The management of gravitational ulcers and the "bottle leg" present many problems. Much time is given over to the treatment of the conditions both in hospital wards and out-patient departments. Recurrence of ulceration is only too common.
The pathogenesis of the condition now seems clear. A previous thrombosis in the deep veins of calf or thigh can be incriminated with certainty in the vast majority. Bauer,1 who has done much work in this field, found that 80% of his patients, attending because of gravitational ulceration, gave a history of such a thrombosis. Dodd and Cockett6 believe that 75% of patients who have had a thrombotic incident suffer subsequently from edema, induration, ulceration, or bursting leg pain.
The time that elapses before the patient has symptoms may be such that the original incident has been forgotten, and, indeed, a deep venous thrombosis may be silent, particularly in the bilateral