OPHTHALMOLOGY.

The Nature of Acute Glaucoma.

In the Annales d'Oculistique for July, Terson compares acute primary glaucoma to the acute idiopathic oedema which occurs in various other organs, but especially in the lungs. He points out the similarity of the mode of production. A diffuse toxæmic condition is present over the whole body, and this may be either a general infection, such as influenza, erysipelas, etc., or some diathesis as gout or rheumatism. He instances the usual association of hypermetropia with this form of glaucoma, and points out that the occurrence of acute primary glaucoma in several successive generations may be explained by the hereditary transmission of hypermetropia. With these two predisposing causes he attributes the exciting cause of the local hypersecretion-which constitutes the condition of acute primary glaucoma-to some temporary nervous or emotional excitement, and thus explains the special occurrence of the disease in neuro-arthritic subjects. This is analagous to Von Graefe's theory of an acute serous choroiditis.] Terson refers to some of the theories that have been put forward from time to time to explain the exact mechanism of the process by which this serous exudation and local oedema is brought about, but leaves the question open for discussion. As to prophylaxis and treatment the writer urges special attention to the general health, and treatment of the existing predisposition or diathesis. The only positive cure is by the performance of an early scleral iridectomy.

Serous Iritis not a Disease per se.

In a lengthy paper in Knapp's Archives for November, Bruns goes fully into the vexed question of the nature of serous iritis, keratitis punctata, or descemetitis, and claims to show that, as a distinct disease, it does not exist. In this he is in the main in agreement with Fuchs, but he points out that the writers of nearly all the text books perpetuate the error of describing it as a pathological entity. Bruns' conclusions are briefly :(1.) There is no such disease as serous iritis; (2.) Keratitis punctata is a disease which is an accompaniment of plastic uveitis (iritis, cyclitis, or choroiditis), and never occurs independently, though the presence of slight degrees of uveitis may be overlooked. He thinks that more exact observation will show descemetitis to be most frequently the principal symptom of an acute outbreak of plastic choroiditis.

The Primary Intradural Tumours of the Optic Nerve (Fibromatosis Nervi Optici).

This is the title of an admirable and exhaustive monograph of over 80 pages from the "Studies from the Royal Victoria Hospital, Montreal," creditable alike to the hospital and to the author, W. G. M. Beyers. The author gives particulars of two cases that had come under his notice, and deals exhaustively with the whole subject. He discusses fully the pathology, symptoms, diagnosis, prognosis, and treatment, and gives an analytical table of all the recorded cases collected from the original papers, and also a complete bibliography. The paper is practically a resume of all the work done in the subject. Extra dural tumours are not included. The writer maintains that in spite of confusion, arising from diversity of terminology, the tumours are essentially mesoblastic in origin, containing several phases of developing connective tissue, and no nerve elements proper. He gives the name of fibromatosis to the condition. With regard to etiology he remarks that the number of cases reported to have followed some febrile disturbance or infectious disease

is too great to be merely accidental. The distinguishing signs are (1) painless, slowly developing exophthalmos; (2) profound and early reduction in vision; nerve, non-adherent to the orbital wall; (4) relatively (3) a palpable tumour in the position of the optic good movements of the globe; and (5) hypermetropia, due to pressure on the posterior surface of the globe. The prognosis is serious, not from recurrence in its strict sense, but from the continued development of the intra-cranial portion of the tumour, which it is imposrecorded where signs of an intra-cranial neoplasm sible to remove by operation. Twelve instances are occurred after operation, and only eight cases are positively shown to have continued in good health beyond five years. As to treatment, Krönlein's operation is times in all for this condition. [A description of this the only one recommended. It had been done five operation will be found in the October number of the cases, in nine of which the results were distinctly bad, A. M.G.] Knapp's operation was performed in 20 resulting in phthisis bulbi, or necessitating enucleation results be considered entirely satisfactory from a cosmetic of the globe, while in only four cases could the after point of view (the sight being of course destroyed in every case by either Krönlein's or Knapp's operations). The remaining tumours of the total of 102 were only table. got after enucleation or discovered on the post mortem

A Plea for the Occasional Performance of Couching of Cataract.

