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.

    51/206 (page 45)
    She left M. Eobert’s ward after three weeks’ stay. A fort- night afterwards tliere was increase of pains with frequent convulsions, for wliich tliey were obliged to tie down the patient. Shfi was admitted under tbe care of M. Huguier, and laudanum was applied over tbe ends of the fingers. M. Huguier considered tbese attacks as symptomatic of an affection of tbe heart, and this opinion was based upon the existence of violent palpitations and of a cardiac murmur, perhaps also upon the knowledge of the antécédent articular pains of which I hâve spoken. In the space of a fortnight he ordered w'et cupping five times, then blisters and cautérisations to be applied over the præcordial région, and digitalis to be given internally. The sum total of this médication appeared to improve the pains without leading to any change in the other conditions of the fingers, and without modifying in any way the palpitations and the cardiac murmur. At the end of January, 1851, the pinna of the right ear took the same tint as the fingers and became the seat of pain and tingling, which disappeared at the same time as the cyanosis, in the course of the month of March. The patient passed from the care of M. Huguier at the end of the same month. The pains of the fingers and the convulsions appeared once more, and she came nnder M. Sandras’ care on the 5th April, when we noted the following condition : general State is good, but there are fre- quent vertigoes, hummings in the ear, palpitations, attacks of breathlessness, constipation, wdth no other abnormality of the digestive System ; puise small, very compressible, but quite perceptible in both radiais ; wûth the first sound of the heart a murmur, having its maximum intensity at the base, but most intense over the aorta and the carotids ; murmur only slightly harsh, and by no means in harmony with the view of organic affection held by M. Huguier. The extremities of the fingers of the two hands présent a violet colour, which is seen also under the nails, and occupies almost the whole of the extremity of each finger, but decreases from the extremity towards the hand. This colour, more marked in the right hand than in the left, extends a little further along the internai border of the fingers than in any other direction, and is prolonged along the internai border of the little finger up to the inner side of the hand and the inferior third of the forearm. The extremities of the fingers are very cold, shrivelled, and withered ; even a moderate pressure