A VISIT TO PROF. KOMOTO 767

ologic and humanistic side of ophthal­mology that Dr. Komoto has either by preference or by fate devoted most of his energies to the care of his multi­tudes of patients. It has created a confidence in and a desire for the best kind of western medicine among a peo­ple who were slow to give up their prej­udices in favor of the old. It has done more than anything else, perhaps, to de­velop in Japan a large body of oph­thalmologists who, in contradistinc­tion to the attitude of very many Jap-

SOCl£T£ BELGE D'OPHTAL-MOLOGIE.

May 1st, 1921 Interstitial Keratitis from Injury.

WEEKERS, Liege, reports a case of typi­cal interstitial keratitis, occurring after duly verified injury, in a man 60 years old who worked in a quarry. There was no trace of syphilis and the Bordet-Wassermann reaction was negative

A diagnosis of interstitial keratitis from injury should not be made except after most careful consideration. All of the cases in the literature cannot be ac­cepted as authentic. In some cases, it is a question of coincidence; in others the injury never existed but was in­voked in order to demonstrate freedom from disease. When the injury actu­ally occurred, as in most of the remain­ing cases, it acted only as the exciting cause for the manifestation of the syphilis, in an individual already in­fected.

However, the above case shows that the question must remain open, for in it there was typical interstitial kera­titis; but the most searching clinical examination did not permit of attribut­ing the lesion, even indirectly, to syph­ilis.

The problem is also complicated by forms of deep, atypical keratitis, in­volving often only a portion of the cor-

anese medical men, consider their pro­fession a healing art rather than an op­portunity to secure subjects for their experimental laboratories.

Japan does indeed owe Dr. Komoto a debt of gratitude for his untiring ser­vice to her people. I t is good there­fore to know that he is "not without honor" in his own country. It is cer­tain that no one will ever be able to dispute the title that his fellow phy­sicians have given him, "The Father of Ophthalmology in Japan."

nea. Such cases, probably due to in­jury, are not so exceptional. The ob­servation of many such cases has con­vinced the author that they are entirely local in nature and uninfluenced by syphilis or any other general disease. Sometimes one finds as the origin of these lesions a slight loss of superficial substance, so slight that it might eas­ily be overlooked. The superficial les­ion is the seat of an infiltration extend­ing, not along the surface, but to the interior of the corneal parenchyma. This deep infiltration shows an ac­knowledged predilection for the center of the cornea. Perhaps in these cases, the outer surface is immune to bacteria so that the lesion propagates only in the interior of the corneal parenchyma. Aniridia and Glaucoma.

WEEKERS, Liege, presented the case of a patient, 48 years old, who had aniridia in both eyes, with congenital cataract and glaucoma. One of his children, 8 years old, suffered from bilateral buphthal-mos with aniridia and cataract, with luxation of the crystalline lens above in one eye.

Great importance is attached to the light that such cases throw upon the origin of the intraocular fluids and the pathogenesis of glaucoma.

The inferences regarding the normal aqueous humor, as drawn from the an-iridic eye, have been raised as the

SOCIETY PROCEEDINGS Reports for this department should be sent at the earliest date practicable to Dr.

Harry S. Gradle, 22 E. Washington St., Chicago, Illinois. These reports should present briefly the important scientific papers and discussions.

758 BELGIAN OPHTHALMOLOGICAL SOCIETY

chief objection to the iridic origin of the aqueous. On the other hand, the coexistence of aniridia and glaucoma seems to destroy the theory attribut­ing glaucoma to an obstruction in the elimination of the aqueous humor at the line of the iridocorneal angle. In reality, the process is not so simple. Anatomic examination has shown that aniridia is never complete. It is, there-fort, not impossible that the iris ele­ments, present in aniridia, suffice to give birth to the aqueous humor. It is also possible, considering their peri-pheric location, that they obstruct the iridocorneal angle. The necessary con­clusion, therefore, is that it is not pos­sible to make a definite deduction from these facts either as to the origin of the aqueous humor or as to the patho-genesis of glaucoma.

In this glaucomatous and aniridic patient, pilocarpin reduced the tension to normal in both eyes. Nevertheless, it has long been believed that pilocar­pin in the treatment of glaucoma is closely associated with changes in the pupil and iris. However, according to Groenholm, pilocarpin acts upon the ocular tension thru the vessels; by con­stricting the vessels, it diminishes the production of aqueous. This theory ex­plains better the conditions observed in Weekers' patient. Familial Nonsyphilitic Retinitis.

KLEEFELD, Brussels, stated that in three boys and two girls belonging to a family of eight children, there oc­curred diminution of vision at the age of ten and a half, with central scotoma for green and red; accompanied by re­tinitis punctata, more marked in the macular region, and optic atrophy. The Bordet-Wassermann was negative. Extreme Unilateral Miosis.

KLEEFELD, Brussels, reported the case of a woman suffering from ex­treme miosis of one eye, without any concomitant nervous lesion. Subconjunctival Injection of Glycerin-

ated Extract of Testicle. KLEEFELD. Glycerinated extract of

testicle in subconjunctival injections is mildly hypertonic, because of the gly­

cerin, and irritant, because of the or­ganic substances.

