30 JUVENILE NEARSIGHTEDNESS. 



claimed that this improvement in speech is equal to the patient's vocaliza- 

 tion at the time that his uvula was in a healthy condition. I am sure, be- 

 cause the observations made on this subject during the last five years have 

 taught me to be so, that the answer to this question should be given in the 

 negative. That a relative improvement in speech does follow an excision 

 of an elongated or hypertrophied uvula there can be no doubt, because this 

 operation brings the organ nearer to its normal size and condition ; but it 

 resembles the improvement made by perforating the raembrana tympani in 

 a case of deafness caused by a closure of the Eustachian tube; such im- 

 provement can never equal the normal function of the organ. This being 

 the case, the eflPect of the excision will be to remove the cause of a mechani- 

 cal hindrance to every word uttered by the patient, made in any degree of 

 force, and it will leave a stump which will not be acause of hindrance, but 

 a cause of an inability to pronounce some words on forced vocalization 

 only, and this even will be overcome in time by the dorsum of the tongue 

 becoming more convex. Therefore, to admit that the removal of a uvula 

 thus diseased may improve the ability to speak in the usual tone of voice, 

 does not prove that it was the uvula's removal that was the origin of the 

 improvement, for, if such were the case, the excdsion of the healthy uvula 

 would not only be advisable, but desirable. 



The effect of the amputation of the whole of the uvula, besides its being 

 a loss of the greater part of the support to the velum, prevents the forma- 

 tion of the azygos prominence to its greatest height, which is done by the 

 contraction or elevation of the azygos uvulse muscles, which terminate in 

 uvula. This height of the prominence is required to prevent, by its con- 

 tact with the posterior wall of the pharynx, the vibrations of the velum 

 during the formation of many semi-nasal sounds. 



The nearer that the surgeon can make the diseased uvnla take the shape 

 and size of the normal one, the nearer will it approach its normal function^ 

 that is, rendering the soft palate a non-vibratory valve, which is required 

 for perfect phonation. — St. Louis Medical and Surgical Journal. 



JUVENILE NEAR-SIGHTEDNESS.. 



The following extract from a report made by Dr. James A. Spaulding to 

 the Maine Medical Association, while applying chiefly to the children of 

 the Portland schools, will be found of decided interest to all teachers and 

 parents, as well as to school boards having the construction of public school 

 buildings in charge. The number of near-sighted young people is alarm- 

 ingly on the increase here as well as elsewhere, and the subject of preven- 

 tion deserves and demands earnest attention and prompt action where it is 

 found necessary: 



" For some time past I have been occupied in making an examination of 

 the sight of the children in the various primary and grammar schools of 



