280 CLINICAL APPLIED ANATOMY. 



Digital pressure upon the artery at this spot, should it fail to 

 bring about a cure of the aneurysm, has not in any way been a 

 disadvantage in view of a subsequent ligature. First of all the 

 vessel will not be tied at the point over which the digital pressure 

 has been applied, but at a more distal spot, either at the apex of 

 Scarpa's triangle or in Hunter's canal. Secondly, it will have 

 opened up the collateral circulation, and thus have diminished 

 the likelihood of gangrene subsequent to ligature. It is always 

 easy to diminish the amount of blood passing into a limb, but 

 difficult to increase it. 



VARICOSE VEINS. 



It is not every vein in the body which is subject to varicosity, 

 but certain veins, chiefly from their anatomical position, are 

 prone to become varicose. The superficial veins of the lower 

 extremity, the spermatic veins, and the veins of the inferior 

 hsemorrhoidal plexus are those which most frequently undergo 

 the change which is termed varicosity. 



Varicose Veins of the Lower Limb. The anatomical reasons 

 why the superficial veins of the lower extremity are so commonly 

 varicose may be stated as follows : they have a long column of 

 blood to support, in the adult often as much as four feet, though 

 of course the weight is partly borne by the series of bicuspid valves 

 present within the vein ; their distance from the heart renders the 

 vis a tergo of the systole less powerful than elsewhere, and 

 distension likely ; and their want of support, owing to their 

 being surrounded merely by subcutaneous tissue and not by 

 muscle. 



There are two chief varieties of varicose veins in the lower 

 limb. The first is that in which one vein, generally the long or 

 internal saphenous, is varicose. This vein commences from the 

 inner side of the venous arch on the dorsum of the foot, passes 

 then in front of the internal malleolus, up the inner side of the 

 leg, behind the internal condyle of the femur, along the inner 

 side of the thigh, to pass through the saphenous opening and 

 join the femoral vein close below Poupart's ligament. 



