Erratum

Page 75, Figure shown is not the Brown sphygmomanometer described in the text, but the Baumanometer manufactured by W. A. Baum Co., Inc., New York. It is claimed that the Baumanometer is made with particular care and hence the readings are said to be more accurate than other mercury instruments. It is apparently a good instrument. The author has had no personal experience with it.

ARTERIOSCLEROSIS

AND

HYPERTENSION

With Chapters on Blood Pressure

BY

LOUIS M. WARFIELD, A.B., M.D., (Johns Hopkins),
F.A.C.P.

PREFACE TO THIRD EDITION

Several years have elapsed since the appearance of the second edition of this book. During this time there has been considerable experimentation and much writing on arteriosclerosis. The total of all work has not been to add very much to our knowledge of the etiology of arterial degeneration. Points of view and opinions change from time to time. It is so with arteriosclerosis. In this edition arteriosclerosis is not regarded as a disease with a definite etiologic factor. Rather it is looked upon as a degenerative process affecting the arteries following a variety of causes more or less ill defined. It is not considered a true disease. Possibly syphilitic arteritis may be viewed as an entity, the cause is known and the lesions are characteristic.

Much new material and many new figures have been added to this edition. Some rearranging has been done. The chapter on Blood Pressure has been much expanded and some original observations have been included. The literature has been selected rather than indiscriminately quoted. Much that is written on the subject is of little value.

It has always seemed to the author that there is not enough of the personal element in medical writings. At the risk of being severely criticized, he has attempted to make this book represent largely his own ideas, only here and there quoting from the literature.

New chapters on Cardiac Irregularities Associated with Arteriosclerosis, and Blood Pressure in Its Clinical Application have been added.

The fact that the book has passed through two editions is very gratifying and seems to show that it has met with favor. The author takes this opportunity of thanking those who have loaned him illustrations. Wherever figures are borrowed due credit is given.

It is hoped that the kind of reception accorded to the first and second editions will also not be withheld from this present edition.

Milwaukee, Wisc.

PREFACE TO THE SECOND EDITION

In this second edition so many changes and additions have been made that the book is practically a new one. All the chapters which were in the previous edition have been carefully revised. Two chapters, "Pathology" and "Physiology," have been completely rewritten and brought up to date. It was thought best to add some references for those who had interest enough to pursue the subject further. These references have been selected on account of the readiness with which they may be procured in any library, public or private. Two new chapters have been added—one on "The Physical Examination of the Heart and Arteries," the other on "Arteriosclerosis in Its Relation to Life Insurance," and it is hoped that these will add to the practical value of the book.

Arteriosclerosis can scarcely be considered apart from blood pressure, and in the view expressed within, with which some may not concur, high tension is considered to be a large factor in the production of arteriosclerosis. As the data on blood pressure have increased, the importance of it has become more evident. The chapter on "Blood Pressure" has been wholly rewritten, expanded so as to give a comprehensive grasp of the essential features, and several illustrations have been added in order to elucidate the text more fully. The chief objects in view were to make clear to the physician the technique and the necessity for estimating both systolic and diastolic pressures.

The author is grateful for the kindly reception accorded the first edition. No one is more keenly aware of the imperfections than he. The necessity for a second edition is taken to mean that the book has found a place for itself and has been of use to some.

The author hopes that this new edition will fulfill adequately the purpose for which he prepared the book—namely, as a practical guide to the knowledge and appreciation of a most important and exceedingly common disease.

Milwaukee, May, 1912.

PREFACE TO THE FIRST EDITION

It is hoped that this small volume may fill a want in the already crowded field of medical monographs. The author has endeavored to give to the general practitioner a readable, authoritative essay on a disease which is especially an outcome of modern civilization. To that end all the available literature has been freely consulted, and the newest results of experimental research and the recent ideas of leading clinicians have been summarized. The author has supplemented these with results from his own experience, but has thought it best not to burden the contents with case histories.

The stress and strain of our daily life has, as one of its consequences, early arterial degeneration. There can be no doubt that arterial disease in the comparatively young is more frequent than it was twenty-five years ago, and that the mortality from diseases directly dependent on arteriosclerotic changes is increasing. Fortunately, the almost universal habit of getting out of doors whenever possible, and the revival of interest in athletics for persons of all ages, have to some extent counteracted the tendency to early decay. Nevertheless, the actual average prolongation of life is more probably due to the very great reduction in infant mortality and in deaths from infectious and communicable diseases.

The wear and tear on the human organism in our modern way of living is excessive. Hard work, worry, and high living all predispose to degenerative changes in the arteries, and so bring on premature old age. The author has tried to emphasize this by laying stress on the prevention of arteriosclerosis rather than on the treatment of the fully developed disease.

No bibliography is given, as this is not intended as a reference book, but rather as a guide to a better appreciation and understanding of a most important subject. It has been difficult to keep from wandering off into full discussions of conditions incident to and accompanied by arteriosclerosis, but, in order to be clear in his statements and complete in his descriptions, the author has