COMMENTARY ON VARICOSE VEINS

I.  Physiological Considerations

    When a person is standing, the force of gravity greatly opposes return flow of blood and lymph from the lower extremities.  Hence in the diseased state varicose veins most often occur in this area.  While the body is in this position, efficient superficial circulation in the extremities depends not only on the pumping action of the heart to overcome gravity but also on the muscular activity within the extremities themselves.  The normal flow of blood and lymph is further aided by and dependent upon smoothly functioning channels through which they may flow.  A thinned out and sacculated vascular wall causes an unequal pressure in the system, thus allowing for stasis and even leakage into the surrounding tissues.  This unequal pressure in the tissues impairs the lymph flow in that area, allowing an accumulation of toxic waste products from the cells which may further suppress or even inhibit the normal activity of the tissues supporting the vascular walls.  This contributes further to the disease state.

    The readings imply that the tendency toward varicose veins usually develops as a result of mechanical trauma or systemic toxicity, both of which tend to impair the drainage from the area affected.  Mechanical trauma may exert its effect either through pressures on the autonomic ganglia and their connections with the cerebrospinal system as a result of spinal subluxations or through pressures exerted directly on the venous return from the lower extremities.  In reading 1093- 1, a 23-year-old maid sustained an injury to the end of the spine years before which brought about a gradual slowing of the circulation, resulting in varicose veins of the legs at an early age.  In another case, trauma occurred more directly to the affected area as a result of standing after overexposure to the sun.

    The present condition as we find arises from too much of the attempt to create or help the internal circulation from the sun heat, and standing too much on the feet has tended to increase the circulation to the portions and not sufficient of that as indicated to take the circulation from same.
    Thus there became the tendencies for the swelling, as well as the spreading of the conditions through the system.  (1541-6)

    Childbirth frequently causes varicose veins as indicated in 5037-1, which is included in the Circulating File on "Varicose Veins." Other cases are as follows:

    Now as we find, there are conditions that are gradually causing distresses through this body.  We find that these have to do with what may be called after-effects in childbearing, and thus are rather specific in their nature; but are producing pressures that cause a disturbance that is gradually cutting off the circulation through the lower limbs.  This will also gradually cause a greater disturbance, and of a more definite nature, unless some measures are taken to correct same.
    From those conditions or positions that developed during the periods while carrying the child, there are misplacements.  This also has caused deflected circulation from the pressures in the lumbar and sacral segments, so that the return of circulation from the lower extremities is causing the enlarging of the veins.  (2867-1)

Q-22.  Does the soreness along legs come from overweight, or poor circulation?
A-22.  As just given, a pressure in the lumbar axis.
Q-23.  Could this be a forerunner of varicose veins?
A-23.  It could be, unless corrections are made - or unless there is the relieving of the pressure by equalizing the circulation.
Q-24.  Why does childbirth cause varicose veins sometimes?
A-24.  Owing to the pressure as indicated, or as created in the area just given, by the natural position of the child through the period of gestation.   (457-9)

    A second cause of varicose veins is a slowing of the return circulation to the lower limbs brought about through toxic conditions originating elsewhere in the body.  As the organs that aid in digestion become unbalanced in their function, subluxations are produced in the related areas of the spinal column and the resulting pressure on the autonomic and spinal nerves tends to bring about a slowing of the venous return from the lower extremities.

    The blood supply indicates that there has long been a disturbance in the liver and gall duct area.  Hence toxic conditions exist that have tended to add to the weight of the body or there is a glandular reaction from the sources or natures of the suppressions and subluxations existent in the lumbar, the sacral, as well as the upper portion of the dorsals.
    These slow up the actions, and we have sediments in the gall duct areas rather than so much of a gall bladder disturbance.  Thus we have also, from the same pressures, a slowing of the return circulation in the lower limbs.  This has tended to produce an engorging of the veins, or varicose veins along on the inside and on portions of the limbs.  (3523-1)

    In another case we find that acidity in the system brought about by improper eliminations plus dietary indiscretions and excessive strong drink exerted such an influence on the entire digestive and eliminative systems as to create lesions throughout the spine.  Varicose veins was one of the results of this type of imbalance.

