Dr Maurice Raynaud
Sometime during the late 1850's a young French girl of 27 years noticed that the fingers of both hands had suddenly become pale and cold. Over the next few weeks the tips of some of her fingers shrivelled up and turned black, causing her great pain and discomfort. The doctor who attended her was an equally young man called Maurice Raynaud. He was perplexed, for he was faced with a patient who had spontaneously developed gangrene of her fingers with no apparent cause. She seemed healthy, there was a good pulse in her wrists indicating a good blood supply to her hands yet her fingers looked starved of blood and the tips of her fingers were gangrenous. His medical teaching told him that gangrene was due to either blockage of a main artery in a limb, diabetes, typhoid, or poisoning by a fungus called ergot which grows on mouldy rye. Clearly his patient did not fit into any of these categories, but she did have a curious history of her fingers turning odd colours whenever she was cold or under stress. He decided that the colour changes must have been due to some sort of intermittent blockage of the blood supply and that the spontaneous gangrene of her fingertips was in some way connected.
Over the next few years Raynaud saw similar patients and discussed the problem with colleagues who had also come across the condition. Before long he had collected the case histories of some 25 patients whose fingers toes, or sometimes face and ears changed colour in the cold. Some of the patients had also developed areas of gangrene on the affected parts He was however, still unsure as to the cause of the problem.
At around the same time another French doctor called Claude Bernard discovered that arteries, those vessels which carry bright red fresh blood all around the body, are supplied by nerves which make them constrict, that is, when the nerves were activated the arteries would decrease in calibre and carry less blood. The nerves in question were called the sympathetic nerves. Here at last was Raynaud's answer! The sympathetic nerves must be overactive, he thought, making the arteries so narrow that not enough blood can get through to the extremities to keep them alive. When the condition is severe enough gangrene develops, but in its milder form the affected areas intermittently turn white or blue and finally red when the blood eventually returns. In essence, the fingers and anywhere else affected were being strangled or asphyxiated due to lack of blood! He published his thoughts in the form of a thesis in 1862 called, "De l'asphyxie locale et de la gangrène symétrique des extrémités" translated as "On Local Asphyxia and Symmetrical Gangrene of the Extremities". Inevitably, the condition came to be known as Raynaud's Disease. (now called Raynaud's phenomenon or simply Raynaud's).
Maurice Raynaud suffered for several years from organic heart disease and in 1881, after dining in apparently good health and playing with his children was suddenly seized with a heart attack and died three hours later. He was forty-seven years of age at the time of his death. Raynaud was a man of great integrity, of spotless character, and recognised for unusual intellectual attainments. He was at the same time a physician, a savant, a philosopher and a man of letters.
What’s in a name?
Below are just some of the spellings which have been received on letters arriving at our office!
REYNAUD’S RENAULTS RAYNERS RAINARDS RAYNORDS RHINOS
REYNOUGH RAYNODES RHENAUDSE REINS RAYNUBEUX RANOS
RYNAUDS RAINOIDS REYNOSE RAYNOUS RAYNOW RAYNOSE
REINAUXS RAENO’S RAWNOWS RHYNOS
Dr Maurice Raynaud