one may feel about the abandoning of such a time-honored drug as the nitrate of silver in the treatment of this disease, it must be conceded that it is entirely inadequate to control the process in the severer cases, and as a therapeutic sheet-anchor leaves a great deal to be desired. The use of cold compresses in gonorrheal ophthalmia continues to be advocated in text-books and practiced in many clinics, especially in America, in spite of the fact that the progressive men in general medicine and surgery seem pretty generally to have abandoned the use of cold applications in the treatment of acute inflammations of bacterial origin. Any merit the cold compresses may have in the reducing of the edema and relieving pain are more than counterbalanced by the fact that the vitality of the tissues is at the same time lowered. In cases in which there is a sufficient swelling of the lids to cause a dangerous pressure on the eyeball, cold should not for a moment be depended upon to control the inflammatory edema but instant recourse had to canthotomy: in cases where this swelling is not marked cold compresses are unnecessary and apart from a certain analgesic effect, of no value. The skepticism, which is becoming more general, in regard to the value of silver nitrate and cold applications has not extended to the third member of the classic trinity,--irrigations,--the efficacy of which seems to be generally conceded. Various substances have been advocated for this purpose,--boric acid, potassium permanganate, bichloride of mercury, normal salt solution, etc., and the consensus of opinion seems to be that it is practically indifferent which one of these is used, the action being mechanical rather than chemical. The ordinary method of half-hourly irrigations has been abandoned by Hosford, Ulbrich, and others in favor of the constant irrigation with the Hosford apparatus or some modification of it. The English adherents of the constant irrigation treatment, who, for the most part, dispense with the use of silver nitrate altogether, report excellent results; but the method is not without its drawbacks. The apparatus is awkward to use, requires as much or more attention than the intermittent irrigations, and undoubtedly disturbs the rest of the patient at night more. Further, since the lids are, of course, not held apart for the constant irrigation, but the flow of the solution across the palpebral fissure is depended on to cleanse the eye of secretion, one is inclined to question whether the mechanical cleansing is as thorough as when the lids are gently held apart while the eye is being irrigated.