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January 25, 1971

White Fingers

JAMA. 1971;215(4):631. doi:10.1001/jama.1971.03180170065015

In 1862, the year he received his medical degree, A. G. Maurice Raynaud published his treatise, "De l'asphyxie locale et de la gangrène symétrique des extrémités," describing intermittent color changes in the fingers and toes elicited by exposure to cold or by emotion. This condition may be primary or secondary to neurovascular disturbances, organic vascular disease, cold injuries, cold agglutination of erythrocytes or cryoproteinemia, and toxins such as nicotine, arsenic, ergot, and lead. Since 1911, Raynaud's phenomenon has been described as an occupational condition of traumatic origin1 following development of the pneumatic hammer and other vibrating tools, a condition known to involved workers as "white fingers."

It is interesting that Raynaud's phenomenon has been related to toxins and to trauma because recently both factors have been incriminated by the occasional finding of Raynaud's phenomenon, associated with acroosteolysis, in men who handscrape the polymerizer chambers used in the manufacture of polyvinyl