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Meetings for Graduate Study
EDITORIALS
Patients v a r y greatly, in the a m o u n t of prismatic difiference that they can o v e r c o m e , and their w i l l i n g n e s s to put up with the n e c e s s a r y d i s c o m f o r t o f learning to o v e r c o m e it. In general a diflference of t w o diopters in the strength of the lenses b e f o r e the t w o e y e s can b e tolerated, and in time the glasses b e c o m e c o m f o r t a b l e . T h e ad j u s t m e n t t o them consists, partly in learning to o v e r c o m e slightly greater prismatic eflfects, and largely in learn ing to not l o o k near the e d g e of the Jens. P r o b a b l y it also includes d e v e l o p m e n t of the ability t o interpret rightly, and t o use for binocular vision, i m a g e s received on points of the t w o retinas not strictly identical. T h e extent of this last factor in " g e t t i n g used t o the g l a s s e s " is w o r t h investigating. A few persons cannot get accus t o m e d to the prismatic action o f lenses that differ 2 D . in strength; but most p e o p l e will b e c o m e a c c u s t o m e d to such a difference and w e a r the glasses with c o m f o r t . S o m e are able to use lenses that dift'er m o r e than this. B u t the writer has seen n o patient w h o used his e y e s freely and c o m f o r t a b l y w i t h lenses that differed m o r e than 4 D . in strength. O c c a s i o n a l l y patients have c o m e w h o h a v e s t r u g g l e d t o use such lenses for m o n t h s o r years, b u t in the end had to g i v e it up. O f c o u r s e if the vision in o n e e y e is v e r y p o o r , s o that its retinal i m a g e s are easily ig nored, the use of such lenses b e c o m e s possible, b y g i v i n g u p for the time binocular v i s i o n . T o m e e t the necessities o f the case w e have the established c u s t o m of g i v i n g for high a n i s o m e t r o p i a an accurate correction of the better e y e ; and for the other a lens that will g o as far t o w a r d a c o r r e c t i o n as is practicable, w i t h o u t m a k i n g the inequality of the prismatic effects t o o great. F o r pa tients w h o have c o r r e c t e d vision a b o u t equally g o o d in the t w o e y e s , it m a y be practical to c o r r e c t the m o r e h y p e r o p i c o r less m y o p i c e y e for distant vision and the other for near w o r k ; an arrangement that g i v e s great satis faction to a n i s o m e t r o p e s w h o are also presbyopic. E . J.
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MEETINGS FOR GRADUATE STUDY. In July of this year there w a s car ried thru in D e n v e r t w o w e e k s of g r a d u a t e s t u d y of O p h t h a l m o l o g y and O t o - L a r y n g o l o g y that demonstrated s o m e things of general interest. Its plan w a s in the main the same as had been f o l l o w e d the year b e f o r e ; s h o w ing some improvements contributed by e x p e r i e n c e and a m o r e c o m p l e t e o r g a n ization. T h e class was larger, see p. 810. T h o s e w h o participated in it re ceived the three essential benefits of g r a d u a t e s t u d y — i n f o r m a t i o n , interpre tation and i n s p i r a t i o n ; and it d e m o n strated h o w these benefits are easily within the reach o f all practitioners of these special b r a n c h e s of m e d i c i n e . L e t us clearly distinguish b e t w e e n t w o diflierent things that h a v e been called graduate, or postgraduate study. T h e c o u r s e leading to the d e g r e e of M . D . , in A m e r i c a , g i v e s certain funda mental scientific training basic to m e d i c i n e , and a general s u r v e y o f m e d i c a l art that m a y help the y o u n g graduate to orient himself. B u t it d o e s n o t really train him for practice and send him out c o m p e t e n t , in any special branch of m e d i c i n e . If he is t o b e c o m e a really creditable m e m b e r of his p r o fession he m u s t seek further education in the line of w o r k he p r o p o s e s to fol l o w . T h i s preparation for special prac tice has b e e n called g r a d u a t e s t u d y ; but it is essentially similar to the kind of s t u d y o n e d o e s in c o l l e g e , after he " g r a d u a t e s " from the high s c h o o l , or in the professional s c h o o l , after he grad uates f r o m the c o l l e g e . T h e r e is another kind of " g r a d u a t e s t u d y " that has to b e d o n e b y every m e m b e r of a profession w h o h o p e s to obtain, o r d e s e r v e the full confidence o f his professional colleagues or a community. It is to c o n t i n u e his mental and professional d e v e l o p m e n t . It is needed first to r e m e d y defects in herent in the educational s c h e m e of f o r m e r years, and t o secure a k n o w l e d g e of the a d v a n c e s that are b e i n g m a d e from year to year in the field of scientific medicine. O n e w h o has prac ticed o p h t h a l m o l o g y for forty years k n o w s , that a v e r y i m p o r t a n t part of
