Two cases of Raynaud's disease with ocular symptoms : one case complicated by scleroderma / by George Howard Fox.

  • Fox, Howard, 1873-1947.
Date:
1907
Catalogue details

Licence: In copyright

Credit: Two cases of Raynaud's disease with ocular symptoms : one case complicated by scleroderma / by George Howard Fox. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the following year. Since then her periods have been regular. They occur every 2-1 days, and last three to four days. Tlow is moderate, pain considerable. She frequently becomes hysterical and faints just before her periods. Two years ago she had a miscarriage. Since then she has had occasional pain in the lower abdomen, and more or v less continual pain in the back. Present history—Five years ago, during the summer, the patient opened an ice cream parlor, and was in consequence compelled to con- stantly handle cold objects. After several months of this work she began to notice that the ring and little fingers of both hands fre- ' quently became “ dead,” that is, cold, numb, and white. The attacks were at first confined to the last phalanx, but later involved the others as well. Toward the end of the following winter all the fingers of both hands began to exhibit the same attacks. Since then the disease has existed more or less continuously up to the present time. The condition is always worse in winter, especially on stormy days, and better in summer. At times during the summer months she is entirely free from attacks for a few days. While the attacks are usually brought on by the application of cold water, she has found during the past year that hot water has the same effect, though to a lesser degree. The attacks are also brought on by excitement, worrj- or hard physical labor. They always begin in the tips of the little fingers and spread to the hand. They occur generally in the morn- ing, less often in the afternoon, and practically never in the evening. Their duration varies from five to thirty minutes. The entire hands become reddish or bluish and swollen when the spasms of “ dead fingers ” have ceased. Pain during the attack is very moderate. During cold weather the hands at best feel “ heavy ” and more or less stiff. The spasms are confined as a rule to the fingers, the thumbs generally escaping. Two years ago during the winter the patient began to notice on the tips of both little fingers, small scaly spots, which were painful enough to interfere with sleep. After three or four weeks the spots would become black, the pain at the same time ceasing. After sev- eral months the black tissue would fall and leave little pits. These slight depressions are sufficiently tender to interfere with fine move- ments of the fingers such as sewing. Last winter a similar condition was noticed in the tips of the first and second fingers. When the tips of the fingers first showed this condition, the pain was very severe and radiated to the shoulder. The three middle toes of both feet frequently become white and cold. The great toes have never become white to the patient’s knowl- edge, but in winter are the seat of more or less continuous pain, espe- j dally about the root of the nail.