On local asphyxia and symmetrical gangrene of the extremities / by Maurice Raynaud ; translated by Thomas Barlow.

Raynaud, Maurice R., 1834-1881.

Date:: 1888

Credit: On local asphyxia and symmetrical gangrene of the extremities / by Maurice Raynaud ; translated by Thomas Barlow. Source: Wellcome Collection.

170/206 (page 164)

$tractions iu diflorent régions. Uiifortunately things do not always corne to pass iu nature in a way which is most agreeable to our compréhension. In fact we hâve seeu that tho cooling with cj’anosis of the extremities and visual troubles did not coincide, but alternated with a perfect regularity in such a way that the diminution of one of these phenomena infallibly aunounced the appearance of the other, and this many times in the same day, and this statc of aflairs persisting for several months. It is precisely on account of this singular alternation that there was good reason to inquire if the vascular nerves of the fundus of the eye had not an origin eutirely different from those of the limbs ; iu which case one could hâve better under- stood a kind of balance being re-establishcd between the bulbar région and the cord, properly so called. One is more embarrassed iu explaining this balance, when one thinks of the short distance which séparâtes the cilio-spinal région from the origin of the affected ganglionary nerves which go to the vessels of the upper limbs. I know indeed, and everythiug demonstrates it, that nerve cells very adjacent anatomically can présent a functiou ■cntirely independent ; but in spite of the immense progress made during the last few years in the study of the iutimate structure of the nerve centres there are obscurities in the subject before which we are brought to a standstill for the présent. AU attempts at interprétation would be here purely hypo- thetical. It is probable that in other cases we may find local asphyxia and visual troubles coinciding as to time, appearing and disappearing together. I am now quite prepared to cite an example of it. Case II.—The patient V., who is the subject of this case, was for a long time under the care of M. Cadet de Gassicourt at the St. Antoine Hospital, where I was able to observe him. He passed theuce into the St. Louis under the care of ]\I. Vidal. His history is somewhat complex. He is a young man of 22 years of âge, of good appearance, admitted in order to he treated for houlimia with polydipsia, dating hack for several months. He eats from 4 to G rations daily. He has eaten up to 12 a day. He drinks 4 to 5 litres of liquid, and passes almost an equal daily quantity of water. The urine contains no sugar. One is struck at first with the livid tint which the hands and$