jprv vj |*1 1M H^J&iil^ Ill til'' ■' ■■ ' ty ■■ ^f,' i'->:: ■ ■-''■•: mM m «s« ,$$• J5P». 5: >> Surgeon General's Office ^ I 1 lM%pb ^^^^^^^o^^^c^occ^cz^ad^G^^ .o»?»> ;3 TO 1 !']!" ;<>! :'!* | i' ^5lK::;:: >5> >rss i> 3^ ?rf «l ^^>» oem>s naHffi»!i^;: %>>. ^ ^ >^^>^ ~» (>J> _> >£ — •> !»** —^> ^ ->;"0 >>•* ^2^ . ^„ >J> !» ^i» t^;> o -5 •>> 1^> >>y*- I y t ATISE ON THE -y \ EYE AND EAR: RULES FOR THE IJcestrbation mib Restoration of jjigjjt: DEAFNESS, ITS CAUSES AND PROGRESS EXPLAINED: NEW DISCOVERIES IN TREM&ENT, ILLUSTRATED WITH NUMFP.OUS CASES ANj/ENGRA VINOS. FREDERICK A. CADWELL, M.D., ■■■+■* * OCULIST AND AURIST, MEMBER OF THE COLLEGE OF PHYSICIANS AND SURGEONS OF LOWER CANADA; -—-- MEMBER OF THE NEW YORK STATE MEDICAL SOCIETY; GRADUATE ^ 0; OF THE JEFFERSON MEDICAL COLLEGE, PHILADELPHIA, U. S.; LICENSED PRACTITIONER OF THE PR CANADA; ETC., ETC., ETC. SEVENTH EDITION* LlB^ PHILADELPHIA, U. S.; r I E PROVINCE OF _ i* I * )- ETC. ,^^^ / J -__l*w^> NEW YORK: 1869. fd WW lets h Entered, according to an Act of Congress, in the year 1861, by Dr. F. A. CADWELL, in the Clerk's Office of the District Court of the United States for the Northern District of Illinois. Dr. CADWELL'S SURGERY IS AT No. 181 LEXINGTON AVENUE, ONE DOOR ABOVE THIRTY-FIRST STREET. Office Hours from 9. A M. to 6 P. K New York, July, 1869. PREFACE. If any apology were needed in offering a work to the public, treating on subjects of so much importance as Sight and Hearing, which is not in reality a work of practical advantage either to the medical practi- tioner or the student in medicine, it will be found in the greater advantage which a work of this descrip- tion is intended to afford to those into whose hands jJf may chance to fall. And in order that it may be re a) alike by rich and poor, and its contents carefully p<, rused and duly appreciated, the Author has mui pleasure in offering the sixth edition (20,000 copies to the public gratuitously. With regard to the Author's qualifications for the task he has undertaken, he feels fully assured that every considerate reader of these pages will unite in acknowledging a decided preference for one who has devoted his labors and energies for upwards of Twenty Years to the acquirement of that knowledge which experience and practice can alone impart. And if it should subsequently appear that the public have pro- (ix) % X PREFACE. fited by any of the few Hints and Cautions which may be gleaned from a perusal of these pages, the Author will feel more than recompensed for the labor he has bestowed upon it. \ r INTRODUCTION. The present work being intended by the Author merely as a work of general information to all who may feel interested in its perusal, and not one of prac- tical advantage either to the medical practitioner or student of medicine, the writer has, on this account, avoided referring to the anatomical description of the Eye or Ear, or offering any remarks on their physi- ology, and confined his observations principally to a discussion of some of their most important and dan- gerous diseases, with a few hints on the rise and pro- gress of disease, and advised means for the protection and preservation of both organs. The reader will be able, by carefully perusing these pages, to draw much information relative to these two useful organs, and the diseases to which they are subject. He will discover that diseases of the Eye are variable, numerous and complicated; more so than those affecting any other organ of the body. He will discover that they arise from causes as numerous as the diseases themselves, and are subject to as many (xi) xii introduction. modifications. He will readily be able to determine how diminished are his chances for obtaining relief in such cases by the course usually pursued, and will not fail to be warned of the danger of trifling with organs so essential to the protection and preservation of life and happiness. The reader must also discover how difficult, and indeed impossible, must be the proper understanding of these diseases, even by medical men of talent, who do not devote their entire attention to them. Long experience has taught me the great necessity of patient investigation of the whole system, before proceeding to treatment, however simple the case might appear to be; for a disease which has the appear- ance of a purely local affection, frequently proves to be of a very different character, and connected with some distant disturbance. In fact, it may be put down as a general rule, that but few affections of either the Eye or Ear are of a purely local character, except they be the result of accident; and certainly by far the most serious of the morbid affections of the Eye and Ear are of spontaneous production, growing out of, or in some way depending upon, disturbances of other important organs, or of the system generally. I have taken pains to avoid technicalities throughout this work, and laid before the reader a plain statement of facts, and enumerated some of the more important features and early symptoms of disease of both organs. INTRODU JTION. xiii I have given in each case but a brief description of the rise and progress of the different diseases, and endea- vored to point out as plainly as possible some of the dangers which diseases of these organs frequently entail. And though it would be impossible to direct any plan of treatment for the cure of such cases with- out having the patient before me, still I hope my re- marks will not be forgotten or allowed to go unheeded by those who are disposed to try every absurd and vul- gar prescription advised by the ignorant, and recom- mended by quacks and conjurers. Never, under any circumstances, suffer your Eyes or Ears to be trifled with by unskilful hands; and if you have diseases of these organs that your physician cannot overcome, de- ' pend upon it 30U will not profit much by the recom- mendations of others. Take your chances by rest and diet, or cold and warm water applications, till such time as you can with more confidence consult one experienced in the treatment and management of such diseases. If what I have said on the importance of seeking early and immediate advice in such cases, shall have the effect to avert one single case of blindness, or deter another from the thoughtless use of improper treatment likely to injure or destroy the hearing, I shall feel fully compensated for the labor I have bestowed on this work, and I trust, while I remain in Chicago, to receive, as heretofore, continued evidences of the just appreci- ation of my services as an operator on the Eye and Ear, TREATISE EYE AND EAR. DISEASES OF THE EYE AND EAR A SEPARATE STUDY. It is the custom in the Old Country, and one that should be followed in every other, to make the Dis- eases of the Eye and Ear a separate study, and a dis- tinct branch of the medical profession. Any one who does not devote his whole energies to the acquirement of a proper knowledge of these two important dis- eases, and the innumerable and complicated changes to which they are subject, could not possibly expect to attain any remarkable degree of proficiency in the treatment and management of them. These diseases (xv) 16 TREATISE ON THE EYE AND EAR. are far too numerous and complicated to be picked up by casual observation, much more to be treated successfully under all their varied modifications and changes. It is to the labors of men regularly educated to the medical profession, but who have devoted themselves in a practical manner to Ophthalmic and Aural Sur- gery, that we are indebted for our most valuable in- formation respecting these two important organs. In curing diseases of the Eye and Ear, he only who is well acquainted with the general principles of Surgery, as well as with the peculiar remedies re- quired for many of their diseases, and can apply such principles by analogy to the structure, functions, and diseases of these organs, can hope to practise with safety and success; and no one can expect to succeed as an Oculist and Aurist who is not well acquainted with the constitutional as well as the local causes of disease, and with the effects of remedies as they operate on the general system. Any person possessing common understanding would at once be convinced that diseases of these organs are too complicated, and far too delicate to be handled roughly by inexperienced persons, or their diseases to be judged of and treated with success by the unskilful and ignorant pretender. In fact (and I hope the medical profession will excuse me), too much reliance is often placed by patients on their medical attendant, and by this means it often hap- pens that an eye is lost, or the hearing destroyed. TREATISE ON THE EYE AND EAR. 17 NO CHARGE FOR AN OPINION. Any one desirous of having my opinion of any case relating to either the Eye or the Ear, will at all times receive the same without charge, if application be made in person. I am generally able to inform the inquirer, by a moment's inspection of the organ, whether or not a cure can be effected; if not, whether relief can be given, and to what extent. My motives for giving advice gratuitously in such cases are, that those who reside in the country, as well as in the city, need not abandon their cases as hopeless and incurable because they have been unsuccessful in ob- taining relief through other hands, or because they have been told they are incurable—for many cases, I am sorry to