Dr. Sieveking says of this case that probably the patient might have done equally well without the leeches and tartar emetic. Of this there can be no doubt. The progress of broncho-pneumonia is always more tedious than that of simple pneumonia, and the recovery was further delayed by the complication of typhoid fever. Can the treatment be defended? How is it shown in these four cases that the pneumonia in all of them was not precisely the same, that it varied in type, or required a different treatment? That it may be complicated with various diseases, and be associated with strength or weakness of the individual attacked, is no proof of any specific change in the disease itself. In this respect it is in no way different at present from what it has ever been. Then, as to treatment, can it be seriously maintained that the low diet in the first case, that the loss of six ounces of blood in the second, or the six leeches and other treatment in the two others, benefited the pneumonia and hastened its resolution? Of this there is no proof whatever. Unquestionably they tended to an opposite result, as would at once be made apparent if Dr. Sieveking, instead of lecturing on four cases, would tabulate one hundred cases so treated, and let us count what follows. I submit, therefore, that the principles laid down by Dr. Sieveking are in no way supported by his own facts; and, as they are directly opposed to the conclusions derived from more extensive data, they offer no evidence in favour of that mixed treatment which seems so reasonable, and is so popular with many members of the profession.[5] The question of blood-letting as a point of scientific practice has again been raised by Dr. Richardson,[6] who, appealing to that love of authority so powerful among medical men, asks—“Is it possible that twenty centuries were grossly abused by the infliction of what in the present state of feeling, was, on occasions, akin to crime? I believe not.” He then proceeds to discuss ten propositions—or, as he calls them, discoveries made by the ancients; and asks with regard to each of them how far the application of them is sound and judicious practice. His conclusion is, that blood-letting is still useful in some stages of typhus fever; in cases where there is sudden tension of blood, of which sunstroke is an example; in cases of chronic congestion of brain; in cases of acute pain from serous membrane; in some classes of spasmodic pain; in cases of sudden arrest of circulation from concussion; in cases of congestion of the right heart; and, it may be, in extreme cases of hæmorrhage. Above all, he says, “I claim for it a first place in the treatment of simple uræmic coma.” It is impossible to discuss at length, in this paper, all the important practical points referred to by Dr. Richardson. But I shall refer to two great principles in modern as distinguished from ancient medicine, which I think must vitiate the most of his conclusions.