The four essays by Sanford Gifford collected in this journal issue trace the passage of psychoanalysis from Europe to the U.S. They focus specifically on the work of émigré analysts in Boston and their significance in the institutional history of BPSI. The essays explore the careers of Jenny Waelder-Hall and Walter Langer, and the interaction between Felix Deutsch and Sigmund Freud during the years that Freud was diagnosed with cancer and first responded to the diagnosis.

In the discussion on a paper by Hurst, one of us (S. R. G.) 1 summarized the cases of leptotrichosis of the conjunctiva in which a thread mold had been observed in sections in our laboratory, and a case was mentioned in which cultures of the organism were obtained. Other cases have been seen since this time, and it seems worth while to review this material. REVIEW OF LITERATURE A brief review of the literature will include only the reports of cases in which the leptothrix, or a thread mold presumed to be the leptothrix, was seen in sections or culture. A discussion of the oculoglandular syndrome of Parinaud has been published elsewhere by Gifford and Dillon, 2 and most American ophthalmologists are familiar with the three diseases which may be grouped under this name : tuberculosis of the conjunctiva, the oculoglandular form of tularemia and leptotrichosis conjunctivae. The observation of

Pendulums, as is well known, have a way of swinging. When an idea has served to explain one condition satisfactorily, the attempt is invariably made to use it for other purposes, and the pendulum is set in motion. The concept of angiospasm is by no means new, but the attempt to explain a number of pathologic ocular conditions as due to that entity is largely an effort of recent years. My own interest in the subject began with a study of Krogh's1work on the capillaries, originally published in Müller's atlas2(1922), and some applications of this work to ocular conditions by Scheerer, Parrisius and Mayer-List,3in the University of Tübingen. Out of this work arose the concept of a vasoneurotic diathesis. When the peripheral circulation was studied by various methods, certain persons were found to have an abnormally labile vasomotor system. In response to various stimuli,

For about two years before the report of Bruce1which appeared in 1940 we had been interested in keratoconjunctivitis sicca and had collected data on a number of cases. Bruce covered the subject so well that the complete review which was in preparation seemed unnecessary, but the number of patients seen both before and after his report, in most of whom the disease was previously undiagnosed, and the fact that no other satisfactory study of the condition has appeared in the American literature prompt us to summarize certain facts learned from observation of these patients. During the past four years, we have listed in our diagnosis file 49 patients as having evidence of deficient lacrimation. These patients may be divided into three groups : Group I comprised 16 patients showing a lacrimal deficiency with moistening of less than 15 mm. on the Schirmer test after five minutes, but no corneal

After many years of experience with Harold Gifford's method of simple evisceration of the globe, the only disadvantage which I have noted, when proper indications are observed, is the occurrence of conjunctival chemosis. It will be remembered that the operation consists in an incision across the cornea and into the sclera at each side, removal of the ocular contents by an evisceration spoon and careful wiping of the inside of the scleral shell with sponges to remove all uveal tissue. The entire cornea is retained. No sutures need be employed, or, at most, one suture between the lips of the corneal wound to keep them from overlapping during the healing process may be used. No implant is employed. The normal attachments of the conjunctiva are not disturbed, and, as a result of the trauma of evisceration, fluid tends to collect within and beneath the conjunctiva. This chemosis may be severe,

From 1937 to 1940, one of us ( M. K.) resided in Equatorial Africa as parasitologist and pathologist for the Belgian department of public health. The region was heavily infested with Filaria loa, 25 to 50 per cent of the native population showing at some time signs of infection. In 1936 M. K. had shown an eosinophil count of 12 to 16 per cent. but examinaof the blood for microfilarias at that time gave negative results. In 1938 the first clinical signs of infection appeared, moderate swellings of the right arm which would last for six to twelve hours and disappear. In April 1940, when he was visiting Chicago on leave, pain about the left eye was felt and the parasite to be described could be seen moving beneath the lower part of the bulbar conjunctiva of this eye. M. K. consulted Dr. N. K. Lazar and was seen by one

A review of the literature reveals a certain confusion with regard to conditions which may be called ring ulcer of the cornea. Fuchs1in 1893 described what he called metastatic marginal ulcer. It occurred in old people with multiple fine punctate infiltrations in the superficial parenchyma near the limbus. "For a time," he stated, "they resemble marginal superficial punctate keratitis, but frequently break down to form marginal ulcers crescentic with the limbus. They tend to heal rapidly but recur." He also described the occasional confluence of several catarrhal ulcers to form an annular ulcer completely encircling the cornea and stated that deep penetration of such an ulcer may cause ectasia of the cornea. De Schweinitz2described a severe form of ring ulcer, seen in debilitated persons, in which the central part of the cornea is girdled and cut off from its nutrition, with perforation of the cornea and

