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February 5, 1955


JAMA. 1955;157(6):513. doi:10.1001/jama.1955.02950230027014

Probably the surgical disease most commonly afflicting the human race is varicose veins of the lower extremities. That is the penalty man pays for assuming the up-right posture. The varicosities may be the result of a congenital weakness of the venous wall and of the valves or they may develop secondary to thrombosis in the deeper veins of the extremities. The contributing factors here are repeated trauma to the lower extremities, childbirth, operative interventions, or chronic infections requiring prolonged rest. All of these causative factors have their origin in deep venous occlusion of thrombotic nature. Incompetence of valves leads to a venous stasis and hypertension in the saphenous system of veins. The sequence of events in uncontrolled venous stasis is that of edema, induration of the skin, chronic cellulitis, and fibrosis. Later the skin becomes pigmented, and dermatitis and eczema follow. Recurrent attacks of cellulitis and of phlebitis are late

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