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axes according to the rule at 90, 14 per cent. had axes against the rule at 180.

Of the myopic astigmatic eyes 46 per cent. had axes according to the rule at 180, and 15 per cent. had axes against the rule at 90; 38 per cent. with axes oblique against 30 per cent. of hypermetropic with axes oblique, making in my case the oblique relatively more numerous in the

myopes.

In the deviation of the axes from 90 and 180, the tendency in the hyperopic eyes is to 90, and in the myopic to 180.

In addition to the above, I give below a table of the one thousand eyes divided according to the conditions existing, giving the number of eyes and per cent. of the whole existing in each condition relative to the number examined:

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In 40 mixed A. M. predominates in 18.

It will be noticed that in my simple hypermetropic cases

only 27 were given a correction of .50 D. or less, and in my simple myopic cases only 2 were given as low as .50 D., while in all I have reported 88 per cent. required 1.75 D. or less. While it is true that sometimes small errors cause more trouble, produce more trying symptoms, and are harder made comfortable, I do not think it wise or best to correct all errors found. It may seem to some who correct every error of refraction found that this statement is without reason; surely, he will say, no error should go uncorrected, even to the .25 D. in hypermetropes. We know from experience that the youth is hypermetropic and becomes myopic as he develops in literary and scientific pursuits. Let us take this fact into consideration, and in cases where it can be withheld, to give such assistance as we can without the cumbersome appliances sought by so many. I grant you that when a patient presents himself to me, who is constantly taxing his eyes with close, fine work, and who, after the use of his eyes for such work, complains of symptoms we can readily attribute to their use, I would not hesitate, after finding no other cause for the suffering, to supply him with proper glasses, it matters not how small the degree.

In astigmatism I find it necessary to correct small errors much more frequently than simple errors of a much larger degree; in fact when there are symptoms warranting a correction at all, I always correct fully the amount of astigmatism found.

Leaving a great deal unsaid that might be of interest to the refractionist, I will add a few remarks relative to the reflexes. I have not taken the pains to notice in tabular form the percentage of the different reflexes, but in a very large majority of cases, I have been confronted by complaints of headaches of fronto-temporal variety, accompanied in most instances by a blurring of the vision; in a few of the cases there appeared after reading a few moments to be a perfect blank. In most cases of the headaches there proved

to be astigmatism, while in some were found simple hypermetropia of only .25 D., which when corrected gave perfect relief. I think I am safe in saying that in every case where errors of refraction exist sufficient to cause discomfort, we will find conjunctivitis of such a degree as to require some attention. It may be a very low degree of error, and yet there will be presented a severe conjunctivitis, with possibly considerable marginal blepharitis. Do not understand me to say, that with every case of conjunctivitis we will find errors of refraction existing, yet it is far from true. There are many cases of conjunctivitis other than this, but I repeat the statement that errors of refraction sufficient to be troublesome are always accompanied by conjunctival congestion in some degree. In correcting the errors of refraction per se we have not always fulfilled our obligation to the patient. We often find unbalanced muscles produeing conditions or symptoms similar to those produced by uncorrected errors of refraction. These conditions-exophoria, esophoria, hypophoria and cataphoria of low degree— can be overcome by a decentering of the lens. But beyond the lines drawn between operative and non-operative cases by Dr. G. C. Savage, of Nashville, Tenn., I agree with him should be treated by an operation, followed by exercise of the muscles at fault. In a paper entitled "Partial Tenotomy, a Radical Cure for Hetephoralgia," read before this Association at its meeting in Americus in 1893, I fully set forth my views on this subject, so will not pursue it further here. After reading many articles written by able refractionists, and hearing the subject freely discussed by scientific men from different parts of the country, I am still in doubt as to the reliability of ophthalmoscopic examinations for correcting errors of refraction. I make it a rule to examine my cases with the ophthalmoscope, and while I feel certain that my accommodation has been relaxed, I am uncertain about the results, and alto

gether think it is unsafe in the hands of a great majority of oculists for this purpose. In every case considered in this report, except a few presbyopes, I have used discs containing 1-50 grain each of homatropine and cocaine, or a solution of homatropine hydrobromate of 8 grains to the ounce. In only two of the cases have I been unable to secure complete relaxation of the accommodation by one of these preparations. In these two I resorted to a solution of atropia, 2 grains to the ounce, used four times a day for three days, with good results. In every case I have used the ophthalmometer, which I find indispensable. I do not find that the instrument can be relied upon for the amount of the astigmatism, or axes of cylinders in every case, but in most cases I have found it of great assistance and a pleasure. In a few cases I have found it of no value whatever as to the amount of error, or the position of the axis. In one case it showed astigmatism of 2.50 D. with axis at 60, yet the patient could not be induced to accept more than a 75 degree lense, and its axis at 90.

THE ABORTIVE TREATMENT OF ACUTE SUPPURATIVE INGUINAL ADENITIS BY

PRESSURE BANDAGE.

Br HENRY R. SLACK, PH.M., M.D.. LAGRANGE, GA.

There are few simple complications of chancroid and urethritis that worry the physician and patient more than an acute suppurating bubo. The classic treatment with tincture iodine, mercury iodide ointment, belladonna ointment, etc., has in my experience been almost barren of results in aborting this trouble.

The practice of Auspitz of puncturing the inflamed gland before suppuration has taken place, and then introducing a probe and breaking up the glandular septa, so that the substance of the gland is discharged through the external wound, has found but few followers. It is, however, highly indorsed by Bumstead. Taylor recommends the injection into their substance twenty minims of a solution of carbolic acid (8 gr. to the oz.) 0.5 gr. to 30 c.c. of water. This he claims invariably aborted suppuration.

Lydston advocates "the early and complete extirpation of all buboes." The danger of infecting the glands is great. by any of these methods, and besides, they necessitate for their successful practice rest in bed. This is a requirement most seriously objected to by a large majority of patients in private practice. They want to be cured without being put to bed or the use of iodoform.

I must confess I had almost despaired of finding a safe and successful abortive treatment for bubo, until last winter, at the Johns Hopkins Hospital in the genito-urinary

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