Under date of December 1st, 1844, having been in Dublin about a month, he writes as follows:

"In my last letter I mentioned that I had commenced my visits to the Meath Hospital. When Dr. Graves was attached to it, his clinical system was carried out with the greatest minuteness and care. Every patient was carefully examined first by the pupil, and then by the physician, who explained and corrected the mistakes of the other, supplied his omissions, and drew his attention to different points of diagnosis. The pupil was then obliged to write out the history of the case, and paste it on a board at the head of the bed, noting on it the progress from day to day. These notes formed the theme of the lectures, and in their preparation, from the patient being constantly under the eye of the physician, the pupil had to be extremely accurate. Dr. Stokes does not do this. His examinations are more directed to finding out what the disease is, in the shortest way, and in noting the curiosities of it, than to a patient study of its phenomena." "When he gets a case that presents some striking features, or about which there is a good deal of obscurity, his admirable powers of diagnosis and discriminating judgment show to the greatest advantage. His lectures are delivered twice in the week, and are extremely interesting and instructive. These lectures I would not miss for a great deal; I always take notes of them, and write them out as fully as I can when I go home. Sometimes when examining a patient, an interesting point will present itself, and Dr. Stokes will thereupon take a pinch of snuff very thoughtfully, take me by the arm, and walk over to the fireplace and commence forthwith a long talk about the case. On these occasions I resign myself very contentedly to listen, and rather prefer to ask questions than to originate ideas. I have felt rather awkwardly at times at being asked my opinion about what, alas! from my want of practical knowledge, I could say but little, but have generally managed to get off very well, by saying what I knew and no more."

"I have been actively engaged since the beginning of my attendance, in examining cases for myself, accustoming my ear to auscultatory sounds, and my fingers to percussion and exploration, and familiarizing myself with the mode of inquiring into the history of the progress of diseases. I have now under my care four beds, and will increase the number as soon as any interesting cases come in." Again he observes: "Phthisis, pneumonia, rheumatism and diabetes are the diseases I have now under my care, and of which I have notes. I do not, however, confine myself to these, but, when I have time, observe others. I

believe, however, as you have often told me, that there is more to be learned by careful examination of a few cases than by a superficial observation of a larger number." "Besides the Meath, I have taken the ticket of the Dublin Lying-in Hospital, the most extensive institution of the kind in the city. It contains 140 beds, and has fifteen of them appropriated to diseases of the uterus, &c. I am on duty there once a week, and as I do not wish to let anything interfere with my hours at the Meath, selected the night time; so I remain at my post from 9 P. M. to 9 A. M. Women are coming in at all times of the night and day, and there are about 2500 delivered per annum.

"I shall avail myself of the lectures which are generally delivered in the afternoon at the medical schools. Of these Dr. Harrison on anatomy, with constant reference to comparative anatomy, Corrigan on practice, and Montgomery on midwifery, are those which I would care most to hear. But after all, I can go but irregularly, as I would rather devote much of this time to reading. Then my German lessons come three times a week, and I find that without very careful study and practice, I shall get on but slowly. My hours are arranged thus: Rise at half past 7, which is with the sun, and will soon be before it; breakfast at 8; Meath Hospital from 8 to 10 on Mondays, Wednesdays, and Fridays, and from 8 to 11 on Tuesdays, Thursdays, and Saturdays; Lying-in Hospital from 10 to 11 on Mondays, Wednesdays, and Fridays; writing notes before 12 to 1 o'clock, Tuesdays, Thursdays, and Saturdays; study, lectures and visiting 11 to 5, Mondays, Wednesdays, and Fridays; German 14 and 24, Tuesdays, Thursdays, and Saturdays; study, &c., 24 to 5, Tuesdays, Thursdays, and Saturdays; dinner, from 5 to 6; medical and miscellaneous reading, German exercises, cup of tea and musing on absent friends or writing to them till bed-time, from which, till Kitty knocks at the door in the morning, the sole occupation is sleep. Thus, my dear brother, you have my distribution of time. You see the morning's occupations are strictly fixed; those of the latter part of the day are not so, but I try to make the most of it."

Dec. 31. "The circle in which I visit is but a small, although a very agreeable one, but the truth is, I find but little time for visiting without neglecting other duties which I cannot afford to pass over. I attend to my duties every morning at the Meath, and am usually the first on the ground, examining my patients long before Dr. Stokes. makes his appearance. I have now gained some familiarity with the ordinary run of pneumonia, phthisis, bronchitis and typhus, and have also some patients in the chronic ward." (In a subsequent part of the same letter, he says): "The attendance upon these different institutions," alluding to the Meath, the Lying-in Hospital, and the Pitt St.

Dispensary for Diseases of Children, "the necessary reading to enable me to profit by what I see, and a faithful study of my German lessons, occupy my time fully." "I forgot to mention that I also attend regularly the weekly meetings of the Pathological Society, where all the interesting cases that die in the hospitals are recounted, and the specimens explained by the most eminent men in the profession, such as Stokes, Corrigan, Law, O'Ferrall, &c. The Obstetrical and Surgical societies meet once every two weeks; to these Dr. Churchill has taken me, and I expect to attend them regularly."

