Dr. Epstein, of Cincinnati, in a letter of March 29, 1872, to the _Israelite_ of that city, mentions a nearly fatal case from haemorrage after the rite of "_Milah_," and gives the result of his experience in such cases. He argues that _Hitouch_ or _Hitooch_ alone, or the first step or cutting off of the prepuce, performed with ordinary care, could hardly be followed up with any more serious results than can be controlled with the application of a little acidulated water. The second act, or _Periah_, the act of laceration, he looks upon as one that calls for coolness, judgment, and skill, as the membrane should only be torn so far and no farther, the thin, inner fold of the prepuce being vascular only in the sulcus back of the corona and at its lower attachment, where it forms the frenum, or bridle; any carelessness or over-anxiety on the part of the operator in tearing this membrane too far back results in danger of haemorrhage; especially is this part of the operation liable to be badly done if the inner preputial fold is thick and resisting, as in that case undue force may carry the laceration back into the vascular tissue. The means suggested by Dr. Epstein to arrest haemorrhage are those ordinarily used in haemorrhagic cases, such as will be given presently. The doctor regrets that the operators are not as they should be, physicians, and that, when _mohels_ are employed, persons are not sufficiently exacting as to their qualifications.[64] In France the government has managed to secure more safety in the operation. By a royal decree of date of May 25, 1845, in compliance with a desire expressed by the Hebrew Consistory, it was ordered that no one should exercise the functions of a _mohel_ or of _schohet_, without being duly authorized to perform said functions by the Consistory of the Circonscription; and that all _mohels_ and _schohets_ shall be governed in the exercise of their functions by the Departmental Consistory and the General Consistory. By virtue of this decree a regulation was passed by the Consistories on the 12th of July, 1854, ordering that thereafter circumcision should only be performed in a rational manner, and by a properly qualified person. Suction was likewise abolished, and the wound directed to be sponged with wine and water. This decree and the resulting regulations have been of the greatest benefit to the French Israelites, and some attention to the matter would not be amiss in the United States.