be dealt with, and a ligature applied
around the vein above the bulbous end of the stylet enables nearly the
whole length of the great saphena vein to be dragged out in one piece.
These methods are not suitable when the veins are brittle, when there
are pouches or calcareous deposits in their walls, or where there has
been periphlebitis binding the coils together.

Mitchell of Belfast advises exposing the varices at numerous points by
half-inch incisions, and, after clamping the vein between two pairs of
forceps, cutting it across and twisting out the segments of the vein
between adjacent incisions. The edges of the incisions are sutured; and
the limb is firmly bandaged from below upwards, and kept in an elevated
position. We have employed this method with satisfactory results.

The treatment of the complications of varix has already been considered.

ANGIOMA[4]

[4] In the description of angiomas we have followed the teaching of the
late John Duncan.

Tumours of blood vessels may be divided, according to the nature of the
vessels of which they are composed, into the capillary, the venous, and
the arterial angiomas.

CAPILLARY ANGIOMA

The most common form of capillary angioma is the naevus or congenital
telangiectasis.

#Naevus.#--A naevus is a collection of dilated capillaries, the afferent
arterioles and the efferent venules of which often share in the
dilatation. Little is known regarding the _etiology_ of naevi beyond the
fact that they are of congenital origin. They often escape notice until
the child is some days old, but attention is usually drawn to them
within a fortnight of birth. For practical purposes the most useful
classification of naevi is into the cutaneous, the subcutaneous, and the
mixed forms.

_The cutaneous naevus_, "mother's mark," or "port-wine stain," consists
of an aggregation of dilated capillaries in the substance of the skin.
On stretching the skin the vessels can be seen to form a fine network,
or to run in leashes parallel to one another. A dilated arteriole or a
vein winding about among the capillaries may sometimes be detected.
These naevi occur on any part of the body, but they are most frequently
met with on the face. They may be multiple, and vary greatly in size,
some being no bigger than a pin-head, while others cover large areas of
the body. In colour they present every tint from purple to brilliant
red; in the majority there is a considerable dash of blue, especia