INFLAMMATION OF AETEEIES AND VEINS. 251 



stimulants. The etiology of gout is very similar to tliat of 

 endoarteritis ; hence the two diseases are often found together. 



§ 216. The common starting-point of all the lesions due to 

 chronic endoarteritis is to be found in certain flat and smooth, 

 seldom tuberous elevations on the inner coat of the arteries. They 

 rarely project more than a line above the surface ; their margins 

 are very irregular. At the point where a vessel is given off, they 

 encircle it ring-fashion. They vary to some extent in colour 

 and consistency, yet they may be generally described as bluish 

 or reddish grey and cartilaginous ; sometimes they may exhibit 

 more of a gelatinous or mucoid consistency. 



As regards the microscopic appearances, let me insist once 

 more on the fact, of which we may readily assure ourselves by 



Fig. 80. 



Chronic endoarteritis. Section through an indurated elevation 

 of the inner coat, which is ah'eady undergoing fatty de- 

 generation in its interior. ■^; h. Junction of inner and 

 middle coats ; a. Inner coat ; At c this is hyperplastic and 

 thickened, while at d it has become converted into an athe- 

 romatous abscess. For details see text. 



examining sections through the margins of the swollen part, that 

 the outermost lamella of the intima, which is usually least 

 altered, passes uninterruptedly over the surface of the swelling ; 

 that the change consists therefore not in a deposit upon, but in an 

 actual thickening of the membrane itself (fig. 80, a—c). We 

 may further regard it as certain that we have to do with a pro- 

 liferation in and from the connective tissue of the intima, which 

 has caused a positive increase in its bulk ; young cells in countless 



