than the emmetropic; the hypermetropic more. treatment, the prognosis is very favorable. With proper The treatment must depend upon the cause of the affection and the general indications for remedies. Spasm of the ciliary muscle is especially found in the hypermetropic eyes of youthful persons who have strained the accommodation. A spasmodic contraction of the ciliary muscle results from the continued tension put upon it. Patients apparently suffer from myopia, which would require concave glasses for distant vision. The ophthalmoscope proves the refraction to be hypermetropic. Temporary paralysis of the accommodation may be necessary; if so, it should be secured and maintained by the use of a mydriatic for some weeks. Afterward, proper convex lenses should be prescribed. Remedies often render this unnecessary. Atony of the ciliary muscle is a condition analogous to that produced in other muscles of the body from long continued overwork. Continued application of the eyes to near and fine work may cause fatigue of this muscle, with more or less symptoms of asthenopia. Rest of the accommodation must be prescribed and secured by convex glasses strong enough to render rays of light from near objects parallel. These glasses may be substituted for weaker ones, from time to time, until the eye regains its normal tone. Remedies: Argent. nit., Causticum, Opium, Physostigma ven., et al. PSEUDO-MEMBRANE, ESPECIALLY BY W. H. WINSLOW, M.D. The coating of a free surface by a morbid material, which subsequently becomes organized, is a histologico-pathological process dependent upon the morphology of the normal basal tissues. These exert an influence upon the superimposed product, in the kind and arrangement of its anatomical elements, and imitations more or less exact appear. Thus mucous membranes fashion pseudo-membranes; muscles, myomas; cartilage, enchondromas; bones, osteomas; etc. Excrescences are influenced much in character by the vascularity of their hosts, by the function of the part where they are located, and by so-called nervous sympathy. Morbid products seem to possess affinities for a single tissue, or a number of tissues, forming a membrane or an organ. This results probably from the necessity of eliminating systemic poisons by the usual channels, the skin, the mucous membrane and the glands. In the part affected, there occurs a specific chemical and vital change, influenced by the state of health of the individual; this extends by continuity and contiguity of tissue, by the blood and lymph, by sympathy, and lastly, by vicarious action. Carcinoma of the cardiac end of the stomach creeps up the oesophagus, but carcinoma of the pylorus seldom affects the duodenum; pseudomembranes in the throat rarely invade the nasal fossæ, but extend readily to the larynx; bronchitis may become capillary, but the inflammation is arrested at the threshold of the air cells; syphilis passes by the lymph to glands, and by the blood to the brain ; rheumatic inflammation flies from fibrous tissues of joints to the fibrous tissues of the cardiac valves; gouty inflammation journeys from the tendo-achillis, or metatarso-phalangeal articulations, to the diaphragm or the heart; the onus of mumps affects now the |