the properties of casein, by means of alcohol.-Gazette Médicale de Paris. 3 Avril, 1841.

Memoir of the Case of a Gentleman born Blind, and successfully operated upon in the eighteenth year of his age; with Physiological Observations and Experiments. By J. C. AUGUST FRANTZ, M D. M. R. C. S.-The young gentleman who is the subject of this memoir had been affected from birth with strabismus of both eyes; the right eye was amaurotic, and the left deprived of sight by the opacity both of the crystaline lens and of its capsule. At the age of seventeen, an operation for the removal of the cataract of the left eye was performed by the author with complete success. On opening the eye for the first time, on the third day of the operation, the patient described his visual perception as being that of an extensive field of light, in which every thing appeared dull, confused, and in motion, and in which no object was distinguishable. On repeating the experiment two days afterwards, he described what he saw as a number of opaque watery spheres, which moved with the movements of the eye, but when the eye was at rest remained stationary, and their margins partially covering one another. Two days after this the same phenomena were observed, but the spheres were less opaque and somewhat transparent; their movements were more steady, and they appeared to cover each other more than before. He was now for the first time capable, as he said, of looking through these spheres, and of perceiving a difference, but merely a difference, in the surrounding objects. The appearance of spheres diminished daily; they became smaller, clearer, and more pellucid, allowed objects to be seen more distinctly, and disappeared entirely after two weeks. As soon as the sensibility of the retina had so far diminished as to allow the patient to view objects deliberately without pain, ribands differently coloured were presented to his eye. These different colours he could recognise, with the exception of yellow and green, which he frequently confounded when apart, but could distinguish when both were before him at the same time. Of all colours, gray produced the most grateful sensation: red, orange, and yellow, though they excited pain, were not in themselves disagreeable; while the effect of violet and of brown was exactly the reverse, being very disagreeable, though not painful. Brown he called an ugly colour: black produced subjective colours; and white gave rise to a profusion of muscæ volitantes. When geometrical figures of different kinds were offered to his view, he succeeded in pointing them out correctly, although he never moved his hand directly and decidedly, but always as if feeling with the greatest caution. When a cube and a sphere were presented to him, after examining these bodies with great attention, he said that he saw a quadrangular and a circu figure, and after further consideration described the one as being a square, and the other a disc, but confessed that he had not been able to form these ideas until he perceived a sensation of what he saw in the points of his fingers, as if he really touched the objects. Subsequent experiments showed that he could not discriminate a solid body from a plane surface of similar shape; thus a pyramid placed before him, with one of its sides towards his eye, appeared as a plane triangle.

Two months after the above-mentioned operation, another was performed on both eyes, for the care of the congenital strabismus, by the divisions of the tendons of the recti interni muscles, which produced a very beneficial effect on the vision of the left eye; and even the right eye, which had been amaurotic, gained some power of perceiving the light, and, from being atrophied, became more prominent. Still it was only by slow degrees that the power of recognising the true forms, magnitudes, and situations of external objects was acquired. In course of time, the eye gained greater power of converging the rays of light, as was shown by the continually increasing capacity of distinct vision by the aid of spectacles of given powers.-Proceedings of the Royal Society. 1840-1841. No. 46.

By Jos. J. B. WRIGHT, M. D., ASSISTANT SURGEON U. S. ARMY,

No. 6.

It was an apothegm of the ancient Jews, that "no man discharged his duty to his country, who died, without having planted a tree, built a house, and left a child behind him." If I was asked to suggest an improvement of the saying, I would intimate that the physician is obnoxious to the charge of neglect of duty to the community, who passes through life, without having at least attempted to discover some new fact, or verify some already expressed hint, which may sustain the relationship of an improvement, either directly, or indirectly to the ars medica; leaving it for others to clothe the proposition in the precise and appropriate language of an axiom.

It is with the hope of being able, if not to exhibit an undiscovered truth, at least to furnish evidence in regard to the comparative worth of some of the weapons with which we ordinarily combat disease, that the author of the present paper ventures to appear in the pages of your journal.

For the last seven years, the Power that rules his destiny has afforded him opportunity to observe diseases, under the influences of the various climates, and the sundry circumstances which are supposed to modify complaints, as well as constitutions, in sections of the United States, varying from the twenty-sixth to the forty-fifth degree of north latitude, and through an extent of longitude, included between the Atlantic coast and the western limit of Arkansas.

It is proposed, in the series of essays, which the writer will offer for publication in your periodical, if they should prove acceptable, to limit attention, to a consideration in a general way, of the cases which have fallen to his lot, as one of the medical staff of the army; and he would here, in limine, bespeak the indulgent charity of the censors, whilst he pleads in justification of his attempt to confirm the opinion of the wavering, or dispel the doubts of the skeptical, a sense of bounden duty to his professional friends; and in excuse for its defects, that he lacks the facile skill which practice alone can give, in catering for the public taste.

