old-sight (some times called far-sight,) and being due to excess of convexity that the defect of near sight will diminish as age advances. Although occupying still a place in text-books of natural philosophy these notions are to-day demonstrably erroneous.

It has been proved by actual measurement that the cause of near-sightedness is the too great length of the eye from front to back, and a consequent formation of the visual image in front of the retina instead of upon it. In order to throw the image further back a concave glass to diverge the rays of light is required. This defect is therefore structural or anatomical.

Not so, however, in presbyopia. The sight of those who require spectacles for reading or sewing, does not fail for perceiving distant objects. It is only in looking at small objects near by that the necessity for glasses is felt. If the small object is near by, the eye refuses to focus or accommodate so as to make an image on the retina, as in youth. If it is removed to a great distance a very small object will not form in the eye a sufficiently large image to excite visual sensibility. The long mooted question as to where the power of focusing or accommodating for different distances was situated, has been incontrovertibly settled, and it has been conclusively shown, that varying degrees of convexity of the crystalline lens and almost entirely of its anterior face, determine the accommodation. Helmholtz, by a delicate instrument measured the image of a candlelight reflected on the front surface of the lens, and found it greater when the eye was regarding dis tant objects than when regarding near ones; as the size of an image made by a convex mirror is in inverse ratio to the degree of curvature, it follows from the experiment of Helmholtz, that the anterior reflecting surface of the crystalline lens is less convex in regarding distant objects than when accommodated for near objects. Helmholtz also found that no change took place in the size of the corneal image whether reflected from the cornea while vision was accommodated for a near or a distant point. When the lens is wanting, no accommodation exists. It has been determined by careful observation of many thousand cases, that the power of accommodating for a near point sensibly diminishes from the age of ten years, as the lens becomes firmer, until about the age of

forty, it cannot achieve sufficient convexity for accurate definition of fine objects close at hand, and the necessity arises for augmenting the refraction artificially, in other words, for using convex glasses, the ordinary spectacles of elderly persons.

From these considerations it is clear how radically erroneous is the theory that presbyopia may be cured by modifying the convexity of the eye or cornea rather; and it is also clear, that failing sight is owing to a physiological change or hardening of the lens which begins at an early age.

I have said that these eye-cups are dangerous, and that warning should be given against their employment. In proof of this, I will narrate a single case.

Mrs. B. the wife of a wealthy gentleman in a city not very re mote, found her sight failing. She did not like to resort to the use of glasses, and having seen the eye-cups advertised as a sure cure she tried them. After a short time the sight of one eye was lost. Thereupon she consulted an oculist of high repute in another city, who examined her eye with lenses and artificial light, and stated to her that she had a cataract. Although she was enjoined to bear her affliction with resignation, she settled down into a state of melancholy on her return home. I chanced to spend a Sunday with friends in the city where she resided, and her husband requested me to ride out to his residence, and if possible cheer her up. Assuming the diagnosis given as a foregone conclusion I was good deal perplexed as to what I could say to cheer her up; but after having engaged in conversation with her, I requested her to give me the history of her case. She stated that her sight was good until within a few weeks, except that she felt the need of glasses, and she went on to speak of using the eye-cups. One day, she said a black spot appeared before her right eye, and almost immediately it seemed to shoot out processes like a spiders' legs, and her sight was soon gone. This history the gentleman alluded to, had not sought, or I am sure he would have hesitated before comn itting himself to the diagnosis of cataract.

I was glad to find in her account of the manner of losing her vis. ion some ground for encouraging and cheering her. Without even troubling her to submit to examination of the eye, which she

seemed to dread lest it should only confirm the opinion already received, I assured her that I was confident that my friend had made a mistake, and that she had no cataract, for her history of the case and the manner of invasion of her blindness negatived the probability of it. I gave my opinion that by use of the dangerous eye-cups she had ruptured a small blood vessel and that the appearance of the spider-like shot was due to intraocular hemorrhage, which I believed would be absorbed and her sight return. I advised her to keep quiet in a shaded apartment, give her eyes absolute functional rest, and to throw her eye-cups into the fire. I had the gratification to learn by letter from her husband within three or four weeks after that her sight had completely returned.

I regarded this as a fortunate escape for her, for it is not always that the effects of intraocular hemorrhages disappear so completely.

:0:

ART. II.—Medical Society of the County of Albany. SemiMonthly Meeting, January 14th, 1874.

