Phlebitis and thrombosis / by Warrington Haward.

  • Haward, Warrington.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Phlebitis and thrombosis / by Warrington Haward. Source: Wellcome Collection.

    106/120 (page 78)
    activity of the venous wall, and is inevitably delayed by the presence of septic organisms. In simple non-infective cases evidence of commencing organization may be found in a thrombus at the end of a week, whereas in veins the walls of which have undergone degeneration very little change may have occurred at the end of a month. In an uncomplicated case of phlebitis it will probably be safe at the end of six weeks from the last extension of the thrombus to commence some movement of the limb, but this should not be permitted as long as there is any tenderness over the vein, for tenderness implies the possi- bility of further extension of thrombus ; moreover, the first movements should, of course, be made with great gentleness and caution. In cases of septic origin, and also in cases in which there is disease or degeneration of the veins, a longer time should be allowed before move- ment. The organization of thrombus in varicose veins is usually very slow, and when thrombosis occurs in cysts and tortuous dilatations, especially in veins near the knee or in the long saphenous in the thigh, the safest course is to ligature the vein and excise the thrombosed portion. When in an uncomplicated case of phlebitis the clot has undergone early and rapid disintegration, and the blood- current through the vein can be felt to be re-established, movement may be allowed at an earlier period, and may be cautiously commenced when the vein is entirely free from pain and tenderness. When a large trunk, such as the femoral or iliac vein, becomes permanently blocked, many small superficial veins become developed, which not infrequently become inflamed in consequence of some local irritation. A little tenderness is felt on some part of the skin, and on careful