say, have been suffered to continue un- attended for years, and only by some accidental cir- cumstance patients have discovered that their disease was readily curable. DANGER OF WRONG ADVICE. It is a matter of some consequence that every per- son's mind be rightly informed on all subjects, but more particularly those in which we have an interest, or on which our happiness depends. If we are not familiar with any particular subject, we are not capa- ble of giving a reliable opinion; gratuitous advice administered in this way involves too much risk and hazard; and, like the inexperienced pilot who at- tempts the navigation of a vessel through a danger- ous and rocky channel, ignorant of the danger that lies before him, till at last he finds himself, with his noble craft, tossed upon the rocks, a lasting memorial of his incapacity and folly. I cannot, therefore, too 18 TREATISE ON THE EYE AND EAR. strongly condemn the practice so common among nearly all classes of persons, of prescribing and re- commending applications in cases which come under the head of Ophthalmic Medicine and Surgery—a practice which is too often fraught with the worst of consequences to the unfortunate victims who inno- cently use them. Cases of this kind are of daily oc- currence, and many simple and otherwise trifling cases are, by this means, converted into obstinate and often incurable diseases. DELAY AND ITS CONSEQUENCES. Indelible spots and white films or opacities, are pretty sure to follow an inflammation of the Eyes, even should they be preserved from the first attack. These remain sometimes without changing, for weeks or months, and may again be the source of a fresh at- tack. The disease thus becomes established, comes and goes according to circumstances, leaving the pa- tient at times almost without sight, at others able to see enough to go about with caution. Sometimes the Eye (one usually) takes on a worse condition than the other—the sight becomes dim, matter forms be- fore the pupil, the glass breaks, and the Eye is lost; and as but little pain is felt by this change, the pa- tient frequently congratulates himself that all is right, till he is told to the contrary. I speak now from observation, as I have had a few cases of precisely the above description, when the pa- tients took the trouble to call, because they found the sight rather long in returning, and it was found to be very inconvenient to seefwith one Eye, the other, as they justly remarked, feeling weak also. One gentleman, not long since, told me that he had had a bad Eye for ten days, but was much better TREATISE ON THE EYE AND EAR. 19 when he called on me. He had followed the prescrip- tion of some hind old lady, and good neighbor, which had given him great ease, but as he did not find the sight returning, he thought he had better consult me, and had come for that purpose, to place himself under my care. Upon examining his Eye, I at once saw it was lost. You may imagine his surprise, when I told him what state he was in ; for although he could not see, he imagined himself much better, measuring his condition by his feelings! HOW BLINDNESS IS OFTEN PRODUCED. Another very common error for people to fall into, who have bad eyes, is, that because the pain which is usually present at the first stage of disease has passed away, that they are all safe, that their eyes are only weak, and will get well by time. This is a great mis- take, and probably induces many persons to believe they will recover without medical assistance. In this way they are neglected from week to week, and from month to month, till at last the sight begins to fail, and sometimes rapidly, so. that in a few days they find their sight almost entirely gone. Cases like these frequently rally again, and the patient finds himself partially restored to sight, and resumes his vocation fully assured that it will pass away; but again he finds himself disappointed, his sight leaves him and thus it continues—each time it goes farther and remains longer away from him, till at last it ceases to return, and continues its destructive iufluence till the Eye bursts, and is lost altogether. Hence it often happens that diseases of both the Eye and the Ear, of the most 20 TREATISE ON THE EYE AND EAR. simple character, are by sheer neglect rendered en- tirely incurable, which if promptly attended to, would readily have yielded to simDle treatment A SERIOUS AND FREQUENTLY FATAL DISEASE OF THE EYES, IS CATARRHAL OPHTHALMIA. We air know, from personal experience, the ef- fect produced upon a mucus membrane elsewhere, by what is called Catarrh, or more commonly a cold; when, from exposure to certain states of the atmos- phere, a morbid action is set up in the mucus mem- brane of the nose, throat, and bronchial tubes, the result of which is recognized as a "cold in the head," "horseness," or "sore throat,1' according to the part affected. The consequences of catarrh as it effects the mu- cus membranes of other localities, are very similar to those which characterise this disease when it at- tacks the eye; the first indication being very similar to those which give rise to common Catarrh. The first symptom of Catarrhal Ophthalmia is an un- easy sensation or smarting on one spot of the globe, and if the disease be carefully examined at its com- mencement, visible indications of a morbid action can readily be discerned. If you are guided in your opinion of the case by the feeling expressed by the patient, you would probably mistake the case altogether, and conclude that a particle of sand, or some foreign substance had found its way into the eye, and was located in a particular spot treatise on the eye and ear. 21 The patient suddenly feels a sharp, smarting pain within the eye, as if some foreign substance had just entered the organ and located itself between the lids and globe, and no persuasion will easily convince him to the contrary, the eye flows copi- ously with tears, and separating the eyelids you at once discover a spot of diffused inflammation on some portion of the lining membrane, where Catarr- hal disease of the eye first shows itself. In the first stages of this disease the lids are almost exclu- sively affected, but in a short time the blood vessels covering both the lids and the globe become vio- lently injected, throwing out a copious mucus se- cretion, which during sleep, glues the lids firmly together. At its commencement at a particular point, Catarrhal Ophthalmia may be compared to a similar affection of the throat, for generally the first symp- toms of inflammatory sore throat, from Catarrh, is a sharp, pricking pain, refered to a particular point of the mucus membrane of the mouth, or more generally the tonsils and throat, being only painful during the act of deglutition or swallowing. In slight cases of this disease the constitution does not suffer, but where the attack is severe, the usual symptoms, rigor, accelerated pulse, hot skin, head-ache, tfec, mild during the day and increased at night. From neglect or improper treatment of Catarr- hal Ophthalmia, acute inflammation may supervene and extend itself to the Cornea, clouding and ob- scuring the sight, and producing serious if not 22 treatise on tile eye and ear. irreparable mischief to the delicate and more im- portant portions of the organ, by its contiguous influence. Thus a neglected cold or common Catarrh may lead to the development of pulmonary diseases, and other disorders of a different nature, and not unfrequently Deafness will supervene as a conse- quence of neglected Catarrh, which has been found difficult to remove, so therefore, every now and then, neglected Cataharrhal Ophthalmia will lead to consequences far more disasterous to the adjacent structure by its unabated influence. Treatment therefore is important, noi only in reference to the direct consequences of the com- plaint, but also to avert its serious effects upon the more delicate and important part of the complicated structure. In its early stages, and before the disease has ex- tended itself over the Cornea, obscuring the vision, the disease may be readily overcome, and much trouble prevented, but when the disease is of long standing, and severe from the start, involving the whole organ in general inflamation, with complete or partial loss of sight, and when no disorganiza- tion of parts has taken place, the cure may still be affected, in time, and good vision restored. For Catarrhal Deafness the reader is refered to page 110 in this treatise. TREATISE ON THE EYE AND EAR. 23 GRANULAR INFLAMMATION, or GRANULATED EYE-LIDS. This is one of the most frequent, and by far the most obstinate, of all the diseases to which the eye is subject. It is to be found in all places, a.nd among all classes of people, and is very prevalent throughout the wide western prairie. Thousands upon thousands are at this moment sufferers by this terrible destroyer of the human eye, and thousands are now groping their weary way in darkness, never again to behold the face of man, or to witness the rising or setting of a summer sun. This disease, which so effectually and certainly destroys the sight in the course of its natural career, may generally be recognised, after it has become fairly established, by the following ap- pearances : Its commencement is marked with the usual indica- tions of inflammation, such as itching, and soreness in the corner of the eye, and oftentimes not character- 