months had only taken it as it had been placed in his mouth by others. If standing, he held his arms out in an imbecile manner with the fingers spread apart. The saliva flowed in streams from his mouth to the floor. He was thin and pale, and a cold moisture covered the skin. In this pitiable condition it was difficult to obtain exact information of the ocular conditions, but by the exercise of much patience these conditions were sufficiently made out to enable a generally correct judgment to be formed. Under atropine he showed hyperopia 1.00 D, with insufficiency of the externi 4°. On the 14th of October the first photograph (Fig. 1) was taken, and on the same day a tenotomy of one of the internal recti was done, and two days later a similar operation was made on the opposite internus. From that day an improvement could be seen in the lad's mental state. Within a week he was so much improved as to amaze those who had seen him in his first condition. He soon began to take food of his own accord, and in two weeks he was in a fair way to complete recovery. On November 2d the second photograph (Fig. 2) was taken, eighteen days after the first; and three weeks from the day of his first visit he returned to his home, no longer insane. His friends were advised to bring him again after a few weeks, which they wisely did. Slight hyperphoria was then found, and a tenotomy of one When he reof the superior recti was done. turned home the second time he was, so far as could be detected, perfectly well.

The photographs show more than I am able to tell, but even they do not convey a perfect idea of the wonderful revolution which had taken place in the mental and physical condition of the boy in eighteen days].*

*

[Plate VI is introduced here as representing one of the cases treated by attention to ocular conditions at the Willard Asylum for the Insane during the summer of 1886. Space does not permit of a history of any of these cases, but the photographs fairly represent the average change of physiognomy in these people who had, during many years, been confined in an asylum].*

It follows, then, that in mental troubles, also, the condition of the eyes should be carefully inspected, and sudden and gratifying relief will often reward attentions intelligently directed to any embarrassment which may hinder them in the performance of their offices.

HEREDITY.

Enough has been shown in the discussion of neuralgia to render it evident that to a certain extent the construction of the eyes constitutes an important element in hereditary predisposition to neuroses.

The orbit and its contents are facial features, which are, in their general form and relations to other parts of the face, characteristic in families. The resemblances so strikingly exhibited in many families depend very largely upon the construction of this portion of the face. The form of the eyeball and the length * In present edition only.