WDDTY replies: To keep those supplements legal, please lend your support to The Alliance For Natural Health (www.alliance-natural-health.org), which has mounted a legal challenge to the EU Food Supplements Directive.

In parts of the world where only unrefined diets are still consumed, varicose veins hardly occur at all (H Trowell, D Burkitt & K Heaton, Dietary Fibre, Fibre Depleted Foods and Disease, Academic Press, London, 1985). In Oriental Medicine, varicose veins usually correspond to the syndrome described as “Reducing Spleen Chi due to Deficiency”, and is treated accordingly, with at times quite astonishing results.

In Romany Medicine the Gypsies have been able to successfully reduce existing varicose veins and control the spread of them. Boil a half kg of the fresh bark from the small, shrub like hazel tree in a half litre of red wine until only half of the original quantity remains. Apply this as a compress to the affected part(s) daily. Hazel is a member of the birch family (Betula alba); the flavonoids and tannins in the fresh bark (and in the red wine) have an astringent effect on the veins (G Senger, Zigeunermedizin, Karl Ueberreuter Verlag, Vienna,1987).

Then, four tablespoons of the bark of the horse chestnut tree (Aesculus hippocastanum), which has been collected in the spring and dried slowly in a shady place, are soaked overnight in a litre of cold water. Bring this liquid briefly to the boil on the morning after. Drink one glass of this each morning and evening (Wiener Med Wochenschr, 1989; 139(17): 385-9).

In homeopathy, the usual preference for varicose veins is Hamamelis virginica (witch hazel). Other proven, effective remedies in homeopathy include: Aristolochia clematis (worse before, better during, menses), Paeonia officinalis (with venous congestion), Viburnum opulus (with cramps and heaviness in legs) and Ruta graveolens (for variocele, and swollen varicose veins).

The flavonol rutin has long been known to help in degenerative vascular disease and with fragile capillaries (Nutr Abstr Rev, 1950; 20:465). I like to give this either as a vitamin supplement (Solgar has a good one) or, better still, as rue tea (1-2 tablespoons to a cup of boiling water left to infuse 15 minutes. Then one cup 3 times daily.) Buckwheat is also a good source of rutin. Eaten regularly, it definitely has a good effect on varicose veins. Cherries, blackberries, European blueberries (bilberries) and hawthorn berries all contain a rich mixture of flavonoids and oligomeric procyanidines, which are known to reduce vein fragility, increase the muscular tone of the veins and strengthen the venous walls. They should all be eaten liberally (Angilogica, 1972; 9:355-74).

Regularly consuming bromelain, the proteolytic enzyme in pineapples, also helps to prevent the hardening and lumpiness of the parts next to the varicosities, because it promotes fibrin breakdown.

In naturopathy, a wide variety of techniques can help repair vascular damage as well as aid the return of venous blood upwards, and to stimulate flow where there is stagnation (R Trattler, Natural Healing, Wellingborough, Thorsons Publishing Group, Northants: 1987). These include:

Gentle upper leg and calf exercise; then wet grass walking (cools calves).

Knee deep walks in the sea (minerals and salt in the water are beneficial).

Elevate foot of bed 10 cm; keep leg(s) elevated whenever possible.

Bicycling or swimming, followed by headstands.

Avoid constipation and do not sit with legs crossed.

Flex and extend ankles many times a day.

Alternate hot and cold sitz baths (or leg sprays, or leg showers).

Friction brush massage (strokes toward heart but not over thinned veins).

Apply local hot sage tea compress; and slippery elm (or clay or mullein) poultice to ulcer.

Upward massage of area with warm olive oil and myrrh (avoid thinned veins).

Over thinned vessels apply fluid from old coffee grounds.

Expose eczematous leg areas to a moderate amounts of sunlight.

Hydrotherapists recommend leg wrapping twice a week for three weeks, and one night a week thereafter. Dip kitchen towels into warm hayflower tea and partly wring them out. (Make hayflower tea by pouring two cups of boiling water over two teaspoonfuls of hayflower; steep for 10 minutes.) Then wind kitchen towels around the calf to reach from the knee to the ankle not too tightly, but closely enough that the towels cling to the skin. Then wind a bath towel around over the kitchen towels and a plastic material over that (to protect the bed). All wrappings should be removed after 90 minutes (J Keller, Healing with Water, Parker Publishing Co Inc, Bombay,1979).

Herbalists use the South African pennywort (Centella asiatica) which has shown that it can control the level of lysosomal enzymes in the blood (Int J Clin Pharmacol Res, 1990; 10(4):229-233). Another possibility is ribbed melilot (Melilotus officinalis), which contains flavones and coumarin, when the varicose veins are accompanied by water retention, or witch hazel leaf. Butcher’s broom (Ruscus aculeatus) has a long history in Mediterranean countries of successfully treating varicose veins and associated ulcers (Drugs Exp Clin Res, 1988, 14(4):277-83).

