The course of the disease may be complicated by aneurysm, by gangrene, or by an associated emphysema. Physical Signs.-The combination of increased arterial tension, hypertrophy of the left ventricle, accentuation of the second aortic sound, and an appreciable thickening of the arteries affords conclusive proof of the existence of arterio-sclerosis. A high-tension pulse may exist with very little sclerosis, but sclerosis and high tension usually go together except when the left ventricle fails. The pulsewave is slow in its ascent, is felt for an appreciably long period, subsides slowly, and between the beats the pulse remains firm and full. The wave-fluctuations are comparatively small. It is difficult, even impossible in some cases, to obliterate the pulse by firm pressure on the artery. The sphygmographic tracing (Fig. 19) shows a short slanting upstroke, a flat or rounded summit, and a gradual descent in which the dicrotic wave is slighly marked or absent. The prognosis, so far as life is concerned, is not unfavorable. The danger of renal or cardiac disease or of cerebral complications is always present. The chief question is whether compensatory hypertrophy of the left ventricle can be maintained. Sudden death may occur. Treatment.-Much can be done to limit the extension of the disease by a quiet mode of life, plain, non-stimulating diet, and a correction of those conditions known to produce the disease. The state of the bowels and of the urine |