This is a rare disease. It is supposed to be caused by disturbances of the vaso-motor nervous system.

Etiology

Anemia is given as the cause; also chlorosis, neurasthenia, malaria, acute infectious fevers, menstrual disorders, fright, exposure, diabetes, and syphilis. The disease comes on suddenly and affects two or three fingers or toes.

Symptoms

There is a coldness and pallor of the extremities, with dead fingers or toes. The parts affected are stiff, and sometimes more or less painful. A pallor is the first appearance. The features look shrunken, and there is a lack of sensibility. This passes away and then returns. In time it becomes a constant condition. After the disease has been running on for a while, the fingers---or rather the parts affected--become livid and ashen. The capillary circulation becomes exceedingly sluggish. Gangrene often follows severe attacks. Rigor is common. In advanced cases echymose spots and vesicles appear. Hemorrhage sometimes occurs, and it is called purpura. Cerebral symptoms may complicate the disease.

Differential Diagnosis

This disease has to be differentiated from frost-bite, ergot poisoning, neuritis from overstimulation, and endarteritis from toxin poisoning.

Treatment

Avoid exposure to cold, and, if possible, spend the winters in warm climates. This is the usual prescription, but every patient is not able to change climate.

This disease would never have an existence if those afflicted were living properly. It is simply a surface manifestation of toxin poisoning, and, the same as most diseases to which flesh is heir, it originates in the gastro-intestinal canal. Hence this intestinal derangement must be righted, first, last, and all the time, by correcting the eating, and otherwise properly caring for the body.