(_b_) It is more easily regulated (see Vol. I, p. 682). (_c_) Embolism is less likely to occur. =Instruments.= Fixation forceps, tenotomy knife, speculum, a large paraffin syringe, and a short needle having a big bore. =Operation.= This may be performed under adrenalin and cocaine. _First step._ The stump is drawn forwards with forceps. A tenotomy knife, inserted well to the outer side of the stump, is then swept freely round and a pocket is formed in the centre of the orbit into which the injection can be made. The tenotomy knife is then withdrawn. _Second step._ The sterile melted paraffin (melting-point 115° F.) should be poured into the syringe, which should have been previously kept in a hot-water bath. The paraffin is then allowed to cool slowly until it just becomes opalescent. The injection should be made through the hole made by the tenotomy knife, sufficient paraffin being inserted to obtain the desired result. The operation is usually followed by considerable swelling of the tissues, which will subside in three or four weeks. OPERATIONS FOR THE RESTORATION OF A CONTRACTED SOCKET As the result of wearing badly-formed artificial eyes or of subsequent inflammation in the conjunctival sac, the socket not infrequently becomes so contracted that the prosthesis cannot be retained. Enlargement of the sac may be obtained by two methods:-- (_a_) Skin-grafting (Thiersch’s method). (_b_) Transplantation of skin from the surrounding structures (Maxwell’s operation). SKIN-GRAFTING =Indications.= This procedure is especially suitable for cases in which the base of the socket opposite the palpebral aperture has to be enlarged, and it is usually performed prior to Maxwell’s operation for the restoration of the fornices in severe cases. =Instruments.= Scalpel, speculum, skin-grafting razor, probes, and a piece of thick style wire. =Operation.= _First step._ The base of the socket is freely divided in a horizontal direction opposite the palpebral aperture so as to produce a gaping wound. _Second step._ This gaping wound is put on the stretch in the following way: A thick piece of style wire is bent round to fit into the fornices of the socket, the ends being brought out over the lid at the inner canthus. The circle of wire is opened out as far as possible so as to put the wound at the bottom of the socket on the stretch to its fullest extent. _Third step._ Skin grafts are then cut from the inner surface of the arm (see Vol. I, p. 670), applied by means of probes, and pressed down on to the raw surface. No dressings should be applied directly to the grafts, but a watch-glass may be placed over the palpebral aperture and dressings applied over it. The style wire should be removed on the fourth day. INCLUSION OF FLAPS. MAXWELL’S OPERATION