defend the eyeball. Nevertheless much evidence cannot at present be advanced to prove that the eye actually suffers injury from the want of support during violent expiration: but there is some. It is "a fact that forcible expiratory efforts in violent coughing or vomiting, and especially 19 [Dr. Keen, of Philadelphia, calls attention (letter n. d.), to his paper in the 'Med. and Surg. History of the War of the Rebellion (Surgical Part),' vol. i. pp. 206 -- 7, bearing on this point. A patient lost part of his skull by a gunshot wound, and recovered with a con-cavity on the surface of his head, into which the scalp dipped to the depth of an inch. Ordinary respiration did not affect the concavity, but on moderate coughing a little cone bulged up, and a severe cough changed the concavity into a convex surface rising above the surface of the head.] 20 Professor Donders remarks (ibid. p. 28), that, "After injury to the eye, after operations, and in some forms of internal inflammation, we attach great value to the uniform support of the closed eyelids, and we increase this in many instances by the application of a bandage. In both cases we carefully endeavour to avoid great expiratory pressure, the disadvantage of which is well known." Mr. Bowman informs me that in the excessive photophobia, accompanying what is called scrofulous ophthalmia in children, when the light is so very painful that during weeks or months it is constantly excluded by the