Selected monographs on dermatology / Unna, Nielsen, Duhring, Bronson, Blanc, Berger, Prince-Morrow.

  • New Sydenham Society.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs on dermatology / Unna, Nielsen, Duhring, Bronson, Blanc, Berger, Prince-Morrow. 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.

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    upon with certainty as angioneurotic; its appearance only suggests it. After a longer or shorter period these spots become, by swelling of the cutis, converted into an B. papu- latum. At the same time, the colour changes to a move bluish-red, cyanotic tint. A spastic obstruction to the return of blood has now been added, and the veins can no longer cope with the amount of blood which is brought to them. The author thinks we may presuppose a special irrita- bility of the musculature of the venous vessels, which reacts in this unsuitable way upon the increased blood-pressure. Most of these eases occur in anaemic, neurasthenic or neuro- pathic people, in whom muscular spasms of other kinds easily occur. We may suppose that the arteries have the same character of reacting to variations in blood-pressure as we have ascribed to the veins ; bnt the much greater arterial blood-pressure presses upon the paretic arteries, and overcomes any tendency in them to spasm, The obstruction, which is the characteristic of the angio- neuroses, is caused by a tendency of the whole cutaneous vascular system to reply to a stimulus, such as the increased blood-pressure, by a quick and intense increase in muscular tone. Our study has now led us to a clear pathological founda- tion which we may describe as an intense irritability of the musculature of the cutaneous blood-vessels/' which underlies a large number of inflammatory as well as non-inflammatory angio-neuroses. When the muscular stimulus goes on increasing, a time must come when the muscles of all the cutaneous vessels remain in a condition of tetanic spasm. The clinical picture then changes. There is no incongruity in the calibre of the vessels, as only a very small stream passes along the arteries and veins. This condition is an exact picture of those appearances which have been described as Raynaud's disease and dead fingers in the lecture on anaarnia. The stimu- lus of blood-pressure is not sufficient to call forth these appearances; to it must be added the intense cold of the extremities in order that this tetanus of the vessels should be produced.