for degrees in medicine ought to be resumed as soon as possible by St. Andrews University. We have always advocated the necessity of, as soon as possible, obtaining an obligatory state degree, granted by examiners chosen, it may be, from the Medical Council, which should examine all candidates for the title of M.D., indifferently at London, Edinburgh, St. Andrews, &c. The local degree system of past times is a scandal and a disgrace to the intelligence of the day. We are tempted to say, often, that universities seem to be hindrances rather than assistants to the diffusion of learning. Let St. Andrews University and London University always insist on keeping aloof from the evil examples of more narrow-minded corporations, and renew the noble precept of "Good will to all men," by granting their degrees to all, totally independently of all residential qualifications, and only on account of proficiency and experience.

Obituary.

DEATH OF SICHEL.

THE regrets to which we gave expression a few weeks since on the death of Mackenzie, the father of eye surgery in Great Britain, might fittingly be repeated in our record of the death of Sichel, the senior of the Parisian ophthalmic specialists, which occurred late in the last month. Genuine and real in every word of the experiences which he has left to the instruction of his brethren, he separated himself by the hardly-gained barrier of industrious observation and a scientific judgment from the herd of flippant ophthalmological pretenders whose substitute for study and labour is algebraic humbug and ineffable self-sufficiency. Sichel the elder carried with him to the grave more actual intelligence on the subject to which he devoted himself than would furnish the marrow to all the pretentious effusions of the authors who affected a contempt for him. The Bulletin de Thérapeutique in its obituary thus speaks of him:

66

Amongst the losses which our profession has recently sustained we have specially to deplore that of Sichel the elder, the learned and skilful oculist, and the celebrated author of the Iconographie Ophthalmologique. The last honours were paid him with the extremest simplicity, according to his express wish, and therefore, unfortunately, in the absence of that assemblage of his brethren which would not have failed, if they had been permitted, to pay to his memory the tribute of affection, respectful esteem, and regret, which was his just due.

"Sichel was not only at the summit of the speciality which he had embraced. He attached himself to it with a real passion, as we may say, and also with the greatest success to different other branches of knowledge, especially to medical and ophthalmic archæology and entomology. He was president of the Entomological Society of France, and left behind him a magnificent collection of hymenoptera to the Museum of Natural History."

DEATH OF DR. JEREMIAH DONOVAN. WE deeply regret to announce the death, at Plymouth, of Dr. Jeremiah Donovan, R.N., the second son of Dr. Daniel Donovan, of Skibbereen. Dr. Donovan, who was educated at the Cork Queen's College, entered the navy in 1861. Shortly after his appointment he joined the Mediterranean squadron, and served there for nearly four years. After a short stay on shore he joined the Coast of Africa squadron, and returned invalided over twelve months since. Dr. Donovan's health apparently rallied after a time, and he was appointed to the Naval Hospital at Plymouth. But the seeds of fatal disease had been sown in the pestilential climate of "The Coast.” The improvement in Dr. Donovan's health soon ceased to exist,

and after a long and painful illness, borne with admirable resignation and piety, and cheered by the consolations of the church, Dr. Donovan passed away on Wednesday last. The deceased was a valuable and trusted officer, a skilful physician, and a young man of the very highest promisea most amiable, high-minded, and kindly gentleman. His premature demise will cause the most heartfelt sorrow to all who knew him, either in private or official circles. He was one of those who never made an enemy, and who had a host of friends. Had he been spared he would probably have attained the very highest distinction in his profession. As it is, he leaves behind him a blameless and an honoured name. The fondest of sons, and the most affectionate of brothers. All who know them must sympathise with the sorrows of the dear ones he left to mourn his loss.

NOTICES TO CORRESPONDENTS.

DR. JACOB'S Lecture on the Eye is unavoidably postponed to our next number.

A SUBSCRIBER.-The sulphur pastilles are made by Duncan and Flockhart, and may be had of Messrs. Bewley and Hamilton, Dublin; see advertisement.

DR. J. W. LANE.-Enquiries are being instituted. We will endeavour ble, has become rather common of late, and should be stopped in its to enlighten you in our next. The practice, which is strongly reprehensiinfancy.

attention. We were aware of the facts mentioned, and shall rot fail to MR. W. R. B., LONDON.-Thanks: your note shall receive immediate utilize them on the earliest opportunity.

H. H.-The articles in question were written by one of our Scotch editors, hence the point you notice. The Scotch edition is published, like the MEDICAL PRESS AND CIRCULAR, weekly.

A. M. BENNETT.-The question has been referred to one of the ablest physiologists, who will write an article upon it in a short time. DR. BIRD.-The journal in question states in the paragraph to which you direct attention, what its editor has the best reason to know is absolutely without foundation.

HADLOW, H., Esq.-Promoted to Surgeon in Her Majesty's Fleet.