In his next letter, dated January 15th, he gives a very particular and interesting account of the system adopted for supporting the poor in Ireland, and describes his visits to two of the Unions.

"I went a few evenings ago," he adds, "to the meeting of the Surgical Society at the Royal College of Surgeons, and had the pleasure of hearing, among other interesting communications, an account from Sir Philip Crampton of Amussat's operation for artificial anus, which he witnessed when in Paris. Sir Philip is nearly 70 years of age, but straight as a young man, hale and hearty. He is very active, and, it is said, hunts three days in the week. He dwelt a long while upon the admirable manner in which the operation was performed by M. Amussat, and inculcated strongly his opinion of its feasibility and propriety. He said he could never forgive himself for having allowed certain cases of stricture of the colon, which had fallen under his observation, to die without having first attempted the operation."

Towards the latter end of February, Dr. Stillé left Dublin for London. His time had been so profitably and pleasantly spent whilst in Dublin, where he had been stationary for nearly four months, that he left it with much regret. The circle of society into which he was admitted was not only refined and intellectual, but for one constituted as he was, possessed even a higher attraction in the ease and informality of its intercourse. He had also become acquainted with several of its most distinguished physicians, among whom were Drs. Stokes, Graves, Churchill, Hamilton, Law and McDonnell, from all of whom he received many civilities and attentions. He was, in particular, treated with marked kindness by Dr. Stokes, who evidently appreciated his good sense, and the earnestness with which he devoted him

self to his studies. In his last letter from Dublin, he mentions with pride that for two of his most precious and flattering letters of introduction, to Dr. Todd, of London, and M. Louis, of Paris, he was indebted to that gentleman. His letters warmly and gratefully acknowledge all these attentions, the more valued and felt undoubtedly by him from his being a stranger there. To Dr. Stokes, into whose society he was much thrown, from his daily attendance at the hospital, he had become much attached, and his correspondence gives frequent utterance of the enthusiastic admiration in which he held that great physician's character.

"The more I see of him," he says, on one occasion, "the greater is my respect for his opinions and esteem for his character. In him the quick perceptions of genius are moderated by a wise discretion; if he has to pronounce an unfavorable prognosis, his voice is tender with regret, and the hand that detects so surely the fatal and lurking disease is just as ready to extend comfort to the sufferer and surround the dying couch with all that can make the patient's downward path less dreary and painful."

His next letter is dated London, March 2d, whence he thus writes:

"I regret that I shall not be able in this, to give you an account of the manner in which my time here will be occupied. I have wished in the first place to look around me, to see in what direction I should pursue my studies. Wherever it shall be, they must of course be of a less steady character than in Dublin, but I think that by seeing the practice of the most eminent men in the different hospitals, attending their clinical lectures, learning their opinions in conversation, visiting the various museums and extensive collections of specimens of morbid structure, my time will not be unprofitably spent. I shall also visit particularly the London Fever Hospital, and will endeavor to get a systematic history of a few cases of the disease. I hoped to have been able to study urinary diseases as a specialty here, but am afraid the opportunity is not so good as I had been led to expect."

The remainder of the letter is taken up with an account of the doctrines held in Dublin, regarding the cause of the first sound of the heart; after stating which, he says:

"The opinion in Dublin is, as I have said, universal, that the first sound and impulse occur during the systole of the heart, the second during

its diastole. As to the physical cause of the sounds, there probably exists some difference of opinion. Dr. Stokes believes the first sound to be due 'wholly and entirely' to the muscular contraction of the ventricles-for the reason that exactly the same sound can be heard by placing the stethoscope on any other muscle during contraction."

April 2. "I soon saw, after my arrival here, that it would not be possible to undertake any systematic course of study; it is the fag-end of the season, and energy seems to have forsaken every one connected with the hospitals."

The reception he met with from some of the London physicians was discouraging in the extreme.

"How it may be of Englishmen generally," he says, "I know not, but certainly a letter of introduction to a London physician is not sufficient to melt the ice that encases his heart, and warm him to a manifestation of even common courtesy. In Dublin a man has only to let it be known that he is a stranger, to be welcomed with outstretched hands and made an honorable guest at many a hospitable board. In London he is looked upon almost as an intruder, is coldly scanned from top to toe, and even the external seeming of politeness is disregarded."

There were several exceptions, however, to this want of cour tesy, as the following extract will show.

"My letters to Drs. Todd, Murphy, and Marshall Hall," the latter kindly given him by Dr. Shattuck, of Boston, "I have delivered. I can only say at present, that I have been delighted with the reception they have given me, and with the disposition they have shown to further my plans. I shall try to see a great deal of Dr. Todd; he has been very kind to me; I have been round his hospital, and heard him lecture, and am anxious to see more of him."

Of Dr. Hall's kindness to him, in particular, he frequently speaks:

"He is always," he remarks on one occasion, "wanting to know what he can do for me. He gave me, among other things, an introduction to the meetings of the London Medico-Chirurgical Society, which are held every fortnight, and where I have an opportunity of seeing most of the eminent men of London, and hearing their views on important points which arise in the discussion which follows the reading of a paper. Last Tuesday a paper was read upon the minute structure of the lung, and the pathology of tubercle; this gave rise to an animated debate in