At the last meeting of the B.M.A. at Cheltenham Mr. Henry Power read a paper on this subject, urging the propriety of doing this operation in certain cases, such as those of very old and feeble people, where a wound would be likely to heal badly; cases where there is intractable conjunctivitis or mucocele ; in deaf persons, lunatics, imbeciles, epileptics, or bleeders; in cases of tremulous iris with fluid vitreous; or those who had already lost one eye from an unsuccessful extraction. He maintained that the risks of the operation had been much exaggerated. In the discussion that followed there was a general agreement with the author's contention.

At the same meeting Mr. Hartridge reviewed some of the more recently introduced preparations of silver used in ophthalmic work. Protargol was the most efficient. Darier also read a paper in which he regarded protargol as better than silver nitrate for purulent ophthalmia it being safer, and having more penetrating power. He had given up silver nitrate in these cases, using protargol instead, in strength up to 30 per eent.

The Treatment of Anisometropia.

In Knapp's Archives for November Dr. Douane, of New York, describes his practice (which differs from the usual one) of giving each eye its correction in anisometropia, and states (quoting numerous cases) that he gets good results almost invariably. If this be so the work of the refractionist is simplified, and he is spared considerable perplexity in the treatment of these cases. In his tabulated results he records cases in which the two eyes differed by 2, 4, 6, and even 11 dioptres with varying degrees of astigmatism, in which the patients bore full correction of each eye, and gct perfect binocular vision. He refers also to the well known fact that it is not always the cases of high anisometropia that give rise to trouble when corrected Temporary discomfort may ensue in some cases, but this disappears in a week or two provided the patient perseveres steadily with the glasses.

NEUROLOGY.

Regeneration of the Spinal Cord.

Under this head two investigators, Bielschowsky and Fickler (Neurologisches Centralblatt 1901, No. 16.) discuss the possibility of a regeneration of nerve bundles after severe compression of the spinal cord. Working independently they have both found nerve fibres passing down in the pia mater of the anterior median sulcus of the cord. These fibres appear to connect up segments above the lesion with those below it.

Fickler found in his cases a certain amount of improvement which he ascribes to the re-establishment of the motor conducting path by means of these new fibres. There appears to be evidence that such fibres are present normally, but Fickler assents that after such lesions as mentioned above more fibres develop.

An article by Rudolf Kolster (Deutsche Zeitschrift für Nervenheilkunde, Bd. xx, Heft. 1-2. p. 16) helps to support the idea that cell division takes place even in the human central nervous system. It has long been known that a centrosome is frequently found in the protoplasm of a nerve cell, but Kolster, by treating the cells of the ventral horn of gray matter with a solution of ammonia, and later with sulphuric acid, gets rid of the tigroid bodies, which have hitherto been a great hindrance to a clear view of the centrosome being obtained. He then stains the tissue with ironhæmatoxylin, and in many cases is successful in finding one or two cells containing a centrosome in the section. The idea that the centrosome is an expression of overnutrition of the cell appears to be negatived by the fact that Kolster has found these bodies in patients dying from pernicious anæmia.

Daniel McCarthy, Philadelphia (Neurolog. Centralbatt, Nov. 17, 1901) points out the presence normally of a reflex through the fifth and seventh cranial nerves. By tapping the supraorbital nerve with a percussion hammer fibrillary twitching of the orbicularis palpebrarum is set up. He gives instances in which owing to interruption of the reflex path through the fifth and seventh, the reflex was wanting.

Adler (Deutsche Med. Wochenscherift, 1901, Nov. 8) suggests. as the result of experimental research and clinical observation, that the cerebellum exerts an inhibitory influence over reflex tone, and that the symptom picture of multiple sclerosis is dependent on an interruption of the descending cerebellar tract.

Professor E. A. Homén (Deutsche Zeitschrift für Nervenheilkunde, Baud. xx. Heft 1-2, p. 24), gives the results of some investigations on Schultze's comma tract in the dorsal white columns. He comes to the conclusion that his tract represents the descending divisions of the dorsal roots as they enter the cord. The article is illustrated and shows the tract occupying the inner part of Burdach's column stretching from a point near the dorsal white commissure nearly to the periphery. The degeneration could be followed downwards for two ot three segments.

