PHLEBOlvITES. CALCAREOUS BODIES IN THE VEINS. 



Nature. Location. Mode of formation. Calcareous plates in two inner 

 coats. Phlebotomy. Altered sanguification. Treatment. Extraction. 



Calcareous bodies have been repeatedly found in the veins of 

 man, and several observations of the same kind have been made 

 in the horse. Spooner found them in the abdominal veins, and 

 Simmonds in the jugular. Much difference of opinion has ex- 

 isted as to the mode of formation of these bodies, whether by cal- 

 careous deposit in a coagulum or by degeneration of a neoplasm 

 in the vascular wall. Andral held the latter opinion, and Tiede- 

 mann and Cruveilhier found the bodies connected to the inner 

 coat of the vein by a fine membrane. Morton's cut of one of 

 ■Simmonds' specimens (Calculous Concretions) shows a structure 

 in successive layers having their centre at one end, evidently cor- 

 responding to a former connection by pedicle. Cornil and Ran- 

 vier says ' ' sometimes there are seen in chronic varices, calcare- 

 ous incrustations in the form of plates, nodules or spheres with 

 concentric layers . . . calcareous infiltration is seen in the form 

 of spheres or phlebolites in the varicose diverticula. An exten- 

 sive calcareous induration, several centimetres in length, is also 

 sometimes observed, the vein being transformed into a calcareous 

 tube with the ramifications also varicose. 



The calcareous plates of the vein are developed in the fibrous 

 and internal portion of the middle coat. At the beginning they 

 consist of granules deposited in the fasciculi of the connective 

 tissue or between them ; these soon unite and form transparent 

 plates with granular striae. ' ' 



Phlebolites in the jugular suggest a connection with the pouch- 

 like dilatations, and transformations in the vascular walls that 

 have been subjected to phlebotomy. It is probable however 

 that there is usually a morbid condition of sanguification and 

 nutrition which predisposes to their formation. In Simmonds' 

 case the jugular was impervious below the bodies, there was 

 hepatitis and arthritis of the fetlock joint. 



When recognized during life these may be extracted, with due 

 antiseptic precautions. If the vein can be dispensed with it may 

 be ligatured above and below, if not, an attempt may be made to 

 preserve it, extracting through a clean cut longitudinal incision 

 and securing as perfect coaptation of the edges of the wound as 

 possible. 505 



