Licence: In copyright
Credit: Arterial hypertonus, sclerosis and blood-pressure. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
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![ATHEROMA AND ENDARTERITIS DEFORMANS term “ arterio-sclerosis,” as it is already in use, and as it is undesirable to multiply terms. To my mind it is quite reasonal)le to give a new term a limited application while declining to acquiesce in its displacing older and more definite terms. ATHEROMA AND ENDARTERITIS DEFORMANS. Atheroma is a focal or patchy affection of arteries. It is characterised by a local thickening and degeneration of the tunica intima. The thickening consists of a hyperplasia of the subendothelial connective tissue. It is, however, early associated with an atheromatous degeneration in parts of this thickened intima. The atheromatous chano'e is a fatty degeneration, commonly most marked in the deeper part of the thickened tunic. The atheromatous material may become the seat of more or less calcareous deposition. At the part corresponding to these changes the tunica media is thinned and atrophied, or may even show areas of necrosis in the large arteries, as demonstrated by Cowan and others. When these changes are still further advanced and are present in the large arteries, they lead to so nmch deformity that the term endarteritis deformans was applied to them by the older pathologists. In the large arteries, in addition to the changes mentioned, there may be found atheromatous cysts, atheromatous ulcers, calcareous plates (the result of calcareous deposition in extensive atheromatous areas), and local saccidatitms or hulgings, the result of yielding of parts of the arterial wall Ijefore the blood- pressure following u})on the atro])hy or even destruction of the tunica media. The changes may be so extreme, and may so affect the arch of the aorta for instance, that it may be much dilated, a state of matters to which the term aneurismal dilatation is applied. Similar changes affecting a localised area of the aorta give rise to a definite aneurism. It is however as atheroma affects smaller vessels that we are specially concerned here; so it requires somewhat more consideration. The condition is very common in the cerebral and in the coronary arteries, but is comparatively rare in the](https://iiif.wellcomecollection.org/image/b28036591_0039.jp2/full/800%2C/0/default.jpg)
