THE ASSOCIATION OF CAPILLARY SCLEROSIS WITH ARTERIOSCLEROSIS AND PHLEBOSCLEROSIS; ITS PATHOGENESIS AND CLINICAL SIGNIFICANCE *

THIS contribution represents a study of the lesions of the capillaries in organs in which either the main arterial trunk or veins reveal sclerosis. In the lung, pancreas and kidney the vascular lesions show arteriosclerosis; in the liver and spleen, phlebosclerosis. In the former, the capillary lesions are affected by forward intravascular pressures, in the latter by backward pres-sures. In previous publications lf 2 ' 8 I tried to show that prolonged normal intravascular pressure is the dominant conditioning factor in the production of arteriosclerosis and phlebosclerosis and that these lesions come earlier and are intensified under the influence of its increased gradient, hypertension. Likewise the capillary lesions which we term "capillary sclerosis,,, are most prominent in conditions in which prolonged arterial or venous hypertension exists. Capillary sclerosis bears so many of the morbid anatomical attributes of arteriosclerosis or phlebosclerosis that it represents a veritable vascular sclerosis "en miniature.,, Indeed the almost constant association of capillary sclerosis with sclerosis of the larger vascular trunks within an organ enable