tion, which is maintained by Wahlfours, aids in this favorable
action of the myotics remains to be proved. It has been maintained by
this author and by others who have followed him.

The great trouble with myotic treatment is not its lack of efficiency,
but the difficulty of carrying it out successfully on ambulant
patients, even in the better walks of life. It is hard successfully to
maintain in a patient with chronic glaucoma what I may call an eserin
life, just as it is hard to maintain in a person with an enlarged
prostate a catheter life and escape infection, resulting, if it occurs,
in the one instance in a difficult and stubborn conjunctivitis, and in
the other in a cystitis. Still, we are obliged to use myotics, and the
way to employ them to the patients' best advantage, I have ventured to
repeat in spite of the universal familiarity with the methods. Perhaps
we may reach that happy day when, especially with improved tonometric
methods, increased skill in measuring the rate of filtration and better
instruments for determining the light sense, we can anticipate the
advent of glaucoma and get ahead of the ocular and visual deterioration
which increased tension produces, by performing preventive operations
which shall aid nature's filtration channels in the establishment of an
artificial one. But increased tension is not the whole story of
glaucoma, and a filtering cicatrix is not the last word in surgical
therapeutics, and there is much to learn.

2. _Reduction of tension by means of various mechanical measures,
notably massage, and by means of electricity and diathermy._ Massage is
of ancient lineage. In general terms, in so far as ocular massage is
concerned, it may be applied to the eye with the finger tips (ordinary
massage), by means of various instruments (vibration massage), and with
the help of certain suction cups (suction massage, which is indeed a
form of vibratory massage). Many authors are satisfied with their
results without the employment of any instrument, and prefer simple
massage with the tip of the finger to any form of the instrumental
variety, to quote the words of Casey Wood. At one time in my career I
experimented very extensively with massage, not alone for the purpose
of reducing intra-ocular tension, but in various diseases of the lid and
cornea, and taught a trained nurse, who herself had a nebulous cornea,
to make what I may call a specialty of this particular therapeutic
procedure. Sh