Diseases of the nervous system - for the general practitioner and student (1913) (14579898367)

Identifier: diseasesofnervou00gord (find matches)

Title: Diseases of the nervous system : for the general practitioner and student

Year: 1913 (1910s)

Authors: Gordon, Alfred, 1869-1953

Subjects: Nervous System Diseases

Publisher: Philadelphia : Blakiston's Son

Contributing Library: Columbia University Libraries

Digitizing Sponsor: Open Knowledge Commons

Text Appearing Before Image:

rse, Duration, Prognosis.—The course may consist only of thefirst or of the first and second phases. More frequently the entire cycleis observed. The duration of the disease is from one to three months.After an interval of months or years another attack may occur and affectanother part of the body. Life is usually not endangered, except whensuppuration with septic infection is present. RAYNAUD S DISEASE 589 Diagnosis.—The disease is easily recognized from its typical symptoms.Local gangrenous patches may also be observed in hysteria, but thenecrosis is superficial and no changes of the blood vessels are found. In lepra phalanges fall off without pain. Gangrene caused by in-toxication with ergot presents special features characteristic of ergotism. I saw a case of local gangrene caused by subcutaneous injections ofadrenalin above the lesion. There are also allied cases in which the picture of Raynauds diseaseis not complete, cases that present intermediary forms, which may resemble

Text Appearing After Image:

Fig. 168.—Symmetrical Gangrene. (Dehio). one or another of the localized neuroses. In the case referred to inthe chapter on Erythromelalgia the symptoms were those of Raynaudsdisease and of erythromelalgia. Etiology.—The disease occurs not infrequently in the course of organicnervous diseases and psychoses, also in functional nervous disorders.Infectious febrile diseases, syphilis, tuberculosis, lepra, diabetes, may beaccompanied or followed by Raynauds disease. It has been observedin the course of scleroderma. Anaemia and a congenitally small aortaplay an important predisposing part. Emotion, trauma, menses, cold, are exciting causes. Zenner observeda case due to caffein poisoning. Young persons, and especially women,are more frequently affected than old individuals and men. Pathogenesis.—Pathological investigations show a localized involve-ment of the blood vessels (arteritis) and of the nerves (neuritis), but thesechanges are secondary. The majority of observers consider Rayn

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1913

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