Dr. Ashok Yadav1, Dr. Apurva Dixit2, Dr. Yogita Kumari2, Dr. Pushpendra Maharshi 2
1 Professor & Head of Department, Department of Practice of Medicine, Dr. MPK Homoeopathic Medical College, Hospital & Research Centre (under Homoeopathy University), Jaipur, Rajasthan, India
2 PG Scholar (Part-I), Dr. MPK Homoeopathic Medical College, Hospital & Research Centre (under Homoeopathy University), Jaipur, Rajasthan, India
Varicose veins are dilated, tortuous veins of limbs because of failure of venous valves. The complication of varicose veins is responsible for hospitalisation. This article deals with an overview of varicose veins, Its etiology, mechanism, clinical examination, investigations, complications and its treatment with emphasis on homoeopathic therapeutics.
KEYWORDS-:Homoeopathy, varicose veins.
Varicose veins are dilated, elongated and superficial veins of limb1. It is the most common problem of veins of leg due to failure of their valves. Varicose vein permits reverse flow through its faulty valves.2 Varicose veins more common on females due to repeated pregnancy.1
- Primary varicose veins are result of congenital weakness in vein wall due to defect in smooth muscle and connective tissue.it can also occurs due to congenital absence of valves.
- secondary varicose veins mainly caused by deep vein thrombosis leads to destruction of valves resulting in varicose veins. Congenital arterio-venous fistula. pregnancy and pelvic tumours cause proximal obstruction to blood flow oral contraceptive pills alters viscosity of blood progesteron dilates vessel wall.
- Congenital includes any venous malformations, example – Klippel-Trenaunay syndrome and avalvulia 3
Height – Tall individual more suffer
Weight – Obesity weaken vein wall.
Occupation – Policemen, Shopkeeper, Tailors, Hotel workers.
Side – left side more affected than right.1
First a small gap appears between the valve cusps at commissure (where the valve leaflets join the vein wall)
Gap widens and more reverse flow (venous reflux)
Valve cusps degenerate and holes develop in them.
Eventually they disappear completely and the vein below the valve responds by dilating.2
- Presence of dilated veins in the legs.at the end of the day they are large because of venous engorgement.
- Dragging pain or dull ache in the legs due to heaviness. aching pain relieved by taking rest or elevation of legs.
- Night cramps occurs due to change in diameter of veins.
- Sudden pain in calf region with fever and oedema of the ankle region.
- Pruritus and skin thickening.
Inspection (should be done in standing position)
- Dilated and tortuous veins – medial aspect of leg and the knee.
- Ankle flare (group of veins near medial malleolus)
- Localised dilated segment of vein indication of blow out (signifies underlying perforator)
- Healed scar indicates previous ulceration.
- If tenderness present – indication of thrombophlebitis.
- Thrombosed vein feels as firm/hard nodule.
Following tests to be done-
- Cough impulse test (morrissey’s test)
- Trendelenburg test
- Multiple tourniquet test
- Schwartz test
- Modified parthe’s test
- Fegans method
- Hand held doppler
- Duplex ultrasound imaging (mickey mouse sign and saphenous eye sign)
- Venous ulcers
- Eczema and dermatitis
- Equinovarus deformity
- Marjolins ulcers1
- Elastic compression stockings
- Injection sclerotherapy
- Endovenous laser ablation
- Radio Frequency Ablation1
Homoeopathy is a system based on “Law of Similars” which means treat the disease with medicine producing similar symptoms when given healthy individuals. Therefore medicines are selected on the basis of Totality of symptoms.
Symptomatic indication of some homoeopathic medicines –
ARNICA MONTANA – Sore bruised limbs. Great fear of being touched or approached. Heaviness in all limbs. Veins of hands distended. Bed feels too hard.4
ARSENICUM ALBUM – Heaviness, uneasiness in legs with burning pain. Cramps in calves.5
CALCAREA CARBONICA – Varicose veins, burning in veins. Cramps in calves when stretching out leg at night. Feet raw and burning. Cold, damp feet, feel as if damp stockings were worn.4
CALCAREA FLUORICA – Veins dilates and become varicose, inflamed. Swelling and indurated enlargement of tissues. Hard elevated edges of ulcers and surrounding skin is purple and swollen4.
CARBO VEGETABILIS -It acts upon venous circulation and capillaries. Varicose veins during pregnancy. Blue, cold, bruised skin. Varicose ulcers bleed easily and breakout again.5
FLUORICUM ACIDUM – Varicose veins and ulcers with red edges and vesicles especially of lower limb, worse warmth. Old standing cases especially women who have produces many childrens.6
HAMAMELIS – Venous congestion, varicose veins and hemorrhage with bruised soreness of affected part. Vericose ulcers very sore and burn. It causes venous relaxation with engorgement.5
LACHESIS – Inflammation of vein of legs during pregnancy.4 Bluish purple appearance of skin with varicose ulcers.5
MAGNETIS POLUS AUSTRALIS – Throbbing pain in legs when hanging down with feeling of hot water running down the affected part.6
MILLEFOLIUM – Varicose veins during pregnancy when painful. Leg ulcerate and bleed in pregnant women, Capillary are spongy and enlarged, veins break easily when congested.6
NUX VOMICA – Numbness in legs, feel paralyzed, cramps in calves and sole.5
PLUMBUM METALLICUM – Cramps in calves, dilated veins of forearm and legs. Stinging, tingling and tearing in limbs.5
PULSATILLA – Drawing pain in thigh and legs. Veins of forearm and hands swollen. Legs feel heavy, weary, inflamed and swollen. Suffering worse from letting the affected limb hang down.5
PYROGENIUM – Throbbing in vessels of neck with numbness of hand, arm and feet. Aching in all limbs and bed feels too hard. Skin discoloured and dry. Even a small cut or injury becomes swollen and inflamed. 5
SULPHUR – Unhealthy skin, breaks out, dry scaly. Varicose veins, ulcerate, rupture and bleed easily. Every little injury suppurates. Heaviness and paretic feeling in limbs.5
VIPERA – Varicose veins and acute phlebitis. Veins swollen, sensitive and bursting pain, severe cramps in lower extremities. Patient obliged to keep the extremities elevated but if allowed to hang down it seems as they would burst and pain is unbearable.5
- Shenoy K.R, Shenoy A.S. Manipal manual of surgery. New Delhi: 4th ed. CBS publishers and distributors Pvt Ltd; 2014
- Bailey, H., Love, R., Russell, R., Williams, N. and Bulstrode, C., 2000. Bailey And Love’ s Short Practice of Surgery. 24th ed. London: Arnold, pp.237-238
- Weiss R, James willium D. Varicose veins: Practice Essentials, Etiology [homepage on the internate]. Emedicine.medscape.com. c2018[update 2018 Feb 28] Available from: https://emedicine.medscape.com/article/1085530-overview
- Murphy, R. (2010). Lotus materia medica. 3rd ed. New Delhi: B.Jain
- Boericke W. New Manual of Homoeopathic Materia Medica and Repertory. Reprint Edition New Delhi: B. Jain Publishers(P)Ltd.; 2011
- Bishambar Das, R., 2015. Select Your Remedy. 26th ed. New Delhi, India.: Indian books & Periodical publishers, p.252.