Journal of ophthalmology, otology and laryngology . mellseemed to be blunted on both sides. On the left side the blunting ofthe sense of smell may have been in part due to a pronounced obstruc-tion from a deviation; the right side (concave side) was quite free ofmechanical obstruction, however, there was considerable secretion. At 628 The Presentation of a Case. the time of taking the sense of smell there was some question in mymind as to how much was due to an actual blunting of the sense ofsmell, how much to obstruction and how much to slow on, I learned that the patient un
Journal of ophthalmology, otology and laryngology . mellseemed to be blunted on both sides. On the left side the blunting ofthe sense of smell may have been in part due to a pronounced obstruc-tion from a deviation; the right side (concave side) was quite free ofmechanical obstruction, however, there was considerable secretion. At 628 The Presentation of a Case. the time of taking the sense of smell there was some question in mymind as to how much was due to an actual blunting of the sense ofsmell, how much to obstruction and how much to slow on, I learned that the patient under normal conditions, prior toand since operation, is a slow and deliberate talker, but he was moreprompt in his replies at this time (June, 1917) than he had been forsome time prior to operation. II. Nerve: Ophthalmoscopic examination O. D. Optic nerveshowed extreme choking (elevation 6 or 7 diopters), as well as pro-nounced increase in circular dimensions (mushroomed). The outlineof the disc was very poorly defined, apparently blending with the. retina. The vessels of the disc was quite obscured, the veins in theretina markedly distended. The retina showed innumerable streak-like small hemorrhages, mostly surrounding the veins, while at thelower part of the retina there were some larger masses of hemorrhage ;the upper margin of these were horizontal. There were a few smallareas of pale-colored degeneration scattered between the disc and themacula. The distribution of these areas, however, was not of theclassical albuminuric type. The vision O. D. was fingers against ablack background about one foot more often incorrectly esti-mated than correctly. O. S.—the ophthalmoscopic picture was the 629 Geo. W. Mackenzie. same as that of O. D., with the exception that the choking was lesspronounced (4 or 5 diopters), the hemorrhages perhaps fewer, whilethe vision was about the same as that of O. D. III., IV. and VI. Nerves: Mobility of the eyeballs normal, inthat both eyes moved toge
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