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320 EEPORTS OJSr THE PEOGEESS OF MEDICITTE. Generic Oxybutynin is best seen with the inverted image, bnt it is seen too with Order Oxybutynin the upright imaji:e in Purchase Ditropan Online some cases, as Dr. Loring asserts, conti-ary to Mauthner's state- ment, and in this we agree with him. On the appearance of the reflex from the fovea, Dr. Loring says: "Even when present, it is not, however, always of a crescentic shape, for it sometimes has tlie appearance as if it were only tlie segment of a small circle which Avas ilhiniinated, or as if the fossa Vr^ere a triangular one, and light were reflected from only one side of it, in which case the reflection streams out something like the tail of a very inioute comet; again, it has the appearance of a delicate phantom-like veil, stretched in part or entirely across the fovea; and then, again, there is no reflex at all, and the fovea looks like Purchase Oxybutynin a small, yellow dot, varying in size and shape, and has the ap- pearance as if it had been flecked directly on to the surface of the retina with a brush. " May not these differences in effect of the reflection, when present, be due to variations in anatomical construction of the part, and principally to differences in shape and depth of the excavation ; Buy Cheap Oxybutynin and, when the reflex is absent, may not its absence be due to the want of any difference in level?" 28. — Cases of Choroidal MeJano-sarcoma^ with Phthisis Bulbi. By Dr. Bekthold, [Arehiv fur Ophthal., Jahr. xvii., Abth. 1, S. 185.] The cases were chiefly remarkable for the age of the subjects, one thir- teen, tlie other twenty. In both the eyeballs had become atroi)hied in early childhood, in one even congenitally. It was assumed that the cause was panophthalmitis from the growtli of the tumor. These cases, with some published by Knapp, and others by Forster, are presented as an off"- set to tlie prevailing belief in the great malignancy of choroidal sarcomata. They are extremely prone to recurrence; and Graefe, in 1864, could recall no instance in which there had been exemption for more than four years. To have even a few cases with a less gloomy prognosis is satisfactory. Generic Ditropan On the other hand, it is shown that the disease may make its inroad at a much earlier period than is usually assigned to it. (A case of choroidal sarcoma in my private collection was taken from a Purchase Ditropan boy twelve years old. I have had no information about its recurrence. — II. D. N.) 29. — Tlie Origin of the so-called Glassy Excrescences on the Choroid of the Human Eye^ and the Nature of Hyaline Degeneration of its Ves- sels. By Dr. Alex. Eudxew. [Virchow's Arehiv., Band liii,, Heft 4, pp. 455-4G5.] The little masses in question were examined by Donders and Mliller many years ago, and called by the former "colloid globules." Others have since written upon them. They appear beneath the epithelium on the glassy lamella of the choroid, and Buy Oxybutynin Online vary from -^-^ to -J- millimetre in diameter. They are extremely indifferent to chemical reagents. Dr. Rudnew regards these masses as due to transformation of emigrated white blood-corpuscles; he finds them at all ages, and tiiinks their more frequent occurrence in the old is because in Order Oxybutynin Online them vascular obstructions are the most common. In this opinion Dr. Rudnew differs from Donders, who thought they came from the nuclei'of the epithelium. In a case of purulent choroiditis accompanying purulent meningitis. Dr. Rudnew found extensive hyaline metamorphosis of the walls of the vessels. Some vessels were thus completely occluded. There was also great abun- dance Purchase Oxybutynin Online of the above-mentioned hyaline globules. It was possible to see that the transparent substance in the Cheap Ditropan vessels was made by fusion of small masses, and Dr. Rudnew concludes that the glassy state of the vessels originates like the glassy bodies of the hyaline lamella, from changes Oxybutynin Online of the white blood-corpuscles. OPHTHALMOLOGY, 321 80. — Formation of Bone in the Eye. By Dr. II. Knapp. [ArcLives for Oph. and OtoL, vol. ii., No. 1, p. L] A careful description is given of tlie minute appearances in five globes iQ which ossific deposit had taken place. It is clearly shown Buy Oxybutynin that there was actual bony production as distinguished from calcification. Dr. Knapp attempts to show in what particular structure, and under Avhat Ditropan Online conditions, osteoid growth occurs. His conclusions arc, that true ossification has only been found in exudations from the choroid. Calcareous deposits, on the other hand, have been observed in all the structures of the globe. At its beginning tiie bony formation appears in the chorio-capillaris in small plates, which are covered by the hyaline membrane and epithelium. Where there is more abundant exudation of plastic lymph, the bone-tissoe becomes correspondingly thicker, and it iriay in some cases extend in a transverse septum across the anterior part of the vitreous, behind the ciliary body and lens, without involving those parts. The diseases leading to Order Ditropan this gi'owth are chronic inflammations of the iris and choroid. Both ossification and calcification may occur at once. The diagnosis of either is made by feeling a hard and resisting Buy Ditropan Online mass in the deeper part of the Buy Cheap Ditropan globe, beginning about two Buy Ditropan lines behind the cornea, while the anterior parts are soft, or at least impressible. The paper concludes with these remarks: "As ossification does not involve the outer choroidal layers, nor the Order Ditropan Online ciliary muscle and iris, it in itself is not to be dreaded as a cause of sympathetic ophtlialmia. The latter can only result from irido-cyelitis supervening as a complication to ossific choroiditis. "As long as an eye in whicli ossification is diagnosticated remains free from irritation, and its fellow also, the removal of the former for fear of sympathetic inflammation is not indicated. To corroborate this, I may- state that I have not unfrequently observed cases in which eyes bearing the signs of ossification, and even being tender to the touch, in the ciliary region, were tolerated witiiout annoyance for twenty, thirty, and fortv years."

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