INFLAMED VEIN, PHLEBITIS. 203 



The parts around are in a state of tumefaction ; and the 

 vein conveys the sensation to the fingers of a hard cord. As 

 the inflammation advances, pus accumulates, mingled with 

 grumous matter; this forms a sort of abscess, which is 

 easily penetrated, and, when broken, sends forth a foul and 

 unhealthy discharge. In some cases fresh issues of blood 

 itself supervene, and the hemorrhage may prove so frequent 

 or abundant, as even to create alarm. It becomes our duty, 

 then, to secure anew the bleeding orifice either by fresh 

 pinning or by suture, and to bind a compress upon it by a 

 roller of great length, passed many times around the neck. 

 The hemorrhage in this manner being stopped, there will 

 commonly succeed much infiltration and tumefaction of the 

 afi'ected side of the neck ; this is best met by fomentation, 

 poultices, and cathartic medicine, all the while keeping the 

 head confined to the rack, and preventing the patient 

 from lying down. All this time mischief is going on in the 

 interior of the vein, the upper half of whose canal is already 

 plugged by a coagulum of stagnant blood. The inflamma- 

 tion now spreads, and involves the side of the head in 

 general tumefaction, even threatening disturbance of the 

 brain, and death. This was the case with a horse, the 

 property of an officer of Artillery. Unfortunately, no 

 minutes were made of the symptoms ; nor was any examina- 

 tion of the parts instituted after death. It is the only 

 instance of fatality which has come to my knowledge. 



Termination. — The inflammation may result in inter- 

 stitial effusion, obliterating the cavity of the vein ; at least, 

 that portion of it which runs to the head. Or it may pro- 

 duce abscess; matter being sent from some considerable 

 distance along the channel of the vein. These are points 

 on which much light is reflected by the experiments of 

 M. Gendrin. 



" If any portion of any artery or vein be included between two liga- 

 tures, the intercepted blood first coagulates ; a portion of its serum be- 

 comes absorbed; a slight degree of inflammation is excited upon the 

 inner membrane ; the globules of the coagulum lose their colour ; a thin 

 stratum of coagulablc lymph is deposited upon the sides of the vessel, 