BIRNIE, T. K., Surgeon from the 12th Foot, to be Staff-surgeon to the same, vice W. Sinclair, appointed to the 12th Foot. READ, C. C., Assistant-surgeon, from the Grena lier Guards, to be StaffSCOTT, J. A., Assistant-Surgeon, from the 91st Foot, to be Staff Assurgeon to the same.

sistant-surgeon to the same, vice T. P. Smith, M.B., placed upon half-pay.

CLIMO, W. H.. M.D., Assistant-surgeon from the Rifle Brigade, to be Staff Assistant-Surgeon, vice A. A. Macrobin, M.B., who exchanges. BLENKINS, G. E., Surgeon-major, Grenadier Guards, who retires on halfpay, to have the honorary rank of Deputy-Inspector General of Hospitals.

BOOKS, PAMPHLETS, &c., RECEIVED. Transactions of the Pathological Society of London.

1868.

Vol. XIX. Nature and Art. Poems by R. Tonson Evanson, M.D., F.R.C.S., &c. London: W. Hunt and Co.

The Sanitary Aspect of the Sewage Question. By James Adams, M.D. Glasgow: James Macletrose.

M.D., &c. London: H. K. Lewis, Gower street.
The Climatic Treatment of Consumption. By John C. Thorowgood,

Four Letters on Homoeopathy. By Alexander Harvey, M.D. Aberdeen : Wyllie and Sons.

The Nature and Treatment of Diabetes. By F. W. Pavey, M.D., F.R.S. Second Edition. London: John Churchill and Sons.

also liable to the same sympathetic and functional disturbances as occur in the other organs.

In the eye we have exactly the same conditions of inflammation, exudation of lymph becoming organised and forming adhesions, or suppurating and being eliminated from the system as foreign matter; and all more or less amenable to the same course of treatment as when they occur in other organs. In point of fact, I repeat, the animal structures are in the eye modified as regards their uses, but still they are the same structures here as elsewhere, subject to the same diseases, and to be combated with the same remedial measures.

Every general principle which you will learn to apply to the treatment of local diseases elsewhere, will, with certain restrictions, be found proper to the eye, and must be borne in mind as closely in their application to ophthalmic surgery as in all other forms of disease.

But it is to be borne in mind that the eye possesses characteristics which make lesions which would be of the smallest import elsewhere of vital importance here, and which cause an inflammatory process which might be allowed to persist for weeks in other parts of the animal economy, without much consideration, in a few hours to inflict an irreparable injury.

These two qualities are transparency, and that peculiar form of nervous sensibility to light, reposed in the organ, and they are characteristics most vulnerable to all forms of disease. A pustule or an ulcer of the cornea, an exudation of lymph from the iris, or an inflammation of the retina, demand special and peculiar treatment, for if they were permitted to go on as they might do in another position, without any serious result, they would in the eye, while resolution was proceeding, imperil or destroy the transparency of the humours, or the sensibility of the retina. For this reason your treatment of eye affections must, speaking generally, be prompt while it is cautious, and vigorous while it must be judicious; and while you must be careful not to lose time by inefficient measures, you must guard against the mistake too frequently committed of overdoing your treatment, and thereby vitiating your results.

Injuries in the Neighbourhood of the Orbit.-Injuries in the neighbourhood of the orbit differ in their characteristics in no essential respect from those to other regions of the head, and I shall therefore leave your instruction in their treatment to my surgical colleagues, except so far as the result may be influenced by the neighbourhood of the eyeball itself. You will see fractures of the bones and concussion and injury of the brain as elsewhere. Amaurosis may be caused by blows outside the orbit. As the spine or brain may suffer disorganizing injury by the simple shock of violence without absolute rupture, so the optic nerve may be permanently paralysed by indirect concussion. Amongst the commonest causes of this injury are strokes on the temple or on the eyeball itself from a racket ball, or blows inflicted on nurses by the child in their arms unexpectedly raising its head. Thus may result instantaneous amaurosis, which was formerly attributed to an injury of the frontal nerve, but is now regarded as a molecular alteration in the nerve substance. It is frequently attended with dilatation of the pupileither of the whole or a part-and may or may not present under ophthalmoscopic examination appearances of retinal injury. If the loss of vision be immediate and complete, the paralysis of the nerve may be diagnosed; and in such case, if the blindness persist for more than a few hours, relief is almost hopeless, but if any interval, however short, existed between the blow and the blindness, hope may be entertained that it is due to extravasation of blood either on the optic tract or within the eyeball, and that on the absorption of the clot vision may be partially restored.

The recollection of the existence of this lesion should make the surgeon careful of his prognosis when the retina is obscured by extravasation into the eyeball, because

he may find if he succeed in removing the effused blood that the patient is permanently blind.

