How I met St Peregrine

Based on the historic reports about the life of Peregrine Laziosi (1265-1345) and a post-mortem examination 638 years after his death, the most probable diagnosis in this case was a venous ulcer on his right leg. As an act of penance, he did not lie down but stood in an upright position, praying to God for most of his adult life. Therefore he developed swollen legs and one extremity exulcerated. This is the typical story of a venous stasis ulcer. When the doctor came to amputate the leg the wound was healed (maybe due to excellent compression therapy performed by an angel, as demonstrated in many pictures and statues showing the miracle of St. Peregrine) (Canonization 1726). Cancer seems rather improbable based on the autopsy performed more than 600 years later and on the high age of Peregrine at his death. This case report from the middle ages is discussed concerning pathophysiology, prevention and therapy of stasis ulcers and some historic implications for todays practice are reported. Without any doubt St. Peregrine deserves more publicity, not only for the patients with leg ulcers, but also for the medical staff treating ulcer patients and how the fate of St. Peregrine can be prevented.