In an article on Preparing for the Knife in European Hospitals (Medical Record, July 15th), Dr. Preston Miller speaks very disparagingly of the operation-room in London hospitals. Germany is his ideal; French operating is less to his taste. He finds the room too cold in a Paris hospital, whilst the surgeons talk too much, smoke cigarettes, and perspire into the wound. In London, he writes, “operating rooms here are yet colder than at Paris, and some of them with open grates burning soft coal fill the operating room (sic) with suffocating smoke and no perceptible heat. Floors of wide boards and soft wood, with dirt-filled joints, and picture-frames everywhere on the walls containing biblical mottoes, are further adornments of some of the best-known operating rooms. On cool mornings it was interesting to watch steam rise from the hands of the operator as he turned from the washbowl, and the next moment the same emanation from his incision, and again from neoplasms as they were placed about in vessels . . . . Old operating tables are the rule; the Trendelenburg position is not believed in. Finger nails are worn long, and less pains taken to clean them than at Paris. The surgeon generally removes his coat, often his vest, and sometimes even his shirt before putting on his apron. But asepsis, as practised on the Continent, is practically disregarded in London.” Possibly some of this censure is not entirely undeserved, especially as to the wide boards and the picture frames, though Dr. Miller seems to imply that a scriptural text is septic. We doubt very much the high septicity of an English gentleman's finger nails. (BMJ 1899;ii:298)