The Gasserian Ganglion.

To those surgeons interested in the method of removing this ganglion a work by R. Caminiti, termed "Recherches sur l'Anatomie Chirurgicale du Ganglion de Gasser, would probably be interesting. The work includes

detailed information on the position, shape, color, consistence, weight, and size of the ganglion. Much attention is paid to the surrounding topography. The author states that his book is the result of careful investigations made in the post-mortem room on fifty-two bodies. The work is illustrated.

Migraine.

(Ueber Migrane von Dr. Alen Spitzer (Fischer, Iena.) Dr. Alen Spitzer of Vienna in his recent book on migraine introduces many arguments on behalf of a theory that the trouble is due to a vasomotor disturbance producing a partial blocking of the foramen of Monro by the swollen choroid plenuses. He explains the sensory aura as being due to a distention of the ventricles producing pressure on the cortex and explains the pain as due to similar pressure on the dura mater.

Dr. Wilhelm Stekel (Migrane and Wärmebildung von Dr. W. Stekel, Wiener Med. Wochensch 1900, 32-34), has observed a fall of temperature in the axilla in migraine, whilst the rectal temperature remained normal. He finds that an increased production of heat by fast walking, or cycling, etc., has a good effect, whereas warm baths have a bad effect.

Whitehead's article on the treatment of migraine by seton as recommended by him in the British Medical Journal February, 1901, is reviewed in the Neurologishes Centralblatt.

The Mental Functions of the Brain.

Such a

After Flecksig published his valuable work on the cerebral cortex, in which he pointed out he could distinguish about forty areas whose fibres myelinated at different times, and after the suggestion which he made, that these different areas were, perhaps, connected with different functions, it is not surprising and somewhat gratifying to find that an attempt has already been made to trace out such a connection. Dr. Bernard Hollander, has just published a work under the above title, in which he adduces much evidence for the theory that the various forms of mental disease affect not the cortex as a whole, but only localised parts of the same. theory can only be tested by closely and accurately observing and recording the intellectual and emotional conditions of a large number of cases, both normal and abnormal, and at the same time making similarly careful head measurements, to be followed as often as possible by an investigation of the condition, shape. mass, course, etc., of the convolutions, the camera being brought into requisition at almost every step. The work should prove especially interesting to those engaged in the study of the insane, and who thus have excellent opportunities of making such clinical investigations as are indicated above.

Professor Cunningham, President of the Anthropological Section said at the recent meeting of the British Association at Glasgow in speaking of the psychic centres: "But the areas of cerebral cortex to which man owes his intellectual superiority are now roughly mapped out, and the time has come when the effect produced on the cranial form by the marked extension of these areas in the human brain should be noted, and the skulls of different races contrasted from this point of view. To some this may seem a return to the old doctrine of phrenology, and to a certain extent it is; but it would be a phrenology based upon an entirely new foundation and elaborated out of entirely new material."

CORRESPONDENCE.

WEST AUSTRALIA. (FROM OUR SPECIAL CORRESPONDENT.) MUCH activity has been displayed during the past few months in the medical world of this State. In Fremantle, an attempt is being made to form a Medical Institute, which is to include all the members of the existing Friendly Societies. The medical men in Fremantle, assisted by many of us in Perth, have taken active measures in strenuously opposing this up-todate method of sweating the medical profession, and not only has every applicant received a printed memorandum dealing with the medical aspect of this Medical Aid Institution, but most of the members of the Friendly Societies themselves have received a printed memorandum stating the case from their point of view. Should any medical practitioner accept the position, his life will certainly not be a "bed of roses."

During the past month the "West Australian Medical Defence Union " has been incorporated, and we are at present seeking to obtain as members most, if not all, of our fraternity in this State. I feel sure that much benefit will be derived both directly and indirectly by the presence, amongst us, of this much-needed organisation. We are at present far too content to allow both our personal and collective interests to remain in the background, instead of attempting to raise the tone and standard of the profession, not only amongst ourselves, but also in its relationship to the general public.

