The "galloping" history of intermittent claudication

Intermittent claudication (IC) due to arterial occlusive disease was first diagnosed by the French veterinary surgeon Jean-Francois Bouley jeune in a horse drawing a cabriolet in the streets of Paris as early as 1831. The ani mal was repeatedly exercised and always started to limp with the hind legs at similar work loads. Autopsy revealed partially thrombosed aneurysm of th e abdominal aorta and occlusions of both femoral arteries which were correc tly identified as the cause of IC. In 1858 the famous neurologist Jean-Mart in Charcot working at the Salpetriere in Paris first discovered the conditi on in a patient, who was wounded by a bullet during the conquest of Algery and developed iliac artery aneurysm obliterated by a thrombus. He was aware of the first description in veterinary medicine. In Germany IC was also fi rst mentioned in horses (Rademacher; 1838). 13 reports of patients were con tributed by the neurologist Heinrich Erb in 1898 and 1904. Some interesting features of the phenomenon of IC like the amount of exerci se necessary to provoke it, localization, social relevance, prolongation of the Achilles tendon reflex, decrease of maximal plantar flexion force of t he foot and production of "Lewis-factor p" are summarized. In human patients arteriosclerosis is the well recognized principal cause o f arterial obstructions, in horses, however the lesions are due to infectio n by the roundworm Strongylus vulgaris. In the fascinating life cycle the l arvae migrate into the intima of small and large arteries and provoke aneur ysms and intravascular thrombosis.