Case of Fatal Hemorrhage from a Varicose Vein

Abstract

upper and hack part of the cricoid cartilage, in the lacunae beneadi the ary tenoids, was denuded in two places by ulceralion, which in one of them had removed a small part of (he ossified Cartilage, leaving the usual appearance of carious bone. No other morbid appearance was discovered. The body, the following day, was decomposing rapidly.Cambridge, Aug. i 822.ON Sunday morning June 2d. I was called in haste at about seven o'clock to D. W. aged 47, 1 went immediately, but found him dead. He was a blacksmith, and had long been in the habit of intemperate drinking to a great excess. For twenty years or more he had been affected with varicose veins, and has had ulcers on one ancle. The veins have lately burst several times, and bled considerably, sometimes, as I was told, to tlie amount of a pint; and then the hemorrhage has stopped spontaneously, or with only such remedies as were used in the family without the aid of a physician. He had not however taken warning from these bleedings to take any care of the disease.He did not wear bandages nor any thing else to support the; limbs.On the morning before mentioned, he had risen pretty early and taken a walk, as was supposed but without violent exercise. He had returned but a few moments, when his wife, who was still in the chamber, heard him exclaim that he was bleeding to death. She ran instantly down and found him bleeding profusely from his right leg. The blood streamed out with great violence, first upon the floor, and afterwards into a pail which he had placed to receive it. She ran for a small tub of cold water into which the foot was put, and nothing else was done to check the bleeding. He very soon fainted, and in a short time expired. Several other persons came info the room almost as soon as his wife, and they all agreed in stating that it could not have been more than five minute» from the time that the hemorrhage began till he was quite dead. He had been dead several minutes when I arrived.About two hours after, we examined the leg. There was a round orifice, about the size of a small quill, on the inside of The New England Journal of Medicine, Surgery and Collateral Branches of Science as published by The New England Journal of Medicine. Downloaded from nejm.org at MONASH UNIVERSITY LIBRARY on July 2, 2016. For personal use only. No other uses without permission. From the NEJM Archive.