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number was' already bewildering. Coreg 20 Mg
De. Agnew's experience had confirmed his belief in the
bold use of canthoplasty. He had been led to modify the
operation by division of the edge of the external tarsal liga-
ment of the upper lid only, as exposed in the wound. It
was the pressure of the tarsal cartilage of the upper lid
which caused the chief trouble ; and the incision of skin and
mucous membrane alone would not always make such press-
ure harmless. He felt confident that, since the introduction
of iridectomy, no other addition so important as canthoplasty
had been made to the resources of ophthalmic therapeutics.
De. Edward Curtis could testify to the value Coreg Cr 20 Mg of the pro-
cedure in phlyctenular conjunctivitis, the promptness of its
effect seeming at times almost magical. He related a case,
attended with great photophobia, cured by its means in a
couple of days.
Dr. It. H. Derby thought that the advantage of the
operation lay, perhaps, as much in its enabling the surgeon to
reach the retro-tarsal fold with his applications, as in the
relief from pressure it afforded. Coreg Cr 40 Mg Von Graefe objected to its
'employment in diphtheritic conjunctivitis, from the danger
that any wound in such a case might itself become the seat
of diphtheritic deposit.
Dr. Althof had had only seventeen cases of diphtheritic
conjunctivitis in five years, up to September last, though since
then he had seen at least twenty. He would not set his own
slight experience against Yon Graefe's ; but, although he had
always found the diphtheritic deposit infiltrating tlie incision,
PROCEEDINGS OF SOCIETIES. 301
as it does wounds of other parts, yet he regarded tliis as of
slight consequence when compared with the great advantages
confeiTed bj the operation. By the time the diphtheritic
trouble was cured, the wound was well healed, Coreg 2.125 Mg and no harm
had come of Generic Coreg Cr it.
De. Roosa had never seen any grave consequences from
the operation as performed by Dr. Althof, though he had
several times seen ectropion of the lower lid follow, as a
result, perhaps, of the incision having been made not hori-
zontally outward, but obliquely downward. He had known,
however, one or two instances of serious injury from the
operation, where the dissection of Coreg 18.75 Mg the conjunctiva was made
very thorough and carried into the orbital tissue. In one
case the eye was lost.
Four years ago he had had a dispensary-case of phylc-
tenular keratitis relieved most remarkably, in twelve hours,
by the operation. He was not aware, at the time, that it had
been previously performed for this form of disease.
Dk. Loeing had been anticipated by the last speaker in
most of what he was about to say. He had observed some
half a Coreg Er dozen cases of ectropion due to Coreg Cr 10 Mg the operation ; and had
several times seen trouble from too free a dissection of the parts.
He thought the division of the external tarsal ligament,
suggested by Dr. Agnew, should be limited to those cases in
which trachoma had progressed to the extent of converting
the inner surface of the lid into a hard, cicatricial tissue,
which, by its contraction, had war^Dcd the tarsal cartilage,
increasing its natural curvature, so as to bring its sharp edge
against the cornea. He had himself formerly employed the
method, originally proposed by Pagenstecher, of dissecting
up the conjunctiva so as to make a considerable flap, the sides
of which were so stitched to the skin, near the outer extremity
of the horizontal incision, as to convert this into a wound,
with its long diameter vertical. But this produced much
greater deformity than the method followed by Dr. Althof;
and, Coreg 40 Mg moreover, as before remarked, the liberal incision into the
orbit was by no means free from danger. Cheap Coreg He had seen two
instances of severe inflammation from it, one of them being
that referred to by Dr. Roosa, in which the eye was destroyed.
302 peoceedijstgs of societies.
He had, Coreg 80 Mg tlierefore, abandoned tlie plan in favor of the simple
operation recommended in the paper. In this, as there stated,
the stitch at the angle was the main point upon which success
would depend.
Dr. Agnew did not mean to say that he would cut the
tarsal ligament in every case, or that Coreg Cr 20 he would ever cut it in
the lower lid. Coreg Generic Name Bat he would incise it oftener than Coreg 10 Mg recom-
mended by Dr. Loring, on account of the danger of relapse
wlien this was omitted. Indeed, he had more than once been Coreg Cr 40
obliged to divide the ligament by a secondary operation,
where the ordinary horizontal incision, previously made by
another surgeon, had proved insufficient. There was no dif-
ficult dissection required, and no danger of orbital cellulitis.
It usually sufficed to make the incision through the edge of
the ligament, near its insertion into the periosteum of the
orbital rim. It need not be cut in such simple cases as those
of phlyctenular ophthalmia with photophobia.
CEREBRO-SPESTAL MENINGITIS.
Dr. Kussel said that, within three days, seven cases of
cerebro-spinal meningitis Order Coreg had occurred Coreg Cr Generic in the city, three of
which had proved fatal. At the suggestion of Dr. Peters, he
read the report of an interesting case furnished by Dr. C. E. Coreg Cr 80 Mg
Simmons. The Health Board were anxious to study the dis-
ease, and asked, as a matter of favor, an early report of any
cases which Is Coreg A Beta Blocker might be discovered.
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