Selected Monographs.

  • New Sydenham Society
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Selected Monographs. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    There is a suggestion of this association in the history of a case recorded by Mr. Hutchinson so far back as 1871.* A woman, aged 30, had suffered during the winter with frequent shivering fits after exposure to cold. These attacks were accom- panied or followed by general malaise, and the urine often became dark after them. One cold day after returning home, she found that her nose and left ear were quite black. During her stay in hospital small superficial sloughs gradually separated from the above-mentioned spots. She was liable to slight shiverings, during which she got icy coldness and purple congestion around the sloughing patches, but no blood or colouring matter appeared in the urine. Mr. Hutchinson, in commenting on the above case, was inclined to the view that the history pointed to h&ematinuria, and that this and the limited localised gangrene of extremities, in the absence of malaria, had a common origin in exposure to cold, the patient's idiosyncrasy being taken into account. In 1879 Dr. Wilksf had a boy aged 16 under his care, who, in consequence of some injury to the hip, had had profuse suppura- tion from the bursa between the glutseus maximus and the great trochanter. The patient, when transferred to Dr. Wilks's care, was cyanotic, and had a systolic murmur at the third right space. The edges of the ears became very blue, and the nose and toes likewise, but the tips of the thumbs and of several fingers became affected with definite gangrene, from which they slowly recovered. The urine was at different times dark in colour, and gave the guaiacum test; granular casts and debris were present, but on several occasions no blood corpuscles could be found. At a later period, however, some blood corpuscles were present. In Dr. Southey's first case J there was a history of the patient having passed black urine with some of her attacks, in which the fingers became numbed, black, and dead ; but during her stay in hospital with symmetrical gangrene on the legs and attacks of local asphyxia of the fingers, though a trace of albumen is * Medical Times and Gazette, 1871, vol. ii., p. 678. Gangrene of tip of nose and part of ear ; iridoplegia. t Medical Times and Gazette, 1879, vol. ii., p. 207. % St. Bartholomew's Reports, xvi., 1880, p. 15.
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