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Evelyn Holt, M.D.
JAMA. 1928;91(13):959-960. doi:10.1001/jama.1928.92700130001010.
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While rapidly advancing gangrene of the feet is relatively common in diabetic patients, bilateral trophic disturbances are unusual. The latter condition is not mentioned in most discussions of diabetic gangrene, and in studies of trophic disturbances diabetes may or may not be mentioned as a predisposing cause. A case with well marked sensory changes and localized, painless necrosis of both great toes with subsequent healing was recently observed, and is here reported.


History.  —Mrs. L. F., a widow, aged 52, born in Russia of Jewish parents, came to the Cornell Clinic, Jan. 10, 1928, because of diabetes and trouble with her feet. There was no history of diabetes or other chronic illness in her family. She had been in good health and had not had any acute illness or operation. She had had five children, with no miscarriages, and the menstrual periods had been normal


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