In the men the blindness was complete after periods varying from a few hours to 21 years, the average for 25 cases being a little less than 3 years. Hope of recovery was lost usually with the completion of blindness, but in one case was given up a year before and in another 7 years after. In the seven cases in which hope was prolonged, the average was 2 years and 10 months.

Among the women, the cases on which the data are recorded are too few from which to draw any conclusions.

The following case abstracts well illustrate the different types of reaction found in the cases studied and may be regarded as typical. They are given in the order of their supposed intellectual development, beginning with the lowest.

CASE I.-T. G., 48 years old, March, 1907; was seen April 19, 1907. Patient is a Bohemian, and while he has been in this country for several years and gone to school, it is exceedingly difficult to understand him, and it is doubtful if he understands all the questions of the examiners. Probably he is somewhat deaf.

He has been occupied in various ways, chiefly as a coal miner, but his last work was as a laborer at a furnace for eight years previous to his attack of blindness. He has had no occupation for over six years, or since September, 1900. He has constantly had hope of recovery, and even now hopes to recover some sight in his left eye, though he has been completely blind in it for two years and completely blind in the right eye for two and a half years. The cause of the blindness could not be learned from him.

He has been somewhat depressed and has threatened suicide if conditions do not improve. He states that his condition would be better if he were to make but 5 or 10 cents a day, but is not willing to make the effort to learn to cane chairs or do anything else. He was taken to the blind

school and was delighted with the visit, but always complained of being sick and said that he was too weak to work. He now remains constantly indoors and it is probable that his physical health is not very good, largely on this account.

CASE 2.-L. E., will be 21, May 7, 1907. He was seen April 19, 1907, at his home. Patient was a laborer in an iron furnace, but was for a week a puddler, when on May 11, 1905, there was an explosion at 10 p. m. He found his way home in some way, but the next morning he could not see and has been totally blind ever since. For the past year he has also been somewhat deaf. He was very much depressed at the time, but at present his mental attitude is hopeful, and he feels that his sight may be recovered. He has threatened suicide, but not in a very decided way. However, patient is quite religious and says that he trusts in the Most High, that it is through Him alone that his sight can be recovered. Visual hallucinations are denied.

CASE 3.-H. J. Q., formerly a night engineer at Roland Park Electrical Works, was at work sewing brooms, March 4, 1907, and in reply to questions said that his knowledge of his blindness dated back three years, and that at first he could not rest and could not sleep; he gave as reasons for this, "nerves" and "worried." He was depressed and for two years planned how he might commit suicide, but gave that up a year since. He now feels somewhat cheerful, though he has a great deal to worry him, he and his wife having to support their mothers as well as themselves, but he is beginning to make money and the week before was put on the pay-roll. He had been treated at the Johns Hopkins Dispensary and from his history (C 85,457) it was learned that he was admitted October 1, 1905, complaining of depression, trembling and difficulty in seeing, and four weeks later it was noted that he thought his vision was improving; patient had been referred from the eye department (C 85,446) with a diagnosis of double optic nerve atrophy of five months' duration. He attended until July 25, 1906, and was given alkaline gentian mixture and strychnia at various times. At first it was noted that he was emotional and complained of a lump in his throat, with a feeling of increased danger. He was depressed and his memory was impaired, but he showed little physical disturbance, beyond the failing vision.

Miss Kelly stated that she had a great deal of difficulty to get this patient to go to work, because he was coddled so by his mother and motherin-law, and he was becoming "old womanish" when he first came under her observation.

CASE 4.-W. G. M., was seen April 12, 1907. Patient is a man aged 34, having been born August 5, 1873. He was formerly a car builder and made $4.00 a day, though it is doubted if he could have been called "skilled" except in his own particular work. It does not seem possible that he could have taken up other work and displayed any special ability in it. On March 23, 1906, when visiting his brother-in-law in the neighborhood, there was a general shooting-up of the family and the patient was

shot in the right eye. He was taken to the hospital, but vision failed pretty rapidly and, about four or five months before, patient lost hope of recovery. Since this time, depression has been fairly well marked, and the patient thinks that he had better be dead than the way he is, though he denies that he has thought of suicide. At the time of the visit, the patient had refused to continue efforts to learn the point system or to continue his work of caning chairs, though he had obtained enough proficiency in the latter to be paid for some of his work; neither did he wish to learn netting, and thought the best thing that he could do would be to sit around in the sun. In order to assist in the family maintenance, the patient takes charge of a small store, and states that he is working up a milk and butter route, but refuses to deliver papers, preferring to pay a boy about $6.00 per month, though the patient and his children could very well do it. The depression does not seem especially deep, but there is apparently a rather marked condition of apathy. In all probability his lack of ambition and the apathy are an exaggeration of his normal "make-up." At the time he was taken in charge by his teacher six or seven months before, he was spending 22 hours of the 24 in sleep. Apparently the patient has never had visual hallucinations, but insists that when his celluloid shade is in front of his eyes, there is a sensation as of a flickering lamp, this probably being due to pressure.