    There is irregularity with the eliminations from the kidneys and bladder, and some distress in this area at times - which is also indicated by pressures in the lumbar and sacral axis, especially that produces a slowing of the circulation through the lower limbs and the dilation in the veins in portions of the limbs themselves.
    We find that these are the effects, then, of this toxic force that is produced by the pressure existing in the distribution of energies and circulation in the lower extremities, from the 9th dorsal downward - as well as from that which has been and is a part of the condition by an excess of carbonated forces upon the system itself, combined at times with a toxic condition produced by strong drink.
    These we find are the sources of this condition. . .
    The acidity is producing disturbances more and more through the digestive system, as well as those influences upon the liver itself This is causing a lesion in the upper dorsals and lower cervicals that is a part of the whole general condition.
    The affectation is to the organs as indicated - the liver, the assimilating system, the colon, the activity of the kidneys, and those conditions in the superficial circulation; or the plethora in the veins - or varicose veins are showing their effect, which tends to make for slowing of activities through the body.  (2461-1)

II.   Rationale of Therapy

    Any system of therapy designed to restore and maintain normal function to the circulatory systems in the area of the varicose veins must concern itself with relieving the localized congestion as soon as possible, reestablishing and maintaining adequate venous and lymph drainage, and instituting measures designed to correct the underlying causes and resultant mechanical defects.  In general, it may be said that patience and persistence are the key factors in application of treatment to assist the body in its correction of the diseased state.

    Reestablishment of the normal circulation is assisted through frequent elevation of the affected part and applications of local medication; to relieve congestion of the tissues, massaging of the area using stimulating oils and supporting the weakened vessels through elastic stockings or bandages while standing or walking.  Caution is given that prolonged standing or sitting is harmful, whereas walking is in general beneficial to the circulation.  Of course, any complications such as infection, thrombosis, hemorrhage or ulceration must first be dealt with adequately.  Caution must be used in making a concerted effort to deal with the underlying problem if such treatment might have an adverse effect on the presenting complications.  In case [1956], surgery is advised if the patient cannot stay off his feet for adequate lengths of time or if rupture of the veins occurs.

    Osteopathic manipulations designed to relieve pressures on the involved nerve pathways is considered to be one of the first treatments necessary in most cases.  Likewise, any direct pressures obstructing the circulation should be alleviated as soon as possible.  Any systemic toxicity that might have a bearing on retarding venous return must be dealt with.  Usually this therapy consists of improving eliminations through the bowels and kidneys and improving the diet so as to reestablish the acid-alkaline balance.  Mullein tea is often prescribed as a means of promoting better eliminations and improving the coordinations between the organ systems.

    Take internally mullein tea not more than three times a week, but make it fresh each time it is taken.  Prepare a tea made from mullein.  For uniformity, preferably use the dry mullein, a pinch between thumb and forefinger.  Put into a teacup and pour boiling water on same.  Let this stand for 30 minutes, strain, cool and drink.  This is a reaction to the liver, the lungs, the heart and the kidneys, as to produce coordinating activity in circulation.  It works with each of these and also makes a better condition through the alimentary canal.  (5148-1)

(In the 1960 edition of The Herbalist, by Joseph E. Meyer, under "Mullein" the properties and uses of mullein are listed as demulcent, diuretic, anodyne, and antispasmodic.)  

III.  Suggested Therapeutic Regimen

    Therapy is directed toward correcting the underlying causes of the condition while relieving congestion in the affected area and restoring adequate circulation.  Rest, with the feet propped higher than the head, is necessary to promote better drainage from the legs.

    Keep off of the limb as much as possible.  Keep off of the feet as much as possible, and when reclining keep the limb elevated a little above the normal, so that the circulation is tended toward the body-forces themselves.  (1541-6)

    It is frequently advised that elastic stockings or bandages be worn when walking or standing.  Walking is prescribed as an excellent exercise, especially if there is a tendency toward varicose veins while pregnant.

    As we find, in the main, conditions are developing nominally.  However, the body should take those precautions about being on the feet so much and not using them.  Standing is hard on the body, as is being indicated by the swelling in the limbs - which will tend to make very bad circulation, and produce varicose veins unless there are some activities taken to prevent same.  Either walk or don't stand on the feet so much!  Walking is the best form of exercise for the body.
    If there will be the walking, and not merely standing or resting, and the taking of a small quantity of mullein tea every other day, these will disappear - and this disturbance will disappear.  The therapeutic reaction is to better circulation - through the kidneys, especially as related to the lower limbs.   (457-13)

    The site for osteopathic adjustments to relieve pressure on the involved nerves varies from case to case and depends on correction of the lesions found.  In general, lesions are found most often in the lower dorsal, lumbar, sacral and coccygeal areas, although in more than one case lesions occurred as high as the lower cervical and upper dorsal areas.  Treatments are usually given in a series and often in cyclic fashion with periods of rest in between.  At times deep osteopathic manipulations are stressed.

