erous allowance for
these difficulties, and I gladly welcome the suggestion that all the
cases which I have operated on in America be collected together and
reviewed as a whole.

Fifth: In conclusion I would like to express the pleasure with which I
listened to Dr. de Schweinitz' paper. I believed from the title that
there might be a wide divergence of opinion between us. I find to my
great relief that we are in absolute accord. I know, however, that there
are in America and elsewhere able men who consider that the medical
treatment of glaucoma should be pushed as long as possible. I cannot but
feel that this is a survival of the dread that most surgeons have felt
in recommending one of the older operations for glaucoma. We have now in
our hands a method so safe, so easy and so certain that I feel sure that
this dread will ere long pass away, and that the diagnosis of glaucoma
will then be followed by a very early operation. In India I have gone
farther than this, and where one eye has shown high tension, I have
frequently trephined both. The prophylactic use of the operation is more
than justified in that land of long distances and scattered medical aid,
and where the patient is not likely to return a second time for surgical
help. This prophylactic trephining is a proposition that I put before
you today for your consideration, reminding you at the same time that
glaucoma is practically invariably a bi-lateral condition. I have seen
even in America not a few people blind in both eyes who might have
retained the sight of the second eye had the surgeon advised a double
sclerectomy when he first saw the case, despite the fact that the second
eye was then to all appearances non-glaucomatous.

Dr. Robert Henry Elliot's Paper on Trephining for Glaucoma

Discussion,

FRANK C. TODD, M.D.,

Minneapolis.

It is very difficult for one of limited experience to discuss a subject
presented so ably by Lieutenant Colonel Elliot to whom we are indebted
for the sclero-corneal trephine operation. He has already over a period
of a little over four years performed over 900 trephinings, and has made
a most careful subsequent study of the results of those operations on as
many cases as he had the opportunity to observe.

Anyone who has read Colonel Elliot's book on the sclera-corneal
trephining operation will be struck with the fact that he has not only
had a tremendous experience in ophthalmic surgery, but that he has made