Abstract
This is a case of 19 years old female with the principal complaint of languor in both of the upper extremities.
In the anamnesis, she claimed that she could feel pulsation up till her age of 7 or 8.
However, during her course in the primary school, no particular illness was experienced. Since her age of approximately 18, she had been becoming easily get tired, had been complaining of shortness of breath, palpitation of the heart. At times, she had to lower her head with pale face.
In the present status, she had no disturbances in her eyesight. According to the results of the physical examinations,
1) pulsations could be felt only at inner carotid and femoral arteries, but not at the radial artery or other places,
2) in the hematological findings, blood sedimentation rate after 1 hour was 70, after 2 hours, 120; coagulation time, 20 minutes ; circulation time, 16 seconds ; plateletts count, 300, 000 per cmm ; no increment in blood globulin content,
3) in the tests for vegetative functions, pharmacologically, atropin test was strong positive ; physically, Czermack reaction was positive,
4) the enhanced carotid sinus reflex showed Type IV according to Prof. Saito,
5) ophthalmologically, no particular abnormality in the eye ground or other places.
In this case the patient stated that occasionally the immage of electric light blurred, but no particular symptomes were noticed otherwise. However, the case furnished every symptomes of so-called “myaku-nashi byo”, therefore, the case was entirely different from Burger's disease. Although Prof. Shimizu, Tokyo University, claims that “myaku-nashi byo” is caused by the obliteration of carotid artery and subclavian artery, the severity of this case seemed slightly milder. Most probably, this case was caused by the relatively strong obliteration of subclavian artery and slight obliteration cf carotid artery.
