Varicose vein

“ This remark I have had opportunities of verifying in cases, where needles have been introduced under varicose veins in the lower extremities, and allowed to remain, with a ligature around them, for ten days or a fortnight. The circulation through the vein will in such cases be obstructed; but, in a year or two, will be found to have become completely re-established. ”

“ When a person is bleeding from a deep wound, press the lips of the wound together. Not the edges only—this is no good. Press the complete thickness of the lips of the wound together. If you cannot do this, stuff your handkerchief into the wound and press on that.
A not uncommon cause of bleeding to death is rupture of a varicose vein. Hundreds of thousands of women have varicose veins, but in very few do the veins rupture. Still, if a vein does get torn and the patient does not know what to do, her life will be lost while seeking assistance. ”

“ Systematic rubbing or massage is of some value for varicose veins; but it is not altogether safe, and is not worth a trial. Rest with the legs elevated, walking, and the support given by an elastic stocking are the chief items in the treatment of varicose veins. Standing is to be avoided as far as possible. ”

“ The wisdom teeth develop in nearly everybody, not only in those who are wise. Nor does the early appearance of the teeth indicate superior mental powers. Indeed, savages and idiots usually have the best teeth. Sometimes they do decay very soon, but very often they remain as sound serviceable teeth until the end.
A Lover of Dancing.—A large vein in the leg is not necessarily a varicose vein, but most probably it is so or will become so in time. A varicose vein is a diseased vein. It is very common, indeed, to have varicose veins in one leg only. ”

“ Swollen Legs from Enlarged Veins (Varicose Veins.) —The veins are frequently much enlarged and distended, causing the legs to be greatly swollen and very painful, preventing the patient from taking proper walking exercise. Swollen legs are owing to the pressure of the womb upon the blood-vessels above. Women who have had large families are more liable than others to varicose veins. If a lady marry late in life, or if she be very heavy in pregnancy—carrying the child low down—she is more likely to have distention of the veins. ”

“ Chronic phlebitis is usually the sequel of an acute attack or else is developed in a vein already varicose. The coats of the vessel become thickened and hardened by interlamellar development of nucleated fibrous tissue, so that the walls become more or less rigid. This thickening may be partly at the expense of the lumen of the vein, thus reducing its calibre, or it may be entirely excentric. The vasa vasorum are sometimes developed in chronically-inflamed veins to a remarkable extent. Quincke states that they may attain the size of cuticular veins.12
12 Ziemssen's Cyclopædia, art. ”

“ For this reason you should promptly report to him even the slightest swelling and begin to measure and save your urine for examination.
72Varicose veins are not peculiar to pregnancy but they are among the pressure symptoms which frequently appear during the later months, particularly among women who have borne children. The enlargement of the veins is not usually serious but it may cause a good deal of discomfort. While varicose veins may occur in the vulva, they are usually confined to the legs, and both legs are about equally affected. ”

“ In parts like the brain, where it is very important that there should be no compression, since any disturbance of circulation would lead to serious results, the vessels are enclosed in thick walls, and in the liver, through which all the blood passes and where compression is sure to cause trouble, the veins are simply caverns carved out in the organ and have no walls. They lie open when the organ is opened. Varicose veins are the result of valves giving way through inherited weakness or disease so that others have an unduly large weight to support. ”

“ If elastic garters are worn at all, they should be applied above the knee, and not below, where they obstruct all the superficial veins. Tight lacing, too, predisposes to varicose veins, in consequence of the abdominal viscera being pushed downward into the pelvis, causing undue pressure on the veins of the lower extremities. ”

“ Under no circumstances are garters allowed to be worn, as they form a constriction around the leg and interfere with the return of the venous blood to the heart, and so increase the tendency to the formation of the varicose veins. It is better not to use any means to hold the stockings up ”

“ They are, no doubt, chiefly caused in the same way as varicose veins, that is by the enlarged womb preventing the proper flow of the blood in the small veins, and so causing them to swell, and form tumors. They may in fact be called varices, as truly so as those on the limbs. In many persons however they are undoubtedly brought on merely by Constipation, which will undoubtedly either cause them or make them much worse when otherwise produced. In general they become worse as the pregnancy advances, because the womb becomes larger and the bowels are more apt to be confined. ”

“ Sometimes bluish, small, soft, rounded lumps, or a fine, branching network of veins may be seen. Oftentimes varicose veins may exist for years—if not extensive—without either increasing in size or causing any trouble whatsoever. At other times they occasion a feeling of weight and dull pain in the legs, especially on long standing. When they are of long duration the legs may become swollen and hard, and eczema, with itching, is then not uncommon. This leads to scratching and sores, and these may enlarge and become what are called varicose ulcers, which are slow and difficult of healing. ”

“ First, simple section of the skin lying above the dilated vessel is made, and with the hook it is separated from the neighboring tissues and tied. After this the dilated portion is removed and pressure applied by means of a bandage. The patient is ordered to remain quiet, but with the legs higher than the head. Some people prefer treatment by means of the cautery." Gurlt, in his "History of Surgery," calls attention to the fact that two of our modern methods of treating varicose veins are thus discussed in Aëtius, that by ligation and that by the cautery. ”

“ Walking does not encourage this disease, for the active muscles force on the venous blood. Clerks who are subject to varicose veins should have seats behind the counters where they may rest when not actually employed. A deep breath helps the flow in the veins, and a wound may suck in air with fatal effect. A maimed horse is most mercifully killed by blowing a bubble of air into the veins of his neck. As the deep-sea pressure would burst valves, the whale has none ”