According to the British Herbal Pharmacopoeia, another good remedy is marigold (Calendula officinalis) in combination with distilled water of witch hazel as a lotion.

Harald Gaier is a registered naturopath, osteopath and homoeopath.

As well as diabetes, other conditions linked to refined carbohydrates include varicose veins, coronary artery disease, appendicitis, cholecystitis, diverticular disease and more.

There is a singularly interesting chapter detailing the relationship between peptic ulcer and refined-carboyhydrate intake.

Cleave also has convincing ideas regarding the role of overconsumption of refined carbohydrates in the causation of hiatus hernia and gout.

This man has many papers and books to his name extending over many years, and there are many other researchers and doctors who back up his theories, but he seems to have been forgotten or ignored. – Francesca Tox, Nesbon, Cheshire

Their suspicions are based on a study of 19,161 patients who were operated on at their clinic in Geneva. Until their views are tested in a proper study, they urge doctors to give their patients preventative medications.

See WDDTY 7.2 for Alternatives to treating varicose veins.

BMJ, May 4, 1996.

Researchers from Karlsbad, Germany monitored 240 patients for 12 weeks, and tested them while either taking a placebo or a 50 mg twice daily dose of the extract. The rest wore the compression stockings.

The extract and the stockings were equally as good in reducing leg swelling caused by chronic venous insufficiency, they concluded.

But some doctors could be worried that the extract may be treated as a pharmaceutical but without passing the clinical tests to prove its safety. “They might remember that it is not that long since digoxin was prescribed as pills

ontaining standardized amounts of digitalis leaf,” warns a Lancet editorial accompanying the research.

A Varicose veins usually develop in the legs. When the valves in the veins do not function properly, the blood pools in the veins, especially when standing for long periods, resulting in these swollen veins. Apart from being cosmetically unsightly, they can be painful – causing throbbing or cramping – and may cause itching or a burning sensation on the skin.

The goal of any treatment for varicose veins is to improve blood flow to the heart. The usual medical line is that the only alternative is surgery, in which the physician ‘strips’ out the offending vein and creates a tiny circulation bypass in place of the vein. However, there are a huge number of disadvantages:

* Surgery for varicose veins is neither curative nor preventative. Even early surgery of uncomplicated veins will not prevent the development of future varicosities (J R Coll Surg Edinburgh, 2001; 46: 154-8)

* Varicose veins recur in 10 per cent of those who have had them surgically stripped, in 10 per cent of those who have had radiofrequency ablation (using heat to seal off the vein), in 6 per cent of those who have had them removed by lasers and in up to 50 per cent of those who have undergone sclerotherapy (injecting an irritant solution into the vein, causing it to scar over and eventually become absorbed by the surrounding tissues (Healthwatch, CBS News, 22 January 2003)

* The surgery itself has risks, including blood clots, haematomas, nerve injury and, with sclerotherapy, an obstructed blood flow or leaking of the irritant solution into surrounding tissues

* A greater risk of deep vein thrombosis (DVT), but only if you are having major abdominal or pelvic surgery (BMJ, 1996; 312: 198).

Thankfully, there is a host of alternative measures that can help prevent or treat varicose veins without the need for surgery, including:

* all the simple measures that work the legs and avoid blood-pooling – elevating the legs while sitting; avoiding tight clothing around the ankle, calves and groin; avoiding high heels, which don’t work the calf muscles as much as low heels do; avoiding standing or crossing your legs for long periods of time; and losing weight if you are overweight

* walking, cycling and rowing – all of which cause the leg muscles to contract and push blood back to the heart. Best of all is swimming, as the water pressure helps drive the blood back to the heart. Also, being horizontal while you swim allows the veins to empty

* all the simple measures that work the legs and avoid blood-pooling – elevating the legs while sitting; avoiding tight clothing around the ankle, calves and groin; avoiding high heels, which don’t work the calf muscles as much as low heels do; avoiding standing or crossing your legs for long periods of time; and losing weight if you are overweight

* walking, cycling and rowing – all of which cause the leg muscles to contract and push blood back to the heart. Best of all is swimming, as the water pressure helps drive the blood back to the heart. Also, being horizontal while you swim allows the veins to empty

* a judicious use of compression therapy, usually support hosiery – preferably the pantyhose-type of stockings – to control symptoms, although some people may find wearing such tight garments rather uncomfortable (BMJ, 2002; 324; 689-90).

