even to a great extent, without hemorrhage occurring; when such is the case, the ulceration for the most part extends, with surrounding induration and condensation of the parts. The whole or part of the adventitious tissue may thus be destroyed; the parts cicatrise, and a spontaneous cure is sometimes accomplished. In other cases, though the disease is not extensive, frequent and most violent hemorrhage occurs. A hemorrhagic tendency also occasionally occurs in affections of a different nature,—a trifling sore pouring out blood on the slightest touch. In some constitutions, leech-bites, trifling punctures, or the extraction of a tooth, have been followed by dangerous hemorrhage. The disposition very often exists in many members of the same family, and is sometimes hereditary. Great trouble has been experienced in staying the bleeding; large vessels have been tied without effect, and some patients have even perished notwithstanding every exertion on the part of the attendants. It becomes a difficult matter to treat surgical diseases in such constitutions: openings cannot be made with the knife for the evacuation of matter or any other purpose. A good case will be found in the _Lancet_, 1838-39.[19] The same patient again presented himself with a very large and deep abscess of the hip, which was opened by caustic, though nearly one inch and a half from the surface. It is not easy to account for this disposition to bleed so profusely, or from slight causes. The blood is in a diseased state, probably as in the patient here referred to, in whom it contained pus globules, and coagulated slowly; there is probably also a want of tone in the vessels themselves. Many such cases are on record. The cause, or causes, of aneurism by anastomosis are also unknown.