During recent years the Literature on peripheral
vascular disease has grown enormously. Especially
frequent have been articles on the clinical features and
the response to treatment, but strangely enough since the
publication of Buerger's book (1924) relatively little
has been written on the correlation of the morbid
anatomical appearances and the physiological readjustment
of the circulation. This is all the more surprising in
view of the fact that so much attention. has been directed
to functional derangement of the arterial circulation in
the heart and kidney, especially as it is so much simpler
to Make absolute measurements of the arterial circulation
in the limb than in the other organs.
The present study is based on material obtained
from a variety of sources my interest was first
aroused in the subject by experience gained in the
investigation of material kindly supplied by prof. J. R.
Learmonth from his peripheral vascular diseases unit.
.part from one biopsy performed on a superficial vein
this material consisted of lower limbs amputated as a
result primarily of ischaemic gangrene. The greater
part of this work accordingly consists of an account of
observations made in examining This tissue in the
Pathology Department of the University of Edinburgh.
The study has however been continued in the Medical Unit
of St. Mary`s Hospital in an attempt to answer some of
the questions raised during the course of the
investigations made Edinburgh)and a brief account of
some of this later work will accordingly be included.
Although many specimens were available in the departmental
collections of the R.I.'S. and the university of Edinburgh
pathology Department the account has been restricted to
include only cases of thromboangiitis obliterans and
atherosclerosis personally studied. Thus every case
on which this account is based has been investigated by
me both in the ward ana in the laboratory. This is
considered to be a most valuable point, namely that both
the anatomical and physiological aspects should be
studied by one and the same person.