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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![There is, of course, no doubt that the arteries we examine clinically vary enormously in the thickness of their wall, and the relation of thickness of wall to bore. There are, however, no records of the results of the examination after death of radial arteries known to be thickened during life. Pathologists and clinicians in the post-mortem room have gone to the aorta or the cerebral arteries in search of atheroma, and ^lave left the vessel felt during life undisturbed in its resting place, and overlooked even amidst the yearnings of clinical curiosity. This was formerly my own position, but in 19 01 I drew attention to the gravity of the omission; and what I wrote then and subsequently is the outcome of obser- vations which are almost monotonous in their uniformity. The difference in the thickness of radjal arteries and in the relation of thickness of wall to bore has been shown in Figs. 9 and 11, and is further represented in Figs. 14, l5, 16, 17, 18, 29, andl^; There is no question here of post-mortem rigidity, and the influence of fixatives ; these arteries felt after death as they had felt during life, save for the absence of pulsation in them, so that the only question is what changes led to their thickening ? These changes I have described in an earlier chapter. No fixative treatment of normal arteries will produce such pictures as I have given. Professor Mac- AVilliam found that arteries taken from amputated limbs were l>y stimulation so altered that their diameter coidd be reduced to one-tliird, with, of course, a corresponding thicken- ing of the wall. This is a wide range of contractility in a normal vessel, yet in arterio-sclerosis, where the tliickening encroaches upon the lumen, and contractility is retained, the diminution is still greater. Some of my cases have shown a thicker wall and a smaller bore than IMacAVilliam records. I cannot but think that those who have tliought that the vessel wall was negligible have not had the data necessary to a correct opinion. The following chapters will illustrate the part taken by the vessel wall in hpemomanometer observations. It is, however, necessary to repeat what has been said eai'lier, that thickness of the arterial wall may be due to two factors, separate or coml)ined, namely, ])ermanent structural thickening and hypertonic contraction ;](https://iiif.wellcomecollection.org/image/b28036591_0080.jp2/full/800%2C/0/default.jpg)
