Varicose Veins, veins in a state of permanent and preternatural dilatation. The cause of the disease is to be looked for in some obstruction to the return of blood through the affected veins. In some cases the obstruction may be in the heart itself; old cases of heart disease, when the right side of the heart becomes involved, are apt to be attended with a varicose condition of the veins of the neck. The pressure of tumors, aneurisms, etc, upon a large venous trunk, causes a varicose condition of its superficial branches; the pressure of the enlarged uterus in pregnancy is a fertile source of varicose veins of the lower extremities; a varicose condition of the hemorrhoidal veins constitutes piles, of those of the testicle varicocele. A varicose condition of the veins of the lower extremity, arising from certain occupations which demand the long continued maintenance of the upright posture, from repeated pregnancies, and sometimes from weakness of the coats of the veins themselves, is an exceedingly common complaint. In the natural condition, by the frequently recurring contraction and relaxation of the voluntary muscles, the veins of the lower extremities are alternately filled and emptied.

Walking about, or any ordinary form of exercise, therefore facilitates the movement of the blood in the veins. But where a single set of muscles only are kept in constant and unvarying action, as in continued standing at a writing desk or a machine, the movement of the blood is obstructed instead of being aided by the muscular contraction, and it accordingly accumulates in the veins near the point of obstruction, especially in the lower extremities, where it has to mount upward against the force of gravity. The veins are thus unnaturally distended, and when their distention becomes so great that the edges of their opposite valves are drawn away from each other, the weight of the superincumbent column of blood is thrown upon that portion of the vein next below, and thus the affection extends, gradually involving successive portions of the venous system. The veins are sometimes unequally dilated, with knots and protuberances distributed along their course. They are lengthened as well as dilated, their course becoming more tortuous. Sometimes the coats of the vein are thicker, sometimes thinner than natural, or both states may be present in the same vein.

They are apt to cause more or less oedema of the affected limb, with a feeling of weight and fulness; sometimes they give rise to or are accompanied by ulcerations which are difficult to heal; occasionally, from gradual thinning of their coats or from accident, they burst and give rise to copious haemorrhage, which may prove fatal. - The annoyance and suffering attending varicose veins may be very much alleviated by the application of a firm roller, or better still, an elastic stocking, to the affected limb, thus affording equable support to the distended veins; an essential condition is also that the patient should avoid a continued standing posture, which has nearly always so much to do with the original production of the disease. Various operative proceedings have been tried with a view of obliterating the diseased veins and thus curing the disease. These are not always successful, nor are they unattended with danger. The best perhaps is that of M. Velpeau, which, consists in passing a needle beneath the trunk of the affected vein, and applying, a twisted suture around it; if sufficient inflammation ensue to cause the occlusion of the vein, the needle may be withdrawn in a few days; if not, it is permitted to ulcerate its way through.