Varicose veins do not as a rule cause any serious disability and their presence should be ignored unless definite signs or symptoms do arise.

Grossly dilated saphenous veins, associated with a congenital inefficiency of the normal valvular action, which give rise page 424 to symptoms, should be treated by an efficient Trendelenberg operation carried out under general anaesthesia, and with the tying off of all the venous branches at the saphenous opening. Partial operations are useless. The sites of ligature, other than at the saphenous opening, should be determined by tests beforehand.

Injections in cases such as the above are useless without operation. Injections generally are fraught with the grave danger of blocking the deep venous circulation— a disastrous condition. Any repetition of injections should seldom, if ever, be carried out. Beautifying injections are quite out of place in the army.

Before any treatment is undertaken the presence of thrombosis of the deep veins must be ruled out.

When deep thrombosis has taken place, varicose ulcers and eczema are prone to develop, and naturally all such cases are useless in the army and should be discharged.