Dissertations on Inflammation, Vol. 2 — John Shaqi
Dissertations on Inflammation, Vol. 2Burns, John
Science
Dissertations on Inflammation, Vol. 2
Burns, John
Inflammation
Two modes of cure have been proposed, the one palliative, and the other
radical. The first is effected by means of rollers, or bandages, which
prevent the vein from being distended, and, therefore, enable it the
better to carry on its circulatory function. In this way, we prevent,
to a certain degree, the hurtful operation of the vein upon the ulcer,
and are often enabled to heal it up. But, as we do not thus restore the
vein to its natural powers, unless in young people, who continue the
support or pressure for years, we can obtain no permanent cure of the
varix; and very frequently the parts again ulcerate; because, whenever
the pressure or support is withdrawn, and the patient walks about, then
the function of the part becomes affected, the organic particles are
not deposited in the same state of perfection, and the action which
is induced by exercise causes the destruction of these granulations;
or even the very circumstance of their being formed imperfectly is
sufficient to produce their destruction, and the opening of the part;
for all parts which have been formerly ulcerated are most ready to
assume this action again, and the organic particles of that part are
less perfect, and less able to bear action.
The second is obtained, by obliterating the diseased vein, or
interrupting its communication with the trunk above, by which we make
the blood take a different course, and be transmitted by healthy veins.
If we now cure the sore, we find, that the same effects are produced as
if we used permanent pressure; and, therefore, the functions of the
part are more properly performed, and the organic particles possess
greater power of acting, and sustaining action. The older surgeons
proposed to effect the radical cure, by tying the vein at the two
extremities of the diseased part, and cutting out the intercepted
portion, or by laying it open, and digesting it, as they said. This,
however, was, as they confess themselves, very seldom submitted to
in ulcers of the legs; and was rather inserted to complete their
treatises, than from a belief that the operation ought to be insisted
on. Of late, it has been proposed by Mr. Home, to tie only the upper
extremity of the diseased portion[57], by which adhesion takes place
at that spot, and the circulation is there stopped. The pressure of the
blood above is thus taken off, and the blood from below must circulate,
in a greater degree, through vessels which are better able to perform
their functions; and, therefore, the actions of the capillary vessels,
whether nutrition, absorption, or conversion of the blood from arterial
into veinous, must be more naturally performed. After the veins are
tied, they gradually become smaller; for the pressure being permanently
removed, the diseased veins can more fully propel their blood by
lateral branches, at the same time that they receive less blood, more
going by other vessels.
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