Varicosity is followed by oedema, hypertrophy, repeated inflammations of the cellular tissue terminating in indurations, and inflammations of the skin, which cause it to coalesce with the subjacent cellular tissue, and give rise to an excessive formation of epidermis, and ulcerous fusion of the tissue - the so-called varicose ulcer, which is distinguished by the callosity and livor of its edges, the production of a purulo-serous corroding secretion, lax and bloody granulations, its sinuous and sometimes serrated form, and, finally, by its obstinacy. The varicose veins at its base, or in its borders, are sometimes corroded, and give rise to exhausting, or even fatal hemorrhage.

When the pressure of the varices destroys the fascia under which they lie, they become deposited in the subcutaneous cellular and fatty tissue, and finally in the true skin itself, which now becomes extremely attenuated, inflames, and gives way, causing a hemorrhage which also may prove fatal.

We very frequently meet with inflammations of these varicosities, which sometimes terminate in resolution, sometimes in obliterations and atrophy - a termination which it is the object of the various operations for varices to induce, - and sometimes in purulent exudation, which may occasionally prove fatal, by giving rise to pyaemia.

B. Varicocele (Circocele)

Varicocele (Circocele), varicosity of the veins of the spermatic cord and of the testicle is usually developed during the period of puberty, and is commonly regarded as of more frequent occurrence on the left than on the right side - a view which is borne out by our own somewhat limited experience. It begins with a uniform, cylindrical dilatation of the veins in the spermatic cord; these gradually assume a character of true varicosity, which extends downwards towards the testicle, and often affects the scrotal veins (circocele, according to Velpeau). It is frequently combined with consecutive hydrocele, and in its higher degrees is followed by atrophy of the testicle, and at the same time by mental disease.

The varicose veins are here rarely attacked by inflammation; and phle-bolites are seldom produced in them, although not so seldom as in varicosities of the saphena.