The majority of surgeons at the present time employ the recumbent posture on a table, a plan which I always follow, the surgeon standing behind the child’s head, and the anæsthetist and assistant one on either side. Some prefer to stand at the side of the infant, with the assistant behind its head. OPERATION FOR SINGLE HARELIP. For convenience of description, the operation may be divided into three stages: 1. Detachment of the lip from the maxillæ. 2. Preparation of the edges of the cleft. 3. Union by sutures, and application of dressing. STAGE I.—_Detachment of the Lip from the Maxillæ._ The importance of thoroughly loosening the attachment of the lip to the maxillæ and alveoli cannot be too strongly insisted on; and although emphasized in monographs on the subject by several authors, yet in our ordinary surgical text-books it is but scantily noticed or not alluded to at all. Unless this proceeding is carried out efficiently, the tension upon the stitches subsequently inserted will be so great as to hazard successful union, and will prevent the surgeon from obtaining a symmetrical adaptation of the parts. In severe cases it may be necessary to carry the knife as far as the infra-orbital foramen, and I have often had occasion to go close up to the orbital margin to gain as much freedom as was needful. The maxillary attachment of the ala nasi must also be completely divided, so that the flattened and distorted nostril may be made to correspond in shape and form to that on the opposite side. This dissection in single harelip is mainly needed to the outer side of the cleft, but rarely to such an extent as described above unless the cleft be very wide. The knife must be kept close to the bone in order to minimise bleeding, and not unnecessarily to lacerate muscular and other structures. Sponge pressure will readily control any hæmorrhage. Afterwards the plastic exudation that results is useful in steadying the mask of the face, and the temporary division of facial muscles has a like effect. STAGE II.—_Preparation of the Edges of the Cleft._ Many different methods have been suggested and practised for the preparation of the margins of the cleft, some of which will be noticed in detail hereafter. It is necessary to keep clearly in view the points to be aimed at in the operation. The mere union of the two segments of the divided lip is not sufficient; we also require to obtain symmetry of the nostrils, to avoid an unsightly flattening of the tip of the nose, to have a scar almost invisible, and no notch in the lip margin; the muco-cutaneous line or red margin, moreover, should be so united as to be continuous.