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Ludwig Isaak, M.D.
JAMA. 1940;114(21):2139. doi:10.1001/jama.1940.02810210071026.
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To the Editor:—  The unprejudiced reader of Dean and Dulin's paper "Pulmonary Embolism Following the Injection Treatment of Varicose Veins" (The Journal, April 6, p. 1344) can easily get the impression that the treatment of varicose veins by injections is not as safe as pictured by "numerous authors" who "report a low incidence of complications following the injection therapy of varicose veins," that "the dangers of this procedure are greater than is usually reported" and that high ligation or other surgical procedure reduces fatal embolism. Drs. Dean and Dulin base their conclusions on their experience with two fatal cases among 600 cases treated by injection; they imply that deadly embolism might have been avoided by a proper treatment explained in their conclusions 2, 3, 4, 5 and 6. The physician who wants to treat varicose veins or has to recommend a certain procedure should get an impartial picture of the


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