. The principles of surgery . eswelling is less, but more diffused; the circulation is more plainly tu-multuous ; thrill and bruit are more or less distinct, according to the sizeof the communicating aperture; varicose distension of the vein is sensations, with some interstitial swelling, attend on the firstformation. But these subside gradually, and, usually, at length almostwholly disappear ; the morbid state remaining in all respects limb below the tumour is imperfectly supplied with arterial blood;a portion of the arterys contents entering the vein, and returni
. The principles of surgery . eswelling is less, but more diffused; the circulation is more plainly tu-multuous ; thrill and bruit are more or less distinct, according to the sizeof the communicating aperture; varicose distension of the vein is sensations, with some interstitial swelling, attend on the firstformation. But these subside gradually, and, usually, at length almostwholly disappear ; the morbid state remaining in all respects limb below the tumour is imperfectly supplied with arterial blood;a portion of the arterys contents entering the vein, and returning tothe heart; the limb consequently is cold, numb, and vitally weak. Byobstruction to venous return, also, passive congestion and oedema arelikely to ensue; at least for a time. By and by, collateral circulationhaving become fully established, both arterial and venous, a healthycondition may be almost completely restored. In consequence of this comparative absence of inconvenience and Fig. 196. Outline of varicose ERECTILE TUMOUR. 559 growth, the case cannot be regarded as one demanding operative inter-ference. Pressure is sufficient; to repress swelling, and to moderate,if not prevent, sanguineous intermixture. We have no hope of sooccluding the aperture. Palliation is our only object; repressinggrowth, removing uneasy sensations, and permitting use of the , however, a case occur of unusual urgency, and the patientbecome dissatisfied with merely palliative treatment, a direct incisionmay be made on the artery; and, a cautious dissection hav- Fig- 197. ing separated its coats from thesurrounding parts, above andbelow the aperture of commu-nication, a ligature may bepassed and secured at each ofthese points. The affection itself is rare ; and, still more so, are examples of urgency sufficient torender such operative interference even expedient. ANEURISM BY ANASTOMOSIS | VASCULAR, OR ERECTILE TUMOUR. This might have been classed with tumours, and considere
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