around the limb sufficient to prevent either arterial or venous circulation, and seems to exercise perfect control over the circulation much more than the Esmarch's bandage. After the contraction, the knife and saw are used as usual.

DR. H. C. LOMBARD is the author of an atlas published in Paris, in which he endeavors to show the geographical distribution of diseases in their relation to climate. It is very instructive, not only as showing where certain diseases do, but also where they do not, prevail. At a glance, one sees that on certain parts of the earth's surface there is neither cholera, malaria, nor consumption. This will lead to the study of the causes which produce such an exemption.

DR. PHIPSON has proposed a new method of solving the question of a cheap household light. He has succeeded, with a comparatively feeble electric current, in perceptibly increasing the phosphorescence of certain bodies which are made faintly light by the rays of the sun. He incloses in a Geissler tube, containing a gas in a more or less rarefied condition, a phosphorescent body, the sulphuret of barium, for instance. By causing a constant current of a certain intensity to pass through the tube, he obtains a uniform and an agreeable light, at an expense which he estimates to be less than that of gaslight.

A SMALL OLD-SCHOOL DIFFICULTY IN KANSAS.-In Kansas, they have a law regulating the practice of medicine, which recognizes the three State Societies as licensing boards, and each of the three took immediate steps under the law, and appointed examiners and commenced granting certificates. Everything seemed lovely, but now it has transpired that there are really but two societies in the State. The Eclectic Society filed its articles of incorporation March 28, 1871; the Homoopathic Society filed its articles of incorporation September 7, 1871; but the Old-School Society has never been incorporated, and is not a body recognized by State law. What will be the outcome it is difficult to predict, but at any rate it is a gol joke on our regular brethren.-Eclectic Medical Journal.

THE

Chicago Medical Times.

WILSON H. DAVIS, M. D.,

In this disease, the cornea loses its true convexity, and becomes extended into a conoidal form, which not only very greatly disturbs vision, but has been regarded as one of the diseases nearly, if not wholly, irremediable by surgical art.

I have attempted to represent the disease in the accompanying drawing, but, except as to the outline of its form, it is particularly difficult to convey in a

drawing the very peculiar appearance presented by an eye with this disease.

Appearance of the eye in a case of transparent conical cornea.

The appearance of the eye is that of a peculiar brightness or sparkle, and fixes the attention of even the casual observer. The light is reflected from the cornea at its apex, as if it were a luminous body, or transmitted from a piece of rock crystal. The patient has the manner of one who is short-sighted in the highest degree, and goes about groping his way like one nearly blind.

Upon closely examining the eye, you will observe, on a profile view, that, instead of an uniform convexity, the cornea is

pushed outward in the shape of a cone, more or less pointed, and looks like a solid and very transparent crystal, and when viewed from the front, has a sparkling appearance, preventing the pupil and iris from being distinctly seen.

Low grades of conical cornea escape even the practiced eye and cause very slight changes in the shape and size of the reflections. The diagnosis is then founded on the dioptric condition of the eye in question, which is usually myopic and astigmatic.

In slight cases of conical cornea, the patient may complain of considerable, and often great, impairment of sight, which is due to the astigmatism, caused by the irregular curvature of the cornea, which gives rise to great distortion and confusion of the retinal images. Concave spherical lenses, therefore, produce but slight improvement, and little or no benefit is derived from cylindrical glasses, on account of the astigmatism being too great for correction.

The conicalness does not always lie in the center of the cornea, but may be more removed to one side, and then the corneal curvature varies at different parts. In a well-developed case the protrusion of the cornea and the extensive widening of the anterior chamber united with it, are such marked symptoms that they can scarcely be mistaken. In fact, the cornea sometimes protrudes so that the lids can hardly cover it and, when closed, they have an irregular appearance.

In slight cases the vision may not be greatly influenced, but in highly developed cases the sight is greatly impaired. For objects in the axis of the cone escape observation, and those passing in at the sides are only recognized in their rough outlines; hence, in attempting to fix an object, the patient turns the side of the eye to it. Where the vision is limited to distinguishing light from darkness, or different colors, or where all sensibility to light is gone, the keratoconus is combined with atrophy of the nerve and retina.

Compared with the normal cornea, the convexity is very marked, and its apex stands at a relatively greater distance from the anterior surface of the lens. Parallel rays of light. falling upon the apex of the cornea would be united in front

of, or in the lens, and, in either case, a spectrum of light, but no image would be formed on the retina.

In a pure case of conical cornea, the brightness of its surface is preserved, and the normal transparency of its tissue. Occasionally, however, where the disease has been of long standing, the apex of the cornea will become opaque and other complications present themselves. Persons suffering from this disease get in the habit of squinting the eye or partially closing the palpebral aperture for the purpose of excluding a portion of the rays of light, as this diminishes the circles of diffusion upon the retina by cutting off a quantity of the luminous impression.

The bulging forward of the cornea is due to inflammatory action, intra-ocular pressure, and relaxation of the corneal tissue, and in no case could this result without the above conditions being present.

In two cases that I have lately treated, the pain and intraocular pressure was a prominent feature of the disease, it being of a neuralgic and periodic character, the intra-ocular pressure increasing and diminishing as the pain appeared and disappeared. It could readily be seen that after a severe pain, the bulging forward of the cornea was increased and the vision diminished, in proportion to the increased tension and severity of the pain, the cornea becoming thinner and thinner as the disease progressed.

In many cases of neuro-retinitis the patient will experience no pain, and yet a destructive inflammatory action may be going on that will eventually disorganize the tissue and render the eye worthless. So in a case of keratoconus the cornea may give way from intra-ocular pressure without pain, as the iuflammatory action may exist in the retina and vitreous where the parts are devoid of sensory nerves, and pain being absent we might readily come to the conclusion that the disease was of a non-inflammatory character.

It is thought by some writers that the quantity of aqueous is diminished, but my experience is to the contrary, as all the cases that I have seen, the quantity of this fluid has been increased and the size of the aqueous chamber much enlarged. The progress of this disease is generally quite slow, first developing in one eye, and, after a time, in the other, much the same as many other of the low forms of inflammation of the internal eye, occurring in persons most frequently of a delicate constitution between the ages of fifteen and thirty.

Innumerable remedies have been suggested and tried for the relief and cure of the conical cornea, such as the different preparations of mercury, iridectomy, paracentesis, iridodesis, extraction of the crystalline lens, division of the ciliary muscle, removal of a portion of the staphylomatus wall, compress bandages, etc. Believing, as I do, that conical cornea is the result of some constitutional disturbance acting upon the nutrition of the internal eye and thereby setting up an inflammatory action producing intra-ocular pressure, relaxation and stretching the corneal walls, and believing we must remove the cause of disease before we can expect to secure a permanent benefit, I have upon this theory treated several cases with good results. Mrs. K., aged twenty-six, came under my treatment February 24, 1880, for conical cornea of both eyes, the right one being much worse than the left and nearly blind. I performed a paracentesis to relieve the immediate symptoms and intra-ocular pressure and gave her tincture physostigma ven, ten to fifteen drops three times daily, also iodide and bromide of potassium in syrup stillingia co. twice daily. Applied a compress bandage, and, at the end of two weeks, performed another paracentesis and continued the internal treatment. Up to this time, the patient had suffered intensely from periodical pains in both eyes and a feeling of great pressure and fullness, but now the pain and feeling of fullness began to subside and the case gradually grew better until all the pain had abated and the vision so much improved that to-day, May 28, she can read the signs on the opposite side of the street and can read coarse print with the eye that was most affected. I neglected to state that both eyes were kept under the