IN THE LOWER LIMB injection of individual nerves is rarely employed, as anæsthesia is easily obtained by the method of spinal analgesia. The _lateral cutaneous_ can be injected as it lies immediately medial to the anterior superior iliac spine emerging from under cover of the inguinal ligament. This procedure may be useful in obtaining skin grafts, the grafts being taken from the antero-lateral aspect of the thigh. Amputations in the middle third of the thigh have been performed by injecting the sciatic, the posterior cutaneous (small sciatic), the femoral (anterior crural), and the lateral cutaneous at the root of the limb. The obturator nerve is difficult to find and anæsthetise in such cases. Operations below the knee can be painlessly performed by this method of anæsthesia. Operations on the Neck. TRACHEOTOMY.--This operation is conveniently and safely performed under infiltration anæsthesia. The anæsthetic solution is injected in the usual way in the line of the incision down to the trachea but not into it, as the trachea itself is insensitive to pain. GOITRE.--A parenchymatous or adenomatous goitre can be readily removed under local anæsthesia, though the administration of ether by intra-tracheal insufflation is usually to be preferred. The principal nerve supply to the field of operation is derived from the cervical plexus, whose branches become superficial about the middle of the posterior border of the sterno-mastoid. An intradermal injection may be made first at this point, and a longer needle then passed down to the posterior border of the muscle, and an area of infiltration produced. From this point the needle is directed first upwards and then downwards round the margin of the goitre so as to produce a zone of infiltration. The same procedure may be repeated on the opposite side, so that the whole gland is surrounded with a zone of infiltration with a special depot of solution around the branches of the cervical plexus. Where only one lobe is involved, it is sufficient to carry the injection down in the middle line after one side has been encircled. When the sheath has been incised and the surface of the gland exposed, the isthmus is infiltrated and divided. The affected half of the gland is then rolled outwards, and the attachments between the posterior aspect of the gland and the larynx and trachea are infiltrated, special attention being paid to the upper pole. The rest of the operation can then be carried out painlessly.