ATHEROMATOUS AFFECTION OF ARTERIES. 395 



plete understanding ever been come to as to what was to 

 be understood by the expression atheromatous change in 

 a vessel. Some have taken the term in a wider, others 

 in a narrower sense, but still it has perhaps been taken 

 in too wide a sense by all. When, namely, the anato- 

 mists of the last century applied the name of atheroma 

 to a definite change in the coats of arteries, they of 

 course had in their minds a condition similar to that of 

 the skin, to which ever since the days of ancient Greece, 

 the name of atheroma, grit-follicle, (Griitzbalg) [sebace- 

 ous or epidermic cyst], had been assigned. It is self- 

 evident, therefore, that the idea of atheroma presupposes 

 a closed sack. Nobody ever called anything in the skin 

 an atheroma that lay open and uncovered. It was there- 

 fore a curious misapprehension when people recently be- 

 gan to call changes in the vessels atheromata, which were 

 not seated below the surface and shut off from the sur- 

 rounding parts, but belonged to the surface. Thus it has 

 come to pass that, instead of an enclosed deposit being, 

 in accordance with the original meaning of the term, 

 called atheromatous, a change has frequently been so 

 termed which commences quite at the surface of the in- 

 ternal arterial coat. When the matter began to be exa- 

 mined more minutely, and fatty particles (Fig. 113) were 

 found at very different points in the walls of the vessels, 

 both when atheroma was, and was not, present when 

 at last the conviction was obtained, that the process of 

 fatty degeneration was always the same and was identi- 

 cal with the atheromatous change, it became the custom 

 to unite all the forms of the fatty degeneration of arte- 

 ries under the designation atheroma. Gradually, peo- 

 ple even came to speak of an atheromatous change in 

 vessels, that only possessed a single coat, for in them too 

 we meet with fatty processes. 



At all times there have moreover been observers who 