24 TREATISE ON THE EYE AND EAR. ized by much severe pain. It usually attacks one eye first, and the second soon follows; and the last eye attacked is often much the worst. In the course of a few days, or sometimes in a day from the first appearance of the disease, the eyes will be filled with adhesive matter, gluing them firmly together during sleep. The first, or inflammatory stage of the disease, which is not usually very severe, soon passes over, and the eyes begin to feel much more comfortable; still they do not. get well, and every change of weather, from dry to wet, or from heat to cold, is likely to pro- duce an unfavorable change in the condition of the eyes. The sight becomes dull and misty, and the lids not more than half uncovering the organ. The • mist now increases, and the eyes grow weak, and sensitive to the light. This characterizes the forming stage of Granular Inflammation; and now, if the eyes be carefully ex- amined, as follows, the true character of the disease will be readily discovered. Take a knitting needle and place it upon the centre of the upper lid, parallel with the eye, then with the other hand seize hold cf the eye-lashes, (requests ing the patient to look downward,) draw gently upon the lash till it is separated from the eye-ball, then turn it over the needle, so as to expose the under surface of the lid, and you will find that this mem- brane, which should present a delicate pink appear- ance, to be of a bright red or crimson hue, and the surface, instead of being of a smooth and velvety cast, will present the appearance of coarse raw meat, and covered with red elevations and prominent points, with deep creases and fissures, resembling the surface of a ripe strawberry more than anything else I can compare it to. The above engraving will give a TREATISE ON THE EYE AND EAR. 25 tolerable good idea of an eye affected with this disease, especially if it be an old and confirmed case. Some- times these little points will not be as prominent as at others, although readily visible; and this is more especially the case in the earlier stages of the disease, and in young and plethoric subjects. This peculiar appearance which I have described is termed Granu- lation, from its near resemblance to proud flesh, or a grain-like or sand-Yike appearance which this delicate membrane usually presents. Later in this disease, you will find, by moving the upper lid upwards and requesting the patient to look downwards, so as to expose the upper part of the cornea, or dark portion of the organ, that a dull, cloudy appearance is readily visible on the upper part of the sight; and very fre- quently numerous small blood-vessels may be seen shooting down from the white portion above, so as to obscure the sight, and render the true color of the organ at this point quite indistinct. This appearance is readily recognised in the above drawing, and the obscurity of the pupil or sight is also well shown. Frequently this vascularity will dip down so low as to partially or completely obscure the pupil or sight, rendering vision in such cases little better than useless. These, then, are the principal characteristic fea- tures by which this eye-destroying disease may be re- cognised from almost any other; and when it has once firmly fastened itself upon the eyes, it is seldom cured, or even interrupted in its destructive course, by the aid of ordinary practising physicians, and still less frequently does it yield to the baneful influence of the quack nostrums, and vulgar applications re- commended by every old conjurer, or prescribed by the numberless impostors and itinerant operators who infest every inhabitable section of this great western 26 TREATISE ON THE EYE AND EAR. country. Still, I can assure the reader that this disease is readily curable, when properly treated, if taken in time, or before the eyes have undergone fatal disorganisation. A disease so common, and yet so dangerous, meets of course with ready treatment at the hands of every quack and pretender to ocular science in the country; and yet I do not think it would be wrong to say, that not one case out of every fifty that receives treatment at the hands of these pretend- ing sons of Esculapius, ever had, the eyes restored to a sound and healthy condition. Under the most favor- able circumstances, no more is ever effected than partial relief from the more painful stage, and tem- porary relief from the great uneasiness which the eyes usually experience during the first few weeks of its formation. But in a very brief period after- wards, the disease will again break out with increased violence, and in the short space of a few hours, or perhaps two or three days, they will be found to have lost all that was gained by a tedious course of attendance—each and every attack crippling and weakening the organ more and more, till at last its delicate structure yields to the repeated relapses, and the eyes are lost beyond recovery. Hundreds of patients pass through my hands monthly, as victims of this dreadful disease, and I have never any diffi- culty in effecting a radical cure, and a complete re- moval of all its baneful influences, so long as the eyes are not destroyed before they present themselves to me for examination. I have never less than fifty such patients in daily attendance, and can show them in all stages of progression towards a cure, and will be happy to refer to such cases at an}' time, when applicants for treatment would like to see them. I have those who have been nearly or quite blind for TREATISE ON THE EYE AND EAR. 27 months and years, who can now see to read and work, and I have those where the disease had only partially destroyed sight, but where it completely unfitted them for all business; and my patients are ever ready to make their own statement as to the condition they were in when received by me, in broad contrast with the state in which they will be found when these inquiries are being instituted. This disease I can readily cure, even though it has existed for twenty years, and the patient been blind most of the time, so long as the eyes have not under- gone complete disorganization. If you are still in doubt as to the nature of the disease, call and have the eyes examined. It will cost you nothing, and the opinion given will be well supported. EGYPTIAN OPHTHALMIA. A FRIGHTFUL DISEASE. I will now endeavor to give a brief statement of the character and consequence of some of the diseases of the Eye most commonly met with in this Western Country, but the nature of this work will barely admit of my doing more than simply refer to them, and to show to what an alarming extent they some- times advance. SYMPTOMS. Egyptian Ophthalmia is a most frightful form of in- flammation of the Eye. It is rapid in its progress, and destructive in its effects. The svmptoms which characterize this disease are, at first a slight redness and a sensation of heat. The organ soon becomes painful, and has a feeling as if sand or dirt had got in 28 treatise on the eye and ear. the Eye. Itching is also experienced more or less, and at night the Eye will be glued together by the forma- tion of matter. The pain and redness increases, sight becomes dull, with more or less head-ache, water and matter are both abundantly poured out, and sometimes in the course of two or three days the Eye will be lost by the excessive swelling of the membranes and con- sequent mortification. One Eye is usually much worse than the other, and after it has been lost the disease may abate, or if badly managed, may continue its destructive work till the other has been lost also. EGYPTIAN OPHTHALMIA IN THE DIFFERENT ARMIES. This disease prevailed extensively among the Bri- tish soldiers during the war of 1812, and in order that the reader may place a proper value on its import- ance, and take heed to himself in good time, I will give a brief statistical account of the disease as it raged among the different military corps up to the year 1840. It has been stated by Dr. Vetch, a celebrated French Surgeon, that two-thirds of the French army were affected with this disease at one time, and the same gentleman informs us, in his interesting account of the Ophthalmia which appeared in England since the return of the British army from Egypt, that the total strength of the second battalion of the 52d was some- what above 700 men; that 636 cases of Ophthalmia, including relapses, were admitted into the Hospital from August, 1805, to the same month, 1806; of these, fifty were dismissed with the loss of both eyes, and forty with the loss of one; and the Ophthalmia depot, under the care of this able Physician, contained TREATISE ON THE EYE AND EAR. 29 in the summer of 1808 upwards of nine hundred cases of this disease, from more than forty different corps. It appears from the returns of the Chelsea and Kilmainham Hospitals, that two thousand three hun- dred and seventeen soldiers were, on the first of December, 1810, a burden on the public from blind- ness, in consequence of this disease, and that those soldiers who had lost the sight of one Eye, were not included in the number above stated. It has been further stated that thirty thousand cases occurred in the Persian army from 1813 to 1821, and that Blindness followed in eleven hundred cases. In the Belgian army the disease appeared in 1814, but was restricted to four garrisons till 1830, when it spread very generally, affecting