When a prisoner is reported sick or asks to see the doctor, he is automatically freed from the ordinary rules. If the medical man decides that there is nothing in his condition to warrant his being put on the sick list he falls back under prison discipline. If, however, he requires medical treatment, the Medical Officer may prescribe any regimen which he considers applicable to the case, and the Governor has the instructions carried out. It may broadly be stated that cases requiring the constant attendance of a skilled nurse and those demanding serious operative treatment do not need to be treated in Scottish prisons. Section 72 of the Prisons (Scotland) Act, 1877, enables the Governor, in certain cases, to petition the Sheriff for a warrant to remove sick prisoners to hospitals outside. He must present two medical certificates to the effect that the prisoner (1) is suffering from a disease which threatens immediate danger to life and cannot be treated in prison, or (2) a disease which makes his removal necessary for the health of the other inmates of the prison, or (3) that continued confinement would endanger his life. This is one of the wisest provisions in the Act. Cases might occur in which the treatment required would be of such a character as to make it inadvisable to have it carried out in prison. Assuming that there is no difference in the experience and skill of the prison doctors and their staff from that of the corresponding officials in the general hospital, the conditions in prison are essentially different. In a general hospital there are all sorts of people as patients, and their friends have access to them; it is a public place compared with the prison. The staff is subjected to continual criticism; not always enlightened, and sometimes unfair, but it exercises a healthy effect on their actions. There is no greater danger to the public than the uncontrolled specialist; and it is a bad thing for him if he is led into any belief either in the infallibility of his judgment, or in its necessary applicability to the case with which he deals. He can perform no operation without the consent of the patient or his friends, even though he believe that operation is necessary to the saving of life. There are cases in which this permission is refused in spite of all the persuasions of the medical man; and in some of these cases, contrary to expectation, the patient gets well. In others death takes place where life might have been saved had consent to the necessary treatment been obtained; yet it would be an intolerable condition of affairs if the medical man were to have his patients placed at the discretion of his judgment; and no one would propose that the inmates of a hospital should be compelled to submit to any treatment that the doctors in their wisdom might see fit to prescribe.