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Varix is most frequently met with between puberty and the age of thirty, and the sexes appear to suffer about equally. The amount of discomfort bears no direct proportion to the extent of the varicosity. It depends rather upon the degree of pressure in the veins, as is shown by the fact that it is relieved by elevation of the limb.
In aneurysmal varix, a not infrequent result of a bullet wound or a stab, the communication with the vein may involve the main trunk of the femoral artery.
As there is little tendency to spontaneous cure, and as the aneurysm is liable to increase in size and finally to rupture, operative treatment is usually called for. This is carried out on the same lines as for aneurysmal varix, and at the same time incising the sac, turning out the clots, and ligating any branches which open into the sac. If it can be avoided, the vein should not be ligated.
But for the local aneurysmal thrill at the point of the scar the condition would have been diagnosed as angioma, but as a bruit could be heard over the entire mass it was called an aneurysmal varix, because it was believed there was a connection between a rather large artery and a vein close to the mass. There is a curious case reported of cirsoid tumor of the ear of a boy of thirteen.
It is a common experience in women that the signs of varix date from an antecedent pregnancy. The importance of the wearing of tight garters as a factor in the production of varicose veins has been exaggerated, although it must be admitted that this practice is calculated to aggravate the condition when it is once established.
These symptoms are due, in the majority of cases, to an aneurysmal varix of the internal carotid artery and cavernous sinus, which is often traumatic in origin, being produced either by fracture of the base of the skull or by a punctured wound of the orbit.
The usual complaint is of a sense of weight and fulness in the limb after standing or walking, sometimes accompanied by actual pain, from which relief is at once obtained by raising the limb. Cramp-like pains in the muscles are often associated with varix of the deep veins. The dilated and tortuous vein can be readily seen and felt when the patient is examined in the upright posture.
Two varieties are recognised one in which the communication is direct aneurysmal varix; the other in which the vein communicates with the artery through the medium of a sac varicose aneurysm.
The term varix is applied to a condition in which veins are so altered in structure that they remain permanently dilated, and are at the same time lengthened and tortuous.
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.
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