Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


Varicose veins in immediate relation to the base of a large chronic
ulcer usually become thrombosed, and in time are reduced to fibrous
cords, and therefore in such cases haemorrhage is not a common
complication. In smaller and more superficial ulcers, however, the
destructive process is liable to implicate the wall of the vessel before
the occurrence of thrombosis, and to lead to profuse and it may be
dangerous bleeding.


These ulcers are at first small and superficial, but from want of care,
from continued standing or walking, or from injudicious treatment, they
gradually become larger and deeper. They are not infrequently multiple,
and this, together with their depth, may lead to their being mistaken
for ulcers due to syphilis. The base of the ulcer is covered with
imperfectly formed, soft, oedematous granulations, which give off a thin
sero-purulent discharge. The edges are slightly inflamed, and show no
evidence of healing. The parts around are usually pigmented and slightly
oedematous, and as a rule there is little pain. This variety of ulcer is
particularly prone to pass into the condition known as callous.

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