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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    soon after it, the ears were noticed to be very much cyanosed when the boy was chilly, and they ached much as he got warm. Subsequently gangrene of both ears set in, and this relapsed several times in successive winters. During the last two years the gangrene had stopped, but there was extreme cyanosis, ten- derness, and aching of the ears on exposure. The attacks of paroxysmal hemoglobinuria had continued, being more frequent in winter than in summer. The attacks were typical in every respect. The blood was examined during the attacks, being taken from the cyanosed ears and from the hands. The coloured corpuscles were fairly normal in outline, but sometimes had crenate edges; there was always an abnormal disinclination to form rouleaux, as Boas and others have noticed. Blood 'flakes,' as they have been called, were found, varying in colour from a deep reddish black to a thin transparent red, and in size from about four to ten times as large as a normal coloured corpuscle. On one occasion they seemed to be contained in a transparent envelope, and to be themselves somewhat granular, shading off into the colourless envelope. II. With respect to the skin : (1) Although chilblains properly so-called are rare in Raynaud's disease, there are some cases of localised patches of subcutaneous mottling in which the deep purplish colour is permanent for a time and then gradually clears up, with or without pigmentation, which have a close connection with local asphyxia and symmetrical gangrene. Perhaps also the cases described by Dr. Cavafy (Clinical Society's Trans- actions, xvi., p. 43), as symmetrical congestive mottling of the skin are examples of an allied condition. Of the cases to which Dr. Weir Mitchell has applied the name of erythro-melagia, or the red neuralgia (vide American Journal of Medical Sciences, July, 1878, on A Rare Vaso-Motor Neurosis of the Extremities ) there are certainly some, which are examples of Raynaud's disease. (2) Urticaria has been observed by Dr. Southey in one case to occur in the paroxysms of Raynaud's disease, and the same skin affection has been observed by Dr. Dickinson, Dr. Stephen Mackenzie, and Dr. Forrest in paroxysmal hemoglobinuria. (3) There is a considerable number of observations bearing on the relationship of local asphyxia, symmetrical gangrene of
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