PHLEBITIS (Neo-Lat., from Gk.c6X0, phleps, vein), Or INFLAMMATION OF THE VEINS. Al though seldom an original or idiopathic disease. it is a frequent sequel of wounds, in which case it is termed traumatic phlebitis, and is not un common after childbirth. ( See PHLEGM. SIA ALBA DoLExs.) It commonly arises by the extension of an inflammation from contiguous structures, as in phlegtnonous erysipelas or cellnlitis, or by the plugging up of a vein by an embolus or thrombus. If severe, the disease begins with a chill or chilly sensations, and a rise in tempera ture. There is great tenderness and pain along the course of the affected vessel. which feels like a hard knotted cord, and rolls under the fingers. If the vessel is small the consequences of its obstruction may be of little importance, but when a large vein is affected the consequences are always dangerous, and may be fatal.
Phlebitis may terminate in one of several ways. The most favorable is by simple resolution—the clot is absorbed, the vein becomes permeable. and circulation is reestablished. In other cases organization of the clot takes place, little blood vessels growing into it, from the walls of the vein, and the latter finally becomes a fibrous cord. The circulating blood is diverted to other channels which gradually dilate to accommodate time increased flow. Again, the clot may become
infected, if it is not so from the beginning, undergo purulent softening. and the pus either be discharged by the formation of abscesses, or emptied into the blood current to be carried by the general circulation to all parts of the body. These purulent particles find lodgment in the large viscera, such as the liver, spleen, kidneys, and give rise to multiple abscesses. In the liver this frequently happens from inflammation of the portal veins. This general distribution of septic material is known as pyrumia (q.v.) An organized clot may in rare instances become calcified by the deposition in it of lime salts, and form a phlebolite.
The treatment of phlebitis comprises rest in bed, elevation of the part, and the local applica tion of antiphlogisties—lead water and opium at first, hot fomentations later. If abscesses form, they must be opened and drained. In certain cases it is possible to ligate the vein above and below the clot, open the vessel, and wash out the purulent material. The internal treatment varies with the symptoms, but in general must be stimulating.