On varicose disease of the lower extremities and its allied disorders : skin discoloration, induration, and ulcer : being the Lettsomian Lectures delivered before the Medical Society of London in 1867 / by John Gay.

  • Gay, John, 1812-1885.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: On varicose disease of the lower extremities and its allied disorders : skin discoloration, induration, and ulcer : being the Lettsomian Lectures delivered before the Medical Society of London in 1867 / by John Gay. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    outline is broken by several varieties of segmental configuration, from the merely wavy serpentiform or convolute to the severely tortuous. Its size and dermoid relations vary much ; for at times it is small, and appears lazily to meander just below or scarcely above the level of the skin ; whilst at others it stands out in bold and vigorous relief, almost entirely above its plane. Cases are recorded in which these veins have attained an enormous size, and in which the transit of the blood is accompanied with an arterial thrill. An instance is recorded by Mr. Colies,* in which the veins about the knee were said to have been quite as large as the vena cava, and others as large as the portal vein. “ Every one of these veins had the thrill characteristic of an aneurismal varix, beyond which there was nothing to warrant the supposi- tion that they communicated with arteries. It is said, however, that they scarcely impeded the man’s walking or interfered with his usual occupation—that of a farm labourer.” Other cases of the kind are reported ; one by Mr. Goss, to which I shall have occasion to refer hereafter. In the thigh, varicosity is met with in one or two, rarely more than three or four, of the principal branches of the saphena, or their secondary tributaries; and in the leg their number, even in severe cases, is not greater, although, from their proximity to each other, they often appear to be comparatively numerous. About the ankle, however, they often exist in such numbers as to form a wide-spread and inextricable plexus; and, in the foot, a series of parallel veins, which creep over its edge and front towards their larger receptacles. The disease is in most instances confined to the primary * Colies’s Lectures, by M ‘Coy.