indeed one-eighth of the whole army, and in some regiments one-half of the soldiers. In 1840 there were five thousand cases of the disease in the army, which consisted of fifty thousand men, and upwards of one hundred thousand cases had occurred since the first appearance of the disease. DISEASE CONTAGIOUS. This disease is readily contagious under favorable circumstances, and frequently attacks whole families within a few days of each other. Children as well as adults suffer severely from this disease, and if not promptly met in these young subjects, it is almost sure to eventuate in the loss of one or both Eyes. The disease, however, I consider, is not so violent in this country as has been described in the foregoing state- ment, except in a few rare instances. I have had cases of this description within the last three years, where 30 TREATISE ON THE EYE AND EAR. the disease had appeared only 48 hours before I saw the patient, yet both eyes were completely ruined, and the whole organ in a complete state of mortification. CHRONIC INFLAMMATION OF THE EYES Is another disease of the eye which presents nearly all the symptoms of the foregoing in a more mild form; and although the destruction of the organ is not so rapid, it is nearly as certain. This disease, which arises from cold and common causes, has been known to linger with the patient for twenty years, and at last destroy the sight entirely. Sometimes the work of destruction is complete in the course of a few months, or perhaps may go two or three years, according to circumstances, and with great care may continue for many years before sight would be destroyed. This is a very common disease in the country, and seldom undergoes any permanent spontaneous change for the better; and, as it is frequently fluctuating from better to worse, and from worse to a better state, patients constantly deceive themselves by supposing that every favorable change the eyes undergo is the one which will remove the disease. When the Eyes are found to evince such changes as I have described, they are seldom cured without the aid of more experience than generally falls to the lot of the regular practitioner. Most, or many of the cases I have to deal with, are cases of this description. After exhausting every means within their reach, weakening and irritating the delicate organs with every description of vulgar and ruinous application, they present themselves to me for inspection, and, if possible, for cure. Fortu- TREATISE ON THE EYE AND EAR. 31 nately most of these cases are curable, under proper direction and attention, yet it is remarkable that so large a proportion of such cases are restored, when one considers to what an alarming extent these delicate and sensitive organs have sometimes been trifled with. COMMON WEAK EYES Are a trouble of almost universal prevalence. There are but few who do not experience more or less incon- venience from weakness of the delicate organs. If examined, they do not appear inflamed, but still a red- ness will be perceptible about the whole organ, and at times, perhaps, some trifling pain may be present, and now and again they will be slightly adhered together on waking in the morning. With some, this condition of the* Eye is first felt on waking in the morning,— through the day the Eye looks well. With others, it is evident the}' are slightly affected, and this appear- ance is greatly increased when the Eye is fatigued by excessive use, or exposure to cold or wind. This par- ticular state of the eye is very frequently met with. Patients often consult their physician for it, but almost as often to no purpose, and in spite of everything they can do, the same state of trouble continues. No one can tell how it came, or what caused it, or assign any reason for its appearance, and but few are so fortunate as ever to get rid of it under the treatment that is usually prescribed. I will here merely hint that this condition of the Eye is usually of a sympathetic character, and has its dependence on some derangement of the stomach or liver; and under a proper course of diet and regimen, together with a well directed medical treatment, this 32 TREATISE ON THE EYE AND EAR. state of the organ will disappear like magic. No treat- ment is necessary for the Eye itself, unless it has be- come the seat of local inflammation: then more judg- ment would be required; but if the medical attendant would look into the matter carefully, I have no hesi- tation in saying that seven-tenths of such cases would be cured by a few days' treatment. I have but little difficulty in effectually removing this extremely un- pleasant condition of the Eye in a few days, though in some cases it may have been present for years. PTERYGIUM, OR WINGS. This is a thick growth of membrane, of a red or fleshy appearance, which usually starts from the inner angle of the Eye, and stretching itself forward, finally reaches the cornea, or dark portion of th§ Eye, and may be readily seen encroaching upon this delicate texture. When it reaches this portion of the Eye, it soon interferes with the sight; and, if not attended to, will continue to stretch itself onward, until it passes the centre of the Eye, completely destroying all useful vision. The above cut will give a tolerable good idea of the appearance of an Eye affected with this disease, and show how the sight is injured by its continued growth. It usually arises from cold, which when frequently re- peated, so thickens the delicate membrane, as to form TREATISE ON THE EYE AND EAR. 33 it into a mass of fleshy matter, giving the patient the appearance of one of dissipated habits. Once started, this disease seldom undergoes a spontaneous cure, but goes on, thickening and extending itself, till the sight is destroyed. The cure of this disease is very readily effected by a slight, but delicate operation, and when this delicate membrane has been removed by operation it seldom causes any interruption to business. Its complete removal is effected in one minute, and with but little or no, pain, and when done, affords the most effectual protection to the organ against similar attacks. No medical applications will reach these cases after the disease has reached the cornea; but before that, and when first discovered, they may be removed by suitable topical applications. SIMPLE INFLAMMATION. Simple inflammation of the Eye, arising from cold and various other causes, is also frequently to be met with, and is of course attended with a great variety of changes in the course of its progress, depending on circumstances, and on the habits and constitution of the patient. Inflammation from such causes is readily curable, if taken in good time, but too often the disease is meddled with and irritated by improper treatment, so that what was of itself a very trifling disease, is often converted into one troublesome and tedious. Diet and rest, both of the body and the diseased organ, with a little open- ing medicine, will suffice in most instances to put the trouble aside, if begun in good season; some cooling lotion or cold water, or a little alum and water, may also be used as a local application, and when this does 3 * 34 TREATISE ON THE EYE AND EAR. not suffice, rest assured it is no trifle, and the sooner you consult a competent person the better. DISEASED EYE-LIDS Is a complaint very frequently met with among children and young subjects, particularly aintvng young ladies. It frequently results from Measles or Scarlet Fever, and may come from cold, and causes of a trifling nature. It is more*frequently met with in persons of fair com- plexion, with light Eyes. In fact, I have remarked that disease of the Eye generally is to be found in per- sons of fair complexion, or at least with light Eyes, and that most of the diseases attacking dark Eyes were forced, or perhaps the result of some local casualty. This is a troublesome disease, and one which the medical practitioner is not generally able to remove. During the progress of the disease, the lids become very much thickened, the lashes fester at their roots and fall out, and soon the whole range of little hairs will be lost, the Eyes looking watery and weak, and presenting a very unpleasant appearance; and when the lashes are lost by this process they are never repro- duced, even should the disease itself be arrested. It is well for those who can, to take this trouble in hand in season, or before the eye-lashes are all lost; other- wise a perfect cure can never be effected. There is generally but little difficulty in curing this disease, if due attention be given to it; the treatmentis extremely mild, and the cure is generally very speedily effected. I have made a complete cure of this disease in one instance after it had existed for twenty-four years. The time required to remove this complaint, is usually not more than from three to six weeks, with occasional TREATISE ON THE EYE AND EAR. 35 attendance, even in the worst forms, and in simple cases it may sometimes be removed in as many days. PTOSIS, OR DROOPING OF THE UPPER EYE-LID. This singular condition of the organ of vision, though of rare occurrence, is met with occasionally, and requires some attention. It is a nervous affection, and is usually caused by some disturbance of the brain. A patient laboring under this disease, has little or no power over the superior lid, which droops, more or less, as represented in the above drawing. I have had