Recent History
May 12, 1908
Vilhjalmur Stefansson
My Life with the Eskimo - Chapter 2
The Native Americans around Bear Lake would buy civilized clothing that was expensive and not warm enough for the winter, while also purchasing sweet and expensive foods, just to say they are fashionable and modern.
Here, as in many other places on the river, we saw examples of the improvidence of the Indians. Even in winter they dress in imported cloth garments which are far more expensive and not half so warm as the clothing they could make out of the skins of the animals they kill. But similar things occur the world over. Perhaps it should not be regarded as strange, but rather as a proof of the universal brotherhood of man , that the Northern Indian would rather shiver in fashionable attire than be comfortable in the furs which are cheap and therefore unaristocratic. On Bear Lake I have known them to sell caribou skins at fifty cents apiece to buy a duck coat at eight or ten dollars, when two caribou skins would have made a much warmer garment. An Indian woman at Smith Landing, while we were there, traded twenty suckers, which was food enough for a week, for one pound of tinned salmon, which did not make even a meal for her, and this at a time when she had been on short rations for several days on account of the want of fish, and when the twenty fish were all she had caught. Chocolate, imported English jams and marmalade, candies, and ribbons are the staple wares of these posts nowadays. It must be said that it was a part of the generally wise policy of the Hudson's Bay Company not to encourage among the Indians the development of these expensive tastes which it is so difficult for them to find the means to satisfy, but of late years the Company has had to follow where other traders have led them and now , instead of taking into the country what they consider good for the Indian, they are forced to take in anything that the Indian will buy. It is only the wise laws of the land that have determined that these articles shall be candies and sweetmeats instead of brandies and gin.
Page 18-19
We started from Fort Smith June 11th and that afternoon stopped at the mouth of the Salt River to buy salt from the Indians, which they get nearly pure in a bed exposed a few miles upstream . They bring it down to the mouth of the Salt River, where they keep it for trading purposes, supplying the entire Mackenzie district with salt. The Indians everywhere along the river are dressed in general like white men . Many of them speak English, often with a broad Scotch accent, for most of the Hudson's Bay factors, through a whole hundred years or more of the continuous occupation of the Mackenzie valley, have been Scotchmen and Orkneymen. Although practically unknown to science, these Indians are thoroughly sophisticated and have to a large extent forgotten the manners and customs of their ancestors . They are all Christianized, with the exception of one small tribe who live in the mountains westward from Fort Providence. It is a remarkable thing, as we have it from the stories of James Mackinlay and Joseph Hodgson and others who know them well, that this one tribe keep with jealousy the customs, religion, and language of their ancestors. They come down to Fort Providence to trade every summer, but they have nothing to do with the Chris tianized Indians, nor with the white men, except in so far as they are compelled to in the mere matter of trading. These Indians are said by the Hudson's Bay men to differ strikingly from the rest of the natives in being more enterprising, more honorable, and thoroughly self-respecting. Up to four years ago, at least, they had constantly refused to take presents from the Canadian government, a thing which all the other Indians do under the name of "treaty money.” An arrangement was made a few years ago by which all the Indians, with the one exception noted, as far north as Fort Providence, signed away their “tribal rights ” in consideration of the payment to them every year by the Canadian government of five dollars in money, and small presents of tea, flour, and other articles of trade.
This is an arrangement which for the present at any rate does not seem to be doing the Indians any good, for they lose much valuable time in coming from great distances to the trading posts to wait for the “ treaty parties ” of the Indian Department; but the arrangement at least furnishes employment, no doubt both pleasant and profit able, to a few white men who come each year bearing gifts and who make the annual round of the tribes. There is with them a doctor, usually, who takes a glance at whatever sick and maimed there may be in the Indian villages, and who no doubt picks up information of interest about the condition of the natives ; but he could scarcely be supposed to do them much good, directly, by this one visit a year. It would be much more to the advantage of the Indian if the Canadian government would do as the Danish government does in Greenland, and instead of sending these expensive parties on perfunctory visits, should station a medical man every two hundred or three hundred miles so that his services could be available when needed.
January 1, 1913
Studies concerning glycosuria and diabetes.
Frederick Allen discovered that when dogs with only 20% of their pancreas was left after surgery ‘On an Eskimo diet they may be found to live in health...on a Hindu diet they soon go down to fatal diabetes’ proving that low carb diets could be sustained with low pancreas function.
