Angiotrophosis, which includes the so-called Buerger's disease or thrombo-angiitis obliterans, is the only disease with a normal red blood count in which a high viscosity is not an unusual exception. In this desease 85% of all cases investigated had blood viscosities of 4.8 or over.
This finding, the presence of painful papules, the clinical pictures of trench foot (see Sweet, Norris, and Wilmer, Jour. A.M.A., Vol. 70, No. 7) and the clinical course of many cases confirms the writer in his opinion that this entire group of conditions is more or less related and is usually amenable to treatment, a view which offers a much more favorable prognosis than that given by Buerger.
In the immediate case the treatment should consist of rest in bed, bland diet, heat in the form of continuous electric light-baths to the extremities, the ingestion of from 4000 to 6000 C. C. of Ringer's solution by means of the duodenal tube, and sodium iodide intravenously. After the acute symptoms have subsided the treatment should consist in an entire change in the habits of the individual in order to diminish the functional demands upon the local circulation, and the avoidance of all forms of toxic absorption from whatever source, the circulation exercises devised by Buerger, and at the same time the ingestion of large quantities of water to keep down the blood viscosity. The body must at all times be protected from being chilled or compressed, not an easy matter in these days of light clothing, openwork shoes and stockings, and tight, narrow shoes.
(C) 1924 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.