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EDITORIALS
his present professional e q u i p m e n t w a s not possessed b y any o p h t h a l m o l o g i s t at the b e g i n n i n g of that period. T h i s kind of graduate study, w h i c h keeps the o p h t h a l m i c physician and s u r g e o n g r o w i n g and up to date, must b e p r o vided for, just as certainly as an office to w o r k in, or instruments to w o r k with. In a w a y this kind of g r a d u a t e s t u d y has always been carried on, thru medical societies, journals and books. But it can be made far m o r e effective and attrac tive b y using the best m o d e r n means of teaching and illustrating n e w ideas or procedures. Diagrams, photographs, lantern slides, m o v i n g pictures, m o d e l s , microscopic and gross specimens, cadavers, animals' eyes, d e m o n s t r a tions to small g r o u p s , actual use of new instruments, the examination of clinical cases and r o u n d table confer ences, w e r e all available in the D e n v e r Course. Such opportunities are p o s sible w h e r e v e r o p h t h a l m o l o g i s t s ap preciate their value, and w ill g i v e the time and effort necessary to a c c o m plish things that are m o s t w o r t h while. A l r e a d y they are b e i n g c o n s i d e r e d for t w o or three other A m e r i c a n M e d i c a l Centers, and similar m e t h o d s are be ing tried in other fields of m e d i c i n e . T o be m o s t serviceable to m e m b e r s of the ]?rofession w h o have already been trained m o r e or less for special practice and are already e n g a g e d in it, certain c o n d i t i o n s m u s t be o b s e r v e d . T h e m e m b e r s of such classes are b u s y men at h o m e , they leave a circle of patients, s o m e t i m e s rather inadequate ly served during their absence, and can be a w a y a rather brief time. T h e instruction they get should be of the best and should b e g i v e n with the greatest e c o n o m y of time. A t D e n v e r , D o c t o r s de S c h w e i n i t z , D u a n e , Feing o l d and W o o d r u f f , with teachers o f o t o - l a r y n g o l o g y equally^ eminent, and local teachers who ha.\e had ten vears of e x p e r i e n c e in graduate teaching, w e r e able to g i v e this kind of instruc tion. O p h t h a l m o l o g y and O t o - L a r y n g o l o g y are t w o distinct specialties w i t h little m o r e in c o m m o n w i t h each other than with other branches of m e d i c i n e . But there are t w o v e r y i m p o r t a n t ad
811
v a n t a g e s in g i v i n g them t o g e t h e r in such a c o u r s e . M o s t o f the students are practicing and interested in b o t h specialties, and the c o m b i n e d course g i v e s a wider r a n g e of subjects and interest. In the s e c o n d place such a c o m b i n a t i o n m a k e s it p o s s i b l e to se cure a large n u m b e r of g o o d teachers, b o t h local and those secured from a distance. T h e large teaching staff is necessary, to fill the students' time e v e r y d a y to the best advantage. E v e n in a large city, w h e r e t w o or m o r e medical s c h o o l s m a y b e located, the best results will be obtained o n l y b y uniting all the g o o d teachers, from all the s c h o o l s and t e a c h i n g hospitals. T o secure the best teachers from a dis tance rather large classes must be pro vided. T o g i v e students the best use of their time these large classes m u s t be split up a part of the day into small sections and for each section must be p r o v i d e d a c o m p e t e n t instructor. In a t w o w e e k s ' ' c o u r s e it is possible t o c o v e r w i d e fields o f o p h t h a l m o l o g y and o t o - l a r y n g o l o g y . Special t o p i c s m u s t be selected that can be presented in such a time, with their c l o s e l y re lated facts, m e t h o d s , p r o b l e m s and re cent d e v e l o p m e n t . A t D e n v e r , this y e a r the chief central t o p i c s in ophthal m o l o g y w e r e , fields of vision and their significance, c u l m i n a t i n g