The writer got an introduction to the diseases, prevalent in the army, at Fort Gibson, a post situated on Grand River, two miles above its entrance into the Arkansas, in the winter of 1833-34. This fort, whether deservedly or not, sustains the character of "charnel house of the army." Certain it is, that during the year 1834 and part of 1835, no term can be found in any

language, which would do injustice to its character for insalubrity, if we regard only the number of cases within its chain of sentinels, and the mortality which made the scene so tragical. During the summer of 1834, most of the troops west of Arkansas, dragoons as well as infantry, were on distant duty in the prairie: the former in a campaign to the Pawnee towns on the border of Mexico, and the latter building new posts on the Canadian and Red fork of the Arkansas. They all returned to the garrison about the close of summer with a very large sick report. The commands, therefore, were exposed to other influences than those which exist at Fort Gibson, and in justice to the good name it erst aspired to, the fact ought to be recollected. However, that the post would have been unhealthy, might have been inferred from à priori reasoning, if exposure to vicissitudes of temperature, and prox imity to extensive low grounds, in a southern latitude, favour the supervention of disease.

During the writer's residence at Fort Gibson, the mercury in Fahrenheit's thermometer fluctuated through one hundred and twenty-seven degrees; rising in the summer months to 116, and falling in the winter to 11 minus zero! The almost unparalleled elevation indicated cannot be attributed to any inaccuracy of the instrument, or any fault in its site; the observation having been registered from one of two thermometers, which exhibited the lowest elevation of the mercury, both being placed in an airy position, under the piazza of the hospital, which afforded an effectual shade from the sun's

rays.

The valley of the Arkansas is subject to occasional inundations from the river, to an extent which often renders the labour of the husbandman of precarious avail, whilst it makes some parts of it, almost uninhabitable. I write with literal regard to truth, when I say, that in the vicinity of the river, from its mouth to the Verdigris, a distance of perhaps seven hundred miles by water, the traveller will scarcely meet a rubicund visage, or a face and form bearing the impress of good health. Perhaps an exception ought to be made in favour of those who more happily reside, in one or two of the towns on the river, but if the whole truth were gazetted, it is believed a statement of facts would not do even them any considerable credit for salubrity.

Having in view to exhibit recollections of cases which have come under my observation in the army, it may be proper to begin at the beginning. The present essay will relate, therefore, to the acute cases of the winter months, and the chronic forms of disease which were continued in the hospital, at Fort Gibson, since the previous autumn. A consideration of the most interesting cases, viz. the fevers of the summer months, may constitute the second paper of the series.

The prevailing diseases of the winter derived their characteristics from vicissitudes of temperature:-Pneumonia, Pleuritis, Acute and Chronic Bronchitis, and Rheumatism, Catarrh, Phthisis Pulmonalis, and Ophthalmia, made up the register of cases admitted to hospital. The patients who were continued from the previous summer, and autumn, laboured under intermittent fever and its sequelæ, enlargement of the liver and spleen, chronic inflammation of the mucous coat of the stomach and bowels, assuming the form of dyspepsia, chronic dysentery and diarrhoea.

The first named inflammatory affections were treated in the ordinary way, and with perhaps a common result. If any fact impressed itself with signal force on my attention, it was the eminent advantage of copious abstraction of blood from a large orifice, in the incipiency, or at least at a very early stage, of the disease. My observation affords me satisfactory evidence of the oft-repeated truth, that it is not so much the large quantity of blood abstracted, within the first few days of an intense inflammatory affection, as the effect produced by a first venesection, on which we should rely in the management of this class of diseases. Most of the cases of pneumonia and

pleuritis yielded readily, after the tone of the system was thus reduced, to counter-irritation over the seat of disease, an occasional dose of calomel and opium, and gentle antimonial diaphoretics.

The cases of acute bronchitis required ordinarily a resort to the lancet, after which they subsided for the most part, under the operation of common expectorants. When, however, the symptoms were unusually persistent, an irritation more or less extensive, over the surface of the chest, by blisters, or antimonial ointment continued for a greater or less time, rarely failed to extinguish the disease.

The catarrhal affections were made to succumb generally by a resort to an emeto-cathartie of sulph. magnes. and antim. tartarizat., followed by the expectorant and sudorific compounds, usually exhibited in such cases, with due attention to clothing, and avoidance of exposure to the weather. This form of disease, when neglected, betrayed a constant proclivity to bronchitis.

Many of the cases of acute rheumatism creditably sustained the character of this corps of the "grisly troop," for obstinacy.

