t night.

(18) _Popliteal._--Wounded at Magersfontein. _Entry_ (Mauser),
in centre of popliteal space. _Exit_, about centre of patella,
which latter was cleanly perforated. Three weeks later the
typical thickening of the knee-joint following haemarthrosis was
present, also a well-marked thrill and machinery murmur in the
popliteal vessels with no evidence of a tumour. The leg was
normal except for slight enlargement of the internal saphenous
vein and its branches, probably independent of the arterial
lesion.

(19) _Femoral._--Wounded at Magersfontein. _Entry_ (Mauser), 7
inches below left anterior superior iliac spine. _Exit_, at
inner aspect of thigh. One month later slight fulness without
pulsation was discovered on the inner side of the femoral
vessels just above the level of the wound track. Some
blood-staining still remained in the fold between the scrotum
and thigh. Machinery murmur and a well-marked thrill, most
palpable to the inner side of the superficial femoral artery,
were noted. No further symptoms developed and the patient was
sent home.

_Prognosis and treatment._--No one can help being struck with the
disinclination shown by the older surgeons to interference in cases of
either aneurismal varix or varicose aneurism, even after the time that
ligation of the vessels had become a favourite and successful operation.
The objections lay in the technical difficulties of local treatment, and
the danger of gangrene after proximal ligature. Modern surgery has
lightened the difficulties under which our predecessors approached these
operations, but none the less the experience in this campaign fully
supports the objections to indiscriminate and ill-timed surgical
interference, as accidents have followed both direct local and proximal
ligature.

In _pure varix_ no doubt can exist as to the advisability of
non-interference in the early stage, in the absence of symptoms. This is
the more evident when we bear in mind that a stage in which an
aneurismal sac exists can seldom be absent. In many cases an expectant
attitude may lead to the conviction that no interference is necessary,
especially in certain situations where the danger of gangrene has been
fully demonstrated. In connection with this subject I cannot help
recalling the first case of femoral varix that ever came under my own
observation. I discovered the conditi