in the lectures of D r . de S c h w e i n i t z and D r . Feing o l d ; and the ocular m o v e m e n t s and m u s c l e operations, c u l m i n a t i n g in the lectures o f D r . D u a n e and D r . W o o d ruff. Such topics can b e varied from y e a r to y e a r ; but certain others should p r o b a b l y be offered every year, such as the normal and p a t h o l o g i c h i s t o l o g y of the eye, in w h i c h the earlier training of m o s t o p h t h a l m o l o g i s t s has been ileficient. Finally, it should be emphasized that such m e e t i n g s m a y be c o n d u c t e d b y o r g a n i z a t i o n s of those w o r k i n g in these specialties. T h e o n e at D e n v e r w a s m a n a g e d b y a j o i n t c o m m i t t e e of the C o l o r a d o O p h t h a l m o l o g i c a l and O t o - L a r y n g o l o g i c a l Societies. It is not essential to have the support of a university w i t h its plant and organiza tion, nltho the advantages o f such facilities should b e utilized w h e r e v e r possible. M a n a g e d in this w a y such
812
EDITORIALS
meetings d o not need to wait until academic inertia can be o v e r c o m e ; and they are m o s t lilsely to r e s p o n d c l o s e l y to the c o n s c i o u s needs of o u r special branch of the profession. A t the m e e t ing at Montreal last month, the value of graduate study managed by the pro fession was strikingly illustrated. Suc cess is c l o s e l y associated with the mutual character of the m o v e m e n t . Out o f their assigned hours, the teach ers at D e n v e r w e r e m o s t interested and diligent students. E . J.
T H E LONDON MEETING. A t a dinner given t o Professor G e o r g e E . de S c h w e i n i t z at the U n i versity Club in D e n v e r , J u l y 29th, the guest of the e v e n i n g spoke to the students and instructors taking part in the D e n v e r C o u r s e in O p h t h a l m o l o g y and O t o - L a r y n g o l o g y , of the C o n vention of English speaking O p h t h a l mologic Societies to be held in L o n don next year. T h e gathering must be regarded as o f especial interest to all A m e r i c a n o p h t h a l m o l o g i s t s . A t the G l a s g o w m e e t i n g o f the British S o c i e t y he had p r o m i s e d the hearty c o o p e r a t i o n of his A m e r i c a n c o l l e a g u e s , and he hoped t h e y w o u l d r e d e e m the promise with characteristic enthusiasm. It w o u l d b e a rare o p p o r t u n i t y to see English o p h t h a l m o l o g i s t s and ophthal mic institutions under m o s t favorable conditions. ' T h e f o l l o w i n g outline has been ar ranged : M o n d a y , July 13. O p e n i n g E v e n i n g , R e c e p t i o n at the R o y a l C o l l e g e of S u r g e o n s , L i n c o l n ' s Inn Fields, b y the President and Council of the C o l l e g e . T u e s d a y , July 14. Morning, Re ception of d e l e g a t e s ; A d d r e s s b y the P r e s i d e n t ; Scientific papers. After n o o n : Visits to various institutions of o p h t h a l m i c interest. E v e n i n g : R e c e p tion. Wednesday, July IS. Morning: Scientific papers. A f t e r n o o n : Garden P a r t y at A u b r e y H o u s e , C a m p d e n Hill. E v e n i n g : S y m p o s i u m b y selected speakers on " T h e Evolution o f Bin ocular V i s i o n . " T h u r s d a y , July 16. M o r n i n g : Scien
tific Papers. A f t e r n o o n : General meet i n g of the C o n v e n t i o n t o discuss the future of International O p h t h a l m o l o g i cal C o n g r e s s e s . A t 5 p . m. T h e B o w man L e c t u r e , t o be delivered b y Sir J o h n Parsons, F . R . S . E v e n i n g : Ban quet. Friday, J u l y 17. M o r n i n g : D i s c u s sion o n " M i c r o s c o p y of the L i v i n g Eye." A f t e r n o o n : Scientific Papers. E v e n i n g : R e c e p t i o n b y the President at the W e l l c o m e Historical Medical Museum. Saturday, July 18. E x c u r s i o n to O x ford and C a m b r i d g e . T h e r e will b e a M u s e u m of A n a t o m i cal, P a t h o l o g i c a l and other exhibits. A l s o a Business E x h i b i t i o n . Local c o m m i t t e e s are b e i n g f o r m e d to assist over-sea m e m b e r s , desirous of visiting various parts of the British Isles. T h e registration fee for those w h o are not m e m b e r s of the O p h t h a l m o l ogical S o c i e t y of the U n i t e d K i n g d o m will b e t w o p o u n d s , and for ladies, ac c o m p a n y i n g m e m b e r s o f the C o n v e n tion, w h o wish to b e c o m e A s s o c i a t e M e m b e r s , 10 shillings.
