=Pain.=--The pain which follows the operation of couching has attracted the attention of surgeons from very early times, and there has been much speculation as to its cause. When, after Daviel’s discovery, extraction came into serious competition with the older operation, surgeons discussed at much length the relative merit of the two procedures, and it was strongly urged by the extractionists that their operation gave rise to less pain than that of couching. The subject is a very difficult one, for no surgeon, who has had a large cataract practice, can fail to have been struck by the extraordinary difference in the statements of patients as to the amount of suffering they have endured during the first twenty-four hours after the removal of a lens. The majority of them confess to a good deal of pain; this comes on as the effect of the anæsthetic wears off, reaches a maximum, and then slowly dies away, leaving them at the end of twelve hours, and often even at the end of six hours, comparatively comfortable. Occasionally, but rarely, the report is that the pain has been negligible throughout. On the other hand, a bitter complaint of very severe pain is sometimes encountered; fortunately such an occurrence is infrequent. In the case sheets on which the writer’s 780 cases were taken, a special heading was provided for notes on the pain inflicted at or after operation. A striking feature of the replies given was the extraordinary difference between them; this is the more astonishing because in a large number of the operations it is probable that no anæsthetic of any kind was used, and yet it was by no means uncommon to meet with patients, who made little or nothing of the pain either at the operation or after it. On the other hand, some complained of terrible suffering, commencing as soon as the needle was inserted, and lasting for long periods thereafter. The majority admitted to some pain, but neither belittled nor exaggerated it. It will thus be seen that, so far as pain is concerned, the experiences of the coucher and of the extractor are much alike; it is unfair to judge either operation on exceptional cases.