nantes). A very cold wind had hlown ail morning when Kose entered the room. Her cheeks and chin were of indigo colour; lier hands were as cold as marhle. At the first view I helieved them to he gangrenons. The ends of the Angers were of a greenish hlue, the palms of the hands were of a deep purple. On the forearms there were marhlings similar to those which are présent on the legs of persons who use foot warmers. Above the wrists the skin presented its natural colour. These pheno- inena were less pronounced in the lower limhs, which were clothed with woollen stockiugs. Whilst this young woman spoke, a bright redness hegan to develop itself at the root of the nose and over the cheeks ; then it extended and invaded the hlue colour, which soon formed no more than a deep red patch on the tip of the nose, and ended hy disappearing entirely. One moment afterwards the pink colour of the nose hegan to pale, and this orgau resumed little by little its ordinary colour. The same change came into operation at the same time upon the cheeks and the chin ; upon the hands the change did not take place so quickly nor in the same way. The puise was small, feehle, thready, disappearing easily under pressure, especially in the left arm. The right radial was a little more developed than the left, and the pulsation was always stronger and more prompt in the right than in the left. This was how the change took place : at first less livid patches appeared in the palms of the hands along the track of the palmar arches ; they extended until theii* bordera met, and took on a vermihon tint. At the same time other patches were seen to form along the course of the digital arteries, and shoot along the collaterals of the digits. It was at the extremities of the fingers that the cyanosis and the cold persisted longest. Einally at the end of a quarter or half an hour the whole hand was of a vermillon red ; the puise