BOOK NOTICES. The Medical Department of the United States Army in the World War. V o l . X I , Surgery, Part t w o . Pre pared u n d e r the direction of M a j o r General M . W^. Ireland. B u c k r a m , 828 pages, illustrated in the text and b y c o l o r e d plates. Washing ton, G o v e r n m e n t P r i n t i n g Office, 1924. T h e contents of this v o l u m e will b e of especial interest to o u r readers. A l t h o the first part is d e v o t e d t o e m p y e m a , the remainder contains reports on: Maxillo-facial Surgery, b y L t . Col. R o b e r t H . I v y and M a j o r Joseph D . E b y ; O p h t h a l m o l o g y in the U n i t e d .States, b y Brig. Gen. G e o r g e E. de Schweinitz; Ophthalmology in the American Expeditionary Forces, by Col. A l l e n G r e e n w o o d ; O t o - L a r y n g o l o g y in the U n i t e d States, b y Lt. C o l . S. J. M o r r i s ; and O t o - L a r y n g o l o g y in the American Expeditionary Forces, by Col. James F. M c K e r n o n . T h e r e is m u c h in the section o n Maxillo-facial S u r g e r y that bears u p o n
Patients v a r y greatly, in the a m o u n t of prismatic difiference that they can o v e r c o m e , and their w i l l i n g n e s s to put up with the n e c e s s a r y d i s c o m f o r t o f learning to o v e r c o m e it. In general a diflference of t w o diopters in the strength of the lenses b e f o r e the t w o e y e s can b e tolerated, and in time the glasses b e c o m e c o m f o r t a b l e . T h e ad j u s t m e n t t o them consists, partly in learning to o v e r c o m e slightly greater prismatic eflfects, and largely in learn ing to not l o o k near the e d g e of the Jens. P r o b a b l y it also includes d e v e l o p m e n t of the ability t o interpret rightly, and t o use for binocular vision, i m a g e s received on points of the t w o retinas not strictly identical. T h e extent of this last factor in " g e t t i n g used t o the g l a s s e s " is w o r t h investigating. A few persons cannot get accus t o m e d to the prismatic action o f lenses that differ 2 D . in strength; but most p e o p l e will b e c o m e a c c u s t o m e d to such a difference and w e a r the glasses with c o m f o r t . S o m e are able to use lenses that dift'er m o r e than this. B u t the writer has seen n o patient w h o used his e y e s freely and c o m f o r t a b l y w i t h lenses that differed m o r e than 4 D . in strength. O c c a s i o n a l l y patients have c o m e w h o h a v e s t r u g g l e d t o use such lenses for m o n t h s o r years, b u t in the end had to g i v e it up. O f c o u r s e if the vision in o n e e y e is v e r y p o o r , s o that its retinal i m a g e s are easily ig nored, the use of such lenses b e c o m e s possible, b y g i v i n g u p for the time binocular v i s i o n . T o m e e t the necessities o f the case w e have the established c u s t o m of g i v i n g for high a n i s o m e t r o p i a an accurate correction of the better e y e ; and for the other a lens that will g o as far t o w a r d a c o r r e c t i o n as is practicable, w i t h o u t m a k i n g the inequality of the prismatic effects t o o great. F o r pa tients w h o have c o r r e c t e d vision a b o u t equally g o o d in the t w o e y e s , it m a y be practical to c o r r e c t the m o r e h y p e r o p i c o r less m y o p i c e y e for distant vision and the other for near w o r k ; an arrangement that g i v e s great satis faction to a n i s o m e t r o p e s w h o are also presbyopic. E . J.