March, 1908.-It is reported that this patient has lost his apathy to a considerable degree and recently showed considerable initiative, especially in his candidacy for the local postmastership.

CASE 5.-W. S. C.; was seen April 12, 1907. His father, a clergyman, was 48 when patient was born, and became blind two years later. It is thought that he suffered from dislocated lens all his life. The patient has been myopic and has also had a dislocated lens in his right eye. He was a bookkeeper, employed in a railroad company for 13 years, and in 1897 the right lens was needled, but was not absorbed. Following this the patient did all of his work with the left eye, a great deal of it by artificial light, and after suffering a severe pain, his sight failed him in 1900. He was about 33 at this time, and his blindness was complete about a year later. At present, there is no sight, except that the patient states he can occasionally perceive the light of a match when lighting a cigar or pipe, but this is not at all constant. Patient did not lose hope of recovery until he was totally blind, and as is common in these cases, was buoyed by many false hopes; when he was forced to give up his employment, he was somewhat anxious for the future, as he had a wife and four children depending upon him, but real depression has never been present. The man is of a sanguine temperament, was a Methodist preacher, and takes great consolation in his religious beliefs. He has also been a "book-worm" and possesses no mean intellectual ability. He has never thought of suicide. His present mental attitude is cheerful. He is a writer of stories and has been, a little over four years, achieving considerable success, and he hopes to put his work into the “big” magazines where it will be better paid, and he will not have to do so much hack-work.

From the above study it seems justifiable to draw the following conclusions:

I. A knowledge of ultimate blindness is usually followed by a period of depression.

2. This depressed reaction is caused by fear of lack of support of the patient and family rather than a fear of self-deprivation.

3. The more intelligent the patient the more apt is this depressed reaction to be absent.

4. Ideas of suicide are present in about 20 per cent of the depressed cases, but suicidal attempts probably are never made by uncomplicated cases.

5. Hope of recovery usually endures until blindness becomes complete but is prolonged beyond this time in about 35 per cent of

cases.

Proceedings of Societies.

AMERICAN MEDICO-PSYCHOLOGICAL ASSOCIATION. PROCEEDINGS OF THE SIXTY-FOURTH ANNUAL MEETING. CINCINNATI, OHIO, TUESDAY, MAY 12, 1908.-FIRST SESSION.

The Association convened at 10 a. m. in the Convention Hall of the Hotel Sinton, Cincinnati, Ohio, and was called to order by the President, Dr. Charles P. Bancroft, of Concord, New Hampshire.

THE PRESIDENT.-Ladies and Gentlemen, members of the American Medico-Psychological Association: I have the honor to call to order the SixtyFourth Annual Meeting of this Association, and I have the pleasure of introducing, in the absence of the Chairman of the Committee of Arrangements, Dr. Harmon, who is too ill to be with us, Dr. Langdon of that Committee, who will speak to you.

DR. LANGDON.-Ladies and Gentlemen: We have with us this morning a gentleman who was a good farmer in his youth; who has served as an officer with distinction in the Civil War; who has ably represented this country abroad in the diplomatic service; who is to-day one of the best known journalists in the West, if not in the United States-but more than all these, he is in all probability the best-loved mayor that Cincinnati has ever had. (Applause.) It affords me much pleasure to introduce to you Colonel Leopold Markbreit, Mayor of Cincinnati. (Applause.)

MAYOR MARKBREIT.-Mr. Chairman: I want to thank you for your kind words about me. Ladies and Gentlemen: The perquisites of my office, and the only ones I have, are delightful occasions like this one. It does my soul, it does my heart good to look about me here at this audience and see the intellectual faces before me. I welcome you most heartily to our dear old town of Cincinnati. I hope you will enjoy your visit here. I hope that when you leave us, it will be with regret, and with a desire in your hearts to come back to us some time. I assure you you will all be welcome, either as a convention, or as individuals.

While here, I beg of you that you will look around you, go out to our beautiful hills, east, west, north; go over the Belle Riviere-the beautiful Ohio-go up to the Kentucky highlands, go to Fort Thomas and get a view up and down the river-you will not find a more beautiful one in all God's