DISEASES OF THE ARTERIES. 241 



and ultimately involve all three, or it may be the result of an inflam- 

 mation in the vicinity of the vessels, etc. Inflammation of arteries, 

 whatever the cause may be, often leads to very serious results in the 

 development of secondary changes in their walls. Arteritis may be 

 acute, subacute, or chronic ; when the inner coat alone is affected it is 

 known as endarteritis. 



Symptoms. Arteritis is characterized by a painful swelling along 

 the inflamed vessel, throbbing pulse, coldness of the parts supplied by 

 the inflamed vessel, sometimes the formation of gangrenous sloughs, 

 suppuration, abscess, etc. In an inflammation of the iliac arteries we 

 find coldness and excessive lameness or paralysis of one or both hind 

 limbs. 



Pathology. In acute arteritis we find swelling along the vessel, 

 loss of elasticity, friability, and thickening of the walls ; a roughness 

 and loss of gloss of the inner coat, with the formation of coagula or 

 pus in the vessel. Subacute or chronic arteritis may affect only the 

 outer coat (periarteritis) , both the outer and middle coat, or the 

 inner coat alone (endarteritis} ; and by weakening the respective 

 coats leads to rupture, aneurism, or to degenerations, such as bony, 

 calcareous, fatty, atheromatous, etc. It may also lead to sclerosis or 

 increase of fibrous tissue, especially in the kidneys, when it may result 

 in the condition known as arterio-capillary fibrosis. Chronic endar- 

 teritis is fruitful in the production of thrombus and atheroma. 

 Arteritis may be limited to single trunks, or it may affect, more or 

 less, all the arteries of the body. Arteries which are at the seat of 

 chronic endarteritis are liable to suffer degenerative changes, consist- 

 ing chiefly of fatty degeneration, calcification, or the breaking down 

 of the degenerated tissue, and the formation of erosions or ulcerlike 

 openings in the inner coat. These erosions are frequently called 

 atheromatous ulcers, and fragments of tissue from these ulcers may 

 be carried into the circulation, forming emboli. Fibrinous thrombi 

 are apt to form upon the roughened surface of the inner coat or upon 

 the surface of the erosions. 



Fatty degeneration and calcification of the middle and outer coats 

 may occur, and large, hard, calcareous plates project inward, upon 

 which thrombi may form or may exist in connection with atheroma 

 of the inner coat. When there is much thickening and increase of 

 new tissue in the wall of the affected artery, it may encroach upon the 

 capacity of the vessel, and even lead to obliteration. This is often 

 associated with interstitial inflammation of glandular organs. 



Treatment. Carbonate of potassa in 1-dram doses, to be given in 

 4 ounces liquor acetate of ammonia every six hours; scalded bran 

 sufficient to produce loosening of the bowels, and complete rest; 

 externally, applications of hot water or hot hop infusion. 



H. Doc. 795, 59-2 16 