809
MEETINGS FOR GRADUATE STUDY. In July of this year there w a s car ried thru in D e n v e r t w o w e e k s of g r a d u a t e s t u d y of O p h t h a l m o l o g y and O t o - L a r y n g o l o g y that demonstrated s o m e things of general interest. Its plan w a s in the main the same as had been f o l l o w e d the year b e f o r e ; s h o w ing some improvements contributed by e x p e r i e n c e and a m o r e c o m p l e t e o r g a n ization. T h e class was larger, see p. 810. T h o s e w h o participated in it re ceived the three essential benefits of g r a d u a t e s t u d y — i n f o r m a t i o n , interpre tation and i n s p i r a t i o n ; and it d e m o n strated h o w these benefits are easily within the reach o f all practitioners of these special b r a n c h e s of m e d i c i n e . L e t us clearly distinguish b e t w e e n t w o diflierent things that h a v e been called graduate, or postgraduate study. T h e c o u r s e leading to the d e g r e e of M . D . , in A m e r i c a , g i v e s certain funda mental scientific training basic to m e d i c i n e , and a general s u r v e y o f m e d i c a l art that m a y help the y o u n g graduate to orient himself. B u t it d o e s n o t really train him for practice and send him out c o m p e t e n t , in any special branch of m e d i c i n e . If he is t o b e c o m e a really creditable m e m b e r of his p r o fession he m u s t seek further education in the line of w o r k he p r o p o s e s to fol l o w . T h i s preparation for special prac tice has b e e n called g r a d u a t e s t u d y ; but it is essentially similar to the kind of s t u d y o n e d o e s in c o l l e g e , after he " g r a d u a t e s " from the high s c h o o l , or in the professional s c h o o l , after he grad uates f r o m the c o l l e g e . T h e r e is another kind of " g r a d u a t e s t u d y " that has to b e d o n e b y every m e m b e r of a profession w h o h o p e s to obtain, o r d e s e r v e the full confidence o f his professional colleagues or a community. It is to c o n t i n u e his mental and professional d e v e l o p m e n t . It is needed first to r e m e d y defects in herent in the educational s c h e m e of f o r m e r years, and t o secure a k n o w l e d g e of the a d v a n c e s that are b e i n g m a d e from year to year in the field of scientific medicine. O n e w h o has prac ticed o p h t h a l m o l o g y for forty years k n o w s , that a v e r y i m p o r t a n t part of
Λί
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EDITORIALS
his present professional e q u i p m e n t w a s not possessed b y any o p h t h a l m o l o g i s t at the b e g i n n i n g of that period. T h i s kind of graduate study, w h i c h keeps the o p h t h a l m i c physician and s u r g e o n g r o w i n g and up to date, must b e p r o vided for, just as certainly as an office to w o r k in, or instruments to w o r k with. In a w a y this kind of g r a d u a t e s t u d y has always been carried on, thru medical societies, journals and books. But it can be made far m o r e effective and attrac tive b y using the best m o d e r n means of teaching and illustrating n e w ideas or procedures. Diagrams, photographs, lantern slides, m o v i n g pictures, m o d e l s , microscopic and gross specimens, cadavers, animals' eyes, d e m o n s t r a tions to small g r o u p s , actual use of new instruments, the examination of clinical cases and r o u n d table confer ences, w e r e all available in the D e n v e r Course. Such opportunities are p o s sible w h e r e v e r o p h t h a l m o l o g i s t s ap preciate their value, and w ill g i v e the time and effort necessary to a c c o m plish things that are m o s t w o r t h while. A l r e a d y they are b e i n g c o n s i d e r e d for t w o or three other A m e r i c a n M e d i c a l Centers, and similar m e t h o d s are be ing tried in other fields of m e d i c i n e . T o be m o s t serviceable to m e m b e r s of the ]?rofession w h o have already been trained m o r e or less for special practice and are already e n g a g e d in it, certain c o n d i t i o n s m u s t be o b s e r v e d . T h e m e m b e r s of such classes are b u s y men at h o m e , they leave a circle of patients, s o m e t i m e s rather inadequate ly served during their absence, and can be a w a y a rather brief time. T h e instruction they get should be of the best and should b e g i v e n with the greatest e c o n o m y of time. A t D e n v e r , D o c t o r s de S c h w e i n i t z , D u a n e , Feing o l d and W o o d r u f f , with teachers o f o t o - l a r y n g o l o g y equally^ eminent, and local teachers who ha.