File:Modern surgery, general and operative (1914) (14595496359).jpg

Identifier: modernsurgerygen1914daco (find matches)
Title: Modern surgery, general and operative
Year: 1914 (1910s)
Authors: Da Costa, J. Chalmers (John Chalmers), 1863-1933
Subjects: Surgery Surgery, Operative
Publisher: Philadelphia, London, W. B. Saunders company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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as phlebosderosis, andit is a chronic inflammation of the wall of a vein, producing a fibrous changein the vascular coats. It may arise in a part the seat of chronic venousengorgement, but its most frequent cause is syphilis. It is often associatedwith arteriosclerosis. Varicose Veins; Phlebectasis, Phlebectasia, or Varix (Figs. 187and 188).—Definition and Causes.—Varicose veins are unnatural, irregular,and permanently dilated veins which are elongated and pursue a tortuouscourse. This condition is very common, and 20 per cent, of adults ex-hibit it in some degree in one region or another. Some facts indicate hered-itary predisposition. In over 80 per cent, of cases the trouble begins beforethe age of twenty-five. The causes of varicose veins are said to be obstruc-tion to venous return and weakness of cardiac action, which lessens the pro-pulsion of the blood-stream. A. Pearce Gould says obstruction is not acause, because in pregnancy varicose veins may be seen early, before the
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Fig. 187.—Varicose veins. Varicose Veins; Phlebectasis, Phlebectasia, or Varix 411 womb is much enlarged. The real cause is probably a predisposition to thegrowth of vein-tissue, which leads to valve failure and a regurgitation ofblood from the deep veins into the superficial venous channels (A. PearceGould, in Lancet, March i and 15 and June 7, 1902). As Billroth saidover thirty years ago, sudden obstruction causes edema and gradual ob-struction a free collateral circulation. Neither sudden nor gradual obstruc-tion causes true varicosity unless the veins are predisposed by a tendencyhereditary or acquired. Varicose veins may occur in any portion of the body, but are chiefly metwith on the inner side of the lower extremity, in the spermatic cord, and inthe rectum. Varix in the leg is met with most commonly during and afterpregnancy and in persons who stand upon their feet for long periods. It isespecially common in the long saphenous vein, which, being subcutaneous,has no muscular a

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