directed toward obtaining free drainage from
the sinuses gives good results in so many cases, especially if the
relationship is recognized sufficiently early. "Glaucoma proper is
essentially a damming or blocking of the drainage from the interior of
the eye. The chief lymph stream flows from the posterior chamber past
the margin of the lens, through the zonula of Zinn, beneath the iris,
through the pupil into the anterior chamber, thence through the tissue
at the junction of the iris and sclera into the circular canal of
Schlemm and from this space into _the external lymph channels_.
_Obstruction to the steady escape of the intra-ocular fluids at any
point in this drainage system or any undue increase of the fluids
themselves may produce glaucoma._ Probably the most important
obstruction to the exosmosis is at the angle close to Schlemm's canal."

The following hypothesis is based upon Fischer's edema theory of
glaucoma and the relation of the circulation of the eye and orbit and
that of the nose and the accessory sinuses, the minute anatomy of which
is not as yet thoroughly understood. However, sufficient work has been
done to make it appear that the lymph channels which drain the eyes and
orbits empty into the same main channel as do those which drain the
sinuses. Admitted for sake of argument that such is the case, then
disease either acute or chronic of one or more of the sinuses with the
accompanying inflammatory reaction, congestion and stasis, will cause an
increased amount of fluid to be taken care of by the lymph channels
draining these sinuses. This will in turn cause flooding of the common
lymph channel, producing a stagnation in the flow of fluid from the
orbits and eyes at the junction with the main channel, with backing up
of the fluid within these channels and retention of the waste products
within the orbits and eyes; thus will be brought about conditions most
favorable (to quote from Fischer's theory of glaucoma) "to an abnormal
production or accumulation of acid in the eye. In consequence of this
abnormal acid content the hydration capacity of the ocular colloids is
raised and glaucoma results, not because water is pushed into the ocular
colloids, but because these suffer changes which make them suck in water
from any available source."

This hypothesis also might suggest why the subconjunctival injection of
sodium citrate in addition to alkalinizing the ocular contents, may be
effective in reducing t