My own belief is that Messrs. Barker and Pollard have introduced splendid improvement in the management of excisions of the hip, but it is certainly incorrect to say that either" martyrdom" or any severe pain has been suffered during dressing (except in very isolated cases); neither has dressing been'very frequent." Of the advantages of primary union and of the possibility of obtaining it there is no doubt, nor isthere-any doubt of the importance of removing, as perfectly as possible, all tuberculous material from the affected part, a fact I havemany times pointed out in the case of the knee since nine years ago when I originated erasion. I do not, however, think that those who havehad much to do with excision of the hip will agree with Mr. Barker that the anterior incision is so entirely superior to that over the trochanter Ps he seems to think; at least. such is my experience. For other details I must refer to my book.-I am, etc., GA WRIGHT. Mtanchester, January 20th.

ARTERIAL ORIGIN OF PILES. SIn,-1 should not have felt justified in further trespassing upon the valuable space of your JOURNAL had I not considered that a distinct advantage might be gained by a final settlement of this vexed question. Mr. Allingham in his letter states that" nowhere in our work is there any mention of the arterial origin of piles." If I may accept this as a tacit assurance that he wishes to abandon all those passages in his work which, if not definitely stating, distinctly infer that piles originate in arteries, it would contract the differences between us to a narrow point, and that is the clinical advantages of retaining the term arterial pile. In the first placi I fail to see any utility in a term which conveys a false impression, and engenders the conception of a heterodox pathology; and further, I consider a pathological is always a more pre-cise and instructive distinction than any derived froma clinical source. Por instance, I consider that it is far more practical, and