their use of antisepsis. Cure the disease by well directed measures and the germs will yield. The operation suggested will not remove the septic materials from the anterior chamber. We are constantly surrounded by septic materials, breathe them, have them in our water and ice, but when we are in a healthy state we probably escape their illeffects. I do not mean to decry antiseptic surgery, but I think it is on the wane as mere antisepsis. I think that Chlorine water while destroying septic germs, will stimulate healthy inflammation. I also believe in the Peroxide of hydrogen, and have found it useful in many cases. It will likewise destroy septic germs. It is a very useful adjunct in the treatment of ulcerations of the eye, and in inflammation of the lids and conjunctiva. Dr. MOFFAT: Many cases of recurrent headache, will be relieved by proper attention to the eyes, even if there are prominent uterine symptoms as possible causes. In the case related it was undoubtedly reflex from the overstrain of the eye. These recurrent attacks are often due to the eye, although coming on when the patient is fatigued, or below par. Now, under these circumstances, if the eye is not in condition to do its work the first effect of the lowered power will be manifested there, and the headache will be one of the first symptoms. I would call attention of the members of the Society to one fact, namely, if your patient is a boy or even a man, and he has a squint, headache over the eyes, twitching of the eyelids, examine for phimosis or preputial adhesions; if it is a woman examine for uterine trouble. Very often the eye trouble is secondary to some other condition. I have a patient now under treatment, a young lad, with choreic twitchings of the face and astigmatism. Failing in treatment I examined and found adherent prepuce around nearly the entire glans. I tore up the adhesions and by next visit he was better. I have known of several similar cases where no benefit was obtained from the use of glasses until the discovery and relief of the preputial adhesions, when the glasses at once gave relief. With the invited co-operation of Drs. J. H. BUFFUM, Chicago, GEO. MCDERMOTT, Cincinnati. A CASE OF NEURO-RETINITIS WITH SYMPTOMS OF EX-OPHTHALMIC GOITRE RESULTING FROM CERVICO-DORSAL NEURALGIA. BY M. O. TERRY, M. D., UTICA, N. Y. Mrs. B. æt. about 70, nervo-sanguine temperament and of gouty diathesis. Has had persistent pain in head and eyes for weeks. The eyes protrude, having a strained and congested appearance; vision is blurred; sight has failed rapidly; heart's action irregular from muscular weakness; tongue coated white; has enuresis; and feeling of gen *Semi-Annual Meeting eral weakness. There is also cervico-dorsal neuralgia quite marked. Although the case was serious looking from any standpoint, yet the etiological factor of its starting point being the spine gave me the assurance for a comparatively favorable prognosis. The treatment instituted was counter irritation to the spine in the form of Iodine. This was subsequently changed to a small blister which I have not allowed to heal. Internally there has been given with marked benefit, Belladonna, Hypericum, Pulsatilla and Apis for the head and eyes. Convallaria, Nux, and Acid phos. acted well as a tonic regulating also the action of the heart. Cases of this kind presenting such a diversity of symptoms and having functional and pathological conditions of such a variety and of such serious import require a course of treatment more than the mere giving of the symtomatically indicated remedy. They test all of the resources of the careful painstaking practitioner and specialist. The good results obtained however may well encourage us to examine minutely into the causes of the symptoms-chronic and serious though they be. The patient to-day, although having passed three score years and ten, presents an entirely different appearance from that of a few weeks since. The eyes have a natural appearance, the congested and bulging is no longer noticeable. When I began treatment she could see fingers only five feet. Now every thing seems more distinct. (Test: Metrical progression according to swelling and De Wecker.) The ophthalmoscope shows marked neuro-retinitis still, but the improvement is steady. The enuresis has also ceased. but lasts for two or three hours. Headache has occurred occasionally A CASE OF RETINAL HEMORRHAGE IN RIGHT BY M. O. TERRY, M. D., UTICA, N. Y. Mr. B., æt. 55, nervo-sanguine temperament, although, a steady business man yet he was free and easy in his social habits, smoking and using alcoholic beverages. A few weeks since, noticed could not see as well with glasses-thought they were too weak. Examination showed, however, that eyesight could not be improved with them. On examining him I found a rupture of a retinal vessel in right eye, the ophthalmoscope also revealed lymph patches in left eye due to choroiditis. Examination made April 24th, 1888. Treatment. Ordered the discontinuance of the use of tobacco and alcohol and to take only sparingly of meat. Remedies-Merc. cor. To one tablet at meal time. Ophthalmoscope shows healing of ruptured vessel and a disappearance of the lymph patches. A careful examination revealed no disease of the heart, and the microscope discovered nothing abnormal with the kidneys. Now, although this may not be a case of tobacco amaurosis it probably wrought its influence, and with the aid of alcohol began the work of degeneration of the vessels and nerve tissue. The patient is able to use his eyes again and finds no trouble in seeing, as his vision is just short of normal. The Mercurius cor. seems to have acted in a regular specific way. Large doses produce a congested condition of the cerebral vessels which being continued produces the pathological phenomenon of degenerative changes. Small doses relieving the condition when it shows itself from other causes. ANTISEPTIC OPHTHALMOLOGY. BY F. PARK LEWIS, M. D., BUFFALO, N. Y. Some years ago a young lad presented himself at my clinic of the Buffalo Eye and Ear Dispensary, with a small foreign body in the cornea. He was a machinist, and in hammering, a chip of steel had glanced in his eye. The accident was a common one-hundreds of cases of like character had appeared upon our record books. An examination of the eye discovered the fact that the fragment had punctured Bowman's membrane, and was lodged, though not deeply, in the substantia propria of the cornea. It was before the days of Cocaine, but the removal was effected without difficulty, leaving, as is quite usual under such circumstances, a small patch of denuded epithelium. The young man was sent away with instructions to bathe his eye in cold water if it should become in any degree irritated, but no difficulty was apprehended. In every respect the injury, the treatment and the apparent conditions were quite such as were of almost daily occurrence. The spud with which the piece of steel was removed was taken from my own surgical case in which the instruments are always kept in as perfect condition as possible. The next day, however, the young man presented himself, complaining of discomfort in the eye. The cornea, it was found, had not been repaired, and a small gray patch appeared where the steel had entered. I felt a little concern at this and gave some suitable application to cleanse and relieve the eye, with directions on no account to fail to come to me the next day. The following |