ARTERIES. 



bronchitie. The granulations, or fungous growths, which 

 are not unfrequently met with at the origin of the aorta 

 upon the femi-lunar valves, or in the cavities of the heart, 

 are faid fometimes to originate in the lymph thus 

 efFufed upon the internal membrane. Mr. Hodgfon alfo 

 affures us, that the inflammation excited in an artery of the 

 extremities by the application of a ligature has been known 

 to extend along the internal coat of the veffel to the heart 

 itfelf, as we know is often the cafe with refpeft to the 

 veins. 



According to the fame well-informed writer, chronic 

 inflammation may generally be remarked in thickened and 

 calcareous arteries, particularly in aneurifmal fubjefts. The 

 internal coat of the velTel is foft, thickened, of a deep red 

 colour, which is not uniform, but irregularly difpofed in 

 the vicinity of ulcerations, thickenings, or calcareous de- 

 pofitions. P. 9. 



Ulceration of an artery may commence in the veffel itfelf, 

 or extend to it from the furrounding parts. In the firft 

 circumftance, it is always found firft on the internal coat, 

 and is generally preceded by fome other morbid change of 

 the veffel. Thus, it is not unfrequently met with around 

 the circumference of calcareous depofitions, or upon the 

 furface of atheromatous thickenings ; and aneurifm is, with- 

 out doubt, occafionally a confequence of £uch ulceration, 

 the coats of the veffels being completely deftroyed by it, 

 and the blood efcaping into the furrounding cellular fub- 

 fliance, which becomes gradually expanded into a fac. 

 Hemorrhage is often caufed by ulceration extending from 

 furrounding parts to the coats of artenes, as in cancerous 

 and phagedenic ulcers ; and Mr. Hodgfon even thinks that 

 many paflive hemorrhages are produced by ulceration begin- 

 ning on the inner furface of thefe veffels. 



Sphacelation of arteries in confequence of inflammation 

 of their internal coat has not hitherto been obferved. 

 Arteries, however, are often included in exteniive floughing 

 of parts, in which cafe the blood generally coagulates in 

 the veffels to a confiderable extent above the line of fphace- 

 lation ; an occurrence which feems deftined to prevent 

 hemorrhage on the feparation of the flough. The coagu- 

 lum is afterwards abforbed, and the veffel obliterated. 



From confidering the inflammation of arteries and its 

 effefts, our author proceeds to fpeak of various moi-bid 

 appearances to which the coats of arteries are liable, in con- 

 fequence of their peculiar ftruAure and funftions. 



1 . The internal coat of arteries is fometimes thickened and 

 converted into a fubftance refembling cartilage, or the 

 t'hickened peritoneum of an old hernial fac. This difeafe 

 is confined to the internal coat, which having loft its elaf- 

 ticity fometimes cracks, and forms fcales that hang into the 

 cavity of the veffel. Calcareous depofitions often accom- 

 pany this alteration of ftructure, and the furrounding parts 

 of the membrane generally exhibit figns of chronic inflam- 

 mation. The femi-lunar valves of the aorta are not unfre- 

 quently changed into a denfe fibrous ftrutliu-e, refembling 

 ligament, or tendon ; iometimes they are converted into 

 cartilage, and are manifeftly incompetent to their office as 

 valves. In feveral inftances, Mr. Hodgfon has found them 

 ruptured, fonning cartilaginous eminences on the fides of the 

 veffel. 



2. The internal furface of arteries exhibits frequently 

 a thickened and pulpy ftrufture, fometimes with the appear- 

 ance of fmall flattened tubercles, and, in other examples, 

 with an irregular and fomewhat flefhy appearance over 

 the whole furface. This difeafe is confined to the internal 

 coat, and is often found in aneurifmal fubjefts. 



12 



3. A depofition of atheromatous or purulent matter 

 in the cellular membraYie, wliich connects the internal and 

 middle coats of the veffel. The difeafed part is of aii 

 opaque yellow colour, fometimes extenfive, and confiderably 

 elevated above the furrounding furface, and on other 

 occafions circumfcribed, and having a puftular or tuber- 

 culated appearance. If punftured, matter may be preffed 

 from underneath the internal coat, varying in confiftency 

 from that of cheefe to that of common pus. Mr. Hodgfon 

 has feen the emulgent and femoral arteries in the fame fub- 

 jeft quite obfl:ru6ted by the accumulation of this curdy 

 matter. 



4. Certain fungous or wart-like excrefcences have been 

 obferved upon the femi-lunar valves of the aorta and pulmo- 

 nary artery, and alfo upon the mitral and bicufpid valves. 

 They are of rare occurrence. Corvifart's opinion refpeft- 

 ing the fyphilitic nature of their caufe is not intitled to 

 any degree of credit ; and Mr. Hodgfon relates a cafe, 

 where the abfence of that difeafe throughout the whole of 

 life made it impoffible that they could have had fuch an 

 origin. The femoral artery and commencement of the 

 profunda were in this inftance completely obftrufted by a 

 fungous growth, fimilar to what was found upon the femi- 

 lunar valves of the aorta. 



5. The next difeafe to be noticed is a depofition or 

 calcareous matter in the coats of arteries. In old age 

 this happens fo frequently, that Bichat was induced to 

 regard it as a natural phenomenon rather than a difeafe. 

 The incruftation feems to commence in the fubftance of 

 the internal coat, a delicate pellicle covering the calcareous 

 matter, and feparating it from the blood pafling through 

 the cavity of the veffel. Sometimes this pellicle is deficient, 

 or hangs into the cavity of the veffel, and the blood is in 

 contaft with the incruftation itfelf. Sometimes all the 

 coats of the veffel are involved in the difeafe, and are con- 

 verted into a long cylinder, in which no remnants of the 

 original ftrudlure can be traced. (Hodgfon, p. 21.) The 

 formation of thefe depofitions bears no refemblance to that 

 of bone ; they are feldom, if ever, preceded by the exiftence 

 of cartilage ; and no regular arrangement is difcernible in 

 them, correfponding to the fibrous ftrufture of bone. Ac- 

 cording to Mr. Brande's analyfis of them, they contain 

 65.5 phofphate of lime, and 3 1.5 animal matter, without any 

 carbonate of lime. 



Calcareous matter is frequently depofited in the fubftance 

 of the femi-lunar valves of the aorta, and produces more 

 ferious confequences, than when it takes place in any other 

 part of the arterial fyftem. The valves becoming rigid and 

 fixed diminifti the fize of the opening into the aorta. 

 Whilft the pulfe at the wrift is feeble, the heart is afting 

 violently to compenfate for the diminution in the quantity 

 of blood which (hould pafs through the aorta ; and this 

 comparative difference between the pulfe at the wrift and 

 that at the heart will, Mr. Hodgfon conceives, in advanced 

 cafes, be fufficient to enable us to afcertain the exiftence of 

 this incurable difeafe. A fimilar difproportion between the 

 pulfe at the heart and at the wrift exifts alfo when the 

 opening between the left auricle and ventricle is contracted ; 

 but a double pulfation of the heart has been obferved in 

 this cafe, and is faid to diftinguifti it from contraftion of the 

 orifice of the aorta by oflification of its valves. 



Mr. Hodgfon has given fome interefting cafes of oflifica- 

 tion of the coronary arteries. In one, the heart was un- 

 ufually fmall ; its parietes foft and flaccid, and upon the 

 ventricles not the eighth of an inch thick ; whilft the coro- 

 nary arteries and many 01 their ramifications were converted 



into 



