What I object to in medical literature is that prevalent kind of writing, which consists of plausibilities supported by successful cases. What we have at present a right to expect in the way of generalization or theory is that it should be based on positive researches, and not on fallacious authority; and as regards practice, we should have a reasonable number of cases recorded, in which the failures are given as well as the successes. To say that this or that treatment is good, because this or that case recovered, is of no advantage to medicine, unless it stimulate the practitioner to record his cases, tabulate the result, cease from vague opinion, and demonstrate the exact ratio of his success. It is satisfactory for the present state of medicine that such is the kind of inquiry now prosecuted by our most intelligent physicians. When, therefore, Dr. Richardson is of opinion that a restoration of blood-letting is useful in some stages of typhus fever, and other circumstances previously referred to, I venture to think he should show how the mortality of that disease would be diminished thereby, when contrasted with the nutrient system of management introduced by Dr. Graves of Dublin. The same argument refers to other cases he has referred to. I believe with him that there are instances of uræmic coma, in young and vigorous subjects, which may be cured by blood-letting, but as we have not yet accumulated a sufficient number of such cases it would be premature to speak confidently of the results. But with regard to the treatment of acute pneumonia I regard the following axioms as fully established, viz.:— 1. The great end of medical practice is to remove the consolidation of the lungs and restore those organs to their natural condition as rapidly as possible. 2. To this end everything that diminishes vital strength should be avoided, and nutrients administered as early as possible, to favour the cell transformation necessary for removing the exudation from the lungs. 3. There is no relation between the violence of the symptoms or force of the pulse and the fatality of the disease. Young and vigorous subjects suffer most, but almost always recover soonest. 4. The weak pulse, want of reaction, non-disappearance of the pneumonic consolidation, or its appearance during the progress of exhaustive diseases, are the unfavourable signs of pneumonia. 5. Continued exercise or work after the attack; low diet, large blood-lettings; depressants, such as tartar emetic and sedatives; expectorants, such as squills and ipecacuanha; mercury and violent purgatives, are opposed to the restorative treatment of the disease, and when not fatal, tend to prolong its duration. 6. Small blood-lettings of from six to eight ounces may be used in extreme cases, more especially of double pneumonia or of broncho-pneumonia, as a palliative to relieve tension of the bloodvessels and congestion of the right heart and lungs.