This large or giant magnet is the Volkmann magnet imported by E. B. Meyrowitz. It is supported by a swinging bracket. I have attached this bracket to the wall much higher than was originally intended, and I raise and lower the magnet with a rope. The magnet is more out of the way when not in use and is more convenient to handle when in use. I have also had the control button attached to the magnet instead of the wall, so that it is always within reach.

Under proper conditions, on a mass of metal of con siderable size, it develops immense power, and this immense power is necessary to get the small power, which we wish to use on the eye, focalized at the point of the conical tip. None of these large magnets have power enough to pull small foreign bodies through the sclera, or through the cornea.

If the foreign body is to come out of the wound of entrance, that usually has to be enlarged, or if some other line of exit is preferable, an incision must be made large enough to allow the foreign body to pass easily through it.

They will, however, draw the foreign body through the vitreous, through the zonula of zinn, or through the lens. The iris usually stretches before the foreign body, and is more apt to be torn from its periphery, than to let the foreign body through it. From the purely prac tical side of the question I wish briefly to refer to some of the problems involved in five recent cases.

The first is a case of Dr. Topping's. A middle aged man, working at Farist Steel Works, was driving out a steel wedge, striking with a hammer from below upward, when something flew, hitting him in the right eye. His own estimate of the size of the foreign body was that it could not have exceeded a quarter of an inch in any diameter.

The lids and conjunctiva were much swollen, and there was a laceration of the conjunctiva simulating a wound of entrance. The orbital tissue was also swollen enough to push the eye very perceptibly forward. Examination with the ophthalmoscope, after dilating the pupil, made it certain that no foreign body was inside the eyeball. This excessive swelling could have been produced in two ways. First, by the impact of a large foreign body without penetration, or second, by the penetration of a smaller one. The large magnet was brought to the eye repeatedly, from various directions, entirely without re

action. The eye subsequently recovered with normal vision. Here the magnet played the somewhat subordinate part of furnishing a bit of negative evidence. It turned out to be the whole steel wedge, three inches in length, which hit him.

In the second case, the patient estimated the foreign body to be large and it turned out to be small, just the reverse of the first case-a young man working at a drop press, stamping the openings in a piece of sheet steel, which was to form the barrel of a small kerosene stove. At a certain drop, the press did not work properly; something flew, striking him on the bridge of the nose and in the right eye. Both he and the companion, who came with him, were positive that this was a piece of the sheet steel two and one-half inches long, and threeeighths of an inch wide. There was a slight wound on the bridge of his nose, and a wound of conjunctiva above the upper edge of right cornea. Vision was normal. In the upper part of the background of the eye, the ophthalmoscope showed a slight hemorrhage. The large magnet was brought to the eye for diagnosis, but without reaction. A dressing was put on and the patient told to return the next day. I did not see him for a month, when he came with the right eye red and painful. After dilating the pupil with difficulty, the ophthalmoscope showed in the upper part of background a large white plaque of exudation. The large magnet was again brought to the eye for diagnosis, and again with nega tive result. This was about three weeks ago, and the man has been under continuous observation since. After a few days the posterior end of the plaque of exudation became loose and hung down in the vitreous. After a few days more, the whole plaque was down in the vitreous, hanging only by a shred, and from where it came could be dimly seen something dark, which looked like the centre of a sliver of metal, with both ends imbedded in the coats of the eye. On one particular day

I thought I dimly made out the anterior end of the sliver. Five days ago I made an opening into vitreous between superior and external rectus. The large magnet was repeatedly and persistently brought to the opening, without result, and the ophthalmoscope showed no change in the position of the foreign body. Using a small magnet tip as a probe I succeeded in dislodging the particle so that it was free in the vitreous, and again the large magnet was tried, without result. Being now convinced that the particle was non-magnetic, I made one attempt to extract it with forceps, but did not succeed, and the eye having already had an excessive amount of manipulation, I stitched the conjunctiva over the scleral wound, leaving the foreign body in the vitreous. There has been no infection of the wound, and the immediate reaction from this manipulation has been slight.

The third patient gave a description of the size and material of the foreign body, which turned out to be absolutely accurate. He was at work under a metal roof. A man on the roof was punching holes for the rivets. A small disc of the sheet roofing, about oneeighth inch in diameter, was driven by the punch downward through his right upper lid, through the sclera and into the vitreous, leaving the anterior part of the eye untouched. On account of the hemorrhage, nothing could be seen back of the lens. As the vitreous cham. ber had already been opened by this large foreign body, the wound of entrance was chosen as place of exit. To prevent traction toward the anterior part of eye, the man was placed on his back, and while he rotated the eye strongly toward his feet, the magnet was cautiously brought from the top of his head, first for diagnosis, to make sure that the metal had not gone entirely through the eye. While the magnet was an inch away, there was distinct bulging at the wound of entrance, and pain. The wound was slightly enlarged with a small Graefe knife, and on second application of magnet the metal

flew to the tip when about one-quarter inch away. The patient left the hospital four days ago with a quiet eyeball, but no vision.

The fourth patient was using a cold chisel when a piece of steel, about one-eighth inch in its longest diameter, and having approximately the shape of a quarter of an apple, struck him in left eye, going through the cornea, below and a little to the inner side of the pupil; across the anterior chamber, lacerating the iris; through the lens, and stopped with about half or more of it in the anterior layer of the vitreous. Through the kindness of Dr. J. B. Emerson this patient was brought to the large magnet at the Manhattan Eye and Ear Hospital in New York City. Dr. Emerson made a separate incision with a Graefe knife at lower edge of cornea. The eye was then brought to the magnet and the foreign body was at once drawn into the anterior part of globe, but became entangled in the iris. The wound of entrance and the new incision were connected, and on second trial the steel flew to the magnet just before the tip touched the eye. Final result, absorption of lens, secondary operation and, with a correcting lens, 20-40 vision.

The fifth was a case of Dr. Miles'. Small bit of steel through cornea between center and inner margin, across anterior chamber, through iris and lay between iris and lens. Incision above, insertion of magnet point of medium sized electro-magnet. No result. Large magnet pulled it through pupil and out through the incision above. Final result, normal vision, periphery of iris engaged slightly in wound.

One

We have then one case in which the magnet helped in deciding that no foreign body was in the orbit. total failure possibly through faulty manipulation. One case of preservation of a blind eyeball in place of immediate enucleation. One case in which useful vision was preserved, which could not have been preserved in