On the study of the hand for indications of local and general disease / by Edward Blake.

  • Blake, Edward T. (Edward Thomas), 1842-1905.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: On the study of the hand for indications of local and general disease / by Edward Blake. Source: Wellcome Collection.

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    haemophilia, a disease which differs from the other allied conditions by being nearly always hereditary. When the petechia? are associated with nettle-rash [purpura urticans], and with these, there are found to exist multiple arthritis, scanty and albuminous urine and raised tempera- tures, we may have to do with Schoenlein's disease [poliosis rheumatica'}. Here sex and age will help us, for this dis- order is practically confined to males between twenty and thirty years old. All the adult forms of the purpuric group are apt to be associated with arthritis. Purpura urticans, with oedema and severe vomiting, have, according to Morse, followed the injection of diphtheria antitoxin. If the nail be transparent, then a most convenient window into the circulation is afforded by it. It is valuable for viewing the state of the peripheral circulation. Various changes in the blood and in the tubes which convey it, such as arteritis, anaemia and supervenosity, may be esti- mated here. Again, capillary pulsation may be studied at this point. Yellowish red papules or nodules, occasionally seen on the back of the hand, but more commonly on the elbow, may be xanthoma5 diabeticorum; in any case the matter should be set at rest by an examination of the urine for sugar. Larger and darker spots, round or oval in shape, known us xanthoma or xanthelasma rheumatica, but incorrectly, because they do not rise above the surface, are especially found on the hands, face and neck. They are really a form of lentigo. When seen on the upper extremity, they corre- spond with the cutaneous distribution of the musculo-spiral nerve. The connection of these perverted pigment-changes with rheumatoid arthritis, was recorded by the writer seven- teen years ago,6 four years before they were so fully re- described by Dr. Kent Spender of Bath.