PHLEBITIS. ^Z\ 



vessel (John Hunter). This doctrine, however, presented 

 some difficulty, because it was soon pretty generally 

 allowed that a primary purulent inflammation of the veins 

 did not occur, but that, as was first distinctly shown by 

 Cruveilhier, at the commencement a clot of blood is 

 always present. Cruveilhier himself was so greatly sur- 

 prised at this observation of his, that he connected a the- 

 ory with it which was beyond all medical comprehension. 

 He concluded namely from the impossibility of explain- 

 ing why inflammations of the veins began with coagula- 

 tion of the blood, that inflammation in every case what- 

 ever consisted in a coagulation of the blood. The impos- 

 sibility of explaining phlebitis seemed to him to be got 

 over by raising coagulation into a general law, and by 

 referring every inflammation to a phlebitis on a small 

 scale (capillary phlebitis). Cruveilhier was the more in- 

 duced to assert this in consequence of his entertaining 

 similar views with regard to other morbid processes, and 

 believing that cysts, tubercles, cancer, and in short all 

 important processes, accompanied by changes susceptible 

 of anatomical demonstration, really ran their course 

 within special, minute veins imagined by him. This man- 

 ner of thinking, however, continued so entirely alien to 

 that of the great majority of learned and unlearned phy- 

 sicians, that the separate conclusions propounded by Cru- 

 veilhier, which were adopted in medical science in part 

 as drawn up by him, were altogether misunderstood. 



Cruveilhier was right in this point, as indeed has since 

 been more and more acknowledged, namely, that the so- 

 called pus in the veins in the first instance never lies 

 against the wall of the vein, but always first appears in 

 the centre of the previously existing clot of blood which 

 marks the outset of the process. He imagined that the 

 pus was secreted from the wall of the vessel, but that it 

 did not remain there, but by means of " capillary attrac- 



