Prognosis in relation to the use of the upper extremities is bad, as the disease leads to incurable deformities and mutilations. It attacks more often males than females, of all ages, and whether traumatism is to blame for it remains more than doubtful.
It is easy to differentiate it from Ball’s sclerodermitis, for here one never meets necrosis of the bone, nor are bone pieces discharged; the mutilations take place gradually by a kind of absorption of the tissues of the fingers; nor is there any paresis or anaesthesia. Finally the sclerodermic mark is specific, and can never be mistaken for anything else.
In relation to anaesthesia with its atrophy the patient’s hands become very similar to those of the monkey, and the lesions are mostly symmetric. The same trophic troubles may be found anywhere on the body and ulcerations are frequent, and the leprous spots on the skin of such patients are characteristic and known as morphea alba or rubra. Lepra is an exotic plant and so far confined to few countries.
Nor can Morvan’s disease be mistaken for syringomyelia, characterized, as it is, by more extensive muscular atrophy, and though the sensation of contact is preserved, the sensibility to heat and cold is abolished over large surfaces of the body, a characteristic which is only partially met with in hysteria. The rhagades, the arthropachies and the scoliosis belong to both, but a panaris is an exception, while in Morvan’s disease it remains the predominant phenomenon.
Abnormal sensitiveness of the fingers, painful at first, with redness and swelling, then bullae which break and dry up, followed by atrophy of the upper phalanx, which becomes deformed and absorbed.
Nobody as yet has discovered the origin of the malady, and none has yet given a treatment for it. We may claim that constitutional treatment may eradicate the poison and Homoeopathy is rich in resources.
Thuja, fluoric acid, Silicea, Sulphur and others are of great assistance.
Thuja.-Erysipelatous swelling of the tips of the fingers and of the fingers, nails are crippled, discolored, crumbling off; twitchings of the muscles of the arums; coldness and sensation of deadness of the fingers and tips of the fingers; stinging pains in the arms and in the joints; emaciation and deadness of the affected parts dirty and brownish color of the skin.
Silicea and scoliosis go hand in hand, and according to some authors it is found in nearly half the cases of Morvan’s Disease. It is also complementary to Thuja, and in most cases where Silicea suits there is a tendency to chronicity of the disease; emaciation and atrophy of affected parts; paretic states; nails rough and yellow; pain as if panaritium would form on left index; dryness of tips of fingers; ulcers about nails; felons with violent shooting pains deep in the fingers, with great restlessness and irritability.
Sodium sulphate is also correlated to Thuja. Perhaps it may come in at a later stage when the paronychia sets in painless or with hardly any pain. Among its symptoms we read twitchings of the hands, trembling of the hands on waking, and also when writing; loss of strength of the hand, is unable to hold anything heavy; tingling, ulcerative pain under the nail; internal coldness; with yawning and stretching.
Graphites has emaciation of the hands, distortion of the fingers, gouty nodosities on the finger-joints; thick and crippled nails; soreness between the fingers; sensation of debility without pain and liability to take cold. Cracks and fissures anywhere are often the key-note to the use of this drug, and as it has a long action, it ought certainly be of benefit in such a chronic affection as Morvan’s Disease.
Sepia also has diseases and crippled nails with painless ulcers on the joints and tips of the fingers and paralytic drawing and tearing in arms and fingers. Venosity and stagnation is the red thread which goes all through the pathogenesis of the drug; it is also a long lasting remedy, hence the neurasthenia and the paretic condition, and the more we consider all these diseases, except lepra, of constitutional origin, the more will we be able to prevent the deformities which, when once present, are out of the pale of therapeutic measures.
