are yellow, some reddish-brown, some almost coal black, with every intermediate shade between. It is possible that our investigations failed for want of competent assistance with the spectroscopic analysis of the lenses. An interesting field for research is here presented. That deep-seated metabolic changes accompany the development of a cataract has been shown by J. Burdon Cooper, and it seems not unlikely that the apparent prevalence of lenticular opacities in tropical countries may be closely bound up with the metabolic changes we have described. It is probable that the retinal pigment layer is not the only source of the deep discoloration of the lenses met with by surgeons in India. A point in favour of the argument we have been elaborating is that some years ago McHardy published the analysis by MacMunn of the spectrum of the pigment obtained from a black cataract. This was found to be quite distinct from blood-pigment, and to be allied to the cell-pigment, which gives coloration to ectodermal structures in animals (Trans. of the O.S. of the U.K., 1882). To collect the 780 cases now under review has taken over twelve years, and the writer is deeply indebted to Major Kirkpatrick for his great generosity in allowing his 230 cases, the later ones of the series, to be made use of in this paper. Throughout all these years one definite purpose has been kept in the forefront--viz., to ascertain the real value of lens couching. After making every possible allowance for the vaidyan, the fact remains that he is a standing menace to society, and that he should be suppressed. His methods are crude, filthy, and dangerous; his results are so appalling that anyone unacquainted with the ignorance and credulity of the Indian ryot would think it impossible for him to continue to exist. His impudent lying includes not merely a grossly exaggerated statement of his own successes, but extends to the most barefaced falsehoods as to the nature of the results obtained in European hospitals. It may be permissible to quote one instance--unfortunately, far from a solitary one in Madras experience. Some years ago a peasant, who had had a cataract removed in the Government Ophthalmic Hospital, and whose recollections of his treatment there were most kindly, returned for operation on the second eye. On the steps of a temple, within a hundred yards from our operating theatre, this man, who had travelled several hundred miles for aid, was induced, by a tissue of impudent lies, to sit down and submit to couching. A few days later he presented himself at the out-patient room with panophthalmitis. There is no branch of ophthalmic disease and treatment in India which so profoundly impresses the Western surgeon’s imagination as this one. Remember that cataract strikes a man down in his maturity, at a period of his life when he has begun to reap the benefits of his earlier years of toilsome industry. His pay and his home expenses are both alike at their maximum. He is