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Art. I.—7%e Ophtluilmia of Ireland: its Nature, Effects, and Treatment. By John Williams, A.B., Trinity College, Dublin; Licentiate of the King and Queen's College of Physicians, and of the Royal College of Surgeons, Ireland; Surgeon to the Cork Eye Dispensary.—Dublin, 1857. 8vo, pp. 44.
From the title of this work we were under the impression that it was devoted to the consideration of the formidable disorder which, whilst never entirely absent from the pauper establishments of Ireland, has from time to time ravaged them with terrible results. The pestilential period of 1847 and 1848 was followed by an outbreak of epidemic ophthalmia, and between 1849 and 1852 no less than 118,835 cases occurred in the union workhouses of Ireland alone! The disease' prevailed most in the unions of Tipperary, Cork, Limerick, and Clare, and principally attacked children under fifteen, the number of such sufferers being 84,136.
The author, however, touches but lightly upon this affection, devoting his pages first to an anatomical description of the palpebral, conjunctiva, and cornea; and then considering, in order, simple inflammation of the conjunctiva, pure catarrhal ophthalmia, catarrho-rheumatic ophthalmia, scrofulo catarrhal ophthalmia, purulent ophthalmia, granular lids, and affections of the cornea.
As the work is addressed to the members of the profession, we think it a pity that the author has indulged in such puerilities of description as stating that
• "The palpebral, or eyelids, are those moveable curtains situated in front of the orbit, and moulded with accuracy to the anterior surface of the eye, over which they slide with facility, and which is alternately concealed or exposed as they arc in opposition or separated." (p. 1.)
"The cornea is that highly-polished, strong, and transparent window in the front of the eyeball." (p. 5.)"
Such passages are perfectly unnecessary, and only encumber a work like the one before us. To those who have neither time nor opportunity for studying elaborate treatises, the short account here given of the various affections would be useful; but there really is nothing in the description of the diseases, or of the treatment, which calls for particular comment. The author states that ophthalmia in Ireland is characterized by that peculiar condition of the conjunctival mucous membrane, termed "granular lids," more frequently and in a severer form than in any other country in Europe; and this condition of the conjunctiva is also the most frequent cause of blindness in the poorer classes. To this point therefore we turn, and find a description, good, without being too minute, of the morbid conditions constituting granular lids. He says truly that
"The hypertrophied papillas are occasionally disposed in a row immediately behind the' posterior edge of the tarsal border; or they may occur large, dis. tinet, and pendulous from the superior palpebral sinus, which is a favourite reheat for them, and where they frequently remain undiscovered—I fear in some instanees unsought for. The entire palpebral investment may present a uniformly florid and granular appearanee—litce the surface of a granulating ulcer—and in this case the granulations, which do not present a very irregular surface, are disposed in groups or packets." (p. 24.)
The rules laid down for the management of this troublesome disease are sound. The author justly remarks that, "although in this disease local applications caunot be dispensed with, I consider the employment of them very secondary to well-directed constitutional treatment;" and we concur with him in the disadvantages arising from the abuse of escharotics and stimulating applications. The treatment recommended is prolonged counter-irritation, snipping off the larger granulations, and the application of astringents to the smaller; internally, bark and the oxymuriate of mercury. Mr. Williams does not mention scarification of the lid, but we have seen great benefit from it, combined with the application of the undiluted liquor phtmbi acetatis to the granular surface, and we are much in the habit of employing cold water freely to the eyes. The preparations of steel, either by themselves or with quinine, are valuable auxiliaries when prescribed with judgment.
It seems to be generally admitted that the main exciting causes of the various ophthalmiae among the lower orders of Irish are their inattention to cleanliness, debility of constitution, and the derangement of general health induced by excessive privation. Mr. Williams mentions that want of covering for the feet is the commonest cause of all; it would be interesting to ascertain whether ophthalmia is very common in Scotland, where bare feet arc the rule and not the exception among the lower orders.
Admitting that these opinions are correct, and that the excessive prevalence of diseases of the eyes and of their appendages are really due to such influences, it is not unreasonable to hope that the great social change now working in Ireland will sweep before it this, among the many evils arising from the curse of idleness and poverty; and that ophthalmia and its consequences will disappear under the benign influence of industry and prosperity.