a number of such cases during the last year, and have succeeded admirably in restoring the lid to its normal condition, so that the patient could raise and close the lid over the Eye as well as ever. It is an important disease, as it usually precedes amaurosis,' (which is frequently fatal to vision,) and always indicates some serious disturbance of the brain, or system generally. PARTIAL OR COMPLETE BLINDNESS, AND THE EYE UNCHANGED IN APPEARANCE. When this truly unfortunate state of vision is ob- served, no time should be lost by the patient in obtain- ing advice, particularly if it be a recent case. It is usually preceded by more or less head-ache, and some- times of a severe kind, or it may have been produced 36 TREATISE ON THE EYE AND EAR. by excessive use of the organ on small objects or very fine needle-work, or may be the result of too long exposure to the rays of the sun without a suitable cov- ering to the head; arises, also, from falls and blows upon the head; from a disordered system, and from • perverted habits. The earlier symptoms are partial loss of vision, with an indistinctness and an appear- ance of a veil or gauze being interposed between the object looked at and the observer. Small motes or hairs, or particles floating in the air, will sometimes be observed, and these will assume various shapes and forms. The sight is usually best in bright sun- light and dull in'the shade. It is a most uncertain disease, and may take a very unfavorable turn, result- ing in complete and entire loss of sight, even without the Eye undergoing any organic change whatever, or showing the least signs of a diseased or inflammatory action. This is called Amaurosis, and the immediate cause of blindness in these cases is by the loss of power of the Optic Nerve, and when complete it is generally incurable. Whenever these unpleasant symptoms are observed, lose no time in consulting an 'Oculist before it becomes too late. EYE WOUNDED BY HOT METAL, SPARKS, AND TURNING CHIPS. Every working mechanic who has much employ- ment at the turning-lathe, casting metals, pecking mill stones, and such descriptions o£ work, has pro- bably experienced more or less suffering from the lodgment of minute particles flying into their Eyes, when engaged in their various occupations. Many persons thus employed, who are almost daily encountering accidents of this sort, have acquired considerable tact and dexterity in removing such par- TREATISE ON THE EYE AND EAR. 37 tides from the Eyes of each other. Mill-wrights are particularly prone to this species of accident, while engaged in pecking the mill-stones, and consequently find it necessary to practise these minor operations on each other, for often they would have many miles to ride before they could find a physician, and still go further to obtain a skilful Oculist. 1 have known such persons carry a magnet in their pocket, so that when the particle is not too firmly fastened in the coats of the Eye, it may be removed by its'application. Usually, however, the metal thus deposited in the Eye goes there in a state of fusion, and absolutely burns itself into the coats of the Eye, and then becomes firmly fixed, causing at first but little inconvenience, but after a day or two the Eye begins to feel tender, and soon the whole organ is in a high state of inflam- mation, and if this foreign substance (small though it be) is not removed, the Eye will fester at the point where the metal is lodged, and will be lost. In such cases, where it is known that there is a particle of metal in the Eye, though it may be too small to be observed by inexperienced optics, the best course to take is, to tie the eye up with a damp bandage, so as to prevent the friction of the lid over the ball, and lose no time in seeking a competent and skilful person to remove it, otherwise the Eye may be destroyed. A drop of sweet oil placed between the lids before applying the bandage, will be of service. I am- almost daily in the habit of removing such foreign substances from the Eye, and know from experience that it requires a great amount of tact to do so without otherwise wounding the delicate organ; and I have known them to be so firmly imbedded, that considerable force would sometimes be required to raise them from their bed. 38 TREATISE ON THE EYE AND EAR. SKELETON OF THE EYE, SHOWING THE LACHRYMAL GLAND, TEAR PASSAGES, AND D-UCTS, WHICH CONVEY THE TEARS FROM THE EYE TO THE NOSE. a a.......Puncta Lachrymalia, or orifice of the tear passage, which con- veys the surplus tears to the nose. ab c d...Lachrymal Canal, through which the tears pass. efg......Lachrymal Sac. This is the seat of inflammation when the tear passage becomes obstructed; and when the obstruction is com- plete (which usually takes place at the lower end of the sac), it frequently happens thar, severe inflammation sets in, and con- tinues till it points, breaks, and discharges, as may be seen more clearly by examining the engraving at the head of " Weep- ing and Watery Eyes," p. 39. e..........Blind erd of Lachrymal Sac. g.........Termination of Lachrymal Sac, at which point the passage is slightly contracted. hi........Nasal Duct. hi........Lachrymal Gland, which secretes the tears. TREATISE ON THE EYE AND EAR. 39 WEEPING OR WATERY EYES. This is a disease frequently met with, and is of some importance, not so much for the weeping of the Eye as for the condition which follows. The patient is perpetually annoyed with the flow of tears over the cheek, whenever exposed to the cold or wind, and at times while reading or sewing. Sometimes a small t swelling is observed at the corner of the Eye near the- nose, and if pressed upon a quantity of thin matter will be forced from it into the Eye, and by this manoeuvre patients avail themselves of temporary benefit. This is caused by the obstruction of the tear passage, which conveys the surplus tears to the nose, and after it has existed for a time, if not relieved, an inflammation takes place in the situation of the sac near the nose, and after many days of severe suffer- ing, the sac breaks, outwardly, and discharges, and the Eye feels relieved; and thus it continues on through the life-time of the patient, until relieved by treatment—which, if attended to before this last-men- , tioned condition takes place, can generally be relieved and entirely cured by simple treatment, but after- wards would require a trifling operation, with the introduction of a gold or silver tube, to effect a radi- cal cure. 40 TREATISE on the eye and ear. The preceding engraving shows the appearance which an eye affected with this disease presents after the sac has broken. At the point of rupture, matter may be seen oozing from the orifice, which constitutes a most loathsome disease. This swelling at the side of the nose, near the inner angle of the eye, is usually present from the commencement of the attack, and is only converted into a fistula, or running sore, by the long continuance of the disease, and the repeated attacks of inflammation. HORDEOLUM, OR STY. Many persons suffer with these festerings of the lids. Sometimes half a dozen may be seen at one . time*—occasionally but one; and no sooner is that cured, than another, and still another, will make its appearance, to the infinite annoyance of the patient, for they usually attack the young and fair of both sexes, and are therefore considered a great u Eye-Sore." I have usually looked upon this condition of the lids of the Eyes, as indicative of a disordered state of the system. There will be found to have existed some error in diet, or a deranged condition of the stomach or bowels, or the habits of the patient have not been as correct as they should have been. If a course of abstemious living, and the estab- lishment of good habits, together with some mild opening medicine, does not remove them, they should receive the attention of an Oculist; for by this they will be prevented from forming themselves into hard tumors, which will require the knife to remove them. treatise on the eye and ear. 41 CATARACT. Fig. 1. Fig. 2. This is a disease of the Eye which may be recog- nised by the loss of the clear black lustre of the pupil or sight of the Eye, as may be clearly seen by the above engraving. Fig. 1 represents a partial or incomplete Cataract. Fig. 2 shows a complete and perfect Cataract. It is a disease which ordinarily arises very slowly, and without any previous inflam- mation of the Eye, (unless it has been produced by accident.) In its early stages it is likely to escape observation, lyiless closely and carefully examined; but after it has become fully formed, may be readily seen at a distance. It is a disease which completely destroys sight when it is fully formed, and its first symptoms are, a mistiness or fog before the sight, and a difficulty of recognising persons or objects as usual. This continues to increase more or less rapidly, according to the nature of the case and the constitution of the patient, and may not become complete for months, or even for a year or two. This is an important disease, and requires skilful hands to manage. It is seldom cured without an operation, though much relief may be given to the 42 TREATISE ON THE EYE AND EAR. patient during the formation of the disease, by local treatment. I have frequently, in such cases, enabled a patient to read large print, by an application to the Eye, which has taken effect in ten minutes, though