Nature. Location. Mode of formation. Calcareous plates in two inner
coats. Phlebotomy. Altered sanguification. Treatment. Extraction.
Calcareous bodies have been repeatedly found in the veins of man and
several observations of the same kind have been made in the horse.
Spooner found them in the abdominal veins and Simmonds in the jugular.
Much difference of opinion has existed as to the mode of formation of
these bodies whether by calcareous deposit in a coagulum or by
degeneration of a neoplasm in the vascular wall. Andral held the latter
opinion, and Tiedemann and Cruveilhier found the bodies connected to the
inner coat of the vein by a fine membrane. Morton’s cut of one of
Simmonds’ specimens (Calculus Concretions) shows a structure in
successive layers having their centre at one end, evidently
corresponding to a former connection by pedicle. Cornil and Ranvier says
“sometimes there are seen in chronic varices, calcareous incrustations
in the form of plates, nodules or spheres with concentric layers ...
calcareous infiltration is seen in the form of spheres or phlebolites in
the varicose diverticula. An extensive calcareous induration several
centimetres in length, is also sometimes observed, the vein being
transformed into a calcareous tube with the ramifications also varicose.
The calcareous plates of the vein are developed in the fibrous and
internal portion of the middle coat. At the beginning they consist of
granules deposited in the fasciculi of the connective tissue or between
them; these soon unite and form transparent plates with granular striæ.”
Phlebolites in the jugular suggest a connection with the pouch-like
dilatations, and transformations in the vascular walls that have been
subjected to phlebotomy. It is probable however that there is usually a
morbid condition of sanguification and nutrition which predisposes to
their formation. In Simmonds’ case the jugular was impervious below the
bodies, there was hepatitis and arthritis of the fetlock joint.
When recognized during life these may be extracted with due antiseptic
precautions. If the vein can be dispensed with it may be ligatured above
and below, if not an attempt may be made to preserve it, extracting
through a clean cut longitudinal incision and securing as perfect
coaptation of the edges of the wound as possible.