Frederick Allen—one of the first to appreciate that diabetes involves total metabolism rather than carbohydrate metabolism alone—developed this model to show that complete removal of the organ resulted in uncontrolled diabetes and death, whereas dogs who retained more than 20% of their pancreas never developed diabetes. The fate of those with 80–90% pancreatectomy depended upon what they ate. ‘On an Eskimo diet they may be found to live in health’, said Allen, but ‘on a Hindu diet they soon go down to fatal diabetes’ [8]. Carbohydrate loading produced progressive glycosuria and hydropic degeneration of the islets, leading Allen to conclude that the as yet unknown pancreatic factor that prevented diabetes had been exhausted. Glucose toxicity had found its first advocate. Physiology also has its cycles, and investigators discovered in 1988 that glucose infusion precipitated pancreatic islet failure in dogs with subtotal pancreatectomy, little suspecting that they had reproduced one of the classic experiments in diabetes 75 years later [9].
Allen concluded that people with diabetes should be given just enough food to keep body and soul together, with as little carbohydrate as possible, and the starvation regimen was born [8]. The physician in charge of this diet has been described as a yachtsman sailing as close as possible to the wind [10]. Too many calories, and symptomatic hyperglycaemia would result; too few, and the patient would die of starvation (as some did). Naunyn had taught that ‘fat burns in the fire of the carbohydrates’, and carbohydrate was needed for the proper combustion of dietary fat, which might otherwise precipitate ketoacidosis. One risk having thus been balanced against another, a man weighing 60 kg and able to tolerate 100 g of carbohydrate might end up on 60 g of protein, 130 g of fat and 25 g of carbohydrate. His daily ration of the latter might consist of 7 oz (198 g) of thrice boiled cabbage, or 5 oz (142 g) of similarly treated spinach or two and a half bran biscuits [10]. The bran was needed to counteract the constipation induced by the rest of the diet.
Adults did relatively well on this regimen, but children hovered miserably between death from diabetes and death from starvation. One 12-year-old boy, already blind from diabetes, was reduced to eating toothpaste mixed with birdseed stolen from his pet canary. ‘These facts were obtained by confession after long and plausible denials’, remarked the pitiless Allen. The unfortunate child died of starvation. A few physicians hailed the treatment as a means of prolonging life, but Carl von Noorden shuddered and turned away when Joslin showed him one of his cases. The controversy concerning the value of extra months or years purchased at the cost of so much misery was very bitter, and Allen was banned from the diabetic clinic at the Rockefeller Institute in 1918 [11].
January 1, 1913
Physiological economy in nutrition
Voit finds that the average man "requires daily 118 grams of proteid or albuminous food, of which 105 grams should be absorbable, 56 grams of fat, and 500 grams of carbohydrate, with a total fuel value of over 3000 large calories, in order to maintain the body in equilibrium. The Voit standard or daily diet is accepted more or less generally as representing the needs of the body under normal conditions of life."
"Almost everyone in the world outside the Arctic then ate a very high carbohydrate diet, and the ‘Vogt standard’, widely accepted by nutritionists, considered that a 3,000 calorie diet for a working man should include 500 g of carbohydrate (66% of calories), 56 g of fat and 118 g of protein [14]."
"Certain dietary standards have been set up which have found more or less general acceptance in most parts of the civilized world; standards which have been reinforced and added to by man's aptitude for self-indulgence. Carl Voit, of Munich, whose long and successful life as a student of Nutrition renders his conclusions of great value, considers that an adult man of average body-weight(70-75 kilos) doing moderate muscular work requires daily 118 grams of proteid or albuminous food, of which 105 grams should be absorbable, 56 grams of fat, and 500 grams of carbohydrate, with a total fuel value of over 3000 large calories, in order to maintain the body in equilibrium. The Voit standard or daily diet is accepted more or less generally as representing the needs of the body under normal conditions of life."
January 1, 1919
Studies on Blood Sugar - Effects upon the blood sugar of the repeated indigestion of glucose by Louis Hamman
Staub-Traugott effect is shown where if two consecutive doses of glucose are given to a healthy subject the hyperglycaemia resulting from the second dose is lower than that after the first.
