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A similar type of elephantiasis may occur after extirpation of the lymph glands in the axilla or groin; in the leg in long-standing standing varix and phlebitis with chronic ulcer; in the arm as a result of extensive cancerous disease of the lymphatics in the axilla secondarily to cancer of the breast; and in extensive tuberculous disease of the lymphatics.

The most typical example of this form of phlebitis is that so frequently met with in the great saphena vein, especially when it is varicose. The onset of the attack is indicated by a sudden pain in the lower limb sometimes below, sometimes above the knee. This initial pain may be associated with shivering or even with a rigor, and the temperature usually rises one or two degrees.

The next day I was taken back to Leeds in a state of absolute helplessness, and, being got to bed in my own house, had to remain there for nine mortal weeks. Some of the experiences of that time were curious. Phlebitis had set in, and for a time I was in serious danger from the formation of a clot of blood in one of the arteries.

If your patient has the symptoms of phlebitis, tell him of the rise of temperature, the swelling of the leg, the tenderness along the course of the vein, and he will know that you know and appreciate the gravity of the disease; but be sure you do not attempt to give the symptoms a name, that is not your place.

Reference is here made to the chronic inflammations of the synovial membrane of joints, of tendon sheaths and of bursæ chronic synovitis, teno-synovitis and bursitis; of the fibrous tissues of joints chronic forms of arthritis; of the blood vessels chronic forms of endarteritis and of phlebitis and of the peripheral nerves neuritis.

May all that is highest and best lie before you both. Your affec. friend, I was gradually recovering my health when on May the 21st, 1895, after an agonising night, Sir John Williams and Henry came into my bedroom between five and six in the morning and I was told that I should have to lie on my back till August, as I was suffering from phlebitis; but I was too unhappy and disappointed to mind.

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.

Anatomy INJURIES OF ARTERIES: Varieties INJURIES OF VEINS: Air Embolism Repair of blood vessels and natural arrest of hæmorrhage HÆMORRHAGE: Varieties; Prevention; Arrest Constitutional effects of hæmorrhage Hæmophilia DISEASES OF BLOOD VESSELS: Thrombosis; Embolism Arteritis: Varieties; Arterio-sclerosis Thrombo-phlebitis Phlebitis: Varieties VARIX ANGIOMATA Nævus: Varieties; Electrolysis Cirsoid aneurysm ANEURYSM: Varieties; Methods of treatment ANEURYSMS OF INDIVIDUAL ARTERIES.

Under these various conditions the formation of a thrombus is not necessarily associated with the action of bacteria, although in any of them this additional factor may be present. The most common cause of venous thrombosis, however, is inflammation of the wall of the vein phlebitis.

Consequently I never became a really expert rider, although during the next few years I had a ride now and then. But after a severe attack of phlebitis following upon typhoid fever, in 1870-71, I was compelled to give up all the physical exercises that I loved best. My temperament expressed itself in a profusion of youthful longings, as well as in my love of athletics.