\e had ten vears of e x p e r i e n c e in graduate teaching, w e r e able to g i v e this kind of instruc tion. O p h t h a l m o l o g y and O t o - L a r y n g o l o g y are t w o distinct specialties w i t h little m o r e in c o m m o n w i t h each other than with other branches of m e d i c i n e . But there are t w o v e r y i m p o r t a n t ad
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v a n t a g e s in g i v i n g them t o g e t h e r in such a c o u r s e . M o s t o f the students are practicing and interested in b o t h specialties, and the c o m b i n e d course g i v e s a wider r a n g e of subjects and interest. In the s e c o n d place such a c o m b i n a t i o n m a k e s it p o s s i b l e to se cure a large n u m b e r of g o o d teachers, b o t h local and those secured from a distance. T h e large teaching staff is necessary, to fill the students' time e v e r y d a y to the best advantage. E v e n in a large city, w h e r e t w o or m o r e medical s c h o o l s m a y b e located, the best results will be obtained o n l y b y uniting all the g o o d teachers, from all the s c h o o l s and t e a c h i n g hospitals. T o secure the best teachers from a dis tance rather large classes must be pro vided. T o g i v e students the best use of their time these large classes m u s t be split up a part of the day into small sections and for each section must be p r o v i d e d a c o m p e t e n t instructor. In a t w o w e e k s ' ' c o u r s e it is possible t o c o v e r w i d e fields o f o p h t h a l m o l o g y and o t o - l a r y n g o l o g y . Special t o p i c s m u s t be selected that can be presented in such a time, with their c l o s e l y re lated facts, m e t h o d s , p r o b l e m s and re cent d e v e l o p m e n t . A t D e n v e r , this y e a r the chief central t o p i c s in ophthal m o l o g y w e r e , fields of vision and their significance, c u l m i n a t i n g in the lectures of D r . de S c h w e i n i t z and D r . Feing o l d ; and the ocular m o v e m e n t s and m u s c l e operations, c u l m i n a t i n g in the lectures o f D r . D u a n e and D r . W o o d ruff. Such topics can b e varied from y e a r to y e a r ; but certain others should p r o b a b l y be offered every year, such as the normal and p a t h o l o g i c h i s t o l o g y of the eye, in w h i c h the earlier training of m o s t o p h t h a l m o l o g i s t s has been ileficient. Finally, it should be emphasized that such m e e t i n g s m a y be c o n d u c t e d b y o r g a n i z a t i o n s of those w o r k i n g in these specialties. T h e o n e at D e n v e r w a s m a n a g e d b y a j o i n t c o m m i t t e e of the C o l o r a d o O p h t h a l m o l o g i c a l and O t o - L a r y n g o l o g i c a l Societies. It is not essential to have the support of a university w i t h its plant and organiza tion, nltho the advantages o f such facilities should b e utilized w h e r e v e r possible. M a n a g e d in this w a y such
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meetings d o not need to wait until academic inertia can be o v e r c o m e ; and they are m o s t lilsely to r e s p o n d c l o s e l y to the c o n s c i o u s needs of o u r special branch of the profession. A t the m e e t ing at Montreal last month, the value of graduate study managed by the pro fession was strikingly illustrated. Suc cess is c l o s e l y associated with the mutual character of the m o v e m e n t . Out o f their assigned hours, the teach ers at D e n v e r w e r e m o s t interested and diligent students. E . J.