The Staub-Traugott Phenomenon
Up to the present the masterly work of Allen and his collaborators has dominated the conception of diabetes mellitus, but recently another line of research has begun to turn thought in a different direction. In 1919 Hamman and Hirschman described the phenomenon which is now usually referred to as the Staub-Traugott effect. They showed that if two consecutive doses of glucose are given to a healthy subject the hyperglycaemia resulting from the second dose is lower than that after the first.
Studies on Blood Sugar - Effects upon the blood sugar of the repeated indigestion of glucose by Louis Hamman
In a communication to the Archives of Internal Medicine Hamman and Hirschmann have demonstrated the blood-sugar response Ito the ingestion of a single large dose of glucose in normal persons and in others suffering from various diseases. For this study 100 grams of glucose were administered in the early morning after the night fast, and the blood sugar and urine sugar estimated at short intervals thereafter. It was demonstrated that there are two important types of reaction, the normal and the diabetic. There is still a third type, not nearly so clearly distinguished as these two, the reaction of increased carbohydrate tolerance. Although the reaction in normal persons varies in different individuals and in the same individual under different circumstances, its general characters are as follows: The blood sugar rises rapidly, but seldom exceeds 0.15 per cent; it falls somewhat more slowly to the original level, the whole reaction being over in less than two hours. In diabetics the rise is higher and longer sustained. If the blood sugar surpasses 0.18 per cent, sugar usually appears in the urine, but sometimes it appears at a somewhat lower level; at other times it fails to appear, even though 0.2 per cent of blood sugar is exceeded. From two to five hours pass before the blood sugar reaches the original fasting level. When the carbohydrate tolerance is increased, there is only an insignificant rise in the blood sugar, which has usually a low fasting level.
January 1, 1923
Elliott P. Joslin
The Treatment of Diabetes Mellitus
Dr Joslin explains that Eskimos can "get along very comfortably upon 52 grams" of carbohydrate a day which "should greatly encourage diabetic patients"
Carbohydrate.-
From the preceding statements it will be seen that 55 per cent of the energy of the diet of the normal individual consists of carbohydrate . These figures are only approximate , but they leave no doubt as to how large a place sugar and starch occupy in the daily ration. (See p.415.) What percentage of carbohydrate is furnished by sugar is problematical . We do know, however, that the average individual was supposed to consume 84 pounds of cane sugar during the year 1921. This would amount to 105 grams, or 0.2 pounds, per day, which would amount to about one - fourth of the carbohydrate calories.
The proportion of carbohydrate in the normal diet varies in different countries, reaching its maximum in the tropics and its minimum in the arctic zones. The people in India take 484 grams carbohydrate daily , while the Eskimos get along very comfortably upon 52 grams . Table 159 is arranged by modifying somewhat a similar table of Lusk's. It shows well the adaptability of different races to different diets . That the Eskimos live upon 52 grams of carbohydrate daily should greatly encourage diabetic patients . All who treat diabetics should be very thankful that there is a race of Eskimos through which proof is afforded that it is perfectly possible to maintain life on a diet in which carbohydrate is largely replaced by fat. The composition of the diet also varies in the same race from time to time and this has been interestingly described by Mendel.
Attention has already been called to the increase in the consumption of sugar in the United States during the last century. Rübner noted that the consumption of meat per capita in Germany had risen three and one - half times during a hundred years prior to the war. The effects of undernutrition during the war were manifest generally in Europe and America, but the total dietary restriction obscures the results of qualitative changes. (See p115.)
Ancient History
8000
B.C.E.
Evolutionary and Population Genomics of the Cavity Causing Bacteria Streptococcus mutans
S. Mutans, the bacteria involved in creating cavities likely evolved and expanded with the population growth 10,000 years ago as humans started relying more on starches and sugars.
Streptococcus mutans is widely recognized as one of the key etiological agents of human dental caries. Despite its role in this important disease, our present knowledge of gene content variability across the species and its relationship to adaptation is minimal. Estimates of its demographic history are not available. In this study, we generated genome sequences of 57 S. mutans isolates, as well as representative strains of the most closely related species to S. mutans (S. ratti, S. macaccae, and S. criceti), to identify the overall structure and potential adaptive features of the dispensable and core components of the genome. We also performed population genetic analyses on the core genome of the species aimed at understanding the demographic history, and impact of selection shaping its genetic variation. The maximum gene content divergence among strains was approximately 23%, with the majority of strains diverging by 5–15%. The core genome consisted of 1,490 genes and the pan-genome approximately 3,296. Maximum likelihood analysis of the synonymous site frequency spectrum (SFS) suggested that the S. mutans population started expanding exponentially approximately 10,000 years ago (95% confidence interval [CI]: 3,268–14,344 years ago), coincidental with the onset of human agriculture. Analysis of the replacement SFS indicated that a majority of these substitutions are under strong negative selection, and the remainder evolved neutrally. A set of 14 genes was identified as being under positive selection, most of which were involved in either sugar metabolism or acid tolerance. Analysis of the core genome suggested that among 73 genes present in all isolates of S. mutans but absent in other species of the mutans taxonomic group, the majority can be associated with metabolic processes that could have contributed to the successful adaptation of S. mutans to its new niche, the human mouth, and with the dietary changes that accompanied the origin of agriculture.
