One's approach to transorbital leucotomy must be critical for many reasons, chiefly that it is another blind operation with all the deficiencies this signifies. Meyer and McLardy have demonstrated the variety of anatomical sites in which lesions may be found following prefrontal leucotomy, and have stressed the variability in the position of the underlying cortex in its relations to the bony landmarks of the skull. Once more, sweeps are to be made with a blunt instrument, and the differing consistency of the brain, and perhaps its movement, will make it impossible to be certain whether the lesion produced is the size intended and in the position calculated. The dangers of intracerebral haemorrhage exist as before, and, in addition, because of the site of entry, there are chances of introducing infection, of cerebral rhinorrhea resulting from damage to the frontal sinuses, and of raising bone spicules from the orbital plate. More recently McLardy has said that with the addition of the deep frontal cut, were the caudate nuclei to be damaged bilaterally, restlessness, persisting incontinence and “delayed operative death” might occur, as may follow posterior cuts in prefrontal leucotomy.