Summary:
The development and changes of opinions conceming the nature and treatment od varicose veins and varicose ulcers are
summarized in this article covering a long period from the Greek antiquity till the 20th century. Whereas in the ancient times
(Hippokrates, Celsus, Galen) the meanings did not contradict the contemporaneous knowledge, curious opinions dominated
from the 11th till the half of the 19th century, obviously influenced by the humoral theory of Avicenna. The official teaching
claimed that black bile and other bad humours collected in varicose veins. Bandaging was thought to push back these humours
into the body and cause madness or other serious illness and, therefore, was refused. On the contrary, ulcers were considered
to be a favourable condition because their function was to drain the bad humours.
The fundamentals of modern surgical treatment of varicose veins were presented by Madelung, Trendelenburg and Babcock
at the end of the 19th and the beginning of the 20th century. Trendelenburg deserves acknoledgement of having introduced
physiological and pathophysiological reasoning into the field of phlebology. The conception of the role of incompetent calf
perforators for the development of leg ulcers advocated by Cockett and others represents a derailment on the way of evidence
based medicine. The substance of this theory, although supported by most autors till the present time, have been repeatedly confuted
by exact hemodynamic measurements. Evidence based medicine whose basement was laid by Trendelenburg more than
100 years ago cuts a difficult way through the field of phlebology.
Key words:
varicose veins – leg ulcers
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