before the treatment they were unable to guide themselves. This improvement will continue for four or five days, and by repeating it, the effect may be continued during nearly the whole process of the formation of the Cataract, and without experiencing the least pain whatever by the treatment. There is no medical treatment that will remove this disease after it has once commenced, or any other application to the Eye that will stay its progress. Nothing short of a Surgical Operation by skilful hands will remove it, and under proper management may be disposed of in a few days, with very little pain. Cataracts vary in their character, according to the age of the patient and the causes which produced them, some being hard, and requiring to be extracted or taken out of the Eye bodily; while others are soft, and are removed by other means. This is usually the case in young subjects. The soft cataract may be removed almost without the Eye becoming irritated, and with little or no pain. Cases 2, 3, and 4, which will be found in the back part of this treatise, are examples of congenital Cataract, having their origin before birth,yet in each of these operations the patient received sight, though blind (from birth), until the moment the opera- tion was made. Other cases will be found reported, where Cataracts have been successfully removed in a patient upwards of 80 years of age, and with but little suffering. In fact, under favorable circumstances, this operation very seldom fails of success in my hands, if not complicated with other diseases of the system. TREATISE ON THE EYE AND EAR. 43 OPERATION FOR THE REMOVAL OF CATARACT BY EXTRACTION. The method of operating for Cataract must vary, according to the nature of the Cataract, and in some measure is governed by the age of the patient. Hard Cataracts, which are seldom found except in elderly persons, are generally removed from the eye bodily, by an operation, which is performed in a few seconds, by a method similar to what is represented in the above cut. This method is called Extraction, because the opaque lens or Cataract is by this means entirely re- moved from the eye; and when skilfully done, will effect a radical cure, and good sight will be restored. There is but a trifling amount of pain given in making this operation, which occupies but a few moments to perform. This may be considered one of the most difficult, and I may add, most beautiful operations in the whole field of Ophthalmic Surgery, and but few 44 TREATISE ON THE EYE AND EAR. men, either as general or special practitioners, possess sufficient nerve and manipulation to make this opera- tion with that degree of dexterity, skill, and con- fidence, that will insure a happy result to his anxious patient. Indeed, I do not think that m&ny operators or professors ever attempt it, for the reasons above mentioned, especially as there are other modes of operating which are much more easy to manage, especially to those who seldom attempt any operative means of cure, and whose want of experience in the use of the knife would be almost certain to result in the complete loss of the organ, the moment the operation was attempted. Extraction, however, is the operation, and in all cases when the Cataracts are of sufficient firmness, (as they generally are in elderly persons,) and not complicated with any other disease of the organ, or system generally, and the case is at all favorable for this method of operation, I invariably adopt that course; and a failure is not to be founds in any of these operations at my hands, unless the result of some unforeseen accident after the operation had been performed. TREATISE ON THE EYE AND EAR. 45 OPERATION FOR THE REMOVAL OF CATARACT BY COUCHING OR DEPRESSION. The above cut shows the appearance of an eye having an operation performed, for the removal of Cataract, by Couching, which consists in introducing a fine instrument into the eye, passing through the white portion, coming in behind the curtain of the eye, and depressing the Cataract so as to sink it down below the line of vision, which, when down, you have instantly a beautiful clear black pupil, and sight is immediately restored. In this case the Cataract is seen half depressed, and so much as has j>assed below the centre of the eye, gives you the clear black lustre of the pupil through which the light passes, and sight is there at once. But the great trouble in such cases is the danger of the Cataract again rising and leaving the patient as blind as ever, which cannot occur when this body is extracted as previously described. 46 TREATISE ON THE EYE AND EAR. There are other modes of operating for Cataract which are entitled to some attention, but the nature of this work will not admit of entering upon them in detail. Cataracts of children, whether caused by accident or disease, or even when they are Congenital (having their origin at birth) may as a general thing be re- moved by a very simple operation, which would scarcely be felt by the patient. Little or no suffering ensues in such cases, and as a general rule, good sight is the ultimate result. The appearance of an eye that is affected with Cataract is always the same, only varying according to the advancement the Cataract has made, and being much more readily visible in a dark eye. But in all cases the pupil or black centre loses its clear black lustre, and has a milky or hazy appearance, having in old people a yellowish, or amber cast, while in children and young subjects they are milky or of a pearly appearance when viewed closely. CONGENITAL BLINDNESS, OR BLINDNESS FROM BIRTH. This is a disease with which children are born, and though it may not be discovered at the time of birth, or even for several months, it soon becomes evident that the child does not see. When this interruption to vision exists, it will be perceived that the child, instead of fixing its eyes on any object, as it should do when it arrives at an age to note passing objects, will be found to have a constant rolling of the eyes, and does not seem to fix its sight on any object definitely; and this rolling of the eyes increases as the child grows older. Upon a careful and close inspection TREATISE ON THE EYE AND EAR. 47 it will become evident that Cataracts exist, and this may be known by the pupil, or black spot which forms the centre or sight of the eye, being white or milky looking. If the Cataracts are complete, they may be easily detected; but if only partial, it may require a more careful inspection to discover them. When mothers or parents detect anything of this nature in their children, they should give it their first attention, as it may be readily removed if taken in season, and good sight be restored; but if allowed to go on till the child grows up to strength and years, (as is too often the case,) under the impression that they are too young and tender to bear an operation, it will be far more difficult to operate, and the chance of success is very much less. Furthermore, the rolling motion which the eyes acquire during the existence of the Cataract, becomes a confirmed involuntary action, and though the Cataracts be removed and sight restored, this very unpleasant rolling of the eyes continues more or less through life. The operation is extremely simple, and attended with but a trifling amount of pain, aifd under proper direction and management, can scarcely fail of success. Several cases will be found reported, of patients operated on by the Author, varying in age, from nine months to twenty-two years. But the most suitable age for the operation is almost as soon as they have been discovered; or say, from six weeks to three months old. The sooner the operation is performed, after their existence has become evident, the better. The reader may refer to the cases re- ported—2, 3, and 4—at the end of this work. * 48 TREATISE on the EYE and EAR. SPOTS, FILMS, AND ULCERS ON TEE SIGHT. After an attack of inflammation, and even after injury or accident, which has wounded the delicate, transparent coat of the eye, spots and films, in various shapes and forms, may be seen to occupy a portion of the eye, and oftentimes to the great detriment of sight. The above cut shows an inflammatory ulcer on the eye partially covering the pupil. This ulcer is fed by numerous small vessels from the main body of the eye, and if not speedily subdued will cover the entire front of the organ with a heavy white film, completely destroying the sight, and producing a most unsightly blemish. Sometimes the entire front of the organ will be covered with a heavy film or cloud, which greatly obstructs the sight, and frequently destroys useful vision altogether. I have seen this opacity so dense in many cases, that the color of the eye could not be distinguished, and still the eye will become perfectly clear by timely treatment, and good sight restored. It is dangerous to allow this state of tilings to continue, for if it be not speedily removed, and the eve fails to receive appropriate treatment during the time this mist is forming, and the inflammation should be subdued, without a proper regard to this particular condition, it will most certainly leave traces behind which can never be so well removed after, if at all, and which will impair the sight beyond the possibility of recovery TREATISE ON THE EYE AND EAR. 49 When excavated patches or ulcers form on the cor- nea, they are capable of destroying the