The best alternative treatments include:

* bilberry as supplements or even the fruit itself. These reduce the fragility of the blood vessels and, added to the daily diet of pregnant women, can prevent and treat varicose veins (Minerva Ginecol, 1981; 33: 221-30). These fruit are also antiangiogenic – they can reduce the growth of blood vessels that may lead to varicose veins and tumours (Biochemistry [Mosc], 2004; 69: 75-80). Take 80-160 mg three times a day (standardised to contain 25 per cent anthocyanidins)

* bioflavonoids, which have a long history of success for varicose veins. This includes rutin, found in citrus fruit, orange/yellow vegetables, buckwheat or as supplements (Am J Ophthalmol, 1948; 31: 671-8), and hesperidin (suggested therapeutic dose ranges are 50-500 mg/ day; for citrus: 500-5000 mg/day)

* pennywort (gotu kola, Centella asiatica) can reduce swelling and other symptoms of heaviness in the lower legs (Angiology, 1987; 38: 46-50), and significantly improve itching, swelling and night cramps (Clin Ther, 1981; 99: 507-13). For varicose veins, studies have used 30-60 mg twice a day

* red-vine-leaf extract (Folia vitis viniferae; grape leaf), reduced lower leg volume and calf circumference in patients with chronic venous insufficiency (Arzneim Forsch, 2000; 50: 109-17). The usual dose is 360-720 mg/day

* bromelain, the proteolytic enzyme in pineapples, can also be taken as a supplement. It can also help prevent the hardening and lumpiness of the tissues around the varicosities as it promotes fibrin breakdown. Take 500-750 mg two to three times a day

* butcher’s broom, which has a long history of use in countries around the Mediterranean for varicose veins and associated ulcers (Drugs Exp Clin Res, 1988, 14: 277-83). The herb can improve venous tone and poor circulation (Fortschr Med, 1989; 107: 52, 55-8). Take 100 mg three times a day (extract standardised for 9-11 per cent ruscogenin)

* oligomeric proanthocyanidins, or OPCs, are derived from pine bark and grape seed. These antioxidant free-radical scavengers can inhibit enzymes that damage connective tissue and vessel walls (Gaz Med France, 1985; 92: 96-100), and increase venous tone in varicose-vein sufferers (Sem Hop, 1981; 57: 2009- 13). Take 150-300 mg/day

* horse chestnut seed extract (Aesculus hippocastanum) is approved by the German government for venous diseases of the legs. This herb can ease both varicose veins and haemorrhoids, another form of varicosity, especially the swelling. It strengthens blood vessel walls and, as an astringent, can also tone and tighten tissues (Arzneim Forsch, 1979; 29: 672-5). For the best results, take it as early in the condition as possible (BMC Cardiovasc Disord, 2001, 1: 5). Take the equivalent of 50 mg/day of aescin (standardised)

* witch hazel in the form of an ointment is recommended by the German Commission E for varicose veins. Note, however, that the ointment may need to be applied three or more times a day for several weeks before there is any noticeable improvement

* pine bark extract (Pinus maritima) is at least as effective as horse chestnut seed extract for varicose veins. Those taking it have reported both symptomatic relief and a reduction in leg swelling (Phytother Res, 2002; 16 [Suppl 1]: S1-S5). Take 75-300 mg/day for three weeks, then 40-80 mg/day for maintenance

* dietary factors for varicose veins include a high-fibre diet and bulking agents to reduce straining during defaecation. Drinking at least six 8-oz cups of water a day will also help

* nutrients such as aortic glycosaminoglycans (100 mg/day), vitamin C (500-3000 mg/day), vitamin E (200-600 IU/ day) and zinc (15-30 mg/day) are also beneficial

The widely-held belief that varicose veins increase the risk of developing deep vein thrombosis may well be wrong. And women with varicose veins who take the contraceptive pill or hormone replacement therapy are not as likely to suffer spontaneous thrombosis as had been feared. Several reports have appeared in the past few months which question these beliefs, and cast doubt on the need for surgery on the veins. Women with varicose veins are at greater risk of thrombosis only if they are having major abdominal or pelvic surgery; otherwise, the risk is no greater than for other women (BMJ, January 27, 1996).

Like other health professionals, homeopaths honor the special role that surgery and surgeons have in health care. Homeopaths are not against surgery, because certain conditions are simply not treatable without it. At the same time, however, surgery is often performed unnecessarily. It is performed when other, safer measures can be effectively used. It is performed too early when the body can sometimes heal itself. And it is performed inappropriately, primarily because surgeons only know surgery and don’t know what else to do (the law of hammers pervades many professions: when you are a hammer, everything becomes a nail).

Even when surgery is successful, this does not necessarily mean that the person is “cured.” Surgery may, for instance, remove an abscess, a tumor, kidney stones or gallstones, or other diseased parts, but because this removal doesn’t change the underlying pathological processes that created them in the first place, it is understandable and even predictable that people tend to reexperience their ailments.

