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June 4, 1904


JAMA. 1904;XLII(23):1497. doi:10.1001/jama.1904.02490680037010

While many cases of angina pectoris are attended with sclerosis of the coronary arteries, the latter condition is not rarely encountered independently of symptoms of the former. It would thus appear that some other factor must be responsible for the clinical picture, and existing evidence supports the view that this resides in increased vascular tension. Symptoms of angina pectoris have been observed also in association with obvious vasomotor phenomena in the extremities, without demonstrable disease of the heart. Dr. J. Pal,1 as a result of clinical studies, considers the phenomena in the peripheral vessels as an integral part of the attack of true angina, which he includes among the vascular crises. He recognizes two typical varieties, namely, the pectoral and the abdominal. The latter is comparable, in his opinion, with the abdominal crises of tabetic patients and with lead-colic, the symptoms of which he attributes to contraction of the

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