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was an offensive ichorous discharge also. The polypus received an application of nitrate of silver once a day for a week, and it gradually disappeared, leaving no trace of it. During part of, this time I applied a lotion composed of nitric acid dilute gtts. x.; tinct. hydrastis, gtts. xxx.; glycerine, zi. The discharge diminished, all soreness disappeared, and within three to four weeks the ear was well and her hearing more perfect than it had been for years.
No. 2. A girl of twelve years about one year previous to applying to me had an attack of scarlatina. Following this she had a most offensive and abundant discharge from her right ear. I found that the membrana tympani was not perforated, as it often becomes from a continued suppurating process. This case was rather a complicated one; nasal catarrh and a bad cough were prominent troubles which would tend to make the ear-affection more difficult to cure. Daily application of a solution prepared according to the above formula were made, and immediately the discharge began to diminish, and in one month it had entirely ceased: the hearing greatly improved, the cough and nasal trouble, by use of special remedies, had almost entirely disappeared, and the girl presented a face of a roseate tinge for one of a pale and haggard expression. No. 3. A lad aged seventeen years, in February last, presented his left ear for treatment. The auricle and surrounding tissue were swollen and quite painful, and a free discharge flowed from the meatus. After cleansing the ear from all morbid matter, my favorite solution was thoroughly applied, and in a few days no trace of the trouble was left to tell the tale.
No. 4. This case is now under treatment and presents difficulties that are not so easily overcome. The little girl is five years of age, and about one year ago she had a severe attack of scarlatina, which left her ears in a bad shape. During the early part of May last, she was brought to me for treatment. The discharge from both ears was profuse and of a yellow color, and at first it was very offensive. The membrana tympani of both ears are perforated by ulceration from the prolonged ichorous discharge. The ears have gradually im
proved, but the right one still discharges a little, and this is on account of not being able to thoroughly cleanse the tympanum from all matter and properly applying the solution. to the interior of the cavity. I hope to overcome this difficulty by giving it closer and more careful attention if it takes all summer. The solution will do the work if it gets a fair show.
My mode of proceeding is simple, and indeed more effectual than the use of a syringe : in fact I do not like the syringe for cleansing the cavities of the ear. A probe, made of a fine stick or metal is sharpened and flattened at one end, and upon this point a small piece of absorbent cotton is twisted and made into a pointed pledget, by means of which the entire cavity can be swabbed and cleansed from all matter more effectually than can be done from any amount of syringing. The pledgets are easily and quickly made, and it requires from three to ten of them to thoroughly cleanse the ear. The last one is dipped into the solution and carefully inserted into the ear and brought into contact with the membrana tympani so that all parts receive the application. It causes no pain and indeed is the most simple and grateful mode of treating eartroubles of the character in question.
AN ENQUIRY INTO THE CAUSES OF ITS INCREASING PREVALENCE AMONG THE PUPILS OF OUR SCHOOLS.
By J. R. BORLAND, M. D., Franklin, Pa.
That Myopia, or short-sightedness, is on the increase in our common and academic schools, will be acknowledged by every well-informed educator; and that its causes should be sought for and if possible remedied, is certainly worthy of the best efforts of all who are interested in the education of the young.
It is not my purpose to enter upon a disquisition upon the anatomical construction or the physiological functions of the eye, nor the philosophy of vision, nor upon the abnormal con
struction or perverted function, which constitutes myopia. The diligent student will find all these fully expounded in works on anatomy, physiology, diseases of the eye, and optics. It would be well, nevertheless, if optics and hygiene of the eye were taught in our public schools. Some authors declare that every near-sighted eye is a diseased eye.
"Cohn, in Germany, and after him Loring, Derby, Risley and others in the United States, have shown by extended investigation that errors of vision, especially myopia and astigmatism, increase remarkably in schools, colleges and universities. In some German universities the near-sighted students constitute sixty per cent. of the whole number. It is not so bad in any institution in the United States; but the evil exists here. Hygienic conditions have a large influence in this matter, especially deficiency of light in reading, and stooping or bending over the desk, so as to use the eyes habitually too near the book or work. Dr. Risley, of Philadelphia, in a recent report of elaborate observations made in the public schools of different grades, shows that under the best possible conditions healthy normal eyes may go through a prolonged course of study without disadvantage." But he adds: “Given an eye with an anomaly of refraction, especially astigmatism, the probabilities are, other things being equal, that the educational process (as now conducted, I hold,) will be fraught with pain and danger to the eye."* Hence follows the propriety of the careful examination of all eyes that give trouble early in life; so as by proper treatment, both in and out of the school-room, they may be protected from injury and increasing disorder.