Even if the ailment seems to have disappeared, homeopaths do not believe that a curative process has always taken place. While the initial complaint may have been eradicated, sometimes more serious pathology develops shortly after the surgery. Although doctors tend to believe that this is a “new” disease, homeopaths theorize that the surgery probably suppressed the original ailment.

This critique of surgery is not meant to devalue its appropriate use in treating various congential deformities, structural problems, severe injuries, or life-threatening pathological conditions. As previously stated, homeopaths are not against the judicious use of surgery.

When possible, homeopaths first attempt to to see if treatment with an individualized homeopathic medicine can prevent the need for surgery. Patients and even homeopaths are sometimes surprised and impressed at the significant results that homeopathic medicines can provide–not that they can do the impossible, but they can often elicit a healing response when conventional therapeutics cannot.

The integration of homeopathic medicines with surgical care uses the best of both worlds to create comprehensive and ultimately more effective health care.



Homeopathic Medicines Before and After Surgery

Once it is determined that surgery is medically necessary, homeopathic medicines can reduce complications of surgery and augment healing so that people can recover more quickly afterward.

Surgeons commonly ask patients not to take any food, drink, or drugs prior to surgery. While it makes sense to avoid food, drink, and conventional drugs, there have never been any reported problems from taking homeopathic remedies prior to surgery.

Some homeopaths recommend Ferrum phos 6, four times a day for two days, prior to surgery in order to prevent infection and hemorrhaging.

Homeopathic medicines can also help people deal with the various emotions they are experiencing prior to surgery. Gelsemium 6 or 30 is a common remedy for the person who experiences great anxiety, apprehension, weakness, and trembling prior to surgery. Aconitum 6 or 30 is indicated when the person is terrified about surgery and thinks that he will die from it.

Take either Gelsemium or Aconitum the night before the surgery and another dose upon waking in the morning. If fear and/or anxiety is felt after surgery, take one to three more doses.

One double-blind, randomized trial on 50 children who underwent surgery showed that 95% of those given the homeopathic medicine Aconitum experienced significantly less post-operative pain and agitation.¹ Aconitum was chosen because it is a common remedy for ailments in which sudden and violent onset of shock or trauma is a primary indication, as well as symptoms of fear and anxiety, which are especially common emotions experienced by children prior to surgery.

Arnica is another common homeopathic medicine given to people before and after surgery because of its ability to reduce surgical shock and minimize bleeding. Surgical shock is a condition that trauma or surgery can cause in which all the capillaries and small blood vessels are filled with blood at the same time. A randomized, placebo-controlled, crossover study showed that Arnica significantly decreased bleeding time.²

The late British homeopathic physician Donald Foubister recommended Arnica 30 the night before surgery, another dose the morning of the surgery, another dose just prior to the surgery, and different medicines afterward, depending upon the type of surgery and the symptoms the patient feels.

Homeopathic medicines can also be beneficial for patients who undergo long-term intravenous (IV) therapy. Frequent insertion of an IV commonly causes phlebitis (inflammation of the vein) and hematoma (the pooling of blood under the skin); a double-blind study using Arnica 5c found that it can effectively reduce and prevent such problems.³ The study showed significant benefits from Arnica, including reduced pain. Besides subjective improvement, there were also objectively measured increases in blood flow and in blood coagulation factors.

While Arnica is the primary remedy to be taken just prior to the majority of surgeries, there are a certain number of operations for which Dr. Foubister commonly recommended other remedies. For surgery involving cartilage and periosteum, as is often occurs in the knee or elbow, it is recommended to take Ruta 30 the evening before, the morning of the operation, and immediately afterward. For hemorrhoidal surgery, it is recommended to take either Staphysagria 30 or Aesculus 30 in a similar pattern as described for Ruta. And for circumcision, Staphysagria 30 and Arnica 30 should be given similarly as above.

The following are common recommendations for after surgery. Please note that the length of time of treatment can and should be different with each patient, depending upon the intensity of symptoms. Doses should generally be taken as long as pain persists, though they should not be taken for more than a couple of days, unless the person is still in pain and the remedy is providing obvious relief. Arnica 6, 12, or 30 should be given for at least two doses after surgery, approximately one hour apart. In addition to this remedy, the following remedies should be given one hour after the last dose of Arnica:



Gynecological surgery:

–Dilation and curettage: Belladonna 30, every 6 hours

–Hysterectomy: Causticum 30, three times a day (some homeopaths
recommend Staphysagria 6 or 30, three times a day)

–Caesarean section or episiotomy: Staphysagria 30 or Bellis perennis 30,
three times a day

–Abortion or miscarriage: Ignatia 30, every four hours

–Plastic surgery on the breast: Bellis perennis 6 or 30, three times a day

–Amputation of the breast or a lump: Hamamelis 30, every 4 hours


Circumcision: Staphysagria 30 and Arnica 30, every four hours for a day.


