NATURE OF PAINFUL VASODILATATION IN CAUSALGIC STATES

Abstract

During times of war certain syndromes, relegated to nonrecognition or oblivion in peacetime, require renewed emphasis. Among these is a peculiar vasomotor disturbance, for which a generally accepted name is lacking. It is my belief that Vulpian's 1 etat physiopathique , Weir Mitchell's 2 causalgia, Sudeck's 3 atrophy, Leriche's 4 post-traumatic painful osteoporosis, the peripheral trophoneurosis 5 and the chronic traumatic edema 6 are only different manifestations of an essentially identical vasomotor disturbance. The diagnosis of this condition should be made early, and its differentiation from compensation neurosis, malingering and atrophy due to inactivity should be attempted, as the success of treatment is mainly dependent on the stage of the disease at which adequate treatment is undertaken. Roughly, three stages of this syndrome are recognizable. In the first stage severe, persistent pain of a burning character with paroxysmal exacerbations due to jarring, air currents or emotional upsets is typical. If the