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May 2, 1977

The Pathology and Surgery of the Veins of the Lower Limb

Author Affiliations

Harvard Medical School Boston

JAMA. 1977;237(18):1987. doi:10.1001/jama.1977.03270450077034

The first edition of this work, published in 1956, emphasized the role of valvular incompetence of the communicating veins of the leg in causing varicose veins and stasis ulceration. It is still the informing principle of this second edition, which emphasizes the same two problems. The book opens with an attractive review of the history of the treatment of varicose veins and the anatomy and physiology of the veins of the lower limb. The major part of the work is devoted to spontaneous varicose veins and to thrombophlebitis and postphlebitic problems. Venous anomalies are briefly considered.

Many theories are considered to explain the causation of varicose veins of "spontaneous" origin, including the congenital absence of a valve proximal to the saphenous termination, but the authors conclude that heredity and race are most important, in ways not yet known. Main perforator leaks are emphasized as the basic pathologic finding, but the