To the Editor.—
In the Nov 25 issue of The Journal (230:1201, 1974), a correspondent wrote to inquire about the physiological basis for puffiness of the feet and ankles of women during hot weather.It may be pointed out that men, too, have swelling of the lower extremities during hot weather. In the days when men wore circular garters, it was common to note that they were too tight at the end of a hot day.The best explanation that I know was given by Eugene Landis in "The Mechanism of Edema Formation," which appeared in Modern Concepts of Cardiovascular Disease, vol 4, No. 11, November 1935:Heat produces peripheral vasodilation, raises capillary blood pressure conspicuously and, through relaxation of capillaries, increases the area of endothelium available for filtration. Patients frequently observe spontaneously that warm weather and local heat accentuate their edema.