ACCIDENTS OF BLOOD-LETTING. 509 



may be supplemented by the anastomotic action of collateral ves- 

 sels above and below the occluded portion. Or, again, the circula- 

 tion may be entirely obstructed, and, as a consequence of the in- 

 flammatory changes, adhesions follow, between the clot and the 

 venous wall, the clot being resorbed, and the obliterated vein 

 transformed into a fibrous cord. So long as the inflammation is 

 limited to the internal wall of the vessel, phlebitis is known as 

 adhesive ; but if it extends to the external or even to the middle 

 structure, and becomes suppurative^ it is so distinguished. Either 

 of these forms of the disease may be changed by a third modifica- 

 tion to that of hemorrhagic phlebitis. These three forms or diver- 

 sities of the disease have been established by Peuch and Tous- 

 saint, whose views touching the treatment of the affection we also 

 reproduce, referring our readers for the pathological history of 

 the lesion to the various works relating to it. 



1st. Adhesive Phlebitis. — At the beginning of the disease, the 

 animal must be placed under such conditions as wiU tend most 

 favorably to influence the process of organization between the 

 clot and the venous walls, and to prevent the estabHshmeut of 

 suppuration. To effect this object, the enforcement of a state of 

 immobility in the patient is most essential. His head must be 

 firmly secured on both sides, and his mastication made as easy as 

 possible, by suitably regulating the consistency of his diet, in 

 order to diminish the force of the circulation, and so far obviate 

 the danger of the displacement of the clot and possible resulting 

 hemorrhage. The diseased parts should be treated by local ap- 

 pHcations, among which lotions of lead water, with continued cold 

 water irrigations, will give excellent results. But ointments of 

 any kind should be avoided, especially in warm weather, from their 

 liabiUty to become rancid and irritant, and to stimulate the patient 

 to rub himself. The use of cooling applications must be perse- 

 vered in, in preference to the frictions with vesicatories, which, 

 especially in nervous animals with tender skin, might be liable to 

 encoiu'age the suppurative process. In tougher-skinned animals, 

 and those of a lymphatic temperament, in which the inflammation 

 has a tendency to become chi-onic, resolvents, blistering, liquid 

 liniments, and alteratives are indicated, and of these, and first in 

 order, must be named cauterization with the red iron. The 

 conical cautery is applied on closed, fine points, and arranged 

 quintuply, every second point being deep, while the others are 