Therapeutically, it can be used to in­duce the resorption of exudates, as fine, dustlike, vitreous hemorrhages. This treament is more effective and more prolonged than those generally em­ployed. It is sufficient to make one in­jection a day, for from three to five days, that is until the conjunctiva is permanently congested. A month's in­termission will then be necessary be­fore the second series of injections. Silver Salvarsan in Syphilitic Affec­tions of the Optic Nerve.

The experiments of RASQUIN (Na-mur) have convinced him that silver salvarsan, when properly administered is not a dangerous medicine. Pseudoblastomy.

MARBAIX, Tournai, and VAN DUYSE, Gand. Exophthalmos with paralysis of the third nerve developed in a pa­tient without inflammatory symptoms. The globe could not be pressed back­ward. Diagnosis; malignant retrobul-bar tumor. A Kronlein operation was performed, but no tumor was found. On resection of the lacrimal gland, it was found to be hynertrophied behind. Resistent tissue in the walls of the or­bit could not be felt with the finger.

Histologic examination: Dissemin­ated, perivascular, lymphocytic foci were found. There were lymphocytes and diffuse plasma cells in the vacular spaces. There were hyalin degenera­tion of the vascular walls and, finally, lesions of chronic inflammation. The exophthalmos was reduced, but the ptosis was accentuated; and vision was reduced to 0.1 by a film of neuroparaly-tic keratitis.

The examination of the blood, after the operation, showed an excess of lymphocytes over pojynuclear leuco­cytes, that is a lymphocythemia. The hemoglobin count, hematin and white corpuscles were normal.

Tuberculosis and syphilis were clearly excluded.

The histologic lesions were identical with those which Birch-Hirschfeld de­scribes successively as disseminated lymphocytosis (1905) and diffuse lym-

SOCIETY PROCEEDINGS 759

phocytosis (1909). According to Mel-ler, iymphocytosis is always compact, but according to Hocheim, it may be diffuse.

Considering the normal state of the blood in his two operations, Birch-Hirschfeld rejected the idea of a gen­eral disease, such as the pseudoleuk-emia supposed by Hocheim. He ad­mits hyperplasia of the preexistent lymph tissue (the embryonic perivas-cular layers of Ribbert) and concedes that a neoplasm may be the unique and only symptom of a general disease, as is shown in the present case by the fact that neither the blood nor the peri­pheral glands were involved.

The histologic examination should take account of the lymphosarcoma of Kundarat, which is sometimes diffuse and which arises from the sphenoid; as well as the leucosarcoma of Sternberg, which was demonstrated by clinical ex­amination.

The study of lymphomas is of pri­mary importance in the diagnosis of orbital tumors. All tests should be ap­plied in such diagnosis; Border.-Was-sermann, tuberculin, opsonic index, leucocytosis, and rhinologic and X-ray examination. Congenital Obstruction of the Lac-

rimal Passages. LEBOUCQ, Gand. Of six children,

born to healthy parents, five showed immediately after birth a bilateral lac-rimal obstruction. The remaining child had a monolateral obstruction. Probing resulted in immediate cure. Paralysis of the Lids in Cataract Op­

eration. VAN LINT, Brussels, uses a 2% novo-

cain solution, with a drop of adrenalin to each cc , added. A 3.5 cm. needle is entered 1 cm. back of the point of in­tersection of a horizontal line, passing the lower margin df the orbit, and a vertical line at its external margin. He injects 2 cc. of the solution to within 5 mm. of the lower margin of the orbit

A second puncture is made 1 cm. above the first. The needle is directed upward, and 1 cc. of the solution is in­jected as far as the external palpebral ligament. A third puncture is made

on a line with the outer terminus of the eyebrow, and 1 cc. of the solution is injected from above downward to the external palpebral ligament.

Such paralysis of the lids greatly fa­cilitates a cataract operation. Siderosis of the Eye.

In a case of siderosis, H. .COPPEZ, Brussels, examined the aqueous hu­mor with the Gullstrand slit lamp. It appeared yellow in color. Chemical analysis demonstrated the presence of iron.

MARCEL DANIS, Secretary.

NETHERLANDS OPHTHALMO-LOGICAL SOCIETY.

56th Semiannual Meeting Translated from the Nederlandische Tyd-schrift v. Geneeskunde by Dr. E. E. Blaauw.

PROF. G. F. ROCHAT, Presiding. Persistent Facial Slit and the Origin

of the Tear Ducts. J. VAN DER HOEVE showed photo­

graphs of a child on the left side of whose face the facial slit had remained partially open and had produced a large coloboma of the lower lid. The lower punctum was situated to the temporal side of the coloboma. Both tear ducts were shown in a Roentgeno-graph after thorium injection, with sounds in the upper and lower canali-culus. Altho this congenital deviation seems to prove that the canaliculi or­iginate from the lid margins, van der Hoeve still accepts the opinion of Ask that the canaliculi originate as shoots from the lacrimal sac; and he showed histologic, embryonic specimens of Ask. Ocular Symptoms of Osteomyelitis of

the Superior Maxilla in New Born. E. MARX stated that what is at the

present time called osteomyelitis of the superior maxilla in the new born was formerly called acute sinuitis of the antrum of Highmore. I t presents some ocular symptoms, and during the last nine years Marx saw three cases. The first, a child a few weeks old, had con­junctivitis, a fistula in the neighbor­hood of the right tear sac, a yellowish