HcBinorrhage. 365 



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 

 liave been subjected to phlebotomy. It is probable however 

 that there is usually a morbid condition of sanguification and nu- 

 trition 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. 



HEMORRHAGE. 



Arterial, venous and capillary haemorrhage belong almost ex- 

 clusively to the domain of surgery. Internal haemorrhages will 

 be considered in connection with the organs in which they take 

 place. 