Prostate surgery: Staphysagria 30, three times a day


Abdominal surgery: Staphysagria 30 or Bellis perennis 30, three times a
day


Appendectomy: Rhus tox 30, three times a day


Gastrectomy: Raphanus 30, three times a day


Gall bladder surgery: Lycopodium 30, three times a day


Eye surgery: Ledum 30, every four hours


Tonsillectomy and adenoidectomy: Rhus tox 30, every four hours


Orthopedic surgery

–involving cartilage or periosteum: Ruta 30, every four hours

–involving the spine: Hypericum 30, every four hours

–Surgery for bullet wounds and/or stab wounds: Staphysagria 30, four
times a day


Plastic surgery: Arnica 30 (internally) and Calendula, (externally) four
times a day


Amputation: Hypericum 30, every four hours


Hemorrhoids: Staphysagria 30 or Aesculus 30, every four hours for two

or three days* Varicose veins: Ledum 30, three times a day


Dental surgery: Hypericum 30 and Ruta 30, alternating every two to four
hours



Homeopathy for Specific Ailments After Surgery

Readers who experience symptoms or syndromes discussed elsewhere in this book should review those chapters. For instance, if you have urinary symptoms after surgery, which is common when catheterization takes place, consult the section on bladder infection in the section on Women’s Conditions (even if you are a man; see: WOMEN). If you are now suffering from acute insomnia, consult the chapter on Insomnia (sorry, not included online).

Some common conditions after surgery for which homeopathic medicines are often effective include the following:


Fear of Death
Aconitum 30 is indicated (every hour for up to four doses).



Bleeding

Arnica 30 helps to slow or stop bleeding after surgery. Phosphorus 30 is the primary remedy for helping to stop bleeding when Arnica does not work adequately. Ipecacuanha 30 is indicated when there is much bleeding of bright red blood, often accompanied by nausea. Secale 30 is effective in treating uterine bleeding that is aggravated by heat and relieved by cold. Cinchona 30 is helpful for people whose bleeding and general loss of fluids lead them to feel weak and faint and have ringing in the ears. This remedy is sometimes indicated several weeks, months, or years after much fluid has been lost, after either an illness or an operation. Arsenicum 30 is useful when profuse bleeding leads to great weakness, burning pains, restlessness, anxiety, and fear, along with a characteristically large thirst for only sips at a time.

Dose: Take the remedy every hour until bleeding stops, not more than four doses. If bleeding has not significantly slowed, consider another remedy. The next day, take one more dose of whichever works to reduce the possible complications of blood loss.



Trauma to Tissue

Arnica topically and Arnica 6 or 30 are useful when the muscle feels bruised or swollen and when there is any pooling of blood under the skin. Hamamelis topically and Hamamelis 6 or 30 are effective when the person has weak veins, passive hemorrhage, bleeding hemorrhoids, or varicose veins. Capillaries are enlarged and congestion is marked. Calendula in external application (gel, ointment, tincture, spray) is indicated to heal wounds or incisions. Bellis perennis 6 or 30 is a remedy for use after abdominal surgery and when deep internal tissue has been traumatized.

Dose: Apply external remedies at least once a day, and apply again if bathing washes them off. Generally, only two to eight doses of the internal remedy over a two day period will be necessary to complete the healing process.



Wound Infection

External applications of Calendula and Hypericum, either alone or preferably together, help to both prevent and treat infection of surgical wounds. If pus has developed and caused hypersensitivity of the wound, Hepar sulphur 30 is recommended. Because Hepar sulphur is an effective remedy for helping to push out splinters, pieces of glass, and various foreign objects that get stuck under the skin, it also has a tendency to push out surgical stitches. Thus it is not recommended to use this remedy when there are stitches, except towards the end of the healing process, when their removal is part of the healing. If the wound becomes purplish, Lachesis 30 or Gunpowder 30 is indicated. If there is much burning in the wound or wound area, Sulphur 30 is helpful.
Dose: Apply external remedies at least once a day, and apply again if bathing washes them off. Take internal remedies every two to four hours during the first 24 hours and four times a day for two to five more days.



Scarring and Adhesions:

Apply Thiosinaminum tincture externally or use an external combination formula that also contains Calendula (some injury gels include these ingredients). Take Graphites 12 internally.

Dose: Apply external remedies at least once a day, and apply them again if bathing washes them off. You may need to do this for several weeks or months. Internal remedies should be taken three times a day for two days, and if necessary, repeated one month later.



Constipation

Raphanus 6 or 30 is indicated when there is constipation with no urgings for a stool and/or when there is painful gas; see also the chapter on Digestive Disorders for other potential medicines for constipation.

