Diminished blood circulation of the lower extremities causes several difficulties which are widespread after the age of fifty. Mostly the result of arteriosclerosis, which is comparable to the rusting and obstruction of a metal pipe, the arteries to the legs become obstructed and are then unable to carry enough blood into the lower extremities for all activities. Intermittent claudication is the name of a pain felt in the calf muscle when it is forced to work without sufficient blood supply.

While these muscles can do light work effectively on poor blood supply, they cry out with pain when not supplied with enough blood for heavy duty and hard work. Since intermittent claudi-

DORSAl(FOOT) ARTERY

Fig. 140. The dorsal pedal artery if felt on top of the foot means circulation is good. When it can’t be felt, the artery may never have been present, but it usually means poor foot circulation.

cation is also sometimes caused by a temporary spasm of the leg arteries, things which increase blood vessel spasm such as tobacco, are withheld in this disease.

Gangrene, seen in severe and far-advanced arteriosclerotic blocking in the arteries of the legs, usually results only after many years of circulation difficulty. It most often begins in the toes, and is an incurable disease which demands an amputation of the leg high enough to reach an adequate blood supply. It is very important to a person with severe arteriosclerosis to avoid even slight accidents or infection in the foot.

Diabetics, in later years, are greatly burdened with the prospect of gangrene of the toes. Diabetes not only fans the fires of arteriosclerosis, which reduces circulation, but also invites infection about the toes. It is a well-known fact that poor circulation plus added infection greatly magnify the possibility of gangrene in diabetics.

The physician’s treatment of circulatory difficulties, especially in the lower extremities, involves the regulation or cure of systemic disease such as diabetes, the elimination of blood vessel irritating factors such as tobacco, the avoidance of extremes of heat, cold and trauma, and the close attention to gentle but thorough cleanliness for the avoidance of infection about the toes or foot.