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Updated: July 3, 2025
He thought the condition was due to cerebral edema, as did other writers of that period. Dagonet remarks about this last a lesson not learned in fifty years by the profession that demonstrable edema does not produce the typical symptoms of stupor.
The primary symptoms of this condition of myocardial weakening are slight dyspnea on least exertion; slight heart pain; slight edema above the ankles; often some increased heart rapidity, sometimes without exertion; after exertion the heart does not immediately return to its normal frequency; slight dyspnea on least exertion after eating; flushing of the face or paleness around the mouth, and more or less dilatation of the veins of the hands.
There are no associated constitutional symptoms, no tendency to similar morbid changes in other parts, and no infiltration elsewhere. There is little or no edema with ainhum. In ainhum there is, first, simple hypertrophy, then active hyperplasia The papillae degenerate when deprived of blood supply, and become horny.
Scleroderma neonatorum is an induration of the skin, congenital and occurring soon after birth, and is invariably fatal. A disease somewhat analogous is edema neonatorum, which is a subcutaneous edema with induration affecting the new-born. If complete it is invariably fatal, but in a few cases in which the process has been incomplete recovery has occurred.
A cavity was opened, which extended from above the knee to the heel; the clots were removed, and cautery applied to check the bleeding. There was extension of the blood-cavity to the thigh, with edema and incipient gangrene, necessitating amputation of the thigh, with a fatal termination. Mackenzie reports an instance of hemophilic purpura of the retina, followed by death.
If there is more general edema, the hands and face puffing, and there are considerable nausea and vomiting, headache and drowsiness, and perhaps muscular twitchings, with neuralgic pains, the most serious trouble at that particular time lies in the kidney insufficiency. The heart is generally enlarged and hypertrophied.
The disturbed circulation is evidenced by imperfect peripheral circulation and capillary sluggishly, with at times pendent edema of the feet and ankles, but, perhaps, little congestion of the lungs. The left ventricle being sufficient, there is no damming back through the left auricle to the lungs.
Optic Nerve and Retina. In the acute form the retina and optic nerve present the same condition that is present in the vascular tunic; namely, that of venous stasis with the consequent edema. Frequently minute hemorrhages occur in the retina, particularly in violent acute attacks. Cupping of the discs slowly develops, causing more or less stretching of the nerve fibers over the edge of the cup.
By the tenth year half the remainder will have died, leaving one fourth both of the men and the women who have lived beyond ten years." The causes of death he would place in the following order: gradual cardiac failure; uremia; apoplexy; some complicating acute infection; angina pectoris; accidental causes; acute edema of the lungs and cachexia.
Reduction of ocular tension by stimulation of osmosis, of lymphagog activity, of absorption of edema, and of capillary contractility, and by decreasing affinity of ocular colloids for water. The Myotics.
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