I have lately had a patient under my care who was struck partly amaurotic from a blow of a snowball on the forehead, but, as I have said, his retine present no lesion, and his symptoms of general paralysis point to the cerebrum as the seat of the injury.

Injuries within the Orbit.—It is only in the case of injuries within the orbit itself that the locality gives a special character to the accident. Proportionately as the external defences of the orbit are strong, 30 is its internal construction frail and liable to dangerous injury, The eyeball is so unyielding in itself, so mobile, and so much smaller than the cavity in which it is lodged, that a sharp instrument, such as the point of a it uninjured, and to pass deep into the orbit, where it stick or umbrella, is almost certain to glance off it, leaving the nervous centres and the ocular appendages. Intermeets only with structures of great fragility protecting nally the lachrymal sac is divided from the orbit only by the os unguis. Above, the anterior lobes of the brain are only protected by a thin expanse of the frontal bone, while above and externally is the lachrymal gland. It is easy to anticipate the result of violence from a penetrating object. So well understood was the weakness of this position, that in the day when the duel with small swords was common, fencers who wished to kill their adversary made the orbit their aim.

I need hardly recall to your minds a recent melancholy illustration of this fact which occurred in the person of one of your fellow students. received a violent thrust of a stick or umbrella in the This poor young man had orbit, and had suffered the following fatal lesions :—

On post-mortem examination, the wound on the head was found simply to be one of the scalp, but that in front under the eye showed the severe nature of the injury which caused death. The instrument, which must have been almost a blunt one, (and which afterwards was shown to have been an umbrella), penetrated under the eyeball, entered the inner side of the orbit, broke through the ethnoid and sphenoid portions of the cavity, and entered the floor of the skull. Opening the side of the cavernous sinus, and penetrating into the brain fully one inch or more deep, the upper and inner part of the orbit were completely broken up, and the under part of the left anterior lobe of the brain was ploughed up by the instru ment in its course; there was a good deal, but not a very excessive amount of clot about the wound internally. The course and direction of the wound indicated what is hoped and supposed to be its fortuitous infliction, by the point of an umbrella used in the excitement of the moment; the anatomical formation of the parts, and the comparatively delicate structure of the bony walls, will easily explain how a very moderate amount of force would penetrate and cause the extensive and hopeless injuries inflicted in this instance, cutting off in the full promise of manhood and vigour one of the finest young men we have seen, whose amiable character had attached to him so many friends and fellow students.

Even if the brain be not injured we see the usual consequences of penetrating wounds elsewhere-extravasation of blood, suppuration or necrosis, with the complications of coma, convulsions, and strabismus, consequent on the vicinity of the great nervous centre.

It should be specially observed that even a fatal injury in this position may take place with very slight external lesion, and the prognosis of such cases should therefore be cautiously made. A careful search must be made for any missile or foreign body which might be broken off and remain in the wound, for if such be detected, it must be removed at once, before swelling sets in, if possible without destroying the eyeball, but if necessary even at the sacrifice of the eye. I shall show presently that the eye may be displaced to a great extent from its normal position without permanent injury to its usefulness, so that every attempt should be made by

more valuable property of curing "all distempers without distinction." He imagined that he had discovered an antimonial preparation which may be deservedly called an "universal medicine," so effectual is it in almost all dis

eases.

Glauber was an enterprising and indefatigable chemist; he was the inventor of several furnaces and other kinds of apparatus, as well as of many useful processes. That which has made him more generally known is his method of making muriatic acid, and the salt which bears his name. Up to his time muriatic acid was the most costly of all the acids, being obtained by the tedious process of distilling a mixture of common salt and potters' clay; to distil one pound of the acid occupied twenty or thirty hours, and consumed from 50 to 100 pounds of clay. He recommends this acid for a variety of domestic purposes: mixed with sugar it forms, in his opinion, an excellent sauce for roast meat; it makes meats delightfully acid, such as chickens, pigeons, and veal; beef macerated in it becomes in a few days tender, if previously tough; it preserves fruits for years, and makes raisins swell out to their original bulk as grapes. He recommends his sauce particularly to be used with an old hen, which, he says, is thus rendered as tender as a chicken. (See his book, translated in 1652.)

The chemists of London very soon began to open shops like apothecaries, and to prepare those articles requiring fire and peculiar apparatus, of which the apothecaries had hitherto the sole manufacture. The chemists therefore named themselves "philosophers by fire;" and in several attacks made on them defended themselves with spirit and intelligence. William Salmon was one of these; he speaks of chemists' shops in 1685, his own being "at the blew balcony by the ditch near Holborn Bridge." His prices were certainly such as to return tolerable profit: for stomach tincture he charged 2s. 6d. per ounce; for tincture of iron the same; for sweet spirit of nitre and spirit of hartshorn the same; oil of turpentine, 6d. per ounce; Glauber's salt, 6s. per ounce; calomel, 2s. per ounce; laudanum (some peculiar kind of his own), 16s. per ounce. These were the halcyon days of chemists' profit.

