A reference handbook of the medical sciences, embracing the entire range of scientific and practical medicine and allied science . grene in the middle-aged and the young isregarded by many as a distinct and primary opinion is based largely upon the fact that pre-monitory symptoms, indicative of gradual occlusionof the arteries, may exist a long time before cuhninat-ing in gangrene, the more prominent sjmptoms beingpain, cyanosis, and coldness. In some cases the com-plex of symptoms called by Cliarcot intermittentclaudication has been present. The arteries morefrequently involved a
A reference handbook of the medical sciences, embracing the entire range of scientific and practical medicine and allied science . grene in the middle-aged and the young isregarded by many as a distinct and primary opinion is based largely upon the fact that pre-monitory symptoms, indicative of gradual occlusionof the arteries, may exist a long time before cuhninat-ing in gangrene, the more prominent sjmptoms beingpain, cyanosis, and coldness. In some cases the com-plex of symptoms called by Cliarcot intermittentclaudication has been present. The arteries morefrequently involved are those of the foot, leg, andforearm. The endarteritis, which is described astypical, with vascularization of the new tissue in theintima and reduplication of the elastic coat, beginsin the peripheral branches. The adventitia may begreatly thickened, and in some cases the neighboring Fia. S29.—Dififuse Arteriosclerosis. Renalartery. WoJKerts elastic-fiber stain. I,Iiitinia with new elastic fibers; M, media,the seat of hyaline degeneration: no elasticelenients; \, adventitia with increased num-ber of elastic fibers. X Fio. —Sclerosis of -terJor Tibial .Vrterj-. Gangrene offoot from thrombosis. I. Fibrous intima; K, elastic lamina; with hyaline degeneration and calcification; A, adventitia;D, beginning degeneration in intimal thickening. Hematoxyhnand eosin. X 100. veins and nerves were found extensively involved inthe perivascular sclerosis. In many cases throm-bosis or jjigmentation, the probable result of throm-bosis, was present, and Thoma, who does not believethere is a special form of obliterating endarteritis,holds that tlie endarteritic changes in this form of gangrene result from the rejilacemcnt by connectivetissue of thrombi in sclerotic Others holdsimilar views. Goebel attributed spontan(M)us gan-grene in a child, one and a half years old, to thrombosisat the bifurcation of tlie pojjliteal artery ()roducedby the presence of snuiU glo
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