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Of sphaceloderma, or gangrene of the skin, probably the most interesting is Raynaud's disease of symmetric gangrene, a vascular disorder, which is seen in three grades of intensity: there is local syncope, producing the condition known as dead-fingers or dead-toes, and analogous to that produced by intense cold; and local asphyxia, which usually follows local syncope, or may develop independently.
Definition Types: Dry, Moist Varieties Gangrene primarily due to interference with circulation: Senile gangrene; Embolic gangrene; Gangrene following ligation of arteries; Gangrene from mechanical causes; Gangrene from heat, chemical agents, and cold; Diabetic gangrene; Gangrene associated with spasm of blood vessels; Raynaud's disease; Angio-sclerotic gangrene; Gangrene from ergot.
Occasionally the other limb becomes gangrenous. On the other hand, the glycosuria may diminish or may even disappear after amputation. #Gangrene associated with Spasm of Blood Vessels.# #Raynaud's Disease#, or symmetrical gangrene, is supposed to be due to spasm of the arterioles, resulting from peripheral neuritis.
It bears certain analogies to Raynaud's disease in that spasm of the vessels plays a part in determining the local death. The main arteries are narrowed by hyperplastic endarteritis followed by thrombosis, and similar changes are found in the veins.
During these attacks the large arteries femoral, brachial, and subclavian can be felt as firm cords, while pulsation is lost in the peripheral vessels. Gangrene eventually ensues, is attended with great pain and runs a slow course. It is treated on the same lines as Raynaud's disease.
We discussed its probable meaning for us, while we were pricking out our course on our maps. "Protection of bombardment avions" was André's guess. "Night combat" was Raynaud's. Every one laughed at this last hazard. "You see?" he said, appealing to me, the newcomer. "They think I am big fool. But wait."
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