3. The spinal accessory occasionally may be divided before it enters the sterno-mastoid in cases of spasmodic wry neck, with great advantage. This operation is an easy one; the sterno-mastoid edge being once fairly exposed, the nerve is easily seen, and a piece should be cut out at least half an inch in length. NERVE SUTURE is occasionally practised with great advantage in cases where nerves have been divided either by accident or in operation. Catgut seems to be the best medium, and cases are on record in which, even after months of separation and subsequent paralysis, improvement has followed an operation for refreshing and joining the divided ends. ADDENDUM TO CHAPTER IX. DR. SOLIS COHEN has recently (in a paper read before the Philadelphia College of Physicians, April 4, 1883) collected the notes of sixty-five cases of excision of the entire larynx. Fifty-six of these were done for cancer, and the remainder for sarcomata, papillomata, etc. Of the fifty-six done for cancer, forty are reported as having died, either shortly after the operation from shock or pneumonia, or a few months later from recurrence of the disease. In two instances the disease had recurred, but death had not been reported when the paper was read. Fourteen remain in which neither death nor recurrence had been reported. Dr. Cohen's conclusion is that laryngectomy does not tend to the prolongation of life, and thinks that the greatest good to the greater number appears better secured by dependence on the palliative operation of tracheotomy. INDEX. Abdomen, operations on, 222. Abernethy on ligature of external iliac, 8. Adams on anatomy of common iliac, 4. on hip deformity, 133. Ægineta, Paulus, on excision of joints, 108. Allarton on median lithotomy, 269. Amputation and excision contrasted, 113. Amputation at ankle-joint (Syme's), 78. of anterior portion of foot (Hey's), 73. of arm, 62. at elbow-joint, 61. through femur, condyles of, 92. of fingers, 51-54. of fore-arm, 58. at hip-joint, 102. at knee-joint, 92. of penis, 286. at shoulder-joint, 63. at tarsus (Chopart's), 75. at thigh, 94. double primary of thigh, 106. of toes, 69. at wrist-joint, 56. Amussat's operation, 252. Anchylosis of elbow, excision for, 122. Ankle-joint, excision of, 137. Annandale on staphyloraphy, 203. Anus, artificial, operation for, 252. artificial, removal of, 254. Arendt, ligature of external iliac, 12. Astragalus, excision of, 145. Auchincloss on ligature of subclavian, 36. Avery, hard palate, fissures of, 203. Barwell on excision of ankle-joint, 139. on excision of tongue, 199. Baudens on amputation at elbow-joint, 61. on amputation of anterior portion of foot, 75. on amputation at knee-joint, 92. Bauer on recto-vesical lithotomy, 272. Begbie, Dr. Warburton, on paracentesis thoracis, 220. Bell, Benjamin, on amputation, 49. on amputation of ankle, 86. on amputation of thigh, 96.