Abnormalities of the deep veins of the leg.

The anatomy and pathology of the venous system of the leg has been, until very recently, a neglected subject. This is so, in spite of the fact that lesions resulting from diseases of these veins are among the commonest from which mankind suffers. To Homans (1917) must go the credit for awakening renewed interest in the subject, for he first clearly showed that the distressing ' ulcer and induration ' syndrome of the lower leg was a sequel to thrombosis of the deep veins; he also first showed that recanalization of these thrombosed deep veins occurred in many cases. On the subject of anatomy and physiology of the veins of the leg, Gay's work in I867, and later the painstaking studies of Turner Warwick (I931), gave a clear picture, although both authors received little attention at the time. During the last ten years, with the advent of safe techniques of venography, radioactive isotopes and accurate methods of measuring venous pressure in the veins of the foot, the growth of knowledge has been fast. In this article we will consider first the normal anatomy of the deep veins, secondly the physiology of venous return from the leg and thirdly how the effects of disease of the deep veins modifies the venous return and produces certain lesions and symptoms.