Tun following cases are consecutive ones occurring ui private practice during tho past year. Few of these present points of unusual or remarkable interest ; but the series as a whole is instructive in that it shows now the so-called misfortunes of surgery may be avoided with reasonable care in operative detail. That there is in the list no case of septicaemia is not any cause for conirratulatiou ; but the avoidance of a • i single case of suppurative fever, with ono exception, 's gratifying,

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... a few remarks on the methods by which this immunity was attained may be not uninteresting. Tho results as a whole seem to show that with reasonably clean surroundings and personal cleanliness on the part of the surgeon, private operative work compares favorably with that of our hospitals where the most elaborate attention is given to every point of aseptic detail. No novel or unusual method was pursued, as the following sketch will show, and tho experience of other operators was many timos confirmed ; that with proper care before and during the operation the patient and his wound may subsequently bo left pretty much to themselves, -with nature and the nurse as their only guardians. However, a constant geueral supervision was not neglected during convalescence. A card of directions was given to the nurse or attending physician a few days previous to the operation. (1) Light diet for twenty-four hours preceding operation. (2) Shave parts the day before operation and apply a soap poultice over night. (3) The morning of operation wash thoroughly with ether and apply bichloride poultice (1-1000). (.4) Move the bowels with cathartic and enema. (5) Havo bladder emptied immediately before operation. (6) Tincture of digitalis (fifteen drops) three hours before operation, and repeat immediately before etherisation ; at the same time give a suppository of morphia and belladonna (one-quarter grain each). (7) Secure a good sleep the previous night; if necessary, by the use of bromide or sulphonal. I'he apparatus provided by the nurse was not elaborate. Plenty of basins, boiled water (hot and cold), steamed towels and sheets and a clean table were called *°P; but in many a case even these were luxuries not '°b e found, and recourse was had to the old and unpleasant wet corrosive wrappings to protect tho field Ul|d bedding. It has been shown that steaming in the •""Hold apparatus for one-half hour will thoroughly Sterilize towels, sheets and the ordinary materials used J" dry dressings. If an Arnold sterilizer is not at hand, a suitable apparatus may be improvised from a Common clothes-boiler, a double deck being made with bricks and a plank to raise the dressings above the evel of tho water, which is poured into the bottom of N'u boiler. After many elaborations in the method of preparing he field for operation tho old soap poultice was reined to, aud has given perfect satisfaction. It is kept in place for about twelve hours, and the bichloride is applied for the few morning hours, only, previous to the operation. Under this treatment of the skin and proper care of needles and sutures, stitch abscesses have become obsolete. It has happened occasionally that an ambitious or ill-instructed nurse lias removed the corrosive poultice before bringing the patient to the operating table. Fortunately, this annoying occurrence has so far been followed by no bad results. The practice of exhibiting digitalis before operation is familiar enough, but is not commonly followed. Its action is incalculably superior to that of alcoholic stimulants ; its effects are more abiding and its use more logical. If given three or four hours before etherization and repeated immediately before operation it vvill usually carry tho patient through the day and well beyond the danger of primary shock beforo its effect is lost. It is well to supplement this stimulant with a warm salt-water enema of half a pint to a pint before the patient recovers from ether, especially if he is not in robust health, if the operation has been protracted or the loss of blood excessive. This enema should be given very slowly by meaus of a funnel and injected rather high through a rectal tube or soft rubber catheter. The preparation and care of instruments, especially when a surgeon operates frequently outside of the hospital, has been an elaborate and tedious process. The simplicity of the methods used in this series of cases vvill recommend itself. Steam sterilization, when the instruments were not used at once, was early abandoned ; as in nearly all cases the instruments were rusted beyond reclaim. Even wheu they are to be used immediately, cutting instruments are dulled in this process. The familiar " Aladdin Oven " was substituted, and its dry heat applied at a temperature of 150°C. for an hour. At. first the instruments were wrapped in cotton and placed in boxes, but it was found that the evaporation of the moisture in tlie cotton injured them as much as did the condensed steam of the Arnold apparatus. A series of carefully made nickel-plated boxes was therefore devised, in which the different instruments were placed without other wrappings. These boxes were fitted with deep covers, so that in emergency they may be used as instrument trays. So far as all instruments except knives are concerned this method has given perfect satisfaction, but no method of sterilization by heat has yet been found which vvill not injure a fiuely tempered blade. The knives are simply washed in scalding water and wiped with a sponge wrung out of peroxide of hydrogen immediately before being used. Blades so treated have experimentally been found absolutely sterile. The edge is thus held perfectly. During operation the instruments are laid in a pan of sterilized water; when soiled, they are quickly washed in a convenient basin of water and replaced in the pan. After being used, they are carefully scalded, brushed, wiped and laid away in the cases ready for the next sterilization. The varieties of stitches used and their application have been several ; but no one variety has been fouud applicable to all cases. A properly sterilized stitch of almost any kind performs its function satisfactorily if it keeps the parts in accurate apposition. Pure silver, Chinese silk and catgut have been variously employed, and have their special advantages aud disadvantages. Of them all, silver is being constantly given a wider application. It has the advantage of