Transactions . nt to warrant the conclusion that it is acausative factor. It is false logic, in fact a case of post hocergo propter hoc. There may be, however, some relation be-tween an angioneurotic edema and the development of this con-dition, for it seems that it may begin as an edema of the sub-cutaneous connective tissues, which later result in a loss ofelasticity and a consequent stretching of the skin and anatrophy of the subcutaneous tissues of the lid. Just why itinvolves the U]:)per lid only, no one has attempted to explain. 203 204 Figure 1 illustrates this condition of the skin wit

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Transactions . nt to warrant the conclusion that it is acausative factor. It is false logic, in fact a case of post hocergo propter hoc. There may be, however, some relation be-tween an angioneurotic edema and the development of this con-dition, for it seems that it may begin as an edema of the sub-cutaneous connective tissues, which later result in a loss ofelasticity and a consequent stretching of the skin and anatrophy of the subcutaneous tissues of the lid. Just why itinvolves the U]:)per lid only, no one has attempted to explain. 203 204 Figure 1 illustrates this condition of the skin with itsredundancy and thin tissue-paper like appearance better thanwords can tell. In all of the cases heretofore reported, I be-lieve, the condition has been bilateral and no complete ptosis.In the case about to be reported the condition was mono-lateral, with a complete ptosis, which raises the questionwhether or not ptosis is not always a concomitant condition inmonolateral cases and absent in bilateral cases.. Fig. 1 Miss Ethel S., age 19 years, family history negative, hasalways lived on a farm, physical condition good, subsequentlaboratory tests negative. Began to menstruate at fourteenyears; at this time it was first noticed that the upper lid wouldswell at times with a slight droop, this droop gradually in-creasing so that it soon became complete. The left eye wasnegative. It has been suggested by some writers that in this condi- 205 tion there is a hernia of orbital fat, so that the protrusion ofthe eye ball was measured by the exophthalmometer and theright eye, the one with the blepharochalasis was found to pro-trude 3 mm. beyond the left. Some months after the opera-tion another reading was made and no protrusion or exophthal-mos was evident. The refraction of the eyes was as follows: R.V. = 20/100;20/30 w -f 1.75 D.S.; L.V. = 20/20; 20/20 w -f 1.00 D.S. On November 22nd, 1915, patient was operated by excis-ing a crescent shaped piece of skin with the subcutaneous