VAKIX. 435 



tension of the saphena-vein, and I felt desirous of obtaining another 

 opinion. Accidental circumstances prevented the fulfilment of this 

 wish until the summer, 1859, when I availed myself of the oppor- 

 tunity of consulting with a member of our profession, Mr J. S. Gamgee, 

 who is surgeon to the Queen's Hospital, and Professor of Clinical 

 Surgery in the Queen's College, Birmingham. At this time, about 

 three years after my first observation, the tumour measured no less than 

 eighteen inches in circumference at its base, eight inches across, and 

 eleven in length, quite flaccid to the touch, shaking loosely as the 

 horse walked, and the lower portion slightly pendulous. We found 

 that the sac could be evacuated by pressure from below upwards. The 

 saphena-vein could be distinctly seen passing upwards from the tumour, 

 which became more full and tense on compressing that vessel. At the 

 same time, a vein, appearing to enter the tumour from below, filled. 



" The diagnosis of the tumour at this period was : An enormous 

 varix in the course of the saphena-vein. The reasons for the diagnosis 

 were, Istly, The situation of the tumour ; 2ndly, Its physical charac- 

 ters ; 3rdly, Its various alterations in shape by pressure upon it, and 

 upon the vein above it. 



" It was evident at this period that, unless something were done, the 

 horse, otherwise a useful one, would speedily become valueless. Ex- 

 tirpation of so large a tumour in such a situation over one of the 

 principal joints was out of the question. Neither did it appear advis- 

 able to evacuate the liquid contents, so long as the interior continued 

 in communication with the parent vein, through which a fresh supply 

 might be continuously derived. The only course open appeared to be 

 to evacuate the tumour by pressure, and to cut off its communication 

 with the circulatory system, by passing a couple of steel pins under the 

 vein, above and below, and inducing pressure, with a view to exciting 

 local inflammation in the vessel, and producing adhesion of its inner 

 coat. 



" The advisability of operating was intimated to the owner, but, as 

 he wanted the horse at the time, interference was further delayed until 

 the 25th May, i860. At this date great change was manifest in the 

 size and character of the tumour. It measured no less than 34 inches 

 in circumference, 17 inches in length, and 17^ inches in breadth. No 

 vein could now be detected ascending to the lower part of the tumour, 

 its size was not influenced to any appreciable extent by manipu- 

 lating it, or by compressing the vein above. The enormous mass no 



