A Case Illustrating the Analogy Between Essential Hypertension and Raynaud’s and Buerger’s Disease
The patient was a man, 42 years of age, who was admitted to the Cleveland Clinic, April 30, 1937, with the complaint of pain in the fingers and toes of 15 years’ duration. In addition to the pain, he had had numbness and tingling in his fingers. The symptoms were intermittent, but progressive in nature, so that he had been unable to work for five years. For three and one-half years, he had had severe paroxysmal pain in the finger tips which felt “glassy” and were very sensitive to pressure. He had resorted to morphine for relief of the pain. He stated that his fingers would become white, then red, and then blue, and that they were “ice cold” at times, even in hot weather. Partial relief could be obtained by plunging the hands into cool water. Exposure to cold produced numbness and a loss of sensation in both the hands and the feet. Because of gangrene, the right middle finger had been amputated in 1934 and the left middle finger in February, 1937. The patient is of Irish descent.
There was nothing of significance in the past history. Physical examination revealed a well developed male who was fairly nourished; height 67 inches, weight 153 pounds. The temperature and pulse were normal. The blood pressure in millimeters of mercury was 120 systolic, 70 diastolic. The skin over the hands and feet was moderately flushed, shiny, and somewhat atrophic. There were patchy areas of brownish pigmentation over the feet, ankles, and. . .