Undoubtedly, one of the major challenges that S. mutans had to overcome as the carbohydrate content of the human diet increased was surviving at low pH. Although S. mutans does not constitute a significant proportion of the oral flora colonizing healthy dentition, it can become numerically significant when there is repeated and sustained acidification of the biofilms associated with excess dietary carbohydrates or impaired salivary function (Burne 1998).
Luxor, Luxor Governorate, Egypt
2475
B.C.E.
The Earliest Record of Sudden Death Possibly Due to Atherosclerotic Coronary Occlusion
WALTER L. BRUETSCH
The sudden death of an Egyptian noble man is portrayed in the relief of a tomb from the Sixth Dynasty (2625-2475 B.C.). Since there is indisputable evidence from the dissections of Egyptian mummies that atherosclerosis was prevalent in ancient Egypt, it was conjectured that the sudden death might have been due to atherosclerotic occlusion of the coronary arteries.
It may be presumptuous to assume that an Egyptian relief sculpture from the tomb of a noble of the Sixth Dynasty (2625-2475 B.C.) may suggest sudden death possibly due
to coronary atherosclerosis and occlusion. Much of the daily life of the ancient Egyptians has been disclosed to us through well-preserved tomb reliefs. In the same tomb that contains the scene of the dying noble, there is the more widely known relief "Netting Wildfowl in the Marshes." The latter sculpture reveals some of the devices used four thousand years ago for catching waterbirds alive. It gives a minute account of this occupation, which in ancient Egypt was both a sport and a means of livelihood for the professional hunter.
The relief (fig. 1), entitled "Sudden Death," by the Egyptologist von Bissing2 represents a nobleman collapsing in the presence of his servants. The revelant part of the explanatory text, as given by von Bissing, follows (translation by the author):
The interpretation of the details of the theme is left to the observer. We must attempt to comprehend the intentions of the ancient artist who sculptured this unusual scene. In the upper half (to the right) are two men with the customary brief apron, short hair covering the ears, busying themselves with a third man, who obviously has collapsed. One of them, bending over him, has grasped with both hands the left arm of the fallen man; the other servant, bent in his left knee, tries to uphold him by elevating the head and neck, using the knee as a support. Alas, all is in vain. The movement of the left hand of this figure, beat- ing against the forehead, seems to express the despair; and also in the tightly shut lips one can possibly recognize a distressed expression. The body of the fallen noble is limp. . . . Despite great restraint in the interpretation, the impression which the artist tried to convey is quite obvious. The grief and despair are also expressed by the figures to the left. The first has put his left hand to his forehead. (This gesture represents the Egyptian way of expressing sorrow.) At the same time he grasps with the other arm his companion who covers his face with both hands. The third, more impulsively, unites both hands over his head. ... The lord of the tomb, Sesi, whom we can identify here, has suddenly collapsed, causing consternation among his household.
In the section below (to the left) is shown the wife who, struck by terror, has fainted and sunk totheflor. Two women attendants are seen giving her first aid. To the right, one observes the wife, holding on to two distressed servants, leaving the scene. . . .
von Bissing mentions that the artist of the relief must have been a keen observer of real life. This ancient Egyptian scene is not unlike the tragedy that one encounters in present days, when someone drops dead of a "heart attack." The physician of today has almost no other choice than to certify the cause of such a death as due to coronary occlusion or thrombosis, unless the patient was known tohave been aflictedwith rheumatic heart disease or with any of the other more rare conditions which may result in sudden death.
Atherosclerosis among the Ancient Egyptians
The most frequent disease of the coronary arteries, causing sudden death, is atherosclerosis. What evidence is available that atherosclerosis was prevalent in ancient Egypt?
