Abstract
In most instances the origin of symmetric gangrene is impossible to explain. I wish to report the following case as the cause seems reasonably clear and the degree of involvement was extensive. REPORT OF CASE D. M., an unmarried woman aged 32, an underwear operator, was first seen by me on June 1, 1936. Her father and mother, three brothers and one sister were all living and well. The menstrual history was normal, and the only previous illness was measles in childhood. The patient drank coffee and wine rarely. The original consultation was to seek relief from articular disturbance associated with generalized weakness, both of which began four years previously when the right wrist began to be painful and later to swell. The weakness and lack of endurance had been slowly progressive, and after a year of debility pain developed in the feet, and the right knee joint became painful
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