. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. cks are RAYNAUDS DISEASE. 829 paroxysmal and reouri-eiit. and ev(Mi oci-iir in cycles. Tlic alVfctcd fiii^ersare usually involved in turn, and the conLTcstion disaijpfars lirst from onepart and then another. ()()nally the nose, ears, and iaee are invaded. The locdl or sifnnnclricdl (jangrcnc may follow eitlur the syncopal statreor the asphyxial stajje. The parts are cold, usually shrivelled, and Inilheform; these hreak and reveal hlaek spots, which result in localized destruc-
. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. cks are RAYNAUDS DISEASE. 829 paroxysmal and reouri-eiit. and ev(Mi oci-iir in cycles. Tlic alVfctcd fiii^ersare usually involved in turn, and the conLTcstion disaijpfars lirst from onepart and then another. ()()nally the nose, ears, and iaee are invaded. The locdl or sifnnnclricdl (jangrcnc may follow eitlur the syncopal statreor the asphyxial stajje. The parts are cold, usually shrivelled, and Inilheform; these hreak and reveal hlaek spots, which result in localized destruc-tion. The ends of the fintrers are destroyed, or the under parts of the spots somt^tiines heal, leaviuf]: a healthy scar. The pain is often severe. Amonpr accessory symptoms should be mentioned ha^mofrlobinuria,which, heintr associated with chill and slip-ht fever, and havinc a paroxys-mal course, has led to the suspicion of malaria; an idea which .seems tofind some favor with Barlow. Amblyopia is also occasionally seen, andmay depend on alteration in the calibre of the retinal vessels, as verified. Fig. 405.—Raynauds Disease.—Dehio. by Galezowski. Temporary changes in the joints have been noted, alsohemiplegia and aphasia, and in rare cases even mental symptoms. Epilepsy,or attacks suspiciously like it, has been reported. Diagnosis.—There are various forms of gangrene which must not bemistaken for Raynauds disease. The disorder closely resembles chil-blain or frost bite, but the history is sufficient to prevent error. Raynaudsdisease is a recurring affection, whereas frost bite is a. simple and solitaryaccident, and by no means always synmietrical. It also resembles ergotism, but the history alone should distingu:J5hthe two. So also of the gangrene of diabetes, in which the glycosuria and theasymmetrical character of the gangrene are significant. Ervthromelalgia resembles the asphyxial stage of Raynauds in the former the affected limb is hot. pulsati
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectmedicine, bookyear192
