H ISTORY repeats itseIf. When a new drug is synthetized, a new bioIogica1 product isoIated or a new procedure devised, a wave of enthusiasm foIIows the introduction of the method. When saIvarsan made its first appearance it was haiIed as a panacea for the entire Iine of human aiIments. Mercurochrome and insulin have been used as therapeutic agents in an endIess variety of diseases. GraduaIIy the enthusiasm subsides and the fieId of usefuIness of the drug becomes Iimited to those aiIments where it reaIIy proves effective. When the injection treatment of varicose veins was first advocated and tried on a Iarge scaIe by Linger, Sitar and NobI, working independentIy, a deIuge of favorabIe reports foIIowed in every country. No untoward reactions were mentioned in the Iiterature until recently. TheoreticaIIy three different dangers are possibIe: (I) puImonary embolism; (2) infectious thrombophlebitis; (3) IocaI necrosis. Experience showed that the ft hence few or no misfortunes. As the majority of papers deaIing with the chemica1 obIiteration of varicose veins comes from the hand of such exceptionaIIy experienced physicians it is obvious that the Iiterature does not give a true picture of the situation. And yet, sIoughs after injections occur even in the hands of a skiIIfu1 physician and the experience in treating such compIications shouId be reported for the benefit of aI1. The axiom stiI1 stands good: “no irritation-no obliteration.” In other words, a chemica1 which does not irritate the intima of the vein is not capabIe of forming a thrombus and of obIiterating the Iumen of the vesse1. The endotheIium of a vein may be and probabIy is more sensitive to a chemica1 irritant than the perivascuIar tissue but it is only a matter of a higher degree of sensitiveness as no irritant is known to have a selective affinity excIusively for the endotheIia1 Iining of the vein and be harmIess to the subcutaneous tissues. Therefore if such a substance due to a. fauIty technique or Ieakage through the waI1 of the vein comes in contact with the perivascuIar tissues, a reaction must be expected. Some chemicaIs such as sodium chIoride or sodium saIicyIate are vioIent irritants and may Iead to necrosis more easiIy than some other substances, e.g., sugar or quinine and urea. Dr. Norman J. KiIbourne’ deserves credit for caIIing attention to such cases in the American medica Iiterature. Dr. Eugene J. Garvinz aIso mentions that he had a case of sIoughing after injection of 20 per cent soIution of sodium chIoride. SeveraI reports of necrosis after injections appeared previously in European maga-