Intermittent claudication and allied syndromes due to angiosclerosis of the extremities / by J. Ramsay Hunt.

  • Hunt, James Ramsay, 1872-1937.
Date:
[1905]
Catalogue details

Licence: In copyright

Credit: Intermittent claudication and allied syndromes due to angiosclerosis of the extremities / by J. Ramsay Hunt. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ing degrees of severity. The ages of the patients were fifty-eight, forty-two, sixty, and forty-nine years respectively. The etiological factors noted were. Case I.—Neurotic temperament, gouty here- dity, anxiety, and tea. Case II.—A moderately ner- vous temperament. Case III.—Excesses in alcohol and tobacco and prolonged exposure of the feet to cold and wet for many years. Case IV.—Syphilis, excesses in alcohol and tobacco, and constant exposure of feet to cold and wet for years. Exciting cause: Restraint in alcoholic delirium. Both legs were affected in Cases I, III and IV, but of unequal intensity. In Case II the left leg alone was involved. Pulsation was absent or di- minished in one or more of the pedal arteries in Cases I, III and IV. In Case II the anomalous con- dition was found of a diminished posterior tibial pul- sation on the unaffected side. The ^r-ray photo- graphs taken of Cases III and IV, the walls of the posterior tibial and dorsalis pedis arteries are dis- tinctly outlined by calcareous deposits. According to Sanger this method has a certain prognostic • importance, for, as was pointed out by Charot, cases dependent upon calcareous deposits are less amenable to treatment, than the arteriosclerosis and the endarteritis. In all the cases something has been gained by treatment, in the amelioration of symp- toms and the lengthening of the “time-limit,” but in none was a very definite improvement noted. On the other hand, since the institution of a proper re- gime and treatment, the malady does not appear to have progressed materially. To Summarize Very Briefly.—Angiosclerosis of the extremities in its gravest form, uncomplicated by a vasomotor nerousis leads to spontaneous gangrene. If the angiosclerosis occurs in combina- tion with a vasomotor instability and a tendency to