stained serous discharge. The synovial cavity of the knee
was distended and doughy on palpation. During the next three
weeks the aneurism contracted considerably and the patient was
sent home.

When admitted to the Herbert Hospital the patient complained
chiefly of pains in the foot and leg. The aneurism was cured by
ligation of the vein above and below the communication and
proximal ligature of the popliteal artery.[15]

(16) '_Femoral arterio-venous aneurism._--A private of the West
Yorkshire Regiment was hit on February 11, 1900, at Monte
Christo by a bullet which passed through the inner border of
his right thigh above its middle. On arrival at Woolwich the
patient was found to have a varicose aneurism at the upper end
of Hunter's canal. On May 31 the femoral artery was ligatured
just above its communication with the vein, and as this stopped
all pulsation in the vein, it was decided to postpone ligature
of the latter to a subsequent occasion, if it should ever be
necessary; such a procedure would, it was thought, interfere
less with the circulation of the limb, and would therefore be
less likely to be followed by gangrene, which is so frequent a
result of high ligature of the femoral. But a few days after
the operation the foot became cold and mummified, and there
was no alternative but to amputate the limb through the
condyles of the femur. From this operation the patient made a
good recovery, and when discharged there was no sign of an
aneurism of the vein.'

Case 16 is quoted from a paper in the _Lancet_ by Lieut.-Colonel Lewtas,
I.M.S. It illustrates a result with which I became acquainted in three
other instances not under my own observation.

ANEURISMAL VARICES

(17) _Axillary._--Wounded at Modder River. _Entry_ (Mauser), at
inner margin of front of left arm, just below level of junction
of axillary fold. _Exit_, at about centre of hollow of axilla.
A month later when the wound was healed a typical thrill and
machinery murmur were noticed. The latter was audible down to
the elbow and upwards into the neck. The radial pulse appeared
normal. No swelling or pulsation existed. At the end of three
months the condition was unaltered; the patient said he noticed
nothing abnormal in his arm, except that it was sometimes 'sort
of numb' a