clinic, I saw Dr. Gaither apply the pressure bandage. I have seen it used in ten cases, most of which were in Dr. Gaither's clinic, though some were in my private practice, with the following results:

One patient complained that it increased the pain, which was so intense he could not allow the bandage to remain on over a few hours. In another case, where fluctuation was distinctly felt, the suppuration continued, and after the third day an incision was made. In the remaining eight the bubo was aborted, including two in which suppuration had begun. The following cases are typical.

Case 1.-C. B., white, aged eighteen, November 16, 1895. Has had discharge from urethra three weeks. First attack. Some pain on micturition and increase in frequency. Discharge profuse and purulent. Has inflammatory bubo on left side, size of a horse-chestnut. Skin covering swelling red. Considerable pain on pressure, but no suppuration.

Treatment.-Injection bichloride mercury 1 to 20,000 and pressure bandage.

November 21. The swelling of the gland almost gone. No evidence of suppuration. Bandage reapplied.

Case 2.—A. P., colored, aged twenty-four, December 27, 1895. Patient has had bubo on left side for three weeks. He says it was preceded by two small discharging sores on either side of the frenum, which can still be seen, though nearly healed. There is a large inflammatory bubo in the left groin; glands are matted together and show evidence of suppuration over a small area. Skin covering swelling is adherent and glistening.

Treatment.-Pressure bandage applied.

January 2, 1896. Bubo smaller, harder and less painful. Signs of suppuration have disappeared. reapplied.

Bandage

January 7. Bubo about gone, not painful. Bandage removed.

Case 3.-J. S., colored, aged twenty-five, cook in hotel, October 6, 1896. Has slight discharge from urethra; inflammatory bubo on both sides. Right as large as hen's egg and so painful can hardly walk; left about size of hickory-nut and painful on pressure, but no fluctuation in either. Skin covering glands adherent and glistening.

Treatment.-Balsam mixture and pressure bandage. Patient said the bandage relieved the pain so much that he could walk with greater ease.

October 9. Complains that pain is more intense in right groin. The gland is larger and suppuration has begun. Left side bubo is smaller, harder and all pain has disappeared. Reapplied pressure bandage.

October 20. "Feels all right now." Right bubo smaller than a hickory-nut and left gland only slightly enlarged. No pain in either. Bandage removed.

Thus it will be seen that the bandage was a success in aborting the bubo in 80 per cent. of the cases in which used. The cases cited represent two gonorrheal and one chancroidal bubo, which was about the proportion treated.

Of course all buboes do not reach the operative stage. Whether treated or not, a good many will subside before suppuration begins.

Now a word as to the method of applying this bandage, about which the text-books are very reticent. This cannot better be given than in Dr. Gaither's own language. "A piece of cotton as large as the fist is folded in on itself again and again until it has the shape of the bubo, and when placed on it does not completely cover it. This is carefully adjusted and a wad of tightly compressed cotton as large as a cocoanut placed over it. Small pieces of cotton are also used on the inner and outer surfaces of the thigh to prevent chafing, and a very tight spica bandage put on."

It

The pressure bandage treatment for acute suppurative inguinal adenitis has in my experience been a success. has the following points to recommend it above any other abortive treatment thus far suggested.

1st. It is safe.

2d. It generally reduces the pain.

3d. It allows the patient to continue his usual avoca-tion without interruption.

4th. It gives a large number of successful cases.

ASTHENOPIA.

BY J. H. SHORTER, M.D., MACON, GA.

When requested to prepare a paper for such a gathering as this, not the least difficulty of the task is, I think, the choice of a subject. Not that there is a dearth of interesting ones on the contrary, their very abundance gives the "embarras de choix." One is always tempted to make such paper the vehicle for discussion of some very abstruse subject or the report of some exceedingly rare affection, an example of which may have come under one's observation and tested his power of diagnosis; but I am convinced that the best paper to lay before a gathering such as this, of the thoughtful, representative practical men of the profession, is one which, while treating of a subject sufficiently frequent to be of importance, is not so common or trivial as to be hackneyed; in other words, a subject of practical interest which may come to the attention of the family adviser as well as that of the oculist every day. The subject of this paper seems to me to entirely answer these conditions.

The term asthenopia, like that of neuralgia, is a careful and convenient one, though very incomplete as a diagnostic verdict, and expresses nothing as to the pathology of the affection which the patient complains of. Meaning literally "absence of strength of eye," or weakness of seeing-from "ops" and "asthenos," the term could rightly be applied to designate impairment of sight or inability from any cause, but in actual practice we restrict its application to descriptions of functional troubles, causing annoyance in the use of such eyes, which are in themselves seem

ingly healthy and without any discoverable morbid change or departure from the normal, except, perhaps, as to shape. As is evident from the meaning of the term and nature of the affection, asthenopia may be associated with or be the result of one or more of several different conditions, and as a fact, authorities divide it into three or four kinds, according to the anatomical or physiological abnormality, which seems as the base of the trouble; hence, asthenopic accommodation, muscular, intraocular, or nervous. Of the three groups the first comprises by far the greater number of cases and gives rise to much of the routine work of the average oculist.

The patient, often a young person, comes with complaint of inability to use the eyes for near work or for any length of time. Examination shows clear media and normal fundus, but an error of refraction (which is frequently a hyperopia or astigmatism); the proper glasses are adjusted, and the relief from symptoms complained of is often very prompt. In such case the treatment and cure follow on the diagnosis and all seems simple; but some years ago many such patients, victims of erroneous diagnosis, were subjected to vigorous constitutional antiphlogistic treatment by blistering, internal medication, confinement in dark room, etc., etc., for a presumed graver inflammatory disease of optic nerve or retina. For removing such erroneous conception and furnishing the correct interpretation of the condition underlying and causing such symptoms, all credit must be given to the genius of the great physiologist, Donders, long-time professor at Utrecht.

The subject of refraction has been pretty thoroughly worked over, and many devices suggested and injurious apparatus perfected for determining with accuracy the nature of the refraction of the eyes. But many causes still remaining unrelieved and the annoying symptoms still continuing, even after the most accurate correction of all re