Q-1.  How often should the osteopathic treatments be given?
A-1.  During this particular siege or period, as we find about twice a week - and four should be sufficient; and then they may be much farther apart - for the general correction.
This will require deep osteopathic manipulations in lumbar and sacral area, and with special reference to the locations for the sciatic centers.  (1541-2)

    Mullein stupes or poultices are used either directly over the affected area or above the area of swelling if obstruction due to edema is present.  The amount of congestion present determines the frequency with which the mullein stupes are applied.  To prepare the stupes:

    Gather the mullein leaves, bruise these and pour boiling water over them (in an enamel pan or glass container, not aluminum or tin).  Then place over the affected areas.  (5037-1)

    We would apply the mullein stupes now more to those areas that are the sources from which the limbs receive their circulatory activity, and those portions about the limb to reduce the swelling.  Apply these about once a day, and for about an hour...
Q-1.  Should the mullein at any time be applied to the back?
A-1.  As has been given, apply it from the sources! or apply it to the sources from which the limbs obtain their circulatory activity!  Does this mean from the toes or from the hips? (1541-6)

    Mullein tea is also to be taken internally from two ounces to one cupful daily. (Instructions for preparation have already been given under "Rationale of Therapy" in this commentary.)

    Massaging the limbs and at times the entire body assists the circulation and prevents swelling.  Various oils are frequently prescribed for this purpose.  This should be done with caution or not at all in those cases where massage might have a deleterious effect on such complicating factors as thrombosis, phlebitis, or severe cardiac disease.  These cases need individual professional evaluation.  A mixture of olive oil, tincture of myrrh and compound tincture of benzoin is used in one instance (reading 1093-1).  In another olive oil and myrrh are used (reading 1956-4); and in still another, peanut oil.

    For the local condition - that is, in the veins, where the larger or varicose veins are indicated - we would massage same at least each day, toward the body, with peanut oil.
    If these still cause distresses, then we would use - if it becomes necessary the elastic stocking for the preventing of the filling of the veins.  But these should gradually disappear entirely, with these corrections being made as indicated.  (2867-1)

    Do use an equal combination of olive oil (heated) and tincture of myrrh to massage in knees, limbs and feet, right after these have been bathed in hot water.  Massage these oils well into them.
    Do these and we will find improvements for this body.  (3523-1)

    Importance is also placed on eliminations.  In many instances it is stated that the bowels should be kept moving a little above normal.  Enemas, as well as a variety of laxatives, are prescribed in various readings.

    Occasionally the enemas are preferable to too much of cathartics of any kind.  And even when cathartics are taken, the enemas are well so that there is not the inclination for such to become reabsorbed in the system.  Remember, poisons are accumulated by the infectious condition, and when there is swelling or inflammation these need to be eliminated.  (1541-6)

    Senna tea or compounds containing senna are one of the more frequently prescribed laxatives.  For more complicated conditions various laxatives in the form of both salts and oils are prescribed on some occasions.  If it is felt that a more harsh laxative in a particular case is indicated, the prescriptions for same as well as some precautions may be found in the Appendix of this book.  Strong purgatives are to be taken frequently only when individual evaluation of the particular case so indicates.

    A balanced diet as well as certain foods are also advised to help maintain the eliminations.

    Just a regular diet for this body would be well.  Keep the well-balanced diet.  While not too much fats nor yet too much of starches, but a well-balanced diet here will keep the body in the better conditions.
    Do use plenty of those that are of the bulky nature, or that tend to be laxatives - that is, plenty of figs, plenty of prunes, plenty of pieplant and of such natures as portions of the diet.  But a well-balanced diet for this body.  For, those combinations, so far as the chemical forces are concerned, are very good in the body; else we would have had - with this particular sort of disturbances great deal more distress through portions of the system.   (2867-1)

    Again it should be emphasized that persistence of treatment is of foremost importance in effecting improvement of this condition

[Note: The preceding overview was written by Frederick D. Lansford, Jr., M.D. and is excerpted from the Physician's Reference Notebook, Copyright © 1968 by the Edgar Cayce Foundation, Virginia Beach, VA.]