Early in 1913 I1reported a case wherein an arteriovenous anastomosis—so-called reversal of the circulation—had been done in all four extremities for the relief of real and threatened gangrene consequent on Raynaud's disease. This was in the days when the Carrel method of suturing blood vessels had become available to clinical uses and when so much was expected of it. The case was that of a young woman under the care of Dr. Joseph C. Bloodgood, who not only assisted at one of the operations but graciously consented to the report after all the work had been completed. Dr. Bloodgood has the patient in his wards at the St. Agnes Hospital once again and has kindly permitted me to study her and make the present follow-up report. In brief, the woman, Mrs. G., was 26 years of age when in February, 1911, an arteriovenous anastomosis of the femoral artery