“ Varicose Veins.—The distention of the surface veins of the legs, the condition known as varicose veins, is not a peculiarity of pregnancy. Anyone who must be on his feet a great deal is liable to suffer from this ailment. It is true, nevertheless, that pregnancy increases the likelihood of the development of varicose veins. The walls of the vessel are generally able to withstand whatever strain is placed upon them during the first pregnancy, and usually the varicosed condition does not develop until after there have been several pregnancies. ”

“ In the case of varicose veins, previously mentioned, it was physically apparent that the cause of the syncope lay in the vessels. Disease of the arteries is well known to be usually associated with degeneration of the heart; the veins are also large and distensible in old people, who furnish the greater number of those who are liable to anæmic syncope; but the pathology of the veins, as regards both their functions and structure, is not yet sufficiently known.
Persons with disease of the heart, who die suddenly in a fit of anger, probably die always with the heart distended ”

“ The circulation will then be obstructed in all the distant branches, and the blood, if long retained, will coagulate in them also. It will then part with its serum, and give rise to all the symptoms of inflammation in the distant vessels; a pulpy elastic swelling, accompanied with great pain, will then be the principal symptom, while the turgescence on the surface will be less than where the superficial veins have been mechanically compressed. It will, however, very frequently happen, that a vein in a part may be felt distended without any symptom of inflammation being present ”

“ The examination of the blood, or of the vessels, in such cases, will by no means invariably indicate the presence of foreign matter after it has once become thoroughly mixed with the blood, nor will inflammation of the vein through which the fluid passes, be by any means invariably produced.
When a foreign substance is introduced into an artery, any immediate effects upon the blood may naturally be looked for in the system of capillaries which it supplies. If the blood then coagulates, local symptoms alone, will, in the first instance, be produced, and the constitution will remain unaffected. ”

“ Varix of the saphena is usually an attendant or sequel 364of tibio-tarsal synovitis, and is the result of combined pressure and congestion. Mammary varices are manifestly connected with the congestion and exudations which affect the udder and environment at the time of parturition, or with a casual mammitis.
The symptoms in superficial vessels are visible enlargement, and often elongation and tortuous direction of the vein or veins, with or without tenderness. Deep-seated varicosities may be attended by stiffness of the part and a halting in progression with or without pain on pressure. ”

“ The radicles of the inferior vena cava and the left posterior cardinal are formed by the renal veins from the two kidneys, and in their forward course to the heart both veins receive in addition genital and segmental veins. In its course through the liver the inferior vena cava receives several hepatic veins, and finally opens into the sinus venosus, while the left posterior cardinal vein joins the corresponding Cuvierian duct, which also receives anterior cardinal, inferior jugular, and subclavian veins. ”

“ Many patients have died of this disease, induced by the application of a ligature to the vena saphena major, for the cure of varix. Wounding of large veins ought to be studiously avoided; and if wounded, the bleeding from them should, if possible, be arrested by pressure. When from any cause the extremity of a large vein in a wound is not closed, when it is not plugged up by plastic matter, pus seems to enter it readily, and by mixing with the circulating fluid causes dreadful mischief ”

“ There is reason to believe, moreover, that a sudden strain may, by rupturing the valves and so rendering them incompetent, induce varicosity independently of any congenital defect. Prolonged standing or walking, by allowing gravity to act on the column of blood in the veins of the lower limbs, is also an important determining factor in the production of varix.
Thrombosis of the deep veins--in the leg, for example--may induce marked dilatation of the superficial veins, by throwing an increased amount of work upon them. ”

“ Blood then ceases to flow along the allantoic vessels; they become obliterated. The vitelline vein, which as the yolk becomes gradually absorbed proportionately diminishes in size and importance, comes to appear as a mere branch of the portal vein. The ductus venosus becomes obliterated; and hence the whole of the blood coming through the portal vein flows into the substance of the liver, and so by the hepatic veins into the vena cava. ”

“ It has been observed, that inflammation after child-birth usually attacks the spermatic veins alone, and for the most part the one only on that side of the uterus to which the placenta has been attached. The hypogastric veins are comparatively rarely affected. The appearances observed upon dissection in the spermatic vein, usually terminate abruptly at its opening into the vena cava on the right side, or into the renal on the left. This fact is in perfect accordance with that observed by Mr. Arnott, that the coagulum in veins extends usually only to the nearest collateral branch ”

“ Under these last circumstances, we may find a vein partially obliterated at different points, leaving intervals where lymph or pus are secreted. If the purulent matter introduced is allowed to remain a short time only in the vein, no inflammation is produced (Experiment vi) . But when any irritating fluid is detained there in consequence of the blood coagulating around it, adhesive, ulcerative, or suppurative inflammation, will be excited (Experiments vii and viii) .
The slowness with which veins inflame when cut, tied, or bruised, has been made a subject of comment by different authors ”

“ The animal regained its appetite, eat and drank freely, and went to sleep. The day following, it appeared nearly well. On the third day, three drachms of the same pus were injected into the opposite vein; after the lapse of a certain time, there occurred, as in the first instance, faintness, vomiting, and frequent desire to pass urine; twelve hours after the injection, frequent liquid, white, and very fetid motions were passed, and the animal died at the expiration of twenty-four hours. On opening the body, no alteration was found either in the intestines or other organs. ”