In some cases of phlebitis there may be pus deposited between the coats of these veins.
In phlebitis the latter are found in the endothelium and in the sheaths of the veins.
Phlebitis Uterina and Para-uterina, with formation of thrombi, embolism, and pyæmia.
To these may also occasionally be added phlebitis and inflammation of the joints, terminating speedily in suppuration.
The studies which I had made from the month of September to the end of December in 1870 had confirmed me in the opinion that purulent infection is neither due to phlebitis nor to the absorption of pus.
Phlebitis and thrombosis are common sequelæ of varix, and may prove dangerous, either by spreading into the large venous trunks or by giving rise to emboli.
Attention must be directed towards the condition with which the phlebitis is associated.
The most typical example of this form of phlebitis is that so frequently met with in the great saphena vein, especially when it is varicose.
Various forms of phlebitis are met with, but for practical purposes they may be divided into two groups--one in which there is a tendency to the formation of a thrombus; the other in which the infective element predominates.
The infective form usually begins as a peri-phlebitis arising in connection with some focus of infection in the adjacent tissues.
Like other pyogenic infections, it may terminate in pyæmia, as a result of septic phlebitis in the marrow.
Infective phlebitis is most frequently met with in the transverse sinus as a sequel to chronic suppuration in the mastoid antrum and middle ear.
The period of the occurrence of what has been described under the name of uterine phlebitis is marked with much precision, and the affection of the system is often general and sudden.
Cruveilhier,[39] that the treatment of phlebitis ought to be concentrated on the first period of the disease, viz.
We consider that the causes of crural phlebitisin the puerperal state are of precisely the same nature as those of uterine phlebitis, already mentioned, viz.
We had been led at that time to suppose that phlegmatia dolens and crural phlebitis were identical, and that, therefore, this was not a veritable case of the disease, because no traces of inflammation of the veins were to be found.
Thus a localised meningitis spreading to the brain may set up a cerebral abscess; a sinusphlebitis may give rise to a purulent lepto-meningitis; or a cerebral abscess bursting into the sub-arachnoid space may produce meningitis.
Sometimes the infection spreads to the meninges, and to the ophthalmic vein, and the phlebitis may then extend to the cavernous sinus.
With the onset of the phlebitis the discharge from the ear stops; there is severe pain in the ear and violent headache.
Chart of case of Sinus Phlebitis following middle ear disease in a boy æt.
If the phlebitis is accompanied by other intra-cranial infections, these are, of course, treated at the same time.
Operative interference is seldom feasible in phlebitis of the superior sagittal (longitudinal) or cavernous sinuses.
A more severe staphylococcal infection may give rise to a carbuncular swelling with great œdema, and lead to infective phlebitis of the facial vein and general septicæmia.
The pathological changes are the same as occur in the suppurative form of thrombo-phlebitis in the peripheral veins (Volume I.
Not infrequently phlebitis spreads to the internal jugular vein, which may then be felt as a firm, tender cord running down the neck, and the head is held rigid, sometimes in the position characteristic of wry-neck.
Phlebitis may be induced by contusions or direct injuries, an extension of inflammation from surrounding tissue, such as in abscess, formation of tumor, or malignant growth.
A very common result of phlebitis is an obliteration of the affected portion of the vein, but as collateral circulation is readily established this is seldom of any material inconvenience.
Phlebitis should be treated by the application of a smart blister along the course of the inflamed vessel; early opening of any abscesses which may form; the animal should have complete rest, and the bowels be kept loose with bran mashes.
In simple phlebitis the disease of the vein is confined to a circumscribed or limited portion of a vein; in diffuse it involves the vein for a long distance; it may even extend from a limb or foot to the heart.
Phlebitis in the course of the veins of the limbs frequently leads to numerous abscesses, which may be mistaken for farcy ulcerations.
Some years ago Sir James Paget called attention to the frequency of adhesive phlebitis as a gouty lesion.
The clot of suppurative phlebitis cannot be absorbed and cannot organize.
Septic phlebitis causes pyemia, and the infected clots of pyemia cause phlebitis.
Septic and pyogenic phlebitis still remain as consequences of accidental wound contaminations and as a penalty for the neglect of surgical cleanliness.
When phlebitis begins, a thrombus forms because of the destruction of the endothelial coat, and this clot may be absorbed or organized.
