The leading symptom in varicose veins is the increase in venous pressure. This first actually arterializes the vein, which responds to the pressure with a hypertrophy of all its layers and then dilates it, whereby the muscular coat disappears almost entirely. Further inflammatory changes, insufficient valves and poorly nourished tissues represent only morphologic end-stages of increase in pressure (table 1) and carbon dioxide retention (table 2). A detailed publication of such studies will be made elsewhere.1
This study is based on 160 cases of varicose veins and ulcers seen at the varicose vein clinic of Northwestern University. With exceptions to be stated, the patients were treated as ambulant and did not have to stop working.
DIAGNOSIS
In diagnosing varicose veins and their complications, the circulation of the affected extremity must be tested. The pulsation of the femoral, popliteal, posterior tibial, and dorsalis pedis is worth investigating, particularly in older