The narrowing or partial obliteration of the nostrils in double harelip from the large size of the columna has sometimes to be remedied subsequently. One plan which I have practised several times for reducing the breadth of the columna is by excising a central lenticular-shaped portion, extending nearly the whole length through its entire thickness, and closing the gap with sutures. But a simpler method consists in paring the edges of the columna on either side to the required dimensions, and allowing the raw surfaces thus formed to cicatrise. The redundant tissue should be removed on the inner or nasal aspect, so that when cicatrisation takes place the skin is drawn round into the nares, and the resulting scar is unobtrusive. The falling in of the upper lip after the operation for double harelip, when the os incisivum has been removed, can best be remedied by the adjustment of a plate carrying the required artificial incisors, and furnished with a central cheek-plate to restore the natural profile. Where the lower lip projects unduly in spite of the above-mentioned artificial adjustment, it may be requisite to reduce its size by the removal of a 𝖵-shaped portion from its centre. This is so easily accomplished as to need no detailed description; suffice it to say that the greatest care is needed in the accurate application of the sutures. I cannot conclude this portion of my subject without mentioning the manual and mechanical aids which may be beneficially employed for the improvement of the mobility and appearance of the face and nose after such operations. The under-cutting of the integuments of the lip and cheek, and the subsequent cicatrisation involved, necessarily lead to a certain amount of rigidity of the parts. This can be remedied in a great measure by persistent gentle manipulation of the lip and cheek, care being taken always to press the parts towards the median line. This should be carried out by the mother or nurse daily after due instruction. A slight depression or collapse of the nostril on one side can be improved by the use of an apparatus supplied by Messrs. Hawksley, consisting of a head-band across the forehead, to which are attached vertical stems ending in smooth bulbs, which, by rack and pinion movement, can be so adjusted as to press the nostril into the desired position. The apparatus can be worn at night and for a certain time during the day. * * * * *