T H E LONDON MEETING. A t a dinner given t o Professor G e o r g e E . de S c h w e i n i t z at the U n i versity Club in D e n v e r , J u l y 29th, the guest of the e v e n i n g spoke to the students and instructors taking part in the D e n v e r C o u r s e in O p h t h a l m o l o g y and O t o - L a r y n g o l o g y , of the C o n vention of English speaking O p h t h a l mologic Societies to be held in L o n don next year. T h e gathering must be regarded as o f especial interest to all A m e r i c a n o p h t h a l m o l o g i s t s . A t the G l a s g o w m e e t i n g o f the British S o c i e t y he had p r o m i s e d the hearty c o o p e r a t i o n of his A m e r i c a n c o l l e a g u e s , and he hoped t h e y w o u l d r e d e e m the promise with characteristic enthusiasm. It w o u l d b e a rare o p p o r t u n i t y to see English o p h t h a l m o l o g i s t s and ophthal mic institutions under m o s t favorable conditions. ' T h e f o l l o w i n g outline has been ar ranged : M o n d a y , July 13. O p e n i n g E v e n i n g , R e c e p t i o n at the R o y a l C o l l e g e of S u r g e o n s , L i n c o l n ' s Inn Fields, b y the President and Council of the C o l l e g e . T u e s d a y , July 14. Morning, Re ception of d e l e g a t e s ; A d d r e s s b y the P r e s i d e n t ; Scientific papers. After n o o n : Visits to various institutions of o p h t h a l m i c interest. E v e n i n g : R e c e p tion. Wednesday, July IS. Morning: Scientific papers. A f t e r n o o n : Garden P a r t y at A u b r e y H o u s e , C a m p d e n Hill. E v e n i n g : S y m p o s i u m b y selected speakers on " T h e Evolution o f Bin ocular V i s i o n . " T h u r s d a y , July 16. M o r n i n g : Scien
tific Papers. A f t e r n o o n : General meet i n g of the C o n v e n t i o n t o discuss the future of International O p h t h a l m o l o g i cal C o n g r e s s e s . A t 5 p . m. T h e B o w man L e c t u r e , t o be delivered b y Sir J o h n Parsons, F . R . S . E v e n i n g : Ban quet. Friday, J u l y 17. M o r n i n g : D i s c u s sion o n " M i c r o s c o p y of the L i v i n g Eye." A f t e r n o o n : Scientific Papers. E v e n i n g : R e c e p t i o n b y the President at the W e l l c o m e Historical Medical Museum. Saturday, July 18. E x c u r s i o n to O x ford and C a m b r i d g e . T h e r e will b e a M u s e u m of A n a t o m i cal, P a t h o l o g i c a l and other exhibits. A l s o a Business E x h i b i t i o n . Local c o m m i t t e e s are b e i n g f o r m e d to assist over-sea m e m b e r s , desirous of visiting various parts of the British Isles. T h e registration fee for those w h o are not m e m b e r s of the O p h t h a l m o l ogical S o c i e t y of the U n i t e d K i n g d o m will b e t w o p o u n d s , and for ladies, ac c o m p a n y i n g m e m b e r s o f the C o n v e n tion, w h o wish to b e c o m e A s s o c i a t e M e m b e r s , 10 shillings.
BOOK NOTICES. The Medical Department of the United States Army in the World War. V o l . X I , Surgery, Part t w o . Pre pared u n d e r the direction of M a j o r General M . W^. Ireland. B u c k r a m , 828 pages, illustrated in the text and b y c o l o r e d plates. Washing ton, G o v e r n m e n t P r i n t i n g Office, 1924. T h e contents of this v o l u m e will b e of especial interest to o u r readers. A l t h o the first part is d e v o t e d t o e m p y e m a , the remainder contains reports on: Maxillo-facial Surgery, b y L t . Col. R o b e r t H . I v y and M a j o r Joseph D . E b y ; O p h t h a l m o l o g y in the U n i t e d .States, b y Brig. Gen. G e o r g e E. de Schweinitz; Ophthalmology in the American Expeditionary Forces, by Col. A l l e n G r e e n w o o d ; O t o - L a r y n g o l o g y in the U n i t e d States, b y Lt. C o l . S. J. M o r r i s ; and O t o - L a r y n g o l o g y in the American Expeditionary Forces, by Col. James F. M c K e r n o n . T h e r e is m u c h in the section o n Maxillo-facial S u r g e r y that bears u p o n