The clause forbidding cutting has excited keen controversy, and the problem is not yet solved. If physicians were known not to have operated, if even it were certain that lithotomy was then in the hands of a select few, whether of good or of mean repute, we might understand the clause. But Hippocrates deals with surgical questions in a way which proves operative familiarity. No one who had not operated could have laid down the precautions he rightly urges. Lithotomy was an old operation; no one is spoken of as its inventor. Ammonianus' invention, as described by Celsus, was for the removal of a calculus too large for the ordinary procedure. Trephining, too, was of great antiquity. Munro has shown that it was freely practised in prehistoric times, and successfully too, if we may safely reason from the fact ingeniously demonstrated by Munro (Prehistoric Problems, c. 5), that the patients survived the operation sufficiently long for the rounding of the cut edges, and for other reparative processes to have advanced a long way. Hippocrates knew all about trephining; why does he forbid lithotomy? There are two ways of meeting the difficulty. Either he did not desire to trench on the province of specialists, for specialism, if not certainly known to have prevailed in Greece, certainly existed at an early period in Egypt, whence many things were borrowed. Cicero doubts whether specialism existed in Hippocrates' time, and certainly paracentesis, even the removal of ribs in empyema, the amputation of a gangrenous limb, the treatment of fistula, the removal of hemorrhoids, all these are spoken of as if the physician knew of them in the ordinary way of his duty. No doubt surgeons at a later time belonged to a less dignified class than physicians, to whom they stood in the relation of ministrants, just as to-day surgeons, even of eminence, put upon the physician the responsibility for an operation which they conduct at his bidding, only seeking to make it safe and effectual. Or, if this does not suffice, it may be said that the passage is corrupt, and Littré's unwillingness to meddle with the text must be set aside if an emendation can be proposed which will make sense of it and not conflict with other knowledge. He suggests that the passage οὐ τεμέω οὐδε μὴν λιθιῶντας should read οὐδὲ μὴν αἰτέοντας—"I will not cut—not even those who ask it of me." The text ΑΙΤΕΟΝΤΑΣ might have been miscopied ΛΙΘΙΩΝΤΑΣ, an alteration such as has frequently been recognised, and of the sort illustrated by Douse in his analysis of examination papers. We at any rate get a meaning for οὐδὲ μὴν, otherwise inexplicable, unless lithotomy was a special exception to Hippocratic practice. The emendation would be still more apposite if castration were meant; at least we know that under the Empire the consent of the victim did not free the operator from penalties, and Littré quotes the case referred to by Justin Martyr in which the governor of Alexandria refused his consent, even on the petition of the young man who desired it. But at best this is only a possible way of evading, not a certain one of meeting, the difficulty. Failing it, the passage must be surrendered as inexplicable, for conjectures about stony tumours and the like are mere idleness. The Hippocratic writings, even the most ornate, are too precise to sanction cryptic interpretations. A good deal might be said in favour of the guild spirit extending to surgeons respect for their speciality. The Arabs certainly placed the surgeon, as a mechanical person, in a low position.