An endarteritis localized to peripheral branches of the vessel was
demonstrated, and illustrations are given of the changes in the wall of
the dorsalis pedis artery.
The views expressed by Stopford are not in agreement with those
of Mcige and Athanassio-Benisty ; yet the practical conclusion drawn
from them, that early relief from irritation should be striven for in
order to prevent the occurrence of secondary vascular changes in the

* Lancet, 1918, i, Mar. 80, p. 665.
94 GUNSHOT INJURIES TO THE BLOOD-VESSELS

distal part of the circulation, is of great practical importance, and is
in strict consonance with their observation that improvement invari-
ably follows measures undertaken for the mobilization of injured
nerve trunks, and hence early intervention is justified..
The question has been dealt with at some length, because in
arteries such as the axillary, where the nerves can scarcely escape
concurrent injury, the results of the combined injury are especially
bad ; while the frequency with which the arterial lesion heals spon-
taneously, as a result of thrombosis, removes the vascular injury itself
from the category in which operation is necessary.
THE OCCURRENCE OF AHJEMIC GANGRENE.
The development of gangrene is a common sequence of gunshot
injuries to the arteries, whether the vessel be operated upon or not.
