In a very interesting note [88] on couching of the lens as practiced by native practitioners, Major R. H. Elliot, I.M.S., writes as follows. "The ignorance and stupidity of the ryot (villager) is so great that he will not very infrequently try one eye in an English hospital, and one in a Vaithyan's hands. It is a very common thing for a native patient to deny ever having visited a native doctor, when he first comes to hospital. After the other eye has been successfully operated on, he will sometimes own up to the fact.... Here in the south, there appear to be two classes of operators, the resident men who live for long periods in one bazaar, and the travellers who move continuously from place to place. Both are Mahomedans. The former appear to get somewhat better results than the latter, and are spoken of as 'men of experience.' The latter seem never to stop long in one place. They collect a number of victims, operate on them, and then move on before their sins can find them out. Both kinds of operators seem to be innocent of any attempt at securing asepsis or antisepsis; they use a dirty needle or a sharp wooden skewer; no anæsthetic is employed; a bandage is kept on for ten days, and counter-irritation is freely resorted to, to combat iritis, etc. Many of the victims are ashamed to come to a European hospital after the failure of their hopes. It has been said that, if the Vaithyan did not get good results, he would be dropped, and the practice would die out. This remark can only have come from one who knew nothing of the Indian character, or the crass ignorance of the lower classes of the people. It is hard for those who have not lived and worked among them to realise how easily the ryot falls a dupe to impudent self-advertisement. He is a simple kindly person, whose implicit trust in confident self-assertion will bring him to grief for many another generation. The vision of these poor unfortunate people sitting down in a dusty bazaar to let an ignorant charlatan thrust a dirty needle into their blind eyes has evoked the indignation of the English surgeon from the time of our first occupation of the country. Side by side with a well-equipped English hospital, which turns out its ninety odd per cent. of useful vision, there sits in the neighbouring bazaar even to-day the charlatan, whose fee is fixed at anything from 3d. to 8 shillings, plus, in every case, a fowl or other animal. The latter is ostensibly for sacrificial purposes, but I understand ends uniformly in the Vaithyan's curry-pot. Weirdest, perhaps, of all the Vaithyan's methods is the use of the saffron-coloured rag, with which pus is wiped away from the patient's inflamed eye. On this colour, the pus, etc., cannot be seen, and therefore all is well. It is the fabled ostrich again, only this time in real life, with vital interests at stake."