Phlegmasia alba dolens has repeatedly been described in childhood, in severe chlorosis, pulmonary tuberculosis and other cachectic processes. Recovery has repeatedly been observed in cases of phlegmasia due to chlorosis. Unruh saw thrombosis of the inferior vena cava in a child of one year, caused by an endothelionia of the wall of the vena cava.
Hamorrhoids also occur in childhood, as is not surprising when the hereditary, family and racial predispositions to this condition are con sidered. The affection remains latent during childhood as a rule. But sometimes the symptoms are produced as in adults, pains in the sacrum, constipation, tickling sensations in the rectum and htemorrhage. The htemorrhoids may become tnisted and inflamed also. In children internal htemorrhoids are more frequent than external. IIouzel, among 500 children in whom search for hgrnorrhoids was made systematically, found this condition latent four times. There is no cause for surg,ical interference in children, just as there is no especial treatment for this condition in childhood.
Dilatation of the reins in the form of true varicosities is not observed in childhood except in the veins of the rectum; yet, on the other hand, there are children in whom one or another subcutaneous vein, or the entire district supplied by one vein, appears to be enormously developed.
This is roost frequently observed between the third and tenth year of life, in children with delicate coloring, blond or red hair. There are usually much dilated veins of the face, somewhat raised, also plainly marked veins upon the anterior chest wall and the upper arms. The veins on the back of the hand, on the contrary, so often prominent in later years of life, are only slightly dilated. Though these dilated veins do occur especially frequently in pale children, chiefly those with tuber culosis, there are also perfectly normal, full-blooded children with this kind of veins which usually' disappear totally in later life.
E. Fournier, Jr. considers a dystrophy of the veins characteristic of hereditary syphilis, as shown by ectasia of the veins of the skull. This is not a general dystrophy but only the effect of congestion due to a syphilitic or rachitic hydrocephalus (see also chapter on "Syphilis").
As an exceptionally rare condition should be mentioned varicose dilatation of the cavernous sinus which was observed by Geissler in a child with defect of the interventricular septum.