[Raynaud's phenomenon. History].
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Biomedical subjects
Publications and source records attributed to J F Merlen.
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The semeiological nature of the clinical features described by M. Raynaud have been the subject of continuous discussion since 1862. This "phenomenon" is actually a syndrome, is histo-angeic and purely microvascular, is of acral topography, and implies a predisposition: that of a particular reaction to cold. Distal irrigation and the structure and function of glomic anastomoses show certain particular features. The "phenomenon" is a microrheological storm.
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There are many bioflavonoid compounds, but only a few of them are of value to physicians at the present time as they have not all been demonstrated as having activity on the terminal vascular bed. By using the simple technique of transillumination described by Knisely and Bloch the authors were able to confirm the activity of certain bioflavonoids on the terminal vascular bed of the frog's mesentery. This method demonstrates the point of impact of the compound in the microcirculatory bed and is thus able to evaluate the efficacy or not of compounds before they are marketed.
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A man of 19 years of age was found to have a diffuse livedo, a quadruple asphyxic acrosyndrome, and dementia. Angiography confirmed the presence of distal ischemia with multiple circulatory blocks and a reduced distal network. The patient died at the age of 25 years and histopathological examinations of the vessels demonstrated obstructive atheromatous lesions in the medium sized and small arteries of the brain and viscera. By comparing these findings with those observed in three other cases, in which biopsy of the pulp of the toe was also performed, the hypothesis can be advanced that these juvenile encephalic ischemic accidents are caused by atheroma, which can be detected, at an early stage, by studying the distal arteries in the finger or toe pulp.
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