118 WOUNDS AND BEUISES. 



of the part will be restored. In olden days, when it was a routine practice 

 to bleed both men and horses at least once a year, the repeatedly operated- 

 upon vein kept, in many cases, its circulation unimpaired up to the time 

 of death. The state of health will, as in all other wounds, greatlj; influence 

 the manner .of healing. A blow or severe pressure on the outside of the 

 vein, even without the skin being broken, may cause a clot by injury 

 to the walls of the vessel. If, from the intensity of the injury or 

 diseased action, the stoppage in the vein be complete,^ fibrin will become 

 deposited above and below the clot, as far as the blood is stagnant, so that 

 the vein will be plugged by a fibrous deposit or thrombus. Subsequently, 

 circulation in the vein may become more or less restored, or the vein inay 

 remain permanently blocked up, in which case, loss of direct circulation 

 through the vessel will be compensated for, in process of time, by the 

 establishment of " collateral circulation," by means of branches of veins 

 which communicate together above and below the wound. Wten pus (p. 15) 

 forms in the wound, blood-poisoning may take place with or without 

 embolism, which is the term applied to the plugging-up of distant vessels 

 of comparatively small calibre, by broken-off particles of the thrombus 

 being carried into the circulation. Such embolism is particularly liable to 

 cause a fatal form of infiammation of the lungs, into which organ the blood 

 that passes through the jugular vein, is carried in order to be purified 

 before reaching the heart (p. 10 et seq.). MoUer states that blood-poisoning 

 from inflammation of the jugular vein is rare. 



SYMPTOMS. — The only cases to be considered here are those in 

 which the inflammation of the walls of the vein runs an unhealthy- 

 course, with the formation of pus and an extensive clot. The 

 affected portion of the vein is swollen, hard, knotted, and painful 

 to the touch. The surrounding tissues are more or less swollen, 

 and the wound has an unhealthy and inflamed appearance, and 

 discharges dark-coloured blood and pus. Abscesses may form in 

 the clot. Inflammation of the lungs from embolism may be mani- 

 fested by high internal temperature and great difficulty of breath- 

 ing. For symptoms of blood-poisoning, see page 516. In favour- 

 able cases of blocking up the vein, the establishment, of " collateral 

 circulation " will in time relieve the distressing symptoms of brain 

 disturbance which at first take place, owing to interference with 

 the removal of venous blood from the head. 



To find out if this vein is in working order press a finger on the 

 jugular groove, at about the spot indicated by the arrow head in 

 Fig. 43. If it be all right, it will be seen to fill with blood, above 

 the finger. 



TREATMENT.— Treat the wound antiseptically (p. 67), after- 

 bathing the part with warm water. If any abscesses form, open 

 them freely and treat as directed on page 79. Avoid probing the 

 wound or pressing on the thrombus (clot in the vein), lest embolism 

 (see above) may ensue. Rub in a smart cantharides blister along 

 the course of the inflamed part, and a cure will be efiected in a very 

 short time. The blister is to be applied, whether suppuration be 

 present or otherwise. The vein may be tied (ligatured) either 