The Medical Board has conducted three prosecutions under the "Medical Act" against chemists who have overstepped the line which should separate his conduct from that of a medical man. Perth and other towns in this State are overburdened with chemists, some of whom style themselves "Consulting Chemists," and they, with others, examine, diagnose, and prescribe for their customers in flagrant contravention of the "Medical Act." All cases of this kind which come to the knowledge of the Board will be actively proceeded against in the local

courts. Unfortunately, not much help can be expected from the Pharmaceutical Council, since some of its members are in active sympathy with such irregular practices. A number of letters have appeared in the local newspapers since the last case was tried and a conviction obtained, but their value is to some extent discounted by their having been written by interested parties, at least in some instances.

The West Australian Branch of the British Medical Association is increasing in strength and importance rapidly. A very successful dinner was held at the Hotel Esplanade, Perth, early in November, at which about 24 members were present. Dr. Davy, the president for 1902, was in the chair, and G. Leake, Esq., K.C., M.L.A., the late Premier of this State, was the principal visitor. We hope to have an increasingly successful session in 1902, and many of us desire that the Intercolonial Medical Congress should be held in Perth in 1905. It would give the much needed stimulus, which we, like all young Societies, need, especially when in a sparsely scattered community.

The political world of this State during the past few months has been chaotic, and medical legislation, like all other legislation, has been remarkable for its absence. An attempt was made by Friendly Societies to pass a Bill amending their former Act. This amending Act made it impossible for any medical club to be formed unless it was incorporated under the provisions of the Friendly Societies Act." This pernicious amendment would have given these bodies an increasing power, and would have pressed hardly upon many medical practitioners, who derive a considerable part of their income from clubs formed under other than Friendly Societies' rules. I am happy to state that we are now sufficiently on our guard," and sufficiently powerful to be able to prevent any such Bill from becoming law.

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In conclusion, let me ask all my professional brethren, who are considering the advisability of settling in this State, to make firstly, due and very careful inquiries as to the bonâ-fide nature of the position they are asked to accept, and if in any doubt as to the genuineness of the billet, to write to me since so many specious advertisements proceed from local hospitals and associations in this State.

"A TRUE HERO OF MEDICINE."

(To the Editor of the Australasian Medical Gazette.) SIR,-Might I be permitted to call attention to the case of "A True Hero of Medicine," the facts of which are recorded in the British Medical Journal of December 7th, p. 1709. I feel certain many of the profession would like to show their practical sympathy by subscribing to the fund of the late Dr. Smyth, who have been left destitute. which is being raised to assist the widow and children Personally, I should be very pleased to forward my quota, and would suggest that a subscription list be opened in your columns. Yours, etc.,

R. W. YOUNG.

Milton, January 8th, 1902. [We shall be pleased to receive any contributions towards this object.-ED. A.M.G.]

PUBLIC HEALTH.

New South Wales.

Precautions against Importation of SmallPox. In view of the extension of the small-pox epidemic in London, the Board of Health has directed that all vessels from British ports shall be subjected to medical inspection prior to being granted pratique at Sydney.

Penalties for the Sale of Diseased Cattle.Two cattle dealers recently prosecuted at the instance of the Board of Health were fined, one £40 and the other £20, for selling diseased cattle contrary to the provisions of the Diseased Animals and Meat Act.

Bubonic Plague in Sydney.-No case of bubonic plague has occurred in Sydney since December 11th, 1901, and no plague infected rats have been found since November 26th, 1901. Since the last mentioned date 479 rats have been examined in the microbiological laboratory of the Department of Public Health, all being free from any signs of plague.

Rat Destruction in Sydney.-At the last meeting of the Board of Health it was reported that 15,006 rats had been burnt at the board's furnace, between dates November 28th, 1901, and January 6th, | 1902. In addition, large (but uncounted) numbers of rats had been killed during the fumigation of vessels and sewers.

Victoria.

