the best of that unusual opportunity, and that to a foundation of a
careful training he has added the experience of twenty-two years of hard
painstaking work.

I have recently had the privilege of entertaining Colonel Elliot in my
own city, where I had the opportunity of assisting him and hence closely
observing his technique in eighteen trephinings. It has since been my
duty, and responsibility I may add, to care for those eighteen eyes. For
two years I have been doing the Herbert tongue flap, or a similar
operation. The results have been highly satisfactory thus far and
similar to those following the trephining operation, which operation I
have performed in a number of cases during the past ten months. My
conclusions as to these two operations are favorable to the trephining
operation because the Herbert tongue flap operation is much more
difficult, and hence less certain than the Elliot trephining operation.

The time for discussion does not permit a detailed statement of the
results nor experiences in the handling of these trephining cases. Of
the entire number five totally blind eyes were trephined. Tension was
reduced in all but one. In that one hemorrhage occurred at the time of
the operation. One of these blind eyes had not been totally blind longer
than a few weeks. Hand movement vision developed in this eye. Another
eye totally blind one year has thus far developed perception of light.
Of the cases with varying degrees of vision from hand movements to
six-ninths all but one have either remained the same or shown some
improvement. The one exception was an eye having six-ninths vision. A
small button hole iridectomy was made; prolapse of the iris into the
wound occurred four days later requiring incision. Upon incision of the
prolapse intra-ocular hemorrhage occurred, causing nearly total
blindness for two weeks. Vision is clearing fast and it remains yet to
be seen what the final results may be. One buphthalmic eye trephined by
myself gave good results.

I have as yet seen no cases of remote infection, but the report of
Axenfeld and some others would indicate that this occurred following the
Lagrange as well as the trephining operation, the then bulging
conjunctiva having become eroded and infection having taken place
through the eroded conjunctiva as shown when stained with flourescin.

The opinion, not yet conclusive, that I have thus far formed as a
consequence of my experience and the information obtaine