The veins decidedly have not the virile character of the arteries; they have not the musculature, elasticity, and firmness. Their walls are thin, flabby, and not at all tough. By the time the blood has got through the narrow capillaries, the pumping force of the heart has been expended and instead of a raging torrent there is a dull sluggish backwater. Cut an artery and the blood spurts into the air; cut a vein and there is a welling-up like an overflowing catch-basin after a heavy rain.
What forces carry the blood back to the heart? First, I suppose, is the suction effect as the heart, having contracted, then expands, leaving an empty chamber free of pressure. The elasticity of the tissues of the body presses on the veins, and muscular movements increase this pressure. The veins have valves which allow the blood to move only towards the heart. When the body is in good condition, these factors are sufficient.
Varicose veins and related diseases
You may imagine, though, that this equilibrium is easily upset. Some persons have an hereditary weakness or absence of valves. Pressure on the veins, as by tight circular garters or by the heavy uterus of pregnancy, or the back pressure from a chronically sick and inefficient heart, may result in dilated veins. These are called varicose veins, a redundancy as the word comes from the Latin varix which in itself means an enlarged vein.
Varicose veins may appear in many parts of the body; for instance hemorrhoids or piles are due to them, but the common place to see them is in the legs. Quadrupeds who usually travel on all fours do not put great strain on the veins of the legs, but when man got up on two legs these veins had to stand a pressure of four or five feet. They frequently do not do it well.
So people who spend long periods on their feet, particularly if they remand in one spot, are likely to have swollen veins. They are common in women. One sees many women, middle aged or a little older, who complain of tired swollen legs and feel that their housework is too much for them. Many of them have some constriction by round garters, tight girdles, or rolled stockings. Nowadays most of them have “good” modern kitchens, so compact that everything can be reached by few steps. Webster’s dictionary says that “limbs lose strength by disuse.” The swelling of the ankles and the enlarged veins are often due to the muscles’ failure to help the circulation of the veins. A reasonable amount of straightforward use of a woman’s muscles of locomotion will help to maintain a trim unswollen ankle and more comfort.
When the veins are badly varicosed and the circulation is poor and fluid collects in the tissues, it follows that the nourishment of these tissues is poor, especially in the skin which is much exposed to injury. Wounds do not heal well under such conditions and varicose ulcers result. These are chronic, sluggish, open sores. In the good old days they were very common and innumerable pastes, lotions, and ointments were invented for their treatment. A young doctor starting in practice was fortunate if he could get a few paying patients with this condition as he could make a frugal living dressing the sores; and even if he healed them they would return when the patients again barked their shins.
Another serious aspect of varicose veins is the danger of thrombosis or phlebitis, that is, clotting within or inflammation of the veins. The two are frequently associated. One of the gravest dangers is that part of the clot may break away, be carried to the heart and then to the lungs. When signs of these conditions appear nowadays, surgeons are usually quick to expose the big vein in the groin and tie it off before “emboli,” that is, clots, have broken away and landed in the lungs.
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