Dose: Take this remedy three times a day for up to four days.



Nausea and Vomiting

Nux vomica 6 or 30 is good for violent retching, especially when there is generally ineffectual retching that does not lead to vomiting. Phosphorus 6 or 30 helps to prevent or treat nausea after surgery; it is indicated when the patient has a strong thirst for ice drinks; he or she may also have a concurrent headache. Ipecac 6 or 30 is effective for persistent nausea with vomiting, when vomiting does not provide relief. Arsenicum 6 or 30 treats violent and incessant vomiting which is made worse by drinking water, especially cold water, or eating. There may also be burning pain in the stomach. See also chapter on Digestive Disorders.

Dose: Take a remedy every two hours during intense symptoms and every four hours during less intense discomfort. If improvement is not obvious after 24 hours, consider another remedy.



Gas
Carbo veg 6 or 30 helps people who suffer from great distension and offensive gas, who get some relief from release of gas, and who desire carbonated drinks because they seem to help them release gas. Cinchona 6 or 30 is useful when there is more pain than distension, frequent rumbling in the abdomen, and no relief from releasing gas. Raphanus 6 or 30 is a common remedy for people who have a distended abdomen but are unable to expel gas. Because this condition is extremely common after surgery, especially abdominal surgery, this remedy is often indicated. Colocynthis 6 or 30 is effective when there is more pain than distension, and also cramps that are relieved by bending over.

Dose: Take a remedy every two hours during intense pain and every four hours during mild discomfort. If improvement is not obvious after 24 hours, consider another remedy.

Bedsores
(see the chapter on Conditions of the Elderly for details)

Resources

¹J.P. Alibeau and J. Jobert, “Aconit en Dilution Homeopathique et Agitation Post-Operatoire de l’enfant,” Pediatrie, 1990, 45 (7-8): 465-66.

²J. Baillargeon, et.al., “The Effects of Arnica Montana on Blood Coagulation: A Randomized Controlled Trial,” Canadian Family Physician, November 1993, 39:2362-67.

³C. Amodeo, et.al., “The Role of Arnica in the Prevention of Venous Pathology from Long-term Intravenous Therapy: Evaluation of Platelet Aggregation,” Ninth National Conference of the Italian Society for Vascular Pathology, Capanello, June 6-9, 1987. The study included 39 patients, including 21 undergoing intravenous feeding, nine in infusion protracted beyond 72 hours, and nine in chemotherapeutic treatment.

When, for any of a number of reasons, a valve becomes incompetent, and allows a back-flow of blood, the vein becomes distended, its walls stretch and, like tired elastic, sag, allowing the vein to swell in that region into a miniature balloon.

This is a varicosity.

When this happens in the legs, the commonest site, it is called a varicosity, and when this occurs in the rectum it is known as haemorrhoids, or piles.

How Do Veins ‘Move’ the Blood?

There are a number of driving forces which are involved in the return of blood to the heart for oxygenation, along the veins.
These include the contracting and relaxing effect of muscles in which many veins lie.

As muscles work they automatically apply a pumping action to any vein with which they are in touch,and this, because of the vein’s one-way valve system, causes a forward motion of the blood.

Many veins run alongside arteries (which carry fresh oxygenated to the body tissues) and the pulsating action of these arteries (due to the heart’s beating) also produces a pump-like effect on the veins.

Another key pumping action occurs as we breathe, with the rise and fall of the diaphragm, which creates an alternating positive and negative pressure in the chest cavity.

Much of the blood returning to the heart has to overcome the force of gravity, for example as it passes from the feet upwards into the pelvic area and then onto the chest cavity and its destination, the heart.

While muscle pump action can be said to have most to do with the movement of blood up the legs themselves into the pelvic cavity, the passage onto the heart from the pelvis is largely the result of this alternating positive and negative pressure created by breathing.

So we have three pump mechanisms apart from the heart itself: active muscles, the pulsation of the arteries and diaphragmatic movement.

Finally we should consider the actual structure of the veins, comprising as they do layers of elastic and connective tissue fibres.

Those veins which lie deeper than the more superficial ones are usually enclosed in a sheath of connective tissue in which the arteries are resting, and the health and integrity of the connective tissue can influence the efficiency of the vein.

What Goes Wrong?

The structure of the veins themselves, the healthy constituency of the connective and elastic tissues, is directly related to nutritional factors (as is the integrity of the nervous system which controls the muscles in which many veins lie).

Nutrition: for example the levels of certain important nutrients in the diet most notably dietary fibre, vitamins C and E, and substances called bioflavonoids (which influence the elasticity of the tissues) can have a profound effect on the prevention or development of varicosities.

