The author has found no special apparatus on the market for this purpose. A most practical apparatus may be made as follows: A medium hard piece of rubber is cut into such shape as will fit into the patient’s mouth between the lips and the teeth. In its center a hole is made, into which a metal tube is fixed to which a rubber tube of three-fourth-inch diameter is securely fastened. This tube is connected by its distal end to the anesthetic container, which should be so constructed as to permit the required amount of air to be given with the anesthetic at the desired time. Such an apparatus practically seals the oral orifice, and prevents blood from flowing into the mouth, gives the operator a free field to work in without the encumbrance of large external mouthpieces, and is one that in case of vomiting can be easily removed for the time being, and be replaced without interference to the surgeon. =Preparation and Cutting of Nasal Flaps.=—Under a division of skin grafting some preliminary steps in the preparation and cutting of a nasal flap has been referred to, but the author thinks it timely to repeat here the necessity for a systematic method of procedure. It is well for the surgeon to have fully decided upon the certain operative plan he is to follow several days prior to the operation. He must, especially in total rhinoplastic cases, prepare a paper or oiled silk model of the flap or flaps he has decided upon to take from the forehead or cheek, and to fold and bend this model into the place of the deformity to be overcome, to make sure of the result to be attained, allowing for the loss, if any, of mass by reason of the torsion of the flap at its pedicle. If the hair of the frontal scalp lies within the flap outline, it should be shaven away well beyond the border to permit of unhindered work. Thoroughly cleanse and keep clean with a suitable antiseptic the parts to be operated upon for at least twenty-four hours. Place a rubber cap over the hair of the head, or a fixed gauze or waterproof arrangement to keep it in place. If there be any hair adornment of the face remove it. The surgeon should remember to get the flaps to be utilized on forming the lost parts of the nose, at least one third larger to overcome the consequent retraction. Sterilized sutures, preferably silk of suitable size, should be ready and be cut of such length as will facilitate quick action. Rubber tubes of proper diameter for insertion into the nares should be at hand if required. When all is ready the operator is to proceed quickly and accurately, never changing his prearranged idea of the operation. His assistants should be ready to control by torsion or pressure the bleeding occasioned by cutting, since it covers the field of operation and hinders rapid work.