My experience in the management of this affection has persuaded me that too much danger is apprehended of favouring its conversion to the sub-acute or chronic form, and its metastasis to the vital organs by liberal depletion. My success in its treatment has been more satisfactory, when in the forming stage I have abstracted blood liberally, and I have not witnessed the untoward effects which we are taught to fear from the measure. The symptoms have frequently exhibited, in the course of the disease, evidence of a pathological condition of the heart and pericardium, but not oftener, under my observation, when the lancet has been used, than when it was withheld. Abstraction of blood by cups applied over the seat of pain, when the larger joints are involved, is a remediate measure to which I am much attached, from observation of its advantages, though in order to derive the utmost benefit from the scarificator, it is necessary that the operation should be performed in an effectual way-at least half a pint of blood should be taken from the knee, for instance, when much swelling and pain exist. I am persuaded that too little attention is given by the generality of practitioners to the condition of the first passages in acute rheumatism, having almost invariably found the disease much less refractory when an active purge is given in the commencement, and occasionally repeated during its progress. When the attack has not yielded to the means here noticed, with their common-place co-adjutants, I have rarely known it continue many weeks under the influence of minute doses of calomel and dov. powder. In the chronic form of the disease I have seen marked benefit result from the use of the vinous tincture of colchicum, when the synovial appendages of the joints might be presumed to constitute the seat of pain, and when the fibrous structures are principally implicated, my experience has induced me to rely on the mistura guaiaci, with more confidence than on any other individual article. The tincture of phytol. decandr. has in several instances commended itself to my favour as a remedy in this affection, the preparation being made from the berries; and the popular prescription of nit. potass. in diluted alcohol has seemed, in some instances, to have a claim to respectful regard. The usual adjuvants, viz. blisters, liniments, friction, &c. have been brought in requisition, but principal reliance has been placed on the means indicated above.

Phthisis pulmonalis at Fort Gibson, as elsewhere, merited its title to a place in the front rank of the opprobria medicorum. I allude to it here, with the sole view of remarking, that there is not perhaps, on the earth's surface, an inland spot more ineligible for a consumptive patient; the temperature sometimes undergoing a change of thirty degrees in a few hours. The prevailing winds during the summer are from the southwest, bearing on their wings the most oppressive heat, but ever and anon, old Boreas, inflating his lungs, asserts his empire, and from his habitation in the Rocky Moun

tains, sends his chilling breath over the plains below, scattering almost as many evils as fable attributes to Pandora's box. I will remark, en passant, that among the palliatives used in the management of the cases of pulmonary consumption, large doses of opium and sulphate of iron, as recommended I believe by Dr. Morton, were exhibited with a view to control the colliquative diarrhoea, and with apparent benefit.

There prevailed at Fort Gibson an undue proportion of cases of acute and chronic ophthalmia. If any peculiar circumstances exist there to excite this form of disease, I am unacquainted with them. In many instances the cases were allied to rheumatism, and so far they may be accounted for; but a majority did not bear any such relationship, and I can only attribute its frequent occurrence, to the abrupt atmospherical vicissitudes acting upon, and determining disease in organs habitually predisposed to deranged action, by exposure to the intense light of the sun operating directly upon them, and indirectly, by reflection from the white sand, which constitutes the superficies of the soil in that vicinity.

It may be remarked here, that ophthalmia prevails to a very large extent among the Osage Indians, who inhabit a section of country on the head waters of Grand river. The frequency of the disease among the Indians has been ascribed to a custom which exists among them, of plucking out the hair of their supercilia, thus depriving the eye of the protection from the rays of the meridian sun, which this natural contrivance affords. My experience in the treatment of this disease has not enlarged in any considerable degree my knowledge of the means of combating it successfully. Most of the varieties of inflammation of the eye and its appendages were occasionally presented; the predominant form was conjunctivitis;-next, in frequency of occurrence, was sclerotitis; a few cases of iritis, of syphilitic origin, contributed to make up the variety. The conjunctival form, in its advanced stage, generally implicated the cornea, which became obscure, and occasionally ulcerated.

The cases were managed in the way taught in the schools, and throughout their course furnished very little theme for original remark. They have only left on my mind, at this distance of time, the impression, that in the advanced stage of conjunctivitis the nit. argent. collyrium is, by a majority of practitioners, used of insufficient strength; that in obscurity of the cornea, from protracted inflammation, the lunar caustic should be applied, without stint in substance, to its surface, and that the system should be made to feel at once, the mercurial impression. My acquaintance with the numerous cases which occurred there, gave me opportunity to test the value of aqueous solution of opium, applied to the eye, where great intolerance of light exists. The remedy has my unqualified approbation, having derived more advantage from it, in this way, than from any other application.

Having thus disposed in a discursive way of the prevalent diseases of the winter season, those cases which were continued in hospital from the previous summer come next to be considered.

A majority of these patients it has been remarked, laboured under protracted intermittent fever, and its sequences. It need not be said that in malarious districts of country, this form of disease, which, if the doctrines of the schools be correct, can only originate during the heat of summer, may nevertheless exist throughout the whole year. It may be affirmed, indeed, that in southern latitudes it exercises most obstinate sway in the cold season; its right to empire seeming to be yielded to its more desolating brothers, of the remittent and continued types, during the months of their reign; and it is remarkable that it is very apt to make the quondam subjects of their rule, the victims of its operations. I am so well satisfied of this fact, that I have become a convert to the opinion of MacCulloch, which maintains as a general rule, that patients will not recover from the diseases of this family, so long as they remain in the country in which they acquired them. To arrest intermittent fever is the easiest thing imaginable, but to confer, by