Th r o a t in t he M a s s a c h u - setts General Hospital and in the Boston Children's Hospital. The instrument shown in the accompanying cut has been devised by the writer and employed with satisfaction for the excision of tissue in the nose, which cannot be advantageously removed by the snare or by the galvano-cautery. It consists essentially of two slender parallel shafts, the lower five inches long, bearing auteriorly a Y-8pring, each branch of which terminates anteriorly in a sharp-edged

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... ring in a manner similar to that in Sexton's forceps, the upper shaft ending anteriorly in an eye in which the branches of the Y lie. Thus a forward movement of the upper shaft upon the lower brings the Y branches together and causes one of the cutting rings to pass within the other. The lower shaft posteriorly and inferiorly bears two large rings, one directly below the other, admitting the fore and middle fingers respectively, while the upper shaft is decurved for a vertical distance of an inch at its posterior extremity, which bears a revolving ring for the thumb. The shafts are held in apposition by two sheaths through which the upper travels upon the lower. In action, therefore, the fore and middle fingers are the fixed point, while closure of the cutting rings is effected by a forward movement of the thumb. Two pairs of oval cutting rings are provided, which are interchangeable upon the lower shaft, one with its long diameter autero-poBterior, thus permitting work in a narrow space, the other with the long diameter of its oval lying transverse and affording a broader cutting surface. The instrument cuts readily both soft tissues and the bony structure of the middle turbinate. In the removal of hypertrophied tissue along the lower turbinate, it is to be noted that the area of denudation should be narrow, not generally above onefourth of an inch in width, although it may be over an inch in length aud may penetrate deeply to the bone. The walls of the "trench like deficiency thus formed come together during the process of healing and give finally a linear, often scarcely perceptible, cicatrix. (Removal of the mucous membrane over a wide area, on the other hand, may result in extensive scar-formation aud scabbing.) The hemorrhage following the operation is sometimes considerable, unless a packing of the nostril is maintained for several hours. In about twenty cases of hypertrophy of the lower turbinate the writer has employed this method of reduction of the hypertrophy on one side, using on the other side, for comparison, chromic acid or the galvauo-cautery. Examination after an interval of several months has shown in all cases, on the side of the excision, a more complete removal of the hypertrophy, without a greater amount of scar formation than on the cauterized side. In three cases of ethmoiditis the instrument has readily removed the anterior end of the middle turbinate, aud has been especially serviceable where a narrow configuration of the parts prevented the use of curved scissors, or of Hartmann's conchotome. It has also been of great service in the removal of small portions of tissue for histological examiuatiou, in clearing away stumps of polypi, and in excising large pharyngeal follicles. weak extrinsic muscles. Very weak internal recti muscles are associated with weak ciliary muscles, which well-fitted glasses correcting error of refraction will help but not wholly relieve. Iu inflamed cataractous eyes the lenses generally become obscured much more rapidly than in the quiescent ones. This degeneration of lenses is far more common in elderly people than is generally supposed, for failure of sight is so gradual that great surprise is manifested when the patient is told that it is the eyes that are iu fault and not the lenses. The milky, rapidly forming cataracts from diabetes mellitus belong to a distiuct class, aud have none of the appearances of senile degenerations ; neither do traumatic cataracts. The modern treatment for cataracts varies very little from that of seventy-five years ago. In uncomplicated cases extractiou without iridectomy is more and more the fashion, certainly much easier for the operator ; and results as good as the Graeffe operation of ten years ago are obtained. The first symptoms of degeueiatiou are losBof transparency, and the observer sees points at which light is absorbed or broken, that is, one finds dotB and lines aud smoke where nothing should be seeu. Many a cataract operation is performed with the vitreous body so broken aud muddy that good vision cannot be obtained, and in these cases some of the vitreous may be lost. This vitreous barometer foretells the well-being or the failure of the eyes. Degeneration of the vitreous can be stopped