No doubt the chief cause of this form is the diminished tissue resistance which diabetes occasions. Hence microorganisms can gain easy access. In some primary forms, the origin is purely neurotic. It may be unilateral or bilateral and is apt to affect the middle of the extremities rather than the fingers and toes although rarely it may affect any portion. Its local origin may be purely primary or secondary to slight injuries, such as excoriations, furuncles or knocks. The lesions pass through the various stages of inflammation with the formation of bullae, crusts, granulating ulcers, and sloughing. Kaposi describes a form of bulloserpiginous gangrene, beginning in blebs, which ulcerate and heat at one side while progressing on the other.
Prognosis and Treatment. Cases of spontaneous origin may heal but the disease is usually a grave complication of a most serious underlying condition. The treatment is that of diabetes, together with local antisepsis, and is most unsatisfactory. When septicemia impends surgical interference is often indicated. The following remedies have been used advantageously: Arnica, Arsenic and Kreosote.
American homeopath, he directed several hospitals in New York.
Professor of dermatology.
Served as Lieut. Colonel during the 1st World War.
See his book online: American homeopathy in the world war