But the chemists did not confine themselves to encroachments on the apothecaries, but soon tried how far physicians would bear an experiment. They defended themselves by affecting to believe that, as chemistry was not known in England when the Charter was granted to physicians by King Henry VIII., it is impossible that its prohibitions could have been directed against chemists; and they asked how should medicines be improved if the inventors of improvements may not use them for the benefit of the sick, and the doctors will not prescribe them because they are out of the beaten track. Nathaniel Mery was one of those chemists in 1683, and their apologist; he says, in his published "Plea for the Chemists," that the College had prosecuted him for curing diseases which they could not. They had already prosecuted others and failed. A pamphlet "On the Usefulness of Dispensaries," published in 1702, says :-" Chymists, distillers, astrologers, midwives, &c., have each their share of the practice of physic." Nay, they even made an attempt about this time to obtain an Incorporation Charter, and a privilege of exhibiting secret medicines of their own invention, but failed. The competition of the chemists soon afforded medicines to the public at a much more reasonable rate than the apothecaries had been in the habit of charging. The pamphlet called "Calamities of the English in Sickness, &c.," 1707, says that the chymists charge but a shilling an ounce for spirits and tinctures, which apothecaries would mix and sell at five pounds.

"A Complete Course of Chymistry, containing not only the best Chymical Medicines, but a variety of useful Observations," was published in 1709 by George Wilson, Chymist, who, as he boasts, had been in business for half a century. He kept a chemical laboratory in Watling street in 1686, and published a folio sheet of advertisements containing the prices of all chemical medicines. He invented what he called his "tinctura antirheumatica," and defended

himself for concealing its preparation. He says that modern physicians use chemical remedies, and their use is increasing. He describes "elixir cranii humani” and its preparation thus: put six pounds of human skulls, grossly powdered, into a retort; lute it, and distil in an open furnace; a salt, spirit, and oil come over; dissolve them after rectification in spirit of wine along with two ounces of moss of human skulls. This invaluable remedy is good against convulsions and hysterics; the dose is from five to one hundred drops.

From the same eminent authority we learn that hog-lice are good in jaundice, stone, and other complaints; and that tincture of ants creates courage, and excites the animal appetite.

This moss of human skulls, once in great repute, was called usnea. The celebrated Robert Boyle informs us that being attacked with a violent bleeding of the nose, which had resisted every remedy, he tried the true moss of a dead man's skull, which had been sent as a present from Ireland; by merely holding it in his hand the bleeding speedily stopped. Where and how Mr. George Wilson procured two ounces of this moss it is hard to conceive. Other writers inform us that no usnea can be relied on but that obtained from the skull of a man executed for murder.

About the commencement of the eighteenth century the apothecaries, in order to make good their losses by the encroachments of the chemist, began to invade the trade of the druggist, which was then merely the sale of simples. The druggists, determined not to submit without retaliation, immediately commenced the selling of compound medicines. The apothecaries were so busy in their own encroachments on the provinces of the physician, surgeon, and druggist, that they forgot their own proper business; and a pamphlet called "Present State of the Practice of Physic" (1702), informs us that, amongst the apothecaries, "it is one in twenty that knows anything of chemistry." The pharmaceutical chemists of England, from small beginnings and humble pretensions, have attained to a high position in the healing art. In their splendid establishments is to be found all that research has supplied, or fancy imagined, for relief of suffering humanity, sufficient to satisfy the prurient desire of novelty, for which the present age is so remarkable.

Hospital Reports.

DROPSY AND ITS PATHOLOGY.

Under the care of E. P. SHARKEY, M.B. Dub., L.R.C.S. Edin., &c.

Continued from page 505.

December, 1865.

Bridget M., t. sixty, has been for a considerable time affected with ascites, which had been preceded by constipation and tympanitic distension. The constipation still continues. There is no enlargement of the liver perceptible, but an inward soreness is constantly complained of, referable principally to the epigastrium. The medicines tried in this case were acet. kali in mixture, in conjunction with pills containing powdered squill., pil. hyd. â gr., and digitaline granul. j. (gr. 1-50), together with the use of pills of comp. coloc. mass. and res. podphyll., as a purgative to relieve the constipation. On the 26th, the accumulation of fluid was so distressing that paracentesis was performed, the operation being followed by diarrhoea for two days. A diuretic, containing tinct. scilla was substituted for that with acet. kali on this account. The fluid accumulated again, and between this date and 21st April, 1866, paraceutesis was performed, at intervals of three or four weeks, always at her own urgent request, in consequence of the distress experienced from the accumulated fluid, and after its evacuation the epigastric pain above referred to was felt