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of one side depressed while the angle of that side of the mouth is drawn up. The other brow is ele- vated while the corresponding angle of the mouth is depressed. The facial lines or Generico Do Viagra Como Funciona grooves corre- spond to this irregular and unsymmetrical action of the underlving muscles. As has been already intimated, the demands upon the auxiliary forces of the facial muscles may de- pend, to Generico Do Viagra Como Funciona a certain extent, upon the general Generico Do Viagra Como Funciona muscular Generico Do Viagra Como Funciona condition of the individual. Even if, in childhood and youth, the facial muscles are brought into ac- tive requisition, the cushion of fat overlying the muscles, may in some measure serve to disguise the effect. Individual temperament or habitude, as well as peculiarities of the bony structure, may also modify the effects of the efiforts to bring to the adjust- ments of the eyes the adventitious aid of the facial muscles. Especially do certain peculiarities of declination induce types of expression which are not strictly in conformity with the tvpes of expression described or which appear in certain cases to run counter to the principles of classification which have been laid down. With declinations we have the potential elements of helerophoria, but since the adjustments do not yield to the tendencies, the expressions may be and usually are modified from those which are induced when the adjustments are such as to indicate one or other of the heterophoric conditions. These apparent exceptions to the general rules depend upon the proportion of degree of declina- tion of the two eyes. For example, should there e.xist in one eye a considerable degree of declina- tion and iu the other a less degree of the same sign, we may have the general expression of hyperphoria, while had the degree of declination of the same sign been nearly equal for the two eyes the ex- pression would be that typical of exophoria. Tliat varying degrees and proportions of declination should modify the expression is not only not in un- conformity with the principles laid down, it is on the other hand quite in conformity. There are, however, expressions arising frcni di- ROSEXBERGER: TYPHOID OSTEOMYELITIS. 927 clinations even when no heterophoria is manifest, which render it easy not only to recognize the class of declination but to tell the direction of the lean- ing of the meridian of each eye. In one form, for example, both the brows slant up from the temples toward the median line, the internal extremity ending almost in the general di- rection of the line of slant, or suddenly curving down at the inner end as it is seen in the diagram at Fig. 7. With this form of brow we find positive (-{-) de- .ination of both eves and of nearly equal extent in each. In another form a double positive (-f-) declina- tion, but in which the extent of the leaning is ma- terially different, we have an habitual expression in which the eyebrows ascend from the inner extrem- ity, extending outward, forming what I have called "bird's wing' eyebrows (Fig. 8). With both of these forms we often find more or less exophoria. . Still another form frequently seen is that in which Generico Do Viagra Como Funciona not only is one broW' compressed while the other is elevated, but the asymmetry of the face ex- tends to the actual position of the eye ball, for the eve below the compressed brow appears lower. >ometimes much lower, in the planes of the face than its fellow. Such a form is seen at Fig. 9, and - not at all unusual nor is the diagram exaggerated. I [ere the declinations Generico Do Viagra Como Funciona are extremely unequal of the ?ame sign or that of the depressed eye has positive the otiier negative declination. Agam, both browns may be rounded in a sort of rainbow fashion, in which, again, there is declina- tion of dififerent signs for the two eyes, or the de- clination, if of the same sign, is of very different degree in the two eyes. A single other form of expression will be noticed imong the many which may result from the causes AC are discussing. In seme cases of double Generico Do Viagra Como Funciona posi- tive (-J-) declination, even some in which there may l)e a very marked exophoria or, still more, a marked diverging strabismus, the eyes are pressed close to the nose, .giving a "narrow" appearance to the face. The pupillary distance in the case of a full grown olult may be about the same as that of a child of -even or eight years of age. It is not very rare to find one of these cases in which the pupillary dis- tance is little more than two inches, although the head is of full adult size. This peculiarity is seen in the diagram. Fig. 9. The reason for this would ai)pear to be that from the persistent pressure of the eye ball against the cu.shion between the inner wall Generico Do Viagra Como Funciona of the orbit and the eye ball, the Generico Do Viagra Como Funciona cushion has been atrophied, permitting the globe to api)roach the bony wall with only the layer of connective tis- sue as a separating meditnn. To describe and analyze all the various forms of • xpression wliich an experienced observer may readily associate with various forms of adjustments •if the eyes would demand more space than can be L^iven here. In a second part of this study we may inquire into the reasons for some of the pains, discomforts,