. Virginia medical semi-monthly. ancespresent, and to be described, clearly prove. Here, then, is the third stage of the syphiliticfibrinous exudate, that in which the exudatehas passed out of the vascular tissues and isfound in the retinal tissue proper. In thecase of Mary A., colored, aged 30, where thereexisted iritis, in addition to the arteritis syphi-litica, the fibrinous exudate was profuse, fillingone vitreous body so completely as to shut offany view of the fundus, while into the otherit protruded in great quantities. (In this case,then, we have the fourth stage.) Beyond thisbifurcati
. Virginia medical semi-monthly. ancespresent, and to be described, clearly prove. Here, then, is the third stage of the syphiliticfibrinous exudate, that in which the exudatehas passed out of the vascular tissues and isfound in the retinal tissue proper. In thecase of Mary A., colored, aged 30, where thereexisted iritis, in addition to the arteritis syphi-litica, the fibrinous exudate was profuse, fillingone vitreous body so completely as to shut offany view of the fundus, while into the otherit protruded in great quantities. (In this case,then, we have the fourth stage.) Beyond thisbifurcation, the lower arm could be seen onlyin segments, some of which were the seat ofhemorrhages, some of which seemed filledwith short columns of blood. (Vid. Fig. 3.) The whole area of retina to which this ar-tery supplied blood had a swollen, watery ap-pearance, while all through it were to be seenhemorrhages in various stages of absorption,and at various depths in the retina, a few be-ing just under the hyaloid. Scattered through-. 1898.] THE VIRGINIA MEDICAL SEMI-MONTHLY. 37 out this area were areas, varying in size, madeup of watery white blotches, representing prob-ably hoth the remains of hemorrhages anddegenerated areas of retinal tissue. Thesewhitish patches nearest the macular regionsuggested at first glance retinitis urine,however, was normal, and, moreover,the extensive retinal changes in the other eyebore no resemblance to those caused by kidneydisease. //. Case of Diffuse Syphilitic Retinitis, in whichthe Appearances in the Fundus Closely Resem-bled those of the Advanced Stages of RetinitisPigmentosa. John M., aged 20, contracted syphilis fouryears before he came for treatment. About twoyears ago his sight began to rapidly fail. Ex-amination of his eyes revealed the followingconditions: V., 0. D. and O. S.,=4^ more orless; pupils semi-dilated ; refraction + 21 sph.,which glasses, however, did not materially in-crease the usual acuity. Patient complained
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