Reported by F. C. CURTIS, M. D., Secretary.

The first Semi-Monthly Meeting of this Society for the winter was held as usual at the City Building, Dr. JOHN SWINBUrne, President, in the chair. Thirty-two members were present. After the minutes of the last semi-monthly meeting had been read and approved, the attention of the Society was called to the death f Drs. J. F. TOWNSEND, PETER VAN BUREN, and J. H. LASHER, former members, and committees were appointed to prepare suitable resolutions in regard to them.

Dr. E. R. HUN then reported a case of Calculus in the Urethra, as follows:

W. J., aged 53 year, came to me January 26th, 1873, complaining of a difficulty and pain in passing water. He told me that while in the British army twenty-four years ago, he contracted gonorrhea for which he was treated by strong injections, which put an end to the discharge in a few days. He had no further trouble for

the next ten years, when he suddenly found himself unable to pass water. He was relieved by catheterism, and for some time after had no further symptoms. About six years ago he observed that the stream of urine was becoming smaller, and that it took him a long time to empty the bladder, and some three or four years ago, after retaining his urine for some time and making forcible efforts to expel it he passed two or three small grity particles which occasioned very considerable pain. During the past three years he has never been able to pass water freely, and has several times suffered from retention, which has been relieved by warm baths and various internal remedies, advised by his friends. His urine now is expelled drop by drop, and his underclothing is constantly wet with that which passes involuntarily. He is considerably emaciated and so feeble as to be unable to do ordinary work; does not rest well at night, and has but little appetite. Upon attempting to introduce a silver catheter, I find it arrested about an inch from the meatus by a firm unyielding stricture. A No. 2 olive pointed bougie could be passed through this stricture, but encountered another about two inches farther back, through which it was passed with difficulty, although stiffened by the introduction of a wire stilet, a third stricture was met with in the membraneous portion of the urethra after passing which the instrument entered the bladder. Upon removing the bougie and and examining it, I was surprised to find it cut and scratch on its exterior, as if it had been drawn on some hard jagged body. I then felt along the urethra and found a calculus mass lying between the second and third strictures, which could be pushed up and down the urethra but was too bulky to pass the strictures. I endeavored to dilate the anterior strictures by graduated bougies, but it was so firm and unyielding that I made no headway.

A short time after I first saw the patient, the State Society met in Albany, and Dr. Otis of New York, exhibited his new urethrotome to me, which I thought would be just the instrument for such a case as the one aboved described.

I therefore asked him to meet the patient at my office, which he kindly consented to do, and we tried to introduced the instrumentThe stricture however would not admit it and Dr. Otis then tried

to enlarge the passage with a Maisonneuve's urethrotome. After considerable difficulty he succeeded in passing through the largest size blade of Maisonneuve's, and followed it with his own instru ment, but not without using force, so dense and unyielding were the fibrous bands forming the two anterior strictures. The doctor then by means of the screw in the handle, opened the blades of his instrument so as to dilate the strictures preparatory to dividing it, but after a few turns of the screw the blades became clogged with the calculus material contained in the urethra, and he could neither open or shut it. He managed to withdraw it with great difficulty, and the pain occasioned by the process was so great that the patient refused to allow anything more to be done, and insisted upon going home.

I saw him the next morning, and found the penis much inflamed and swollen. He had passed only a few drops of urine, and the bladder was distended. I tried to induce him to let me perform external urethrotomy and remove the ealculus and give exit to the urine, but he obstinately refused to permit anything to be done. He persisted in his refusal for the next few days, although in the mean time he suffered great pain, and the urine only dribbled away drop by drop. On the fifth day after Dr. Otis had seen him he consented to go to St. Peters' Hospital, where he was at once etherized, and Dr. Swinburne opened the urethra just in front of the posterior stricture. A calculus was removed measuring one inch in length by three-eighths of an inch in diameter, and with it three or four small angular masses of gravel. The stricture was then divided, and an elastie catheter passed into the bladder through which a large quantity of offensive urine passed off. The whole penis was sloughing from urinary infiltration, and the scrotum and several parts in the groin were incised and gave vent to purulent matter, having a strong urinous odor. The patient gradually sank and died forty-eight hours after the operation. No autopsy could be obtained.

From the size and shape of the calculus it must have been in the urethra for a long time, and it would be an interesting point to determine, whether it originally formed in the dilated portion of the urethra between the two strictures or forced from the blad