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its place of entrance into the tumour, and so he treated the descending vein. After a momentary gush of blood there was, without ligature or previous securing of the carotid, no more hæmorrhage. Having then divided the strong bands of cellular tissue and adherent fibres of the styloid muscle, he, by powerful and repeated efforts at wrenching, elevated the whole mass above the mastoid process and ramus of the jaw. The greatly enlarged trunk of the portio dura was then seen emerging from under the mastoid process, and mounting over the posterior margin of the tumour, to enter its substance near its anterior surface. The unnatural tension of this nerve produced such agony, that the patient fell into convulsions and syncope. The division of the nerve instantly removed these symptoms, when the conjunctiva became deeply injected with extravasated blood. The operation was then completed by separating the upper portion of the tumour from the zygoma, and dividing and securing the main trunk of the temporal artery. The cavity of the wound was much larger at the bottom than at the surface. Its depth was four and a half inches, and at its bottom were exposed the walls of the pharynx and other important parts. The lips of the wound being brought together, kindly healed.
The patient recovered, returned to Europe, and subjected the seat of the operation to the careful examination of Sir Astley Cooper and Mr. Abernethy, and obtained their joint opinion in the following words: “That no doubt can exist that the whole parotid gland has been removed.” McClellan has subsequently performed, as has been mentioned, ten similar operations, of which only one was fatal. Since which, it has been successfully performed by Drs. Randolph and J. B. McClellan; and very recently by Dr. Pancoast, making the fourteenth extirpation of the parotid gland which
