The occurrence of _secondary hæmorrhage_ may be of so severe a character as to give rise to great anxiety, and it, as well as the treatment adopted for its arrest, may seriously interfere with the process of repair. Both intermediary and secondary hæmorrhage are met with; the former generally ceases after the application of cold, and seldom requires more active treatment. If, however, it arises from a large vessel such as the posterior palatine, which may have been incompletely divided, the re-introduction of the bistoury to complete the division and allow the artery to retract and subsequent sponge pressure will be necessary. In cases of true secondary hæmorrhage the palate wounds have probably progressed satisfactorily up to the fifth or seventh day, when suddenly there is an alarming gush of blood from one of the lateral apertures, and the patient becomes blanched and faint. The lateral apertures should be at once carefully syringed out, and the source of the bleeding discovered, if possible; the patient should lie with the mouth open and the head supported on a pillow. The use of styptics, such as perchloride of iron, should be studiously avoided, and, if absolutely necessary, I infinitely prefer to use the galvanic or Paquelin’s cautery. Some (_e. g._ Howard Marsh) have recommended and practised searching for the posterior palatine canal with a probe, and plugging it with a piece of wood, but of this I have had no experience. Although the bleeding may cease for a time it is liable to recur; under such circumstances it is best to enlarge the lateral apertures in order to expose the source of the hæmorrhage, which can then be dealt with as needful. Plugging of the lateral wounds should be reserved as a _dernier ressort_ for fear of pressing injuriously upon the new vessels in the recent median cicatrix. These plugs, whether of lint, gauze, or sponge, soon become septic and sources of danger, and cannot therefore be long retained, whilst removal is liable to be attended with fresh bleeding. MODIFICATIONS OF THE OPERATION. The operation of _osteoplasty_ demands a brief notice under this heading. It was first practised by Dieffenbach in 1826, and subsequently revived in 1874 by the late Sir William Fergusson, whom I had the privilege of assisting in some eighty cases.