Subcutaneous calcinosis or multiple calcification in the subcutaneous tissue / by F. Parkes Weber.

  • Frederick Parkes Weber
Date:
1914
Catalogue details

Licence: In copyright

Credit: Subcutaneous calcinosis or multiple calcification in the subcutaneous tissue / by F. Parkes Weber. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    illustrated by the accompanying photograph (Fig. 8) of the knee, kindly taken on August 4, 1913, by Dr. Leeser. The lymphatic glands of the axillae and groins, and some in the neck, are still slightly enlarged. During most of the last year the child has been taking syrup of iodide of iron, and during a great portion of the time small doses of potassium iodide as well. All medicine was temporarily discontinued on December 23 of last year, and on January 12 Dr. G. R. Ward found the ‘calcium index ’ of the blood only 0-855. He estimated it again on July 31 after the patient had for some time been having rather large doses of iodide of iron ; it was then very high, namely 1-46. It is worth while mentioning that on that occasion he likewise estimated the resistance of the patient’s red-blood cells to graduated hypotonic saline solutions, and found that haemolysis occurred with between 0-3 and 0-35 per cent, sodium chloride solutions. In regard to the aetiology of the calcareous nodules, svphilis and tuberculosis may be practically excluded by reason of the various above- mentioned data. Moreover, both Wassermann’s reaction for syphilis (tried at the Lister Institute) and von Pirquet’s cuti-reaction for tuber- culosis gave a negative result; the complete absence of fever is likewise an important point. The case is not at all like one of myositis ossificans, for the muscles (at all events as yet) seem not to be affected ; there is no abnormal formation of true bone ; and the inflammatory softening of the calcareous nodules is different to anything which occurs in myositis ossificans. Moreover, the child has no shortness (microdactyly) of the great toes, such as has been recorded in several cases of myositis ossificans. The scattered literature of the subject shows, however, that the child’s condition can be regarded as one of a definite disease, as distinct at least as myositis ossificans and many other ‘ diseases ’. Calcinosis is probably the most convenient term to be used for the disease in question, and more advanced cases have been described under the headings ‘ Calcinosis interstitialis ’ and ' Calcinosis universalis ’,17 pparently the chief danger is the risk of septic infection associated viti the breaking down and discharge of the calcareous nodules, ut m the present case (Anna G.) there has been no breaking down of this kind for quite a long while. There is a condition, occurring in rather older subjects, which pos- d' V a more chronic and less severe variety of the same . lsease- 8 In that condition the calcareous deposits occur chiefly in the subcutaneous cushions of the finger-tips and at the elbows, about e o ecranon, and sometimes in the toes. Such cases have been recently demonstrated in England by Scholefield and Weber,13 by Haldin Davis,3 ^ Hunter6; the patients are all subject to Raynaud's phenomena and most of them gradually develop a sclerodermatous ange c neflv in the fingers (‘sclerodactylia’). Sir William Osier has \\i two such cases of sclerodermia associated with subcutaneous
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