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)

    204/372 page 190
    extremities, and scleroderma recorded by Ball, Vidal, Favier, and others. Ball's case, reported by him as a new variety of scleroderma (Bulletins, dc, de la Societe Medicate des Hopitaux de Paris, 1872, p. 59), was that of a woman who for five years had suffered during the winter from hard yellowish patches on the extremities of the fingers, which subsided with the return of spring. Ulti- mately the fingers were permanently altered in that the extremities became cold, hard, somewhat unsensitive, and decidedly atrophied. The last phalanges were contracted in a state of semiflexion. The lesions were symmetrical, all the fingers of both hands* being affected, but the thumbs were intact. Subsequently the toes were similarly affected. The patient was liable to crises from time to time, during which the finger reddened and became painful, then ulceration occurred and tardy cicatrisation with loss of substance. After each crisis the affected finger became a little more atrophied and deformed than before. There was no trace of scleroderma in other parts of the body. This case was claimed by M. Raynaud as an example of the chronic form of local asphyxia and symmetrical gangrene. Dr. Colcott Fox states that in two of his cases of scleroderma, in which the hands were involved, the patients had been long subject to dead fingers, and one of them continued to have mild attacks of asphyxia of fingers after the onset of the scleroderma. A very valuable case has been recorded by Dr. Finlayson (Medical Chronicle, vol. i., p. 316). The patient was a mason, aged 36^ who presented well-marked scleroderma of hands, feet, legs, front of chest and abdomen, neck and face. This patient was much influenced in regard to the hardness of the skin by exposure to cold. He ultimately developed gangrene of fingers and toes, for which no gross lesion was found to account post- mortem. In an unpublished case under the care of the translator the order of events was the reverse of that which obtained in Dr. Finlayson's case. A lady suffered for a considerable period with attacks of local syncope of the finger ends, which culminated in symmetrical gangrene of the tip of each index finger. From this she recovered, but afterwards slowly drifted into a state in which the fingers generally presented the atrophied tapering parchment-like character described by Raynaud, with some con-
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image