[109] _Lancet_, July 1, 1865. [110] Temporary compression of the facial can be easily managed, in cases where it is of much importance to avoid loss of blood, by passing a needle from the outside through the skin above the vessel, then under the vessel, and out again through the skin below. A figure-of-eight suture can then be thrown round both ends of the needle, and the artery thus thoroughly compressed. [111] Syme, _Contributions to the Path. and Practice of Surgery_, p. 21; Carnochan of New York, _Cases in Surgery_. [112] _Contributions to the Path. and Prac. of Surgery_, pp. 23, 24. [113] _Lancet_, July 1, 1865. CHAPTER VIII. OPERATIONS ON MOUTH AND THROAT. SALIVARY FISTULA, _Operation for._--After a wound or abscess of the cheek, in which the parotid duct is implicated, a salivary fistula is very apt to remain. The saliva thus discharges in the cheek, giving rise to considerable annoyance, as well as injury to the digestion. It is by no means easy to cure this. Perhaps the best operation is the one of which a rude diagram is given (Fig. XXVIII.). The duct (C) communicates with the fistula (D). One end of a thread, either silken or metallic, should be passed through the fistula, and then as far backwards as convenient through the cheek into the mouth; the needle should then be withdrawn, the thread being left in. The other end being threaded should then be re-inserted at the fistula, and carried forwards in a similar manner; the needle should be again unthreaded in the mouth and withdrawn; the two ends should then be tied pretty tightly inside, and allowed to make their way by ulceration into the cavity of the mouth. A passage will thus be obtained for the saliva into the mouth, and every possible precaution should be taken to enable the external wound to close. [Illustration: FIG. XXVIII.[114]] EXCISION OF THE TONGUE, for malignant disease of the organ, may be either complete or partial. Complete excision affords a hope of permanent and complete relief from the disease, but it is an operation of extreme difficulty and danger. It may be performed in either of the following methods. The first is the only one in which absolute completeness of removal is insured. 1. _Syme's method of excision._--The patient being seated on a chair, chloroform was not administered, so that the blood might escape forwards, and not pass into the pharynx. The operation is thus described:[115]--