joint, to prevent the collateral
circulation maintaining the flow through the aneurysm. Matas' operation
has been successfully performed by Hogarth Pringle.

#Axillary Aneurysm.#--This is usually met with in the right arm of
labouring men and sailors, and not infrequently follows an injury in the
region of the shoulder. The vessel may be damaged by the head of a
dislocated humerus or in attempts to reduce the dislocation, by the
fragments of a fractured bone, or by a stab or cut. Sometimes the vein
also is injured and an arterio-venous aneurysm established.

Owing to the laxity of the tissues, it increases rapidly, and it may
soon attain a large size, filling up the axilla, and displacing the
clavicle upwards. This renders compression of the third part of the
subclavian difficult or impossible. It may extend beneath the clavicle
into the neck, or, extending inwards may form adhesions to the chest
wall, and, after eroding the ribs, to the pleura.

The usual symptoms of aneurysm are present, and the pressure effects on
the veins and nerves are similar to those produced by an aneurysm of the
subclavian. Intra-thoracic complications, such as pleurisy or pneumonia,
are not infrequent when there are adhesions to the chest wall and
pleura. Rupture may take place externally, into the shoulder-joint, or
into the pleura.

Extirpation of the sac is the operation of choice, but, if this is
impracticable, ligation of the third part of the subclavian may be had
recourse to.

#Brachial aneurysm# usually occurs at the bend of the elbow, is of
traumatic origin, and is best treated by excision of the sac.

_Aneurysmal varix_, which was frequently met with in this situation in
the days of the barber-surgeons,--usually as a result of the artery
having been accidentally wounded while performing venesection of the
median basilic vein,--may be treated, according to the amount of
discomfort it causes, by a supporting bandage, or by ligation of the
artery above and below the point of communication.

Aneurysms of the vessels of the #forearm and hand# call for no special
mention; they are almost invariably traumatic, and are treated by
excision of the sac.

#Inguinal Aneurysm# (_Aneurysm of the Iliac and Femoral
Arteries_).--Aneurysms appearing in the region of Poupart's ligament may
have their origin in the external or common iliac arteries or in the
upper part of the femoral. On account of the tension of the fascia lata,
they tend to