Art. II.—Elementary Treatise on tlie Wavc-Theory of Light. By
Humphry Lloyd, D.D., D.C.L., F.R.S. L. <fe E., &c. pp. 208. With the exception of voltaic electricity and electro-magnetism, no branch of physical science has recently made such rapid strides as that of light; indeed, for nearly a century—viz., from the time of Newton to the time of Young, it was almost stationary; wonderfully advanced by the former, it received but few accessions till the investigation of it was renewed by the latter, to whom, indeed, mainly is owing the revolution of doctrine from that of the emission or projectile theory, advanced and elaborated by the genius of the firstnamed philosopher, to the undulating or wave-theoiy suggested by Hooke and more fully expounded by Huygbens. It is not a little remarkable that the projectile theory which had been adopted so long, and considered so well established, should now have hardly a supporter! How strongly does this change show the instability of hypothesis! And ought it not to be a lesson to us to adopt that excellent motto of a Society of which Newton was the greatest ornament, Nuttius in verba magistri, and to follow the example of those able and zealous inquirers, the contemporaries and successors of Young, by whose brilliant discoveries the " wave-theory" of light has been confirmed?
The name of the author of the treatise before us—himself one of those inquirers to whom we have just alluded—is sufficient warrant for its sterling worth; and its being a second edition is a proof of the successful manner with which he has dealt with his subject. Expressly designed, in the first instance, for the use of the student— being, as he states, an extension of the lectures delivered by him in his professorial capacity in Trinity College, Dublin—it can hardly fail of being acceptable, and of proving highly useful to those anxious to indoctrinate themselves in the science. It is recommended by its logical precision throughout, and by happily combining the historical ■with the experimental and theoretical.
In concluding his preface, Dr. Lloyd states,
"His only aim has been to present to those who were conversant with the elements of mathematics a clear and connected view of his attractive subject; and he has been compelled by this limitation to confine himself in many cases (as in all that relates to the dynamics of light) to a general account of methods and of their results. Those who desire a more exact acquaintance with the science will, of course, study it in Sir John HerschePs 'Essay on Light,' and in -Mr. Airy's tract ' On the Undulating Theory of Optics ;'"
And for a general knowledge, we would beg to add, in Professor Forbes's admirable dissertation ' On the Physical Sciences,' recently published in, and forming a part of, the 'Eucyclopoedia Britannica.'
It is foreign to our purpose to attempt an analysis of Dr. Lloyd's ■work, and we shall make only one extract, in which are clearly defined the characteristics of the opposite theories.
"We have seen that light travels from one point of space to another in time, and with a prodigious velocity. Now, there are two distinct and intelligible ways of conceiving such a propagated movement. Either it is the sai,te individual body which is found in different times in distant parts of space; or there are a multitude of moving bodies occupying the entire interval, each of which vibrates continually within certain limits, while the vibratory motion itself is communicated in succession from one to another, and so advances uniformly. These two modes of propagated movements may be distinguished by the names of the motion of translation and the motion of vibration. The former is more familiar to our thoughts, and is that which we observe when with the eye we follow the path of a projectile in the air; or about which we reason, when we determine the course of a planet in its orbit. Motions of the latter kind, too, are everywhere taking place around us. When the surface of stagnant water is agitated by an external cause, the particles of the fluid next the origin of the disturbance are set vibrating up and down, and this vibratory motion is communicated to the adjacent particles, and from them onwards to the boundaries of the fluid surface. All the particles which are elevated at the same instant constitute what is called a trace; and that this wave does not consist of the same particles in two successive instants, may be seen in the movements of any floating body, which will be observed to rise and fall as it is reached and passed by the wave, but not to advance, as it must necessarily do if the particles of the fluid on which it rested had a progressive motion. The phenomena of sound afford another well-known instanee of the motion of vibration. The vibratory motion is communicated from the sounding bodv to the ear through all the intervening particles of the air, though each of the aerial particles moves back and forwards through a very narrow space.