sight very soon, and sometimes very suddenly. When they have eaten through the delicate coat, the water will escape from the opening, the curtain of the eye rushes to the open- ing by the pressure of the ball from behind, the pupil becomes entangled in the ulcer, and closes immediately, >. and sight is instantly lost, though it may have been good one moment before. It would be well, therefore, for those who have had a severe attack of inflammation, either of long or short duration, to keep a good look-out for such visitors as I have described, for in whatever form they may appear, or wherever located, they never fail to leave those traces behind which, if not fatal to the sight, will certainly prove an indelible blemish. When this condition of the eye has been discovered, and receives merited attention, it can generally be removed, and vision preserved without performing any operation. PURULENT INFLAMMATION OF THE EYE. The above engraving represents the appearance of an eye destroyed by this disease. There is no disease of the Eye so rapidly fatal to vision, with the exception of the Egyptian Ophthalmia, 4 50 TREATISE ON THE EYE AND EAR. as the one under consideration. It attacks all classes and all ages indiscriminately, and comes at all seasons. It is a contagious disease, and frequently attacks whole families almost simultaneously. It commences with itching and soreness in the inner corner of the eye, and the organ soon becomes red and inflamed, and adhesive matter is thrown out, which firmly glues the lids together when they have been closed for a few hours. It is generally felt in one eye first, and after a few days the opposite eye will be attacked. At the onset of the disease, a free discharge of scalding tears will escape, accompanied with consider- able intolerance of light; eyes grow red, and soon the whole organ is like a mass of raw flesh ; head-ache and pain in the organ increases, and in a few days, if some relief be not obtained, the sight becomes dim by the excessive swelling, the white portion of the ball will be very much swollen, and the sight of the eye greatly obscured. When these early symptoms are severe, the eye will soon be lost by the excess of swelling around the sight, which causes a strangulation in the blood-vessels, cutting off the supply of blood to the transparent cornea or front of the eye. On examina- tion it will be discovered, that the eye will appear dim and misty, both to the patient and the observer, and on close inspection, a dull white patch, having a dead white centre, shaded off at its margin, which greatly obscures the sight, or altogether destroys useful vision, will be found to have commenced. This marks the first stage of gangrene or mortification, and in a day or two more, if the inflammation and swelling be not speedily subdued, and the free circulation through the eye restored, the white patch will be entirely detached and slough out, causing an immediate escape of a TREATISE ON THE EYE AND EAR. 51 portion of the humors, a collapse of the eye, and com- plete destruction to the sight. At this stage of the case, the pain suddenly subsides; and the patient, feel- ing relief, flatters himself all is at an end, and he will soon be better, but little dreaming his sight is irre- coverably lost. It now becomes apparent, however, that the mischief is not over, for the opposite eye is usually attacked, and in a few days will be lost also, if prompt and active measures be not taken to arrest the disease. Such is the destructive nature of Purulent Inflammation, and it becomes those having the pre- monitory symptoms of this disease, to look to them- selves in good time, and thus avert the miseries that await them. The early symptoms of this destructive visitor will readily point out the nature of the case. PURULENT INFLAMMATION OF THE EYES OF NEW- BORN INFANTS. This disease, though not of very common occur- rence, is occasionally met with, and from its danger- ous nature, requires a passing notice. It commences with a light yellow or straw-colored discharge, which gathers at the inner angle of the eyes, and glues them together. In the course of two or three days, the lids begin to swell and puff up, matter increases, the ball seems to protrude, and the eye becomes very sensitive to light; and in bad cases, the delicate membrane which lines the entire socket becomes so enormously tumified and swollen as to protrude through the lids, while the eyes are so com- pletely concealed from view by the swelling, that they cannot be examined, even by the greatest exertion. This stage exists but a very short time, for the deli 52 treatise on the eye and EAR. cate cornea or front of the eye mortifies, in part, or wholly so—generally the latter—and then the disease begins to subside ; one or both organs having been com- pletely destroyed by the rapid course which it usually takes. Whenever the premonitory symptoms of this disease present themselves in the infiint, it should be promptly treated by those who understand the nature and danger of the case. A lady brought a beautiful boy to me a few days ago, aged five months, whose visual organs presented a complete wreck from the effects of this disease. She sought the advice of one of the many pretenders to ocular science, in good time, and the wise son of Escu- lapius promised her a perfect cure of this, her only child, and assured her there was no occasion for alarm. He had been treating this child for a period of two months, when it was brought to me for my opinion, and I had no hesitation in pronouncing the case a hopeless one, as both fronts had mortified and sloughed from the eye, leaving nothing to hope for in the way of sight. Yet the mother informed me that her medical attendant gave her renewed assurance that the child would certainly recover its sight, and ordered, accordingly, a little Castor Oil to be dropped into each eye daily, as had been done for several consecutive weeks, notwithstanding the eyes were then a complete wreck, and without the least hope of restoration. The cut on page 49 represents the condition of an eye destroyed by this disease. TREATISE ON THE EYE AND EAR. 53 CROSS-EYE OR SQUINTING. This is an affection so apparent as scarcely to re- quire explanation. It is to be met with in every period and in all conditions of life. It is a most un- pleasant defect, particularly to young people, and never fails to impair the sight more or less. CAUSES. It arises from a great variety of causes, viz: Mea- sles and most diseases of children; blows on the head, falls, looking at the nose, teething, worms, indiges- tion, convulsions, imitation, and in some cases it is congenital. Many persons suppose that, although they have cross eyes, their sight is still perfect! But this is not the case; and any one who feels desirous of test- ing the truth of these remarks, may close his straight eye, and endeavor to place the tip of his fore finger, with his arm extended, on the point of a pencil held upright by another person, and he will find it will not be readily done, though by a few trials he may succeed at last. 54 TREATISE ON THE EYE AND EAR. BALL OF THE EYE with the MUSCLES ATTACHED. OPERATION FOR SQUINTING. The operation is one of extreme simplicity, and is usually performed by me in about thirty seconds, with very little pain, and without the least risk or danger to the eye itself. The effects of the operation are only visible for a day or two, and immediately the operation is over, the eye becomes perfectly straight. No interruption to business need be experienced on account of it the day after it has been done. My patients are allowed to come and go at all seasons, but as a matter of prudence are advised not to read, write or sew, for two or three days after the operation has been made; no pain or other inconvenience fol- lows. I have made the operation on over one thou- sand cases, and know of none that have not succeeded well, and given general satisfaction. Usually no fault can be found with the operation or its results, by the closest inspection. Several young ladies of Chicago and vicinity, having double Cross-eyes, have had this operation performed by me within the last few weeks, whose cases have given the most perfect and entire satisfaction, and who are now not only rejoicing over a straight pair of optics, but have the advantage of greatly improved sight added to it. I have also operated on several small children, from the age of TREATISE ON THE EYE AND EAR. 55 two to ten years, with equal success. References to the above cases will be given at any time, on appli- cation. The operation is but momentary, and a straight pair of eyes is the immediate result. Subjects as young as two or three years may be operated on for this defect, but older ones are much more easy to manage; and when parents are willing, I frequently administer chloroform to these young subjects, which enables me to operate without the least risk or danger. TUMORS ON THE EYE-LIDS AND BALL OF THE EYE. Tumors and morbid growths and swellings fre- quently appear about the eye-lids, and at the angles of the eye, sometimes on the temples and brow, and not unfrequently on the ball of the eye itself, as represented in the above engraving. They are gene- rally very troublesome to the patient, and produce more or less disfigurement, besides oftentimes ma- terially interfering with sight. They may be removed with but little trouble or