A feature of this book is its complete coverage of historical aspects and theories of causation of this disorder. Unfortunately, no new evidence is presented to give any weight to one or another explanation of pathogenesis. Moreover, there is a certain ambiguity in quoted material, as when a majority of all adults are said to be suffering from varicose veins, or when, on some pages, lymphatic obstruction is said to play a major role in the syndrome, whereas this role is denied on other pages.
Since Dr. Popkin is an internist, non-operative therapy is covered most comprehensively. Most surgeons would probably find the insistence on a lifelong regime of rest for the patient, as advocated by Luke, at variance with their own philosophy of treatment. The author devotes but little space to surgical treatment, suggesting reference to standard texts on this important aspect of treatment.