Faulty healing in the lower extremities; vascular deficiency as a complication in industrial injuries.

The failure of injuries of the lower extremities to heal properly can often be traced in older persons to arteriosclerosis obliterans. In industry this condition presents a serious problem to older workers, to employers and to insurance carriers. In persons with severe varicosis or those who have had extensive thrombophlebitis, ulcers of the leg may develop following bruising of the skin in the region of the ankle.A third and little recognized condition is edema with or without induration of the skin and subcutaneous structures of the leg, with or without the existence of varicose veins and without evidence of cardiac or renal disorders. This condition is often associated with the absence of or marked diminution of the production of hydrochloric acid by the stomach. An accompanying diminution in or absence of pepsin may occur. It is corrected slowly by taking with each meal small amounts of dilute hydrochloric acid. When pepsin is deficient, the enzyme papain is given.