On the study of the hand for indications of local and general disease / by Edward Blake.

Date:
[1898]
Catalogue details

Licence: Public Domain Mark

Credit: On the study of the hand for indications of local and general disease / by Edward Blake. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    temperatures—we may have to do with Sclioeulein’s disease (peliosis rheumatica). Here sex and age will help us, for this disorder is practically confined to males between twenty and thirty years old. All the adult forms of the purpuric group are apt to be associated with arthritis. If the nail be transparent, then a most convenient window into the circulation is afforded by it. It is valuable for viewing the state of the peripheral circulation. Various changes in the blood and in the tubes which convey it, such as arteritis, ansemia and supervenosity, may be estimated here. Again, capillary pulsation may be studied at this point. Yellowish red papules or nodules, occasionally seen on the back of the hand, but more commonly on the elbow, may be xanthoma diabeticorum;'^ in any case the matter should be set at rest by an examination of the urine for sugar. Larger and darker spots, round or oval in shape, known as “xanthoma, or xanthelasma rheumatica,” but incorrectly, because they do not rise above the surface, are especially found on the hands, face, and neck. They are really a form of lentigo. When seen on the upper ex- tremity, they correspond with the cutaneous distribution of the musculo-spiral nerve. The connection of these per- verted pigment changes, with rheumatoid arthritis was recorded by the writer seventeen years ago,^ four years before these changes were so fully re-described by Dr. Kent Spender, of Bath. Brown spots, which do not disappear on pressure, are seen on the dorsum of the hand in the later stages of many of the diathetic diseases, notably in adult scurvy, in syphilis, osteo-arthritis, in tubercular phthisis, in carcinoma, and in xeroderma pigmentosa or Kaposi’s disease, one common factor being the presence of the pyogenic process. Arsenical poisoning. Graves’ disease, and morbus Addisonii, often have this symptom in common. When in Norway the writer observed brown pigment spots on the face and on the extremities of leprous subjects. However white the hands may have been, they usually grow red in the earlier