The first occasion to study his condition in peoples of ancient civilizations presented itself when the mummified body of Menephtah (approx.1280-1211B.C.), the reported "Pharaoh of the Hebrew Exodus" from Egypt was found. King Menephtah had severe atherosclerosis. The mummy was unwrapped by the archaeologist Dr. G. Elliot Smith, who sent a piece of the Pharaoh's aorta to Dr. S. G. Shattock of London (1908). Dr. Shattock was able to prepare satisfactory microscopic sections which revealed advanced aortic atherosclerosis with extensive depositions of calcium phosphate.
This marked the beginning of the important study of arteriosclerosis in Egyptian mummies by Sir Mare Armand Ruffer, of the Cairo Medical School(1910-11). His material included mummies ranging over a period of about 2,000 years (1580 B.C. - 525 A.D.).
The technic of embalming in the days of ancient Egypt consisted of the removal of all the viscera and of most of the muscles, destroying much of the arterial system. Often, however, a part or at times the whole aorta or one of the large peripheral arteries was left behind. The peroneal artery, owing to its deep situation, frequently escaped the em- balmer'sknife. Otherarteries,suchasthe femorals, brachials, and common carotids, had persisted.
In some mummies examined by Ruffer the abdominal aorta was calcified in its entirety, the extreme calcification extending into the iliae arteries. Calcified plaques were also found in some of the larger branches of the aorta. The common carotid arteries frequently revealed patches of atheroma, but the most marked atheroselerotic alterations were in the arteries of the lower extremities. The common iliae arteries were not infrequently studded with calcareous plaques and in some instances the femoral arteries were converted into rigid tubes. In other mummies, however, the same arteries were near normal.
What is known as Mdnekeberg's medial calcification was also observed in some of the mummified bodies. In a histologic section of a peronieal artery, the muscular coat had been changed almost wholly by calcification. In one of Ruffer's photographic plates, a part of a calcified ulnar artery is shown. The muscular fibers had been completely replaced by calcification.
In the aorta, as in present days, the atherosclerotic process had a predilection for the points of origin of the intercostal and other arteries. The characteristics and the localization of the arterial lesions observed in Egyptian mummies leaves litle doubt that atherosclerosis in ancient times was of the same nature and degree as seen in today's postmortem examinations.
As to the prevalence of the disease, Ruffer ventured to say that the Egyptians of ancient times suffered as much as modern man from arterial lesions, identical with those found in our times. Ruffer was well qualified to make this statement having performed many autopsies on modern Egyptians, Moslems, and other people of the Middle East. In going over his material and examining the accompanying photographic plates of arteries, one can have litle doubt that what Ruffer had observed in Egyptian mummies represented arteriosclerosis as it is known today.
Although the embalming left no opportunity to examine the coronary arteries inl mummified bodies, the condition of the aorta is a good index of the decree of atheroselerosis present elsewhere. In individuals with extensive atheroselerosis of the aorta, there is almost always a considerable degree of atherosclerosis in the coronary arteries. If Ruffer's statement is correct that the Egyptians of 3,000 years ago were afflicted with arteriosclerosis as much as we are nowadays, coronary occlusion must have been common among the elderly population of the pre-Christian civilizations.
Furthermore, gangrene of the lower extremities in the aged has been recognized since the earliest records of disease. Gangrene of the extremities for centuries did not undergo critical investigation until Cruveilhier (1791- 1873) showed that it was caused by atherosclerotic arteries, associated at times with a terminal thrombus.
SUMMARY
The record of a sudden death occurring in an Egyptian noble of the Sixth Dynasty (2625-2475 B.C.) is presented. Because of the prevalence of arteriosclerosis in ancient Egyptian mummies there is presumptive evidence that this incident might represent sudden death due to atheroselerotic occlusion of the coronary arteries.
Cairo, Cairo Governorate, Egypt
1580
B.C.E.
ON ARTERIAL LESIONS FOUND IN EGYPTIAN MUMMIES
Arteries of Egyptian mummies from 1580 B.C.E. to 525 A.D. have extensive calcification of the arteries, the same nature as we see today, and unlikely to be due to a very heavy meat diet, which was always a luxury in ancient Egypt. Instead, the diet was mostly a course vegetarian one.
DISCUSSION OF RESULTS.
