PHLEBITIS. 401 
leave this office to the apothecary ; consequently it was rather a conde- 
scension in one who deservedly ranked so high in his profession to stoop 
to such an act. What, therefore, could possibly cause disease to follow 
the operation, when performed by him who was accustomed to surgery 
upon its grandest scale ? 
The cause was soon explained. The person operated upon chanced 
to be a lunatic. This insane individual embraced the notion that the 
healing process was much favored by constant motion; consequently he 
kept on flexing and extending his arm with all the violence which is 
natural to the demented. In vain was every effort made to persuade 
him from so mad an action. He clung with extraordinary pertinacity to 
his unwholesome theory. On the following day, Mr. Liston was sur- 
prised to find his patient in bed, but still moving the arm in which disease 
had already declared itself. Measures were taken to seep the limb quiet, 
but it was found impossible to accomplish this in a satisfactory manner ; 
and when Mr. Liston again called, the patient was no more! 
A vein being about to inflame, the earliest intimation of the fact is 
given by the separation of the lips of the wound, while through the 
opening drains a small quantity of a thin discharge. Should this warn- 
ing excite no attention, a round and hard swelling appears. That may 
be like a hazel-nut in size, or it may resemble half a chestnut in magni- 
tude; and this is soon followed by a swollen state of the vein superior 
to the orifice. 
Then supervenes the sec- 
ond stage of the disorder. 
Unhealthy abscesses are 
formed along the course of 
the vein. As these mature, 
they burst, and send forth 
an unsightly and filthy liquid 
resembling thin, contamina- 
ted pus. On examination, A HORSE WITH PHLEBITIS, OR INFLAMMATION OF THE VEIN, IN 
these tumors are found to Be ea 
be united. They penetrate to the interior of the vessel, and are joined 
together by numerous si- 
nuses. They literally con- 
stitute so many holes in the 
neck. 
If no attention be now 
paid to the aggravated 
symptoms, worse speedily 
ensues. In the direction THE THIRD STAGE OF PHLEBITIS. 
26 
