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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![ARTERIOSCLEROSIS t,]iR ,l,iinioa media, due to a hypertrophy of _ muscle fibres; (2) a thickening: of the tunica intima, clue to a hyperplasia of its subendothelial connective tissue, without atheromatous d^raeration; in some instances fibrous liyperplasia and thickening of the tunica adventitia. The muscular coat might show some degeneration, but the prevalent notion that in such thickened vessels the muscle of the middle coat was replaced by fibrous tissue, and so the seat of fibroid degeneration, was found to be entirely erroneous. These changes were not confined tcplhinted areas of vessel wall, as in atheroma, but affected uniformly the whole length of tbe radial. They were found to be distributed through- out the body, the coronary and _renal jirteries, for instance, showing corresponding changes. The change^ are shown in Figs. 9, 10, 11, 12, and 13. In Fig. 9 great thickening of the artery is shown, ancl is seen to be due to hypertrophy of the tunica media and some hyperplasia of the tunica intima. Fig- 10. a section of the kidney from the same case, shows, in the centre of the field, an artery with a much diminished lumen due to fibrous hyperplasia of the tunica intima, while the tunica media is atrophied; at a there is an occluded arteriole, Fig. 11 shows a small thickened radial artery, which was persistently small and hard during life. The thickening here is partly a hypertonic contraction, and in part, I think, the result of a hyperplasia of the adventitia. Fig 12, a section of the kidney from the same case, shows two arteries with their lumen encroached upon by hyperplasia of the tunica intima, while the tunica media is atrophied. Fig. 13 is a section of the trunk of one of the coronary arteries, showing hypertrophy of the media and hyperplasia of the intima. Here, as is sometimes found, there is also some atheromatous degeneration in the intima. The changes were often present when there was practically no atheroma in the aorta or tl_ie large arteries. They were, howe\eij soinetinies associated with atheroma of the aorta; while atheroma of the cerebral arterie^is.so_cpinmm in later life, that it, so far as my observations go, often accompanies arterio- sclerosis elsewhere.](https://iiif.wellcomecollection.org/image/b28036591_0047.jp2/full/800%2C/0/default.jpg)