"Each of these modes of propagated motion has been applied to explain the phenomena of light, and hence the two rival theories—the theory of emission, and the trove-theory. In the former, the luminous body is supposed to send forth, or emit, continually, material particles, of extreme minuteness, in all directions. In the latter, the same body is supposed to excite the vibrations of an elastic ether, which are communicated from particle to particle to its remotest bounds. This ethereal medium is supposed to pervade all space, and to be of such extreme tenuity as to afford no appreciable resistance to the motions of the planets."
Art. III.—On tiie Pathology, Symptoms, and Treatment of Ulcer of tlte Stomach. By William Brinton, M.D., Fellow of the Royal College of Physicians, Physician to the Royal Free Hospital, Lecturer on Physiology and Forensic Medicine in St. Thomas's Hospital.—London, 1857. pp. 227.
Were it not that a good portion of this work has already appeared before our readers in the pages of this Journal, it would challenge a more particular notice than that which we are now able to afford it. The modest statement of the preface is more than justified:
"That it may be described as collecting and ineorporating facts hitherto scattered and little accessible, and as recording the existing state of our knowledge respecting this disease, in a form calculated to facilitate those additions and corrections which time is sure to bring."
One of its chief merits appears to us to be, that all the particulars relating to gastric ulcer are examined into on the basis of a larger number of facts than has yet been done; the author having with great industry brought together and utilized the observations of those who have preceded him in this inquiry. Perhaps we may confess to * certain amount of distrust of some of the less obvious statistical calculations, the results of which, indeed, the author himself does not rank above "conjectures." These are, however, the fashion in physic at the present day, and can scarce be objected to. One point we must notice as well brought out—viz., the greater liability to perforation in the young female, contrasted with the greater frequency of occurrence of ulceration in advancing life.
The symptoms and concurrent conditions are exceedingly carefully and well investigated, and the reader will find a complete resume of all our knowledge on these heads. We feel surprised that Dr. Brinton should lay stress on the effect of pressure in increasing pain (epigastric or dorsal) as a diagnostic sign (" a very important test") of gastric nicer. To us it has appeared simply to indicate that the mucous surface was in a state of inflammatory irritation, tender and irritable, just as an inflamed conjunctiva. Of course this state may, no doubt often does, concur with ulcer, but it is not a sign of this lesion.
The etiology of the gastric ulcer is well discussed. The author objects to an explanation of its peculiarities founded upon the local circumstances, so far at least as accounting for the origin of the ulcer. In this we concur with him, as also with regard "to the remarkable influence of poverty and intemperance." Dr. Brinton considers that there is nothing specific in the ulcer of the stomach, any more than in ulcers of the leg, and he believes that either lesion may originate in very various ways. He cites Mr. Critchett's experience as to the existence of similar characters in the ordinary cutaneous ulcer at the epoch succeeding puberty, to those observed in the gastric at the same period—viz., a more or less complete absence of inflammatory reaction at the base and margins. We would remind Dr. Brinton of the analogous instance afforded in ulceration of the cornea, to which Dr. Handlield Jones has drawn attention. In this we have a marked example of ulceration occurring in a tissue in a primary manner, uncomplicated often with any other morbid action. We observe it always in states of debility, and we watch its cure Tinder au analeptic and tonic treatment. To comprehend aught of its origin seems altogether at present impossible, from our entire ignorance of the secrets of vital chemistry. If we knew anything of the power which originally constructed the tissue, and which continues to maintain it, we might look to understand the results of that power's failure.
We have next to notice the subject of diagnosis. Dr. Brinton, after posing the question, "What is the minimum of evidence that will justify our affirming the existence of an ulcer of the stomach during life i" replies, that he
"Is inelined to think nothing less than all the chief symptoms enumerated entitle us to pronounee a decided opinion. In other words, unless the pain possess the characters attributed to it, unless this pain he accompanied by vomiting, and unless there be evidenee of haemorrhage having occurred in the course of the malady, there is no sufficient basis for a definite diagnosis of the existenee of a gastric uleer."
He adds, however, that he has
"Not the slightest doubt that an absolute enforcement of this rule of diagnosis would lead us to overlook a vast number of cases, and might thus be the occasion of grievous errors in practice."