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 The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    112/372 (page 98)
    CHAPTER III. PATHOLOGICAL HISTORY OF LOCAL ASPHYXIA AND OF SYMMETRICAL GANGRENE OF THE EXTREMITIES. I propose in this chapter to give a general description of the affection of which I have hitherto presented only isolated ex- amples. One word at first upon the name hy which I propose to designate it. The term local asphyxia is not new; it has had scientific circulation since Boyer's time, and is hased upon real analogies. With regard to the variety of gangrene which appeared to me capable of resulting from it as the more advanced expres- sion of a similar morbid state I have for a long time sought a distinctive and special character. The absence of arterial obliteration has only a negative value, and also applies to diabetic gangrene. In examining closely the preceding cases I have been struck with the remarkable tendency of the mortification to affect symmetrically similar extremities; thus it is the two hands, or the two feet, or all four at a time, sometimes the nose, composed, like all the median organs, of two equal halves; they are, in one word, similar parts which become affected together in the very great majority of cases. Further, I have recorded cases in which the localisation of the pathological process to the fingers or to the toes has taken place under the same form and with an equal intensity in exactly corresponding parts. Thus in Case XIII. on each side it was the fourth toe which presented the most advanced lesion ; then came the big toe, then the third, then the fifth; finally, the second was almost healthy. In Case XV. the similitude was perhaps still more complete, because it existed at the same time in the hands and the feet. On examining this patient long after her recovery I was struck with the remarkable similarity on the two sides, even of the stumps and cicatrices which had been left after the separation of the sloughs on the two sides. These are, it is true, the most trenchant cases, and those which