The principles of surgery . ss ofcure, recumbency, antiphlogistic regimen, with absence of all excitement,must be observed; and, at the time of the sloughs separation, precau-tion should be doubly vigilant. At this period, were the patient to getout of bed and walk about, or indulge imprudently in diet, hemorrhage—great, and perhaps fatal—might possibly ensue. And further, thatbeing the period of inflammation and ulceration of the venous coats, fordetachment of the slough, such imprudence might very probably lead toextension of the phlebitis ; a greater danger than even that by loss ofblood. I
The principles of surgery . ss ofcure, recumbency, antiphlogistic regimen, with absence of all excitement,must be observed; and, at the time of the sloughs separation, precau-tion should be doubly vigilant. At this period, were the patient to getout of bed and walk about, or indulge imprudently in diet, hemorrhage—great, and perhaps fatal—might possibly ensue. And further, thatbeing the period of inflammation and ulceration of the venous coats, fordetachment of the slough, such imprudence might very probably lead toextension of the phlebitis ; a greater danger than even that by loss ofblood. It is also to be remembered that, independently of all immediate risk,the caustic sores may prove indolent and slow to heal; perhaps becom-ing a source of greater inconvenience than the original malady, on ac-count of which they have been incurred. 538 RADICAL CURE OF VARTX. The tivisted suture is applied directly to the affected vein, in thefollowing manner; and is generally preferred, as the simpler and safer Fig. Obliteration of varicose veins, at three points. The radical cure. mode of treatment. A needle, such as used for harelip, is passed be-neath the vein; and round it a silk or thread ligature is twisted, so asto completely obstruct the venous canal at that point, and compress thecoats with some power against the needle. This application is permittedto remain undisturbed for some days. Should much pain, swelling, andredness occur, then the needle is withdrawn; the vascular excitement issufficient for occlusion; and it would be imprudent to seek a highergrade by continuance of the exciting cause. If, however, no uneasinessbe complained of, beyond what is ordinary and desirable, the needle maybe permitted to remain undisturbed, until it becomes spontaneously de-tached by ulceration. For, in those cases in which the application hasbeen but temporary, experience has shown that renewed circulation isliable to occur, at the part supposed to have been obliterated. An
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