poral subcutaneously, but as this did not check the bleeding he ligated the ruptured vessel on the inside of the lid. Dr. Angear was of the opinion that the varix was largely supplied by branches of the lachrymal artery, and that ligation of the common carotid would have to be made. At the time of the second visit of the patient the condition of the lids was not materially changed, but the patient was still anæmic and weak from loss of blood. I advised the operation which had been urged in the first place, but warned him that it might not prove successful, and in that case ligation of the common carotid would have to be made. The patient acquiesced. On May 11, under ether, four subcutaneous ligatures, one including the pulsating branches of the supraorbital, and three along the course of the temporal branches, were applied. The first of these was introduced at the outer rim of the orbit, and the other two at intervals of one-fourth of an inch towards the temporal region. After the sutures were introduced pulsation was only detected at the outer extremity of the lid in a small area. A fine electrolysis

needle was then inserted about a dozen times in different directions through the engorged tissues of the upper lid. Cold water dressings were applied, and the patient was ordered to be kept quiet in his room and friends were warned of the possibility of secondary hemorrhage. Considerable reaction followed the operation. The ligatures had all come away by the end of twelve days without any hemorrhage, and by the end of three weeks the swelling had subsided to a degree less than existed before the operation. The surface of the lid is now smooth. Pulsation is still felt over the outer rim of the orbit and the eye-lids are still much thickened. On June 1 electrolysis was again freely used·

without employing an anæsthetic, and but little reaction. followed.

At present, June 8th, the lids have not entirely recovered from the last operation, but I think it is safe to say that it will be followed by further improvement.

It is still a question as to whether a cure will be effected by the means instituted. I present the patient for your inspection and advice. I am encouraged to give further trial to electrolysis. We all know that ligation of the common carotid is a hazardous operation, and is not always successful in curing aneurisms about the orbit. There is no doubt about the aneurism in this case, starting from the injury of ten years ago, and it is my opinion that the injury was primarily directed to the branches of the middle temporal. It was upon this opinion that my hope of benefiting the patient by the treatment detailed was based.

The third annual meeting of the society was held on October 12th, at the Tremont house, F. C. Hotz, M.D., in the chair. The following officers were elected for the ensuing year: President, Dr. E. L. Holmes; vice-president, Dr. Lyman Ware; secretary and treasurer, Dr. Boerne Bettman.

Dr. F. C. Hotz then read a paper entitled

THE RATIONAL TREATMENT OF PATIENTS AFTER CATARACT

OPERATIONS.

Though the safety of the eye is of prime importance, we must, in our anxiety for the recovery of this organ, not entirely disregard the comfort of the patient, for we have no right to deprive our patients of any comfort which does not disturb the healing process. The usual treatment after cataract operations is anything but pleasant to the patient, and many dread the confinement to bed, and in a dark room; worse

than the operation itself. If it can be shown that such measures are superfluous, they should be abandoned.

When a wound is carefully cleansed and thoroughly disinfected, and its edges are nicely approximated, it will heal by first union, provided the close adaptation of its edges is not disturbed by external violence or by muscular tractions. Rest of the wounded part is the first condition for kind healing. But to rest the eyeball it is not necessary to put the patient to bed; we can secure the necessary rest for the operated eye, i. e., we suspend the functions of the ocular muscles and immobilize the eyelids by bandaging both eyes. As long as they are closed they remain comparatively motionless. The bandage over both eyes accomplishes this result just as well whether the patient is in bed or sitting in a chair. The confinement to bed, therefore, is irrational, and the recumbent posture is not only of no advantage, but may even disturb the healing, because it favors the flow of blood to the head; consequently congestion of the ocular tissues is more likely to occur in the recumbent posture than when the patient is sitting up.

The uselessness of darkening the room will be apparent to everyone who will bandage his own eyes just in the same manner as we dress the eyes after cataract operations. The bandage shuts off the light so thoroughly that we will be unable to tell whether the room is light or dark. To the patient it is immaterial, but to his attendant it is a great comfort to have light in the room.

In regard to the dressing there is a difference of opinion: the majority of oculists employing the pads and bandage; some closing the eyelids only by strips of plaster, and others discarding all dressings.

If we dispense with the dark room, we cannot leave the

eyes without dressing, because the winking of the eyelids and the constant rotations of the eyeball would disturb the wound and cause a good deal of irritation.

The plaster strips overcome this difficulty; but they do not give the eye any protection against mechanical insults which might cause a re-opening of the freshly united wound. The bandage with padding of absorbent cotton or any other soft material secures to the eye rest and protection against accidents and is therefore to be recommended as the most rational dressing. The flannel roller is open to the objection of being easily disarranged by the movements of the head on the pillow; but a roller of mosquito netting or Swiss gauze applied wet forms, when dry, an immovable bandage which does not become loose, and keeps nicely adjusted for any desired length of time.

The sensitiveness of the operated eye to bright light is not due to the bandage; it varies greatly in different persons; some even do not show it at all. Where it exists it only shows that the eye has not completely recovered from the effects of the operation though the external wound may appear well healed. With the eyes well bandaged my patients are sitting in easy or rocking chairs, in light rooms, and are even allowed to take an exercising walk in their rooms; they go to bed when they please, and get up whenever they like. I have never observed any complication or accident which could directly or indirectly be attributed to this mode or treatment. The recovery was as rapid and the results as good as under the old-fashioned régime.

ABSTRACTS.

EXPERIENCES CONCERNING ONANISM IN YOUNG CHILDREN. BY PROFESSOR HIRSCHSPRUNG, in Copenhagen. Berliner Klinische Wochenschrift, September 20, 1886. The author of this paper is convinced that masturbation occurs in very young children, though we may be disinclined to believe it; and that the effects on the organism, and especially on the brain, are much worse than after puberty.

"I will show that masturbation is practiced at a very early age, not only by boys but also by girls, most frequently, according to my experience, by the latter.

"The following typical case occurred lately: A shapely, well-nourished girl, just thirteen months old, of Danish parentage, was brought to me on the 20th of November, 1884. She was the only child; the mother seemed very nervous, the father was healthy. The attending physician could not explain the attacks from which the child suffered.

"The child was said to have been suffering for eight or nine months from its attacks, which were still of a doubtful nature.

“On examination absolutely nothing was to be learned. The child was ruddy, was not rickety, had a normal temperature, normal urine, suffered a little from constipation. It cried continually during the investigation, and became quiet for the first time when the nurse took it in her arms. It grew gradually quiet, and I then observed an attack which lasted for about five minutes. The child lay stretched over the