begin at the cricoid cartilage, and terminate as at a little distance from the fossa at the top of the sternum. I have no idea that the trachea is often laid open to that extent. Pancoast directs, “that after separating the two sterno-thyroid muscles, partly with the point and partly with the handle of the knife, and finding no large vessels in the way, pushes up, or if necessary divides the isthmus of the thyroid gland.” The next cutting he speaks of, is, “that of the third, fourth and fifth rings, puncturing the tube, with the point of the knife below the fifth ring.” He then speaks of running the scalpel upwards with the handle inclined to the sternum, so as to avoid injuring the posterior wall of the trachea. It is easy to perceive in the practice of the present day, that this operation is done for, and best suited to the insertion of the canula, and that the opening of the third, fourth and fifth rings of the trachea can, when divided, answer by binding the canula, a much better purpose than a larger opening, which would allow it to move about, thereby incurring the danger of displacement. The word tracheotomy as a general term does harm. We ought rather to particularize, and make known on what part of that tube we operate, and not speak of tracheotomy as though it were of little moment in the performance, and that one part of the windpipe cut into, was as much a tracheotomy as another; not by any means should this be thought. I consider that tracheotomy strictly, and according to the definitions of anatomy and surgery, is one of the most dangerous that come within the province of the surgeon; and, on the contrary, I consider laryngo-tracheotomy, or crico-tracheotomy as it is sometimes denominated, a very simple operation, and only requiring ordinary tact in the performance. * * * * * Since the above article was written, this operation has been successfully performed by Dr. J. L. Nicholson, assisted by myself and Dr. C. Thompson. MR. GRANT GIVES THE FOLLOWING RULES ABOUT FOREIGN BODIES IN THE EXTERNAL EAR. 1. Be sure that the foreign body is _seen_. To attempt to extract a foreign body without first seeing it is highly dangerous. 2. Determine what the body is, and, if possible, obtain a sample of the body supposed to be in the ear. 3. Remember that a body which will not swell, and has no cutting edge, will generally remain without causing any urgent symptoms. 4. Seeing the body, determine with a probe if it be movable. If easily movable, concussion with a downward position of ear will often remove it. 5. Warm water injection is the best of all methods of removing foreign bodies. 6. If it be a vegetable substance, do not inject fluid unless you have time to extract the body either at one operation, or shortly afterwards.