[Do the clinical symptoms described by Raynaud correspond to a nosological entity or a syndrome with multiple etiologies?].

In considering this problem, our opinion concerning Raynaud's phenomenon is as follows: The symptomatology described by Raynaud includes among other things a local asphyxia and gangrene. All the patients in whom these two signs are not found should not therefore be included under the label of Raynaud's disease. It is preferable in such cases to use Reil's term of "dead fingers". But our experience shows that if there is local asphyxia or even gangrene, in addition to the syncopal episodes, there is always a causal disease. However it is not justifiable here to speak of Raynaud's disease, but rather of Raynaud's syndrome or Raynaud's phenomenon complicating some causal disorder, such as progressive scleroderma or obstructive arterial disease with digital localisation. The phenomenon of "dead fingers" is very common and most marked at the time of puberty. The symptoms regress in the years following. It is rare to see Raynaud's phenomenon at the time of puberty, this being commoner in later decades, with a course which is more or less pronounced and progressive according to the underlying disease. The prognosis is also a function of the underlying disease and is likely to be unfavourable, even threatening life, in cases of progressive scleroderma.