The following cases are taken from among many others similar, with the intention of showing the results of treatment both in those which require operation and in the milder ones which get well without it. It may be added that in all a light nourishing diet was ordered; and that in accordance with the experience of Dr. Mackenzie in similar conditions of the cornea sometimes arising after operation-as in the old flap operation for cataract-porter was always ordered. In some cases where its exhibition was delayed a little, improvement seemed to follow very soon after it was given.

CASE I.-A. E., æt. 23, admitted 3rd February, 1879. On admission, a sloughing ulcer occupied the greater part of the upper half of left cornea: the anterior chamber was empty, and patient complained more of the loss of vision than of any pain. He stated, however, that six days before he had received a blow on the affected eye from a fragment of stone, which caused him so much pain that he had to leave work. Poultices were applied to the eye with a view to relieve pain, and after three days, he says that "the eye gave way," and he had almost immediate relief. He has since continued almost free of pain.

He was ordered to have atropine in the form of ointment (4 grains of atropine to the ounce of vaselin) twice daily, with light dry fomentations to the eye; and to keep in bed.

On the 6th of February, he had severe pain at night, and the tension of the eye was found to be increased. The anterior chamber, which had been gradually filling, showed a slight trace of pus.

On the 9th, the pain remaining constant, except when controlled by sedatives, and the pus accumulating in the anterior chamber, the cornea was incised through the ulcer, and the contents of the anterior chamber evacuated. For a few minutes after the operation he had severe pain, but this soon subsided, and he remained free of pain for some days, while the eye began to look more healthy. On the 13th, however, the aqueous rapidly reaccumulated in the anterior chamber, and he began to complain of pain. Dr. Reid was prepared to incise the cornea again if necessary, but found the wound not quite united, and a little manipulation allowed the aqueous to drain away. Patient's uneasy symptoms soon subsided, and the eye remained quiet and continued to improve. On the 22nd, it was noted that the anterior chamber was again filling, but that patient remained free of pain.

On the 26th, cicatrisation of the ulcer was going on rapidly,

and the eye was quiet. Patient was allowed to rise for a short time.

On 4th March, cicatrisation was almost complete, and on the 8th patient was dismissed with moderately good vision, and the iris free of any attachment to the cornea.

He has not since then attended regularly at the Dispensary, as he came from the country; but when last seen the opacity on the upper part of the cornea was clearing satisfactorily, and vision improving.

CASE II.-H. C., æt. 43, gardener, presented himself at the Dispensary, on 3rd February, 1879. The following are the notes from the Dispensary Day Book:

"Traumatic ophthalmia in left; an ulcer in centre of cornea, with an onyx. Said to result from a blow by the branch of a bush. The pupil yields partially with atropine.

To have atropine ointment; and a compress and bandage to be applied.

February 5th. Pus in anterior chamber, which is deep. Tension increased. Pain in ball, which has been severe, has now subsided. Severe circum-orbital pain. There are two ulcers on cornea, with infiltration of epithelial layer."

Patient was admitted to house; and the same day the cornea was incised, both ulcers being included in the section.

Light fomentations, with tincture of belladonna, were applied, and extract of belladonna to the brow.

February 8th. Cornea more healthy; some pus escapes

from wound: no re-accumulation in anterior chamber.

February 19th. Remains free of pain.

Cornea much clearer and healthier, but with a slight tendency to bulge at centre. Bandage to be more firmly applied.

February 23rd. No tendency to bulging: ulcer becoming

vascular. Adhesion of iris at lower aspect of ulcer.

February 28th. He was dismissed, eye being quiet, and vision improving.

CASE III.-P. H., æt. 42, admitted 15th February. Suffers from traumatic ophthalmia in right; the result of blow from fragment of coal. Large sloughing ulcer on cornea. Admitted

to house.

To have atropine ointment. Pil. cal. et op. at bed-time, followed by a saline in the morning. Light fomentations to the eye.

Two days later, pain had increased with the tension of the eyeball, and pus was accumulating in the anterior chamber,

while the extent of the ulcer was also greater. Dr. Reid therefore made an incision in the usual way, and evacuated the contents of the anterior chamber. Patient had almost immediate relief; and the condition of the eye continued also to improve steadily till he was dismissed on the 6th of March, the eye being quiet, the ulcer filled up, and the cornea clearing. In this case the iris was free of any adhesion to the cornea.

CASE IV.-J. G., æt. 49, moulder, was seen at the Dispensary, on the 27th of January, when the note was, "Suffers from traumatic ophthalmia in left. Small abrasion on centre of cornea, the result of a 'fire."" (A small piece of iron projected as a spark from the heated metal.)

He had atropine ointment, and was directed to return if inflammation was not subdued.

Two days later he came back, when the eye was found to be more irritable, and the abrasion of the corneal epithelium remained.

