The ischemic lumbago : a further contribution to the lumbar type of intermittent claudication / J. Ramsay Hunt.

  • Hunt, James Ramsay, 1872-1937.
Date:
1914
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Licence: In copyright

Credit: The ischemic lumbago : a further contribution to the lumbar type of intermittent claudication / J. Ramsay Hunt. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    0 t- u *T l ^ I : rh THE ISCHEMIC LUMBAGO A further contribution to the lumbar tyre of INTERMITTENT CLAUDICATION J. RAMSAY HUNT, M.D. Associate Professor of Nervous Diseases. Columbia University College of Physicians and Surgeons NEW YORK In a previous paper I directed attention to the occur- rence of a lumbar type of intermittent claudication.1 This affection is characterized bv a painful spasm of the muscles in the lumbar region following the exertion of walking or standing, which disappears promptly after a brief period of rest. The pain was bilateral, limited above by the twelfth rib and below by the crest of the ilium. The muscle mass corresponding to this region is composed of the sacrolumbar portion of the erector spinae group and the quadratus lumborum mus- cles, and receives the greater part of its blood-supply through the lumbar arteries, which take their origin from the abdominal aorta. A great part of the muscular effort of walking and standing will naturally call into activity these muscles, and the symptoms of inter- mittent claudication were ascribed to an interference with the blood-supply of this region, either by disease of the lumbar arteries themselves or of that section of the abdominal aorta whence these vessels take their origin. In this manner a reduction in the quantity of blood circulating in the affected region is produced. The blood-supply is sufficient when the muscles are at rest, but inadequate for the requirements of active mus- cular effort; hence the intermittent ischemic character of the symptoms. In the present paper this clinical picture is the subject of further study, and is enlarged by the description of a strictly unilateral type, and of a milder form of lumbar I. Hunt, .1. Ramsay: The Lumbar Type of Intermittent Claudi- cation, Am. Jour. Med. Se., February, 1912.