nstances the successful maintenance of a glaucomatous life,
exclusive of operative interference, in addition to sustained myosis,
demands the investigation of the patient's metabolism, which must be
kept at the normal standard, the removal of the evil effects of
auto-infection, as we are wont to call it, and especially the
elimination of the cause which is responsible for the over plus tension
of the arteries and of the veins. This is best secured by just such
regulation of life as has been referred to, aided when necessary by the
ordinary drugs which the patient's condition indicate, and the success
of all treatments, be they operative or non-operative, is enhanced if
such a happy state of affairs can be brought about.

I am firmly convinced that every glaucomatous patient, and I now refer
to those who are the subjects of chronic progressive glaucoma, should be
carefully studied from the general standpoint by the oculist with the
aid of an expert internist, just as I am convinced that the modern
expert internist should not study his cases of cardio-vascular disease
without the help of the oculist. Perhaps I am going a little far afield,
but in justification of my statement I want to quote the opinion of Dr.
Hobart Hare, one of America's most expert clinicians, on blood pressure,
because it seems to me much harm has been done by the more or less
brutal knocking down of blood pressure simply because blood pressure
above the normal existed. "Concerning the matter of high blood
pressure," writes Hare, "independent of cerebral lesions, the longer I
study the matter the more convinced I am that this blood pressure is
devised by nature to compensate for fibroid changes in peripheral
vessels, in order that tissues which would otherwise be cut off from
adequate blood supply may receive plenty of blood, and I consider it one
of the most vital points to ascertain whether a pressure is what may be
called the patient's pathological norm, that is, the pressure which is
required in the face of vascular changes, or whether this pressure is in
excess of his pathological norm. If it is in excess, measures directed
to bring it to the pathological norm should be instituted, but if the
pressure found proves to be the pathological norm it is a bitter mistake
to lower it, be the pressure what it may. If it is lowered below the
pathological norm, all manner of disturbed cardiac action, etc., may
result. There is no more reason for reducing a b