A compress bandage was applied, and he was directed to bathe the eye with Mackenzie's compound lotion.

On the 15th of February he returned, having ceased to attend regularly. A large sloughing ulcer occupied the central part of cornea, and the anterior chamber was almost filled with pus.

He was admitted to House, the compress re-applied, and rest in bed directed. The pain next day rendered a sedative necessary at night. No improvement being apparent, the cornea was incised, and the anterior chamber evacuated of tenacious purulent matter.

Pain remained severe in the supra-orbital region for some time after the operation, and he was ordered a calomel and opium pill at bed-time. On the 19th the anterior chamber remained free of pus, but the sloughy condition of the cornea seemed to advance.

On the 20th no improvement could be observed, and severe pain recurred. This, however, was easily controlled; and on the 23rd an improvement in the condition of the cornea was noted. This improvement continued, and on the 10th of March the cornea was clearing up, and an anterior chamber forming.

On the 14th March there was no apparent flattening of the cornea, and he began to have a perception of light. He was now allowed to rise.

On the 19th he was dismissed, with instructions to continue the use of atropine and to attend the Dispensary. The iris

was adherent to the cornea towards its lower aspect, and the cornea showed a large central opacity. Since then a continued improvement has been noted in the condition of the cornea and of patient's vision when he has appeared at the Dispensary.

CASE V.-C. S., æt. 32, miner. Patient presented himself at the Dispensary on November 18th, 1878, when the following note of his condition was made:—

Soft ulcer on centre of left cornea, with tendency to onyx. Does not know of any injury having been inflicted, but ulcer probably of traumatic origin.'

He was ordered to have atropine ointment thrice daily, with a calomel and opium pill at night; a compress and bandage were applied, and he was directed to keep his bed for two days, and again come up. He had been advised to become an in-patient, but had declined.

When he returned, on November 20th, all his symptoms were aggravated, and he was admitted into the House. The same treatment was carried out, with the addition of extract of belladonna being painted over the brow; and he kept improving till the 25th, when the onyx had disappeared, and the ulcer was taking on a healthy aspect. On the 26th he left his bed against orders, and the same night had an attack of violent frontal pain. This was relieved by a draught of chloral hydrate and bromide of potassium; but he was not quite free of pain till the 30th, when the ulcer again began to look more healthy.

On 3rd December it was noted that he continued improving, that the cornea looked quite healthy, and that the ulcer was cicatrising. He was allowed to rise.

On the 16th of December the pupil continued fixed, notwithstanding the use of atropine, but the cornea was much clearer in the site of the ulcer, and vision was fairly good. He was then dismissed; to continue treatment.

CASE VI.-M. M., æt. 64, farm servant, admitted 5th March, 1879. Three weeks before admission, patient, in taking down a corn-stack, received a blow in left eye from one of the sheaves. On admission an ulcer was found on the centre of the cornea, which tended to become staphylomatous. The ulcer was unhealthy looking, with soft and elevated borders.

A compress bandage was applied, and he was sent to bed. Atropine ointment was used morning and night.

On the 11th March it was noted that the softened corneal

substance had given way, and that a small hernia of Descemet's membrane was presenting. The pad was increased, and bandage more firmly applied.

On the 18th the hernia had almost disappeared, and cicatrisation was advancing.

On the 24th patient was dismissed, a central opacity occluding pupil, which did not yield freely with atropine. The anterior chamber remained, and patient was directed to return in six weeks for iridectomy. This was performed on the 19th of April, at the inner aspect of cornea, with a very good result.

ON THE TREATMENT OF SPONDYLITIS AND SCOLIOSIS BY PARTIAL SUSPENSION TO IMPROVE THE POSITION, AND THE APPLICATION OF THE PLASTER OF PARIS BANDAGE TO RETAIN IT.

Being the account of a Demonstration before the Sixth International Medical Congress at Amsterdam, September, 1879.

By DR. LOUIS SAYRE, New York.

DR. SAYRE spoke as follows:

"MR.PRESIDENT AND GENTLEMEN of the Sixth International Medical Congress, I am very much obliged for the invitation to make, before this representative body of medical men, a practical demonstration of the plan of treatment adopted by me for some years past for Pott's disease, and also for lateral curvature of the spine. By this means, a more clear and definite understanding of the plan can be conveyed than it is possible to impart in any other manner with the same accuracy and attention to the minuteness of detail, which is so essential to success.

"It is neglect of these details in the preparation of the materials used-in the elastic shirt employed-and in the proper application of the gypsum bandage, that has caused the failure of the treatment in the hands of some. I am quite confident that there is no case of spondylitis or scoliosis that is in condition to be treated by any mechanical means, which can not be more successfully treated by this method than by any other yet devised, and with perfect freedom from pain or discomfort, and without any of those excoriations so common in the use of all mechanical appliances.