The translation in 1860, by Mr. John Clay of Birmingham, of Kiwisch’s “Diseases of the Ovaries,” with its valuable tables showing the results of all recorded cases, was of great importance to the progress of ovariotomy. Since then vast improvements have been introduced, the mistakes of earlier operators corrected, bichloride of methylene has been used with gratifying results instead of chloroform, precautions have been taken to prevent the access of any taint of infectious disease, every medical man present at the operation has been put under strict inquiry as to his not having recently been in a dissecting or _post mortem_ room, and the utmost possible purification of house, room, bedding, clothing, and instruments has been practised. Indeed some precautions have been so stringently insisted on as to give considerable offence at times. The old vegetable material for ligatures and sutures, coarse whipcord or twine, has been given up, and after many trials of metallic wires pure silk has been settled upon as the most trustworthy. In fact it is entirely absorbed without needing to be pulled out again. The multitude of intricate details involved precludes our giving an account of the stages by which the present perfection has been reached. In 1864 Mr. Wells, in pursuance of a pledge he had given to record and publish his entire experience, favourable and unfavourable, published a full account of his first 114 cases. Since then two extended records, one in 1872 giving an account of 500 cases, and a second in 1882 with 1071 cases, have been published. The most remarkable thing in the history is the gradual diminution in mortality. In the first hundred cases the deaths were thirty-four; in the last they diminished to eleven; in the seventy-one cases following the first thousand only four died, while sixty-seven recovered. This is notwithstanding the fact that Sir Spencer Wells is often called upon to treat patients rejected by other surgeons as unfavourable cases. A recent record by Thomas Keith, an Aberdeen surgeon, in which a mortality of only three and a half per cent. has occurred, even outdoes this astonishing result. It is needless to relate how the operation has been adopted by most Continental surgeons of mark, and with excellent results.