Vital Statistics, Melbourne.-During the month of November, 1901, the estimated population of Melbourne and suburbs was 494,368. The number of births was 962, a proportion of 23.68 per 1000, being 150 below the average of the month during the previous 10 years, or 213 below it, if allowance be made for the increase of the population. The deaths number 525, being at the rate of 12.92 per 1000. This was 96 below the average of November during the previous 10 years, or 131 below it allowing for the increase of population. 25 deaths were due to malignant disease, 68 to phthisis, 15 to other forms of tuberculosis, 69 to disease of the circulatory system, 50 to diseases of the respiratory system, 43 to diseases of the digestive system, and 37 to disease of the urinary system. The deaths of infants under twelve months numbered 85, as compared with 120 in November, 1900. The rate of infantile mortality was 88 per 1,000 births registered in the month under review, as compared with 117 in November, 1900; 174 in November, 1899; 208 in November, 1898; 134 in November, 1897; 160 in November, 1896; 127 in November, 1895; 115 in November, 1894; 147 in November, 1893; 112 in November, 1892; and 183 in November, 1891. In striking contrast to the decline in the percentage of deaths of children under five years, the proportion of deaths of elderly persons-aged 75 and upwards-has shown a marked increase in the last ten years, proving infallibly that the percentage of elderly persons in the population has considerably increased, and has apparently not yet reached maximum. This point is of considerable interest as The bearing on the question of old-age pensions. actual numbers of aged persons cannot be ascertained until the results of the recent census have been fully

tabulated.

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Diphtheria in Ballarat.-Owing to the appearance of diphtheria in the municipality of Ballarat (Vic.),

the Public Works department has arranged to have the whole of the State schools in Ballarat West fumigated during the Christmas and New Year vacation, in accordance with the request from the board of advice.

Vital Statistics, Ballarat.-During the month of November, 1901, 137 births, and 64 deaths were registered. 31 of these were due to local diseases; 10 to cancer and phthisis: 10 to developmental diseases; and 7 to specific febrile diseases. There were no deaths from typhoid fever.

Inspection of Dairies.-The officers appointed by the Agricultural Department to inspect the dairies of the State have reported that the system of inspection adopted by the municipalities is almost valueless, and at their suggestion the Health department has been urged by Mr. Morrissey to enforce the appointment of municipal inspectors, with a sufficiently limited area to enable them to carry out their duties efficiently. The chairman of the Board of Public Health (Dr. Gresswell) states that the regulations concerning dairies are very explicit, and confer abundant powers on the municipal authorities, whose duty it is to see them carried out. The Government has decided on the preparation of a measure dealing with dairies which will give additional powers, and the board is concerned with the question as to the direction in which the existing law should be amended.

Queensland.

Vital Statistics, Brisbane.-During the month of October, 147 births were registered in the registration district of Brisbane, being 8 less than in the preceding month, and 31 less than in the corresponding month of last year. 82 deaths were registered, being seven more than in the preceding month, and four less than in the corresponding month of last year. The

total number of deaths in Brisbane and suburbs was 119; 65 of these were due to local diseases, 22 to specific febrile diseases, of which one was due to plague, 3 to typhoid fever, and 2 to dengue fever; 15 were due to constitutional diseases, of which 6 were due to cancer

and 6 to tuberculosis. The true infantile mortality, or deaths under one year, as compared to births in the district, is seen to have been 11.11 per cent. within, and 50.00 per cent. outside the municipality of Brisbane. The total rate for city and suburbs being 12.20.

Tasmania.

The Central Board of Health.-At a meeting of the Central Board of Health held last month, a letter was read from Mrs. R. S. Bright, gratefully acknowledging the letter sent to her offering the board's sympathy on the death of her husband, Dr. R. S. Bright. The Secretary (Mr. A. Mault) reported that a tender for the construction of the works at Barnes Bay Quarantine Station had been accepted by the Public Works Department, and the work would now be done. The necessary intermediate building between the hospital and the outside would be put up. Persons would change their clothes in the intermediate building on entering and leaving. Additions would be made to the hospital accommodation, and repairs effected to the caretaker's cottage. The amount of tender was £250. A letter was read from the Town Clerk of Hobart,

stating that the City Council had accepted a tender for the conveyance of the night-soil from the city to Triffit's Point, Glenorchy. Dr. Crouch moved that the Board refuse its sanction to the deposit of nightsoil at Triffit's Point, and the motion was carried.