If much of the movement of blood along veins is dependent on muscles regularly contracting and relaxing, as well as on the diaphragm’s movement, it is pretty clear that exercise, or lack of it, and breathing function as well as mechanical stress factors (see below), are bound to be massively influential in deciding on the overall efficiency of venous return.

When any of the various pumping mechanisms are inefficient, or when the structure of the supporting tissues of the veins is inadequate, there is a strong chance of veins becoming incompetent, allowing back-pressure to build up and causing a varicosity.

The good news is that a great deal can be done to prevent this from ever happening, and to improve things once they have, as long as the causes of the problem can be dealt with.

Factors which make varicose veins more likely include:

• excessive weight (more than 20% above normal bodyweight)
  

  
  

• excessive weight bearing (weight training, carrying etc)
  

  
  

• inadequate exercise (sedentary occupations)
  

  
  

• excessive standing (waiter, hairdresser, soldier)
  

  
  

• increased intra-pelvic pressure (chronic constipation,
  straining at stool, tight restricting girdles, poor posture,
  pregnancy etc)
  

  
  

• poor nutritional status
  

  
  

• use of the contraceptive pill
  

Who Gets Varicose Veins and Are There Dangers?

Very few people in non-industrialized societies ever develop varicose veins but one person in five in the UK has or will have them, and most will relate to their legs.

When not in the legs the commonest sites are the scrotum (varicocele) and the rectal region (haemorrhoids).

In themselves the bunched clusters of tortuous worm-like superficial varicose veins are not dangerous.

The dangers that can develop relate to the relative slow moving nature of blood in varicose veins.

Because it cannot easily move along, due to valve incompetence, the blood becomes increasingly static, or may actually flow backwards.

The symptoms most commonly associated with this sort of picture include heaviness and aching in the area, discolouration of the tissues and commonly itching of the skin over the veins, as well as a generalized tendency to swelling in the limb, mainly affecting the ankles and feet but often the entire calf or at times the whole leg.

When the left leg only is affected it can be suspected that the cause lies in intra-abdominal pressure due to chronic constipation. When overweight or mechanical lifting stress is involved it will affect both legs.

Varicose eczema may develop and in time the skin and overlying tissue may break down leading to varicose ulcers and even to haemorrhage of the vein.

For many people, especially in the early stages, there is nothing more obvious that a tendency for the legs to feel tired more easily than previously.

When haemorrhoids or varicoceles develop symptoms are similar (heaviness, aching, irritation) with the underlying causes being much the same.

Phlebitis and DVT

A possibly serious consequence of varicose veins can be the development of inflammation of the vein (phlebitis).

Some researchers believe that varicose veins do not show themselves until there has been an incident of what is called deep vein thrombosis (DVT), the presence of a blood clot caused by the sluggish movement of the blood or because the blood had a more viscous (sticky) nature than usual.

Another reason for a thrombosis can be the development of a constriction or narrowing in the vessel causing the blood passing through it to swirl and to possibly produce a clot.

The result of any of these causes of a thrombosis would be an inflammation of the vein and consequent damage to it, resulting in varicosity.

It is seldom possible in any given case to say whether the venous damage comes before the thrombosis or the other way around, the same features and factors apply in both sequences.

Signs

If there is a DVT or phlebitis the signs will be local warmth , tenderness and swelling, but these signs can also relate to a muscle injury or cellulitis (inflammation of the connective tissues), therefore if in any doubt at all get expert advice.

The treatment of DVT calls for rest with the leg elevated, pressure (elasticated stockings or bandaging) and possible medication to dissolve the clot and reduce inflammation.

Medical Approaches to Varicose Veins

Surgery is often used to remove the unsightly damaged veins, either by ‘stripping’ them out, or by tying or blocking them off, and thus allowing secondary channels of circulation to take over the load.

This has an obvious cosmetic effect, but the truism ‘out of sight out of mind’ is often evidenced by a return of new varicosities within a short time, because the causes are not dealt with by such methods.

Surgery, or the palliative use of support stockings, as much as these ease the aching in the legs, do nothing for the causes and therefore are not a long-term answer, and more than surgical treatment of haemorrhoids undoes the reasons for their presence.

There are of course a variety of balms and creams to help ease the skin or rectal irritation or eczema symptoms, and some excellent treatments which help to heal ulcers.

But none of these methods has anything at all to do with the causes of these problems.

Complementary and Self-Help Approaches

1. Nutritional Approaches:
   

   
   

   
   
   • Vitamin C and Bioflavonoids: This helps to maintain the health of the connective tissue. To do this effectively it needs bioflavonoids (see below) such as rutin and hesperidin. Many Vitamin C supplements state that they contain bioflavonoids, or these can be taken separately (in the form of buckwheat tea or tablets for rutin)
     
     Take between 1 and 5 grams daily of C with bioflavonoids.
     

