Monadnock Community Hospital

Frequently, we in the health professions are reactive (or even reactionary) in response to the evolutions and revolutions in our system of health care. In fact, at times the best that can be said for us is that we are responsive (and we hope, responsible) to the need for change. I would suggest that we must be innovative in dealing with the plethora of health legislation.

THE term "varicose veins" customarily suggests, immediately, and almost exclusively, abnormal dilatations and tortuosities of the saphenous veins of the lower extremity. If one then stops to reflect where else in the body they may occur, the veins of the left pampiniform plexus, the esophagus and the inferior hemorrhoidal plexus are recognized as obvious, if less common, sites.Varicosities of the veins of the upper extremity are rare and are usually provoked only by such considerable increases in venous pressure as are the result of arteriovenous fistulas of long standing or of obstruction by tumor or thrombosis to the great . . .