The author, in his graduation thesis for the University of Buenos Aires, reviews the anatomy, histopathology and history of clinical observation on obstruction of the central retinal vein and reports his findings in 4 cases. The illustrations are chiefly photographs of fundus conditions, and there is a bibliography. Various theories of pathogenesis are reviewed. While arteriosclerosis seems to be the most common factor, the condition is due in a certain number of cases to syphilis and in others to inflammation in or about the vein resulting from foci of infection in the teeth, in the tonsils or elsewhere. Of the author's 4 cases, arteriosclerosis with hypertension was present in 3, while in the other syphilis was considered probable, the patient being 38 years of age, with a positive Kahn reaction. This was the only case in which considerable improvement occurred, vision returning to ⅔ after three months. Secondary glaucoma occurred

Among surgeons operating for strabismus no agreement has yet been reached concerning certain questions which are of importance in the choice of operation. Almost every operator has, for reasons which seem good to him, fixed his preference on two or at most three operations. He has obtained a fair average of results with these and, in considering the factors involved, tends to accept a theory which favors the operation of his choice. Reminiscent of the former battles between the advocates of tenotomy and those of advancement is the more recent argument between the late Dr. Jameson and Dr. O'Connor on the virtues of recession versus those of cinch shortening with central tenotomy. Worth, Landolt and their followers insist on the value of advancement with the idea that the insertion of the muscle is placed nearer the cornea, while van der Hoeve, Lancaster and others are firmly convinced that the muscle

In 1936 Dickey 1 described a new operation for ptosis which, he claimed, offered certain advantages over operations of the Motais type. His indication for the operation was the presence of complete ptosis associated with normal function of the superior rectus muscle. In such cases ptosis operations on the levator muscle by the Blaskovicz method are usually disappointing, and either the Motais or some method of attaching the lid to the frontalis muscle is customarily employed. The disadvantages of operations of the latter type are well known, the chief of these being failure of the lid to follow the cornea in looking down, so that an area of sclera is exposed. Hence these operations should probably be reserved for cases of complete ptosis with no function of the superior rectus muscle. The chief disadvantage of the Motais operation is the occasional detachment of the superior rectus slip from its new

The program of the seventy-seventh annual meeting of the American Ophthalmological Society may be divided into clinical papers and those of a more scientific character. In the former class are reports by Knapp on "Operative Treatment of Subluxated Lens" and "Retinal Periphlebitis," Gradle and Sugar on "Wound Rupture after Cataract Extraction," Jackson on "Results of Cataract Extraction," Kirby on "Intracapsular Extraction," Beetham on a "Method of Cataract Extraction Employing Iridodialysis Instead of Iridectomy," Bedell on "Papilledema Without Increased Intracranial Pressure," Verhoeff on "Moore's Subjective Lightning Streaks," Benedict on "Blepharospasm," Dunphy and Albaugh on "Cyclodiathermy," Gifford on "Ring Ulcer," Cowan and Klauder on "Ocular Pemphigus," Lewis on "The Sulfonamides in Gonococcal Conjunctivitides" and O'Brien and Swan on "Doryl in Glaucoma Simplex." In the second class may be included the papers by Haden on "Development of the Vitreous," Samuels on "Lenticular Lesions Caused by Purulent Keratitis," Clapp on the "Capsular Epithelium in

Fourteen years ago Meyer Wiener1described an ingenious procedure to correct the pronounced divergence resulting from third nerve paralysis. As he stated, Edward Jackson and Dransart had, unknown to him, suggested a similar procedure and performed it on cadavers but not on patients with third nerve paralysis. Wiener's procedure included weakening the external rectus and transplanting the superior oblique muscle to an attachment beneath the insertion of the internal rectus muscle. He approached the superior oblique on the globe after cutting the superior rectus muscle, which was later replaced. The tendinous portion of the muscle was followed to the pulley, and with a scalpel the pulley was cut, the muscle being freed. The tendon was severed from the globe and the muscle dissected back into the orbit. About ½ inch (1.3 cm.) of tendon was cut off, and the end was sutured beneath the insertion of the internal rectus