_Results._--Pilz has collected 600 cases, of which 43.16 per cent. died. The united tables of Norris and Wood give 188 cases, with a mortality of sixty, or nearly one in three. These tables include cases in which the vessel was tied for wounds, and as a preparatory step in the operation of removal of tumours of the jaw, etc. Later statistics give a very much lessened mortality, due chiefly to the use of animal ligatures. Of thirty-one cases in which it was tied for pulsating tumours of the orbit, only two died from the operation.[15] Rivington's statistics to a later date give forty-six cases on forty-four patients with six deaths. Both carotids have been tied in the same patient twenty-five times, at intervals of less than a year; and it is a very remarkable fact that only five of these fifty ligatures proved fatal,--two in which both were tied on the same day, and three in which the operation was performed to arrest hæmorrhage from malignant disease of the face and jaws--from gunshot wound,--and from syphilitic ulceration. The external carotid, and also most of its principal branches, have been tied for aneurisms, wounds, goitres, enlargement of the tongue, vascular tumours on occiput and other lesions; also as a first stage in the operation of extirpation of the upper jaw, for the purpose of preventing hæmorrhage. However, such operations are rare, and will probably become rarer still, and it is hardly necessary to describe the operations on each _seriatim_. Aneurism of the external carotid or branches are rare; if idiopathic, ligature of the common carotid will be found at once easier, not more dangerous, and more effectual than ligature of the branch; if traumatic, the aneurism itself should be attacked, and the bleeding point secured by a double ligature. Wounds are common enough, but if accessible at all, the injured vessel should be tied at the bleeding point; if inaccessible (and under this head we may include wounds of the internal carotid), the common carotid must be tied. No one would think of trying the superior thyroids for goitre, unless they were so manifestly enlarged, tortuous, and pulsating, as to render the operation so simple (from their superficial position) as to require no special directions; besides this, the cases in which it has been already done have given very little encouragement to repeat it. As cases may occur in which any diminution of the cerebral supply is contra-indicated, and thus the more difficult ligature of the external carotid may be preferred to the more simple operation on the common trunk, and as the lingual may require ligature near its root, in consequence of obstinate hæmorrhage from the tongue, short directions are given for the performance of both these operations.