The tourniquet should be utilized whenever possible. In operations, however, that are conducted near the base of the skull--subtemporal decompression, cerebellar exploration, &c.--the surgeon, in his effort at hæmostasis, must rely on the application of digital pressure on either side of the incision, the more careful exposure of the vessels, and the application of forceps as soon as they are seen or divided, or by the utilization of Vorschütz’s hæmostatic safety-pins. Other methods of controlling scalp-bleeding are as follows:-- 1. Kredel’s hæmostatic sutures, passed with a large curved needle which slides along the bone and emerges about 5 to 7 cm. from the point of introduction. The silk ligatures are then tied over metal plates, so curved as to lie flush with the surface of the skull in the particular region involved. Four of these plates would be used in the formation of an osteoplastic flap, one on the distal side of each of the three scalp incisions, and one along the base of the flap. 2. The enclosure of the proposed incision by a running suture which, passing down to the bone, emerges about 1 inch further on, then so to speak repeating itself in part until the whole region is surrounded. The ligatures are then tightened up. This method takes some time in its application, and presents no advantages over the scalp-tourniquet. 3. The blocking of the main arterial supply--temporal, occipital, and supra-orbital vessels--by modified safety-pins, mass ligatures, &c. Arterial compression by means of the modified safety-pin as suggested by Vorschütz will be found most useful in those operations in which the scalp-tourniquet cannot be utilized--subtemporal decompression, &c. =Hæmorrhage from the bone.= Severe bleeding may take place from the mastoid and other emissary veins, and from the open mouths of those abnormally dilated diploic and emissary veins so often encountered in the exposure of an underlying dural or superficial cerebral tumour. The foramina in the bone, when exposed, must be occluded as quickly as possible. For this purpose we have the following methods at our disposal--plugging with small bone or wooden pegs, blockage with minute plugs of cotton-wool, and the utilization of Horsley’s wax, smeared over the part and well pressed home. Hæmorrhage may also occur from the bone during trephining, more especially when the operation is conducted over that part of the anterior division of the middle meningeal artery which runs through a channel in the spheno-parietal region. Here the disk of bone should be removed as quickly as possible and the channel plugged with pegs, cotton-wool, or wax. Oozing from the raw surface of the cut bone is controlled by rubbing in aseptic wax, or by the crushing together of the inner and outer tables.