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Gangrene following the blocking of the brachial at its bifurcation usually extends as far as the junction of the lower and middle thirds of the forearm. Gangrene due to thrombosis or embolism is sometimes met with in patients recovering from typhus, typhoid, or other fevers, such as that associated with child-bed. It occurs in peripheral parts, such as the toes, fingers, nose, or ears.
The patient should drink large quantities of milk, which also increases the coagulability of the blood. Monro has observed remarkable results from the hypodermic injection of emetin hydrochloride in ½-grain doses. The processes known as thrombosis and embolism are so intimately associated with the diseases of blood vessels that it is convenient to define these terms in the first instance.
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. The larger the varix the greater is the tendency for a thrombus to spread upwards and to involve the deep veins.
When an obliterative endarteritis is threatening a leg with anemic gangrene, or when one lies too long in the same position on a hard bed, there is threatening injury from local anemia, and as a result there is acute pain, but when the obliterative endarteritis threatens anemia of the brain, or when an embolism or thrombosis has produced anemia of the brain, there may be no accompanying pain.
In the Brain, in the later periods of secondary and in tertiary syphilis, changes occur as a result of the narrowing of the lumen of the arteries, or of their complete obliteration by thrombosis.
Sometimes with serious edema and after serious hemorrhage the heart becomes very slow, unless some exertion is made, when it will beat more rapidly than normal. This probably represents a diminished cardiac nutrition. The cardiac lesions which cause a pulse to be slow are sclerosis or thrombosis of the coronary arteries, fatty degeneration of the myocardium, and Stokes-Adams disease.
This condition characterizes thrombosis. Treatment. In these cases, little if any good directly results from any sort of treatment in the way of medication. Absolute rest is thought to be helpful. Potassium iodid, alkaline agents such as ammonium carbonate and potassium carbonate, have been administered.
The portion of the diaphysis which has sustained the action of the concentrated toxins has its vitality further impaired as a result of the stripping of the periosteum and thrombosis of the blood vessels of the marrow, so that necrosis of bone is one of the most striking results of the disease, and as this takes place rapidly, that is, in a day or two, the term acute necrosis, formerly applied to the disease, was amply justified.
Thrombosis of the deep veins in the leg, for example may induce marked dilatation of the superficial veins, by throwing an increased amount of work upon them. This is to be looked upon rather as a compensatory hypertrophy of the superficial vessels than as a true varix. Morbid Anatomy.
In a certain proportion of cases, especially in elderly people, the occurrence of thrombosis leads to cure of the condition by the thrombus becoming organised and obliterating the vein. Treatment. At best the treatment of varicose veins is only palliative, as it is obviously impossible to restore to the vessels their normal structure.
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