March 3. Clitoris excised in the usual manner under chloroform. Was restless and hysterical for the first six days, when she improved daily, became cheerful, and much more intelligent. She never had another fit, and on April 13, being quite cured, was, at her own request, retained in the Home as a servant. She remained there under observation for six months, during which time she had not only no return of her former attacks, but progressively improved in health, and her menstruation became quite regular. Since that time she has been living as cook in a family which I frequently visit, and it is therefore certain that she remains perfectly well. CASE XXXVIII. SEVERE AND FREQUENT EPILEPTIC FITS FOR THREE YEARS AND A HALF—OPERATION—CURE. C. T., æt. 21; admitted into the London Surgical Home June 23, 1864. _History._—Health always good till three years ago, when, after a severe fright, she became very excited and had a fit. Since that time has been continually subject to them. She never passes a day without two or three, and frequently has as many as six, or even eight, in the twenty-four hours. Is most subject to them at night when sleeping. Is always suffering from headache. Her mental powers are somewhat impaired, as she has very slight recollection of persons, or of events, from day to day. Catamenia very irregular. Has not menstruated since March last. Bowels costive; pulse regular and firm. Is of a sallow complexion, with vacant and weak expression of countenance. Acknowledges great and constant irritation of pudic nerve. During the day previous to operation, special notice was taken of the nature of the fits. They are epileptic; for although she does not foam at the mouth, she has, on more than one occasion, _bitten her tongue_, and is _perfectly unconscious_. There is no rigidity, but a constant struggling, and, unless restrained, the hands always, during an attack, are carried to the seat of irritation. June 23. The usual operation of excision was performed under chloroform. As soon as she recovered, she managed to remove the dressings. Hæmorrhage for two hours was the result. When arrested, two grains of opium were administered, which produced sleep. On awaking, she again endeavoured to remove the dressings; but, her hands being confined, she was unable to do so. She had no more fits, and but a few hysterical attacks. On July 17th she was discharged, as her parents were anxious for her return. She had not then had a fit of any kind for sixteen days. August 15. I received the following letter from her father:—