The great number of methods for excision of the tongue gives abundant testimony of the unsatisfactory state in which the various procedures are held by the profession and justifies me in presenting the following plan, which has proved perfectly satisfactory in my hands. It enables the total removal to be made without preliminary tracheotomy, without any annoyance whatever from hemorrhage, without danger, and assures a rapid and an easy convalescence while giving the maximum protection against recurrence.
In every case which can with certainty be diagnosed as carcinoma of the tongue accompanied by infiltration the lymph nodes in line with the lymph current are already involved. The removal of these glands is as important as the removal of the primary growth and should be done in all operable cases. The first step, therefore, should be the making of an incision under the lower jaw from behind one carotid bifurcation to