hi  the  third  stage,  the  integument  is  involved  and  ulcerates ;  or  an
H^rture  is  made  by  wound  or  accident.  The  contents  then  protrude,  in
^  fungous  form,  and  both  structure  and  action  are  prone  to  degenerate.
*  Principles  of  Surgery,  p.  6.^.
168  Sru  B.  Brodie's  Lectures  on  [^^h

It  is  obYious  that  the  only  satisfactory  treatment  of  the  last  two  stages,
is  early  and  free  removal  by  the  knife.  Though  simple  or  **  benign**  at
first,  this  tumour,  like  all  other  cystic  formations,  is  apt  to  change  sadly
for  the  worse ;  more  especially  when  the  open  condition  has  succeeded  to
the  occult.
Lectuees  VIII  and  IX  treat  of  "varicose  veins  and  ulcers  of  tks
legs."  The  disease  is  well  described ;  but  nothing  new  is  advanced,  and
nothing  requires  special  notice.  As  to  treatment,  our  author  airiTes  at
the  conclusion,  with  which  we  feel  pretty  certain  that  the  great  majority
of  the  profession  fully  agree,  namely,  that  in  ordinary  cases  the  palliatiYe
treatment  is  enough,  and  that  the  means  of  obtaining  radical  cure  should
be  reserved  only  for  those  cases  which  are  severe — by  extent  of  varix,  by
amount  of  pain,  by  repeated  inflammatory  accessions,  by  ulceration,  or  by
hemorrhage.  Of  the  various  methods  of  radical  cure  he  seems  to  have  no
decided  preference;  at  least  he  hesitates  between  two : — ^his  own  method  by
subcutaneous  section,  and  that  of  Velpeau  by  the  twisted  suture.  For  our-
selves, we  have  no  hesitation  in  awarding  the  palm  of  superiority  to  the  latter;
as  equally  safe,  and  rendering  obliteration  of  the  veins  much  more  certain.
