Graves's disease, Raynaud's disease, and some of the allied forms of vasomotor disorder (vasomotor ataxia) / by Solomon Solis Cohen.

  • Solis-Cohen, Solomon, 1857-1948.
Date:
[1909?]
Catalogue details

Licence: In copyright

Credit: Graves's disease, Raynaud's disease, and some of the allied forms of vasomotor disorder (vasomotor ataxia) / by Solomon Solis Cohen. 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.

    7/24 (page 47)
    impossible. I have seen the sign of Moebius, which this patient exhibits, occur unilaterally. I now am going to try to develop another sign, to which I think I was the first to call attention, in so far as it relates to Graves’s disease. It occurs in other conditions and has therefore only a confirmatory value. First, you observe that as the man’s chest is exposed to the somewhat cool air there develops gooseflesh and that this passes otf and recurs. If I touch him anywhere yon can see that the gooseflesh increases, and especially if I draw my hand down along his spine yon see that after an interval of some seconds a wave of gooseflesh, as it were, begins along the shonlders and travels down the chest. This is the so-called pilo- motor reflex and in this particnlar patient it is very well developed. Now I am writing with a silver probe npon his skin; I use the slightest possible pressure. You see after a slight interval that the letters which I have traced upon the chest appear, first in white, and afterward in red lines. This phenomenon we term “ dermo- graphism ”—skin writing. The details of its phenomena differ in different cases. The lines may be white only or red only or both red and white, as here. The red lines then become bordered on each side by broad white lines. Running the finger over these red markings we find that they are becoming somewhat elevated above the skin, and at the same time paler in color. In some cases the eleva- tions are much more marked than these. They are veritable wheals, artificial hives, technically called “ factitious urticaria.” Sometimes the gooseflesh reflex is exhibited along the tracings of the probe, and only there. As this writing has faded out slightly 1 will apply over it a towel wnmg out of hot water. It becomes brighter and more distinct. In some cases cold water will bring it out even better. The reactions to hot and cold water differ in different cases. In some cases both will make the dermog- raphy more distinct; in some cases one will diminish, the other increase it. In still other cases one or the other will cause a diffuse red flush in which the distinct outlines of the tracing are lost. These variations have certain minor diagnostic significance, but I cannot enter upon this to-day. I shall ask the class, however, to point out the general significance of the phenomenon. I am answered: “ A vasomotor disturbance.” That is correct. It shows