Besides general anæsthesia by ether, chloroform, and a few other agents, there have been introduced several means for producing “local anæsthesia,” _i.e._, agents which destroy the sensibility of the part of the body to be operated upon while not producing unconsciousness. Freezing the part by ice and salt, or by a quickly evaporating spray of rhigolene or chloride of ethyl, are sometimes used. But cocaine and a somewhat similar substance, eucaine, have of late been more extensively used on man, after their harmlessness had been first shown by experiments on animals. In 1885 Corning, of New York, injected a solution of cocaine as near to the spinal cord as was possible, and produced insensibility of all the body below the point of injection by the effect of the cocaine upon the spinal cord. A few years ago Quincke, of Kiel, in Germany, devised a means of puncturing the spinal canal itself in the lumbar region (the lowest part of the small of the back) for the purpose of drawing off some of the fluid for examination. This suggested to Bier, then of Kiel, who was apparently ignorant of Corning’s work, that cocaine could be injected through a hollow needle inserted into the spinal canal by “lumbar puncture” and so produce anæsthesia of all the body below this point. This method was published by him in 1899, and was soon repeated in America. In France, however, it has been practised more than elsewhere, Tupper, of Paris, having successfully done over two hundred operations by “spinal anæsthesia.” All of the body below the diaphragm can thus be deprived of sensibility. The method will probably never replace ether and chloroform, but in many cases is a valuable aid to the surgeon. But it has its dangers and its inconveniences. The ideal anæsthetic is not that which destroys sensibility and yet leaves the patient perfectly conscious, as spinal anæsthesia does. A patient to whom I recently proposed it for certain special reasons rejected it, saying, with probable truth, that she could never bear the strain of lying on the table perfectly conscious of all that was being done and frightened by any surgical emergency which might easily arise in such a long, difficult, and dangerous operation. The ideal anæsthetic is that which will abolish pain and consciousness without danger to life. The twentieth century will undoubtedly see the discovery of this safe and efficient anæsthetic. ANTISEPSIS But the limits of surgical progress were not yet reached. Let me quote again from the address before alluded to: