2. _Reduction of tension by means of various mechanical measures, notably massage, and by means of electricity and diathermy._ Massage is of ancient lineage. In general terms, in so far as ocular massage is concerned, it may be applied to the eye with the finger tips (ordinary massage), by means of various instruments (vibration massage), and with the help of certain suction cups (suction massage, which is indeed a form of vibratory massage). Many authors are satisfied with their results without the employment of any instrument, and prefer simple massage with the tip of the finger to any form of the instrumental variety, to quote the words of Casey Wood. At one time in my career I experimented very extensively with massage, not alone for the purpose of reducing intra-ocular tension, but in various diseases of the lid and cornea, and taught a trained nurse, who herself had a nebulous cornea, to make what I may call a specialty of this particular therapeutic procedure. She became exceedingly skillful and was quite faithful. We believed that the best results were obtained in a seance of two or three minutes, the finger tip being used over the lid, and the surface of the cornea lubricated with a drop of pure olive oil, although in glaucoma the addition of the oil is not necessary. Four movements were utilized, the first a stroking movement in lines radiating from the central pressure, very much as the spokes of a wheel radiate from the hub, second a circular movement, third a pressure movement, a little dipping motion, so that the cornea was slightly depressed, and finally, a gentle tapping movement, precisely the same, except that it was a diminutive one, as the tapping movement that the Swedish masseur makes. Usually each movement occupied from a half to one minute, according to the results desired. I agree with Casey Wood that such a technic furnishes just as good results as any one with the aid of an instrument. Referring particularly to the reduction of intra-ocular tension, many surgeons have been impressed with the value of various instruments. Thus, Ohm, who has worked particularly in the reduction of the increased tension of secondary glaucoma, for example, after discussion of lamellar cataract, advocates the Piesbergen instrument, which makes 3,000 vibrations a minute, and is applied over the closed lids. I think the instrument best known is the one introduced by Malakow. For this purpose the point of an Edison electric pen is armed with a small ivory ball, and the vibration rate varies from 200 to several thousand a minute, the rapidly revolving ball being passed over the closed lids, in some instances directly upon the cornea itself. I am frankly afraid of these vibrating machines, and again make a plea for the finger tip, just as I am afraid of a Von Hippel trephine, and prefer one which is rotated with the fingers.