_The Complete Method._ An incision down to the bone is first made, completely encircling the orbital margin and including any growth that may be involving the skin. The periosteum is then separated completely, as near to the optic foramen as possible. Care must be taken in dealing with the periosteum over the lachrymal bone, as the bone is liable to be fractured and an opening made into the nose if undue force be used. The apex of the cone formed by the periosteum is divided, as far back as possible, with curved scissors, and the whole orbital contents are removed. The wound is packed with gauze, and skin-grafting is subsequently performed when the bone has become covered with granulations; this usually occurs about the end of the second week. _The Incomplete Method._ The globe is first enucleated and the outer canthus divided. The lids are well retracted and an incision is carried down to the bone along the orbital margins. The periosteum is then stripped up from the walls of the orbit and the apex of the cone divided as far back as possible, as in the previous operation. The conjunctiva and outer canthus are then united with sutures. As a rule, skin-grafting is not necessary after this operation. OPENING AN ORBITAL ABSCESS Orbital abscesses should be incised where they point. In the upper lid care should be taken not to divide the levator palpebræ muscle; the incision should be placed well to one side. In making an incision over the inner side of the orbit care should be taken not to detach the pulley of the superior oblique. The cause of the abscess should be ascertained if possible. Suppuration in the ethmoidal sinuses coming through from the nose is the commonest cause, and should be treated appropriately (see Section V). SECTION III OPERATIONS UPON THE EAR BY HUNTER F. TOD, M.A., M.D. (Cantab.), F.R.C.S. (Eng.) Aural Surgeon to the London Hospital CHAPTER I EXAMINATION OF THE EAR: GENERAL CONSIDERATIONS WITH REGARD TO OPERATIONS In order to perform successfully the various operations upon the ear, it is essential that the surgeon should be familiar with the technique of its examination, which, for the sake of convenience, will first be briefly described. EXAMINATION OF THE EAR For this purpose it is necessary to make use of certain instruments in order to obtain a clear view of the deeper parts of the auditory canal and tympanic membrane. Most important amongst these are the following:-- =Mirror.= A head-mirror, such as the ordinary laryngological mirror with a focus of eight inches, is to be preferred to the hand-mirror, as it leaves both hands free for manipulation. [Illustration: FIG. 171. CLAR’S LAMP.]