A case of “Alpine armailli's apple hands syndrome”

BMJ 2003; 327 doi: (Published 31 July 2003) Cite this as: BMJ 2003;327:273
  1. Bertrand Graz, specialist in tropical medicine and public health
  1. Antenna-Geneva, Switzerland

    The telephone rings in the surgery of the general practitioner of a Swiss alpine valley: “Doctor, please come fast. My man's hands are like apples. He can't even milk the cows. It's an emergency.”

    Embedded Image

    Armailli (alpine herdsmen) in traditional dress and holding a oiseau (a cheese carrier)


    I jump in the car and bowl around a hundred curves up the valley to an isolated old mountain farm, barely hanging on in a steep clearing, almost hidden behind its huge manure heap. I put on my boots—the courtyard seems to be an …

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