INFLAMED VEIN, PHLEBITIS. 205 



no species of treatment, can induce the disorder, when the 

 animal is not naturally disposed to imbibe it ; a result con- 

 firmed by observations made upon the human patient. Where, 

 however, predisposition presides, the slightest neglect may 

 start up inflamed vein. 



No Want of Adhesive Power. — Professor Coleman has 

 announced as his opinion, that indisposition to union in 

 wounds is the frequent cause of inflamed vein.^ When we 

 consider, however, by what means we are compelled to close 

 the wound, the frequent neglect of all precaution, and the 

 peculiar idiosyncrasy of the patient, these causes will afi*ord 

 reason for phlebitis without ascribing it to an origin the 

 existence of which is at best doubtful. Were it referable 

 to any indisposition of the horse^s skin for adhesive inflam- 

 mation, instances of it would occur oftener than they do ; 

 not only from neglect after the operation, but under the 

 most judicious management. Ask any human surgeon, 

 what would be the result of pinning up the arms of men as 

 we do the necks of horses ? — more particularly if his patient 

 happened to be a maniac, and his injunctions to keep the 

 arm at rest were altogether disregarded ? Could we use a 

 fillet, or adhesive plaster, and impress on our patient the 

 necessity of keeping his head and neck still, we should not 

 have to complain of its healing powers. 



' In the 'Essay on the Wounds and Ligatures of Veins,' we find the follow- 

 ing, as part of a communication from Mr. Coleman : " I have no doubt that in- 

 flammation of the wound sometimes take place in consequence of the mode used 

 to stop the bleeding ; but I should observe that the most simple wound through 

 the integuments of horses is scarcely ever healed hy the first intention ; and it is 

 this disposition to suppurate and resist adhesive union, that is probably the most 

 frequent cause of the external wound after bleeding not uniting by the first 

 intention in horses, the same as in the human subject." That a clean-cut 

 wound, treated in the ordinary manner, seldom heals by the first intention, I 

 admit ; but the lips of the wound made in bleeding, unless they be violently 

 separated, rarely fail to adhere. Nothing is more common, than to close the in- 

 cisions made when performing neurotomy without suppurative action : and 

 could we preserve the adjustment of the divided edges, without the employment 

 of suture, I think adhesion would invariably ensue. These facts induce me to 

 dissent from the opinions quoted : and I am anxious to express myself openly 

 on the subject, when differing with Professor Coleman on a practical point. 