Nature of the lesions. There can be no doubt respecting the calcification of the arteries, and that it is of exactly of the game nature as we see at the present day, namely, calcification following on atheroma.
The small patches seen in the arteries are atheromatous, and though the vessels have without doubt been altered by the three thousand years or so which have elapsed since death, nevertheless the lesions are still recognisable by their position and microscopical structure.
The earliest signs of the disease are always seen in or close below the fenestrated membrane,-that is, just in the position where early lesions are seen at the present time. The disease is characteiised by a marked degeneration of the muscular coat and of the endothelium. These diseased patches, discrete at first, fuse together later, and finally form comparatively large areas of degenerated tissue, which may reach the surface and open out into the lumen of the tube. I need not point out how completely this description agrees with that of the same disease as seen at the present time.
I have already mentioned the absence of leucocytes and cellular infiltration, and need not therefore return to it here.
In my opinion, therefore, the old Egyptians suffered as much as we do now from arterial lesions identical with those found in the present time. Moreover, when we consider that few of the arteries examined were quite healthy, it would appear that such lesions were as frequent three thousand years ago as they are to-day.
I do not think we can accuse a very heavy meat diet. Meat is and always has been something of a luxury in Egypt, and although on the tables of offerings of old Egyptians haunches of beef, geese, and ducks are prominent, the vegetable offerings are always present in greater number. The diet then as now was mostly a vegetable one, and often very coarse, as is shown by the worn appearance of the crown of the teeth.
Nevertheless I cannot exclude a high meat diet as a cause with certainty, as the mummies examined were mostly those of priests and priestesses of Deir el-Bahari, who, owing to their high position, undoubtedly lived well. I must add, however, that I have seen advanced arterial disease in young modern Egyptians who ate meat very occasionally. In fact, my experience in Egypt and in the East has not strengthened the theory that meat-eating is a cause of arterial disease.
Finally, strenuous muscular exercise can also be excluded as a cause, aa there is no evidence that ancient Egyptians were greatly addicted to athletic sport, although we know that they liked watching professional acrobats and dancers. I n the ca6e of the priests of Deir el-Bahari, it is very improbable, indeed, that they were in the habit of doing very hard manual work or of taking much muscular exercise.
I cannot therefore at present give any reason why arterial disease should have been so prevalent in ancient Egypt. I think, however, that it is interesting to find that it was common, and that three thousand years ago it represented the same anatomical characters as it does now.
FIG. 1.-Pelvic and arteries of thigh completely calcified (XVIlIth-XXth Dynasty).
Fro. 2.-Completely dcifiedprofundaarteryaftersoakinginglycerine(XXIstDynasty). FIQ. 8.-Partly calcified aorta (XXVIIth Dynasty).
Fro. 4.-Calcified patches in aorta (XXVIIth Dynasty).
Fio. 5.-Calcified atheromatous ulcer of subclavian artery (XVIIIth-XXth Dynasty). Fro. &-Patch of atheroma i n anterior tibia1 artery (glycerine). The centre of the patch
is calcified (XXIst Dynasty).
FIG. 7.-Atheroma of brachial artery (glycerin) (XXIst Dynasty).
Fro. &-Unopened ulnar artery, atheromatous patch shining through (glycehne) (XXIst Dynasty). 31
FIG. 9.-Section through almost completely calcified posterior peroneal artery (low power). Van Gieson staining. a,al, n2, Remnants of endothelium and
fenestrated membrane. b, Calcified patches.
Many more are seen.
Same stain. (Leitz, Oc. 1, x &.)
FIG. 10.-Section
FIG. 11.-Section m(Leitz, Oc. 1, x *.)
a,Remains of endothelium.
b, Fenestrated membrane.
c, Muscular coat.
d,f,Membrane coat undergoing degenerntion.
e, Completely degenerated remnants of muscular coat.
atheroniatous patch of n h a r artery. Same stain. (Leitz, (Reference letters the same as in Fig. 11.)
FIG. 12.-Section Oc. 1, x fa.)
through calcified patch of ulnar artery. a,d, Calcified patches.
b, Partially calcified m wular coat. c, Annular muscular fibre.
through atheromatous patch of anterior tibia1 artery. Same stain through
FIG. 13.-Section at edge of atheromatous patch. Hreniatoxylin stain (Leitz, Oc. 1, XTh.1 a,Leucocytes (1). The atheromatous part on the left stains intensely dark with hamatoxylin.
