suffering which were not known before, or at least only to a few. The host of appliances and new methods of treatment are in the opinion of many old and experienced medical men decidedly unnecessary. They lead the student and the practitioner to disregard the empirical—the practical—manual part of his art—to trust to a mechanical system and not to himself, or to his personal skill and his experience. No one can read Sir James Paget’s lecture without feeling that throughout his address he was touching a subject that had only been brought under his notice in the course of his professional career, and that only in a partial manner. If anyone dissents from this view he has only to compare the original report of the lecture in the journal I have mentioned with the revised lecture and notes, edited by Mr. Howard Marsh, and published more than twelve years after the lecture had been first delivered. During that period, a great change had come over the surgical world with respect to the much despised Bone-setters. The greater publicity given to the cures of the Bone-setters by independent men of mark, who had found their pains alleviated and their afflictions cured by the professional Bone-setter, boldly stating their experiences, told the faculty there must be something more in this system of “quackery,” than was “dreamt of in their philosophy.” It was evident, that however distasteful it might be, it must be treated with respect, even if it jarred with their previously expressed opinions and shocked their ideas of strict professional etiquette. [Illustration: PLATE IV.—DISLOCATIONS. 14. Dislocation of shoulder joint. 15. Dislocation of foot inwards. 16. Dislocation of foot backwards. 17. Dislocation of tibia and fibula forwards. 18. Dislocation of ulna and radius backwards.] No Bone-setter can find fault with Sir James Paget’s lecture beyond his vulgarising, if I may so term it, his opening illustration. Such an instance might occur, for there are “Bone-setters and Bone-setters.” The term is doubtless assumed by many whose practice brings disgrace upon those who pursue an honorable calling, even if they do not belong to a chartered society, or are recognised by Act of Parliament and therefore not “legally qualified practitioners,” it is true that they are qualified by long experience, by early training, and the skill gained by the constant practice of many years, but the law does not recognise them. Sir James Paget appears to imagine that all the formula of a Bone-setter is to say that “a bone is out,” and to use a wrench to put it in again, which wrench he admits does good in some cases. He admits “of course they have a certain number of real fractures and dislocations which they reduce, and of old ankylosis which they loosen.” “Of these,” he adds, “I need say nothing; for I believe there is nothing in their practice in these cases which is not as well or better done by regular surgical men.”