Myopia may be congenital or acquired, the last being produced by causes independent of heredity. Although transmitted from parents to children, it is seldom noticed before the seventh year. After that period it begins to manifest itself in those whose antecedents predispose them to it. But myopia is liable to be contracted by children of families in which a near-sighted member was previously unknown. It may then be the result of prolonged and steady looking at an object near the eye, though at proper distance, without rest or
* HARTSHORNE: Essentials of Practice, p. 598-9.
frequent change of the visual focus, as in long and absorbed novel-reading, intense study, or persistent diligence in needlework, more especially if the fabric be black.
Myopia is an accompaniment of civilisation, being, it is said, almost unknown among barbarous nations. It is rare among the poorer classes; and of these the inhabitants of our cities, from the nature of their occupations, are more liable to it than the inhabitants of the country. It has been said that a highly-intellectual people as the Germans, are more liable to it than others. The observation may be true, but that intellectuality of itself tends to produce it is a fallacy which is incapable of demonstration. It is rather the faulty methods that have been employed for generations in promoting intellectual growth which have so extensively produced it among the German people.
CAUSES OF MYOPIA.
The causes are of two kinds, which are analogous and mutual in their action, the one operating within the schoolroom under the eye, and to some extent under the control of the teacher; the other, outside of the schoolroom-at home, amid home-surroundings and amendable to parental control. I will enumerate some of them.
Ist. The school-age, or the age at which children are permitted to enter the public schools, is fixed by statute in most of the States at six years. The eye is then in a tender condition; its tissues like those of other parts of the body soft, tender and undeveloped. Hence it Hence it is easily tired out with the using.
2d. Black-boards and black slates are school-room appurtenances of doubtful utility, if not absolutely detrimental to the eyes. Since the introduction of exercise-boards black has been the color universally employed. If the laws of optics are not to be entirely ignored black is certainly objectionable. Professor Bohn, of Breslau, Germany, has observed that children are obliged to hold dark-colored slates much nearer the eyes to read writing thereon than is necessary with white paper, and finds that writing on white paper is as distinct at a
distance of twelve inches from the eyes as that on slates at eight inches. It is a well-known fact among seamstresses that those who sew on mourning goods lose the use of their eyes much earlier than those who work on light-colored fabrics. 3d. The almost constant use of the eyes which, shortly after the pupil's admission, is, you may say, forced upon him by his teachers, in the intense application to study which the cramming process involves in the competitive race for intellectual advancement.
4th. Fine print of text-books is a prolific cause of myopia and disposes the pupil to acquire the habit unconsciously of holding the book too closely to the eyes.
5th. Faulty construction of school-buildings, as to the admission of light. If there be a profusion of light it produces a glare, if too little a straining of the eyes is the result. The color of the walls and furniture should also be looked after. They should possess sufficient variety and contrast to be, when looked upon, a relief to the eyes.
6th. Ill-arranged seats and desks. Donders says: "In the hygiene of myopia the very first point is to guard against stooping position." It may be the result of habit, or from the desk not being graded to the size of the pupil.
7th. Night-study at home by gas or kerosene, which by their very brightness and glare must produce injury. Some of us can remember when a tallow-dip was esteemed a luxury "to read, write and cipher by." True, it was a poor light as compared with these, but it was soft and mellow and produced no glare. Pupils did not study so far into the night then as now, nor emulate the college-student in consuming "the midnight oil." Now-a-days classes are pushed with break-neck speed and the individuals in them "must study hard nights to keep up."
8th. Habits of home life, as keeping children in-doors, curtailing the area of vision, thereby preventing the exercise and variety so necessary to educate the eye to see at long-range. Children living in cities whose eyes dwell upon bare walls at short-range are more subject to myopia than those living in the country, who have the advantages of variety, of seeing