     
     

   • Vitamin E: This powerful antioxidant is reported by Canadian researchers Drs Evan and Wilfred Shute to improve varicose veins status when supplemented in doses of 500 to 800iu daily.
     
     They believe it assists in the development of collateral channels of circulation, relieving the veins under pressure.
     
     Direct applications of vitamin E to ulcers is helpful.
     
     

     
     

   • Selenium acts symbiotically with Vitamin E and a dose of 50mcg daily should be taken of this.
     
     Ulcers seldom appear if E is supplemented adequately, and its use is a powerful aid when phlebitis is present, reducing pain and preventing clot formation.
     

     
     

   • Essential fatty acids: Evening primrose oil (500mgs daily) and EPA (4 to 6 capsules daily) are both useful in reducing chances of inflammation and the adhesiveness of the blood.
     

     
     

   • Fibre: It is absolutely essential to keep bowel function working smoothly, with no straining at all. Adequate fibre intake means also reducing to nil if possible any refined carbohydrates (white flour products, any colour of sugar, white rice). At the very least these should be cut severely, and as much complex carbohydrate (which is rich in fibre) eaten. This includes wholemeal bread and pasta, brown rice, vegetables and fruit, seeds and nuts, pulses (all the bean family).
     
     A supplemental intake of two or more dessertspoonsful of linseed (the Linusit brand is excellent is recommended daily to ensure bowel function.
     
     A general reforming of the diet is desirable to include minimal animal fat (cut down meat drastically, only use low or no-fat dairy produce, increase poultry, fish or vegetarian meals) as is the abundant use of unprocessed foods.
     
   
   

   
   

2. Self-Help Measures:
   
   
   

   
   

   • a/ Deal with weight and constipation problems (use dietary methods above)
     

     
     

   • b/ Introduce regular exercise, such as walking, dancing, skipping, yoga. DO regular exercises in which you contract the muscles of the leg rhythmically, or move the ankles in circles or up and down firmly, or do upside down cycling exercises… anything which keeps muscles pumping.
     

     
     

   • c/ Learn to breathe more effectively. See a physiotherapist or a registered osteopath for advice and treatment, if necessary, as you may need some work done on the structures which are tight before you can breathe better.
     

     
     

   • d/ Stop use of the contraceptive pill, and get advice on what nutrients you need to make up for the damage this has done (consult a naturopath or nutrition consultant)
     

     
     

   • e/ Stop use of any tight clothing, especially if it constricts the waist area, and avoid use of high heels which stops normal muscle contraction in the lower leg, affecting circulation.
     

     
     

   • f/ Use elasticated support hose if your job entails excessive standing, or when pregnant, or if you are overweight. This should support not just the calf but the entire thigh, and should be put on before getting out of bed.
     

     
     

   • g/ Raise the foot of the bed by up to six inches (place blocks or books under the feet). This is not uncomfortable and helps gravity to ease back-pressure on the veins at night.
     

     
     

   • h/ Avoid standing still for lengthy periods. Rock from one leg to the other or pace gently up and down, to keep muscles moving.
     

     
     

   • i/ When sitting don’t cross legs as this restricts circulation. Try to have a footstool which allows the feet to be at least level with the hips and ideally slightly higher.
     

     
     

   • j/ Avoid hot baths, warm ones are fine, but finish with a cold splash or shower application to the legs.
     

     
     

   • k/ Regular use of alternating hot and cold sitz baths (up to umbilicus in water) is useful for causing a circulatory stimulus.
     
     Always finish with cold. If this cannot be organised use hand shower or bidet to at least apply cold water to rectal area in cases of haemorrhoids (after a bath, after every bowel movement and at least morning and evening as well).
     

     
     

   • l/ Use vitamin E cream on skin irritations.
     

     
     

   • m/ Herbal teas such as Mullein and Buckwheat are useful.
     
     Garlic is a powerful aid in reducing levels of viscosity of the blood and is highly recommended, raw or as a capsule (two or there daily)
     

     
     

   • n/ Spinal manipulation and postural reeducation (osteopathy and Alexander Technique) can together dramatically influence normalisation of poor body mechanics which is a contributor to the problem due to negative effects on breathing as well as forward tilt of the pelvis which causes abdominal/pelvic contents to become crowded.
     
   
   

A combination of nutrition, hydrotherapy, exercise and common sense can transform and improve early varicose veins and haemorrhoids. Once varicosity of any sort is advanced however the best that can be achieved is relief and a stopping of the progression towards a worse state, ulcers etc.

Surgery is sometimes advisable, but only if the sort of long-term approaches recommend above are also used.

Recommended reading: Varicose Veins (Thorsons New Self-Help Series) by Leon Chaitow ISBN 0-7225-1304-6

Leon Chaitow can be contacted at The Hale Clinic, London (071-631-0156)