pain, and without risk to the Eye, unless fixed on the ball, in which situation they may be more or less difficult to manage, accord- ing to the position they may occupy. They some- 56 TREATISE ON THE EYE AND EAR. times attain a very considerable size, and by it, en- croach upon the Eye itself, thereby doing serious injury. They should, as a general rule, be removed when they are first discovered, as they are then gene- rally loose, and unconnected with the solid structure. ONE EYE INJURED, BOTH EYES BLINDED IN CON- SEQUENCE. The above drawing gives a tolerably good idea of the importance of the Optic Nerves, and of their influ- ence, one over the other. They are here seen passing from the base of the brain, stretching forward till they meet, where their little fibres are so closely and inseparably connected, that they form one grand cen- tre ; they again separate in a divergent direction till t they arrive at the ball, where they are beautifully expanded and spread out to form the retina, or true seat of vision. It will not be difficult by this to understand how it is that a sound Eye always feels the effect of a diseased action going on in the opposite organ, and how frequently it happens that disease commencing in one Eye and continued for a time, if not relieved, seldom fails to affect the other; and farther, when blind- ness or the destruction of an Eye has resulted from accident or disease, how frequently the opposite Eye takes on sympathetic inflammation, and is lost also. TREATISE ON THE EYE AND EAR. 57 INJURIES AND ACCIDENTS TO THE EYE. The Eye is constantly liable to accidents and injuries from various causes. They arise from pieces of metal or steel flying into the Eye, in working at the lathe, pecking mill-stones, or in stone-cutting, and various other ways; and when they occur, it is desirable, if possible, to remove the offending matter; if not, bind up the eye with a wet cloth or bandage, and keep it closed, to avoid the friction of the lids on the ball, till suitable assistance can be obtained to re- move it. Much mischief is often done by clumsy efforts at removing such particles, and the Eye suffers more by it than by the presence of the foreign matter. If lim,e, potash, or fused metal, should chance to' get into the eye, they are capable of producing disorgani- zation of the eye in a few hours, and the pain and suffering accompanying them is of the most excrucia- ting kind. Whenever an accident like this has happened, procure a large bowl or basin of pure water and immerse the face in the water, opening and shutting the eyes frequently, to allow as much of the caustic matter to escape as possible; and when done, apply a drop or two of sweet oil between the lids every hour or two. In the mean time, it would be desirable to consult an oculist as soon as possible, or some competent person, in order that the eye may be preserved from complete destruction, which in cases like this, is very likely to follow. Pieces of wood frequently strike the eye with great force while chopping, and, although they do not lodge there, they produce serious mischief to the organ, and 58 TREATISE ON THE EYE AND EAR. often destroy the eye in a few days. In harvesting and threshing, various small particles will fly and lodge in the eye unobserved, and if not removed, produce troublesome, if not fatal, inflammation. I have frequently seen an eye almost ruined from a small particle of chaff or beard of wheat beneath the lid, and so small as to require a magnifying glass to discover its locality. These are readily removed, as a general thing, and by a little cooling treatment subsequently, all unpleasant symptoms rapidly dis- appear. VERTICAL SECTION OF THE EYE. The following figure shows a Vertical Section of the ball of the Eye. In this may be seen, according to the explanation following, the different layers and coats which surround this beautiful optical instrument, and the relative position of each; also the situation of the different humors, and the great Optic Nerve, or Nerve of sight. This profile brings nearly all parts of the organ to view. Each and every part is subject to disease, different in action, and modified by a great variety of circumstances; some requiring one form of treatment, and others the reverse, arising from causes as different as the diseases themselves; and what would be beneficial in one case, would probably prove rapidly destructive to the Eye of another, whose disease was of a different character. Hence, it must not be inferred (as is too often the case), that all diseases of the Eye are alike, differing only in degree and in the severity of the attack. TREATISE ON THE EYE AND EAR 59 EXPLANATION. 1. Represents the Conjunctiva, or outer covering of the Eye. It is loosely attached to the ball, and is traversed with blood-vessels. 2. Is the Cornea, or glass of the Eye. In shape, form, and appearance. it represents the glass of a watch. , 3. Sclerotic, or white coat. It is very thick and firm, and surrounds the entire Eye, except the front or glass. 4. Membrane of the aqueous humor, lining the front chamber of the Eye. 6. Choroid, or vascular coat. 6. Retina, or expansion of the Optic Nerve. 7. Ciliary processes. 8. Iris, or colored curtain of the Eye, with a hole in the centre, which makes the Pupil or sight. 9. Crystalline Lens, or principal Magnifier of the Eye. 10. Vitreous Humor, forming the principal bulk of the Eye. 11. Optic Nerve. 12. Anterior Chamber, which separates the Cornea, or glass of the Eye, from the Iris, or colored curtain, and is filled with a watery humor. 18. Posterior Chamber of the Eye. 60 TREATISE ON THE EYE AND EAR. A WORD TO THOSE WHO REQUIRE GLASSES FROM AGE. After a certain period of life, most people of both sexes require the aid of a certain description of glasses to enable them to read, sew, and exercise the eye on fine work as usual. But with some, a feeling of pride prevents them from resorting to them at the period when they are really needful. Whenever a person is obliged to extend the arm at nearly full length to read a paper or book, and insists on doing so to the exclusion of glasses, he injures his eyes greatly, and by so doing exerts the organ beyond its strength, which may superinduce disease. But aside from this, the power of the organ becomes more and more weakened, and that which they seek to avoid becomes the more necessary. The object of the glass is merely to regulate the focus of vision, and to bring the print within a fair reading distance, which should be about fifteen or eighteen inches. The glasses supply certain deficiencies which the eyes undergo by age, and at a fair distance every- thing looks perfectly plain and clear through them, and without them there is a mist or fog before the letters. Those, therefore, who would wish to preserve the strength of their eyes will do well to observe these remarks, as I frequently have persons apply to me for relief in cases where the eyes had been over exerted to read, at a distance entirely within the focus of vision for aged eyes, and had by this means established a condition of the eye which glasses could not remove. When the arm has to be stretched out to see print of ordinary size, glasses are required, and the sooner they are provided the better. TREATISE ON THE EYE AND EAR. 61 BLINDNESS FROM CLOSED PUPIL The above engraving represents the method of forming an artificial pupil, Jby separating the Iris, or curtain of the eye, from the outer margin. This operation is only rendered necessary when the centre of the eye has lost its transparency, leaving a dense, white film, or cloud, which completely excludes the light, while the margin, or circle around, retains its natural clearness. By this operation sight is imme- diately restored. This very unfortunate condition of the eye I have seen under a great variety of circumstances, and where it exists it completely excludes the passage of light to the Eye; and though there is some perception of light, no object can be seen. It arises from causes various 62 TREATISE ON THE EYE AND EAR. and complicated, and where it exists in both eyes, it affords a complete barrier to the sight. This condi- tion of the eye may be produced from simple inflam- mation, neglected or badly treated. It also arises from wounds to the eye with sharp or cutting instru- ments, and various other accidents. I have also known it to result from the indiscriminate use of mer- cury, a case of which may be read with some interest at the end of this work, the subject being one John L. Elliott, of Port Stanley, who was blind for more than a year, but received his sight by an operation performed by me in the winter of 1854, and was restored to good sight in less than one minute. Also, among the certificates is the case of one Bartholomew McMahon, who was dismissed from the Montreal Hospital as blind and incurable, was operated on by me in the presence of several medical gentlemen, whose names will appear in their proper places, and was immediately restored to sight, and is now able to earn a good livelihood. The appearance which the eye presents, where this disease exists, is, that the pupil or black centre which constitutes the sight, is not visible, and the general appearance of the eye is dull. If the pupil of the eyes was closed in conse- quence of some instrument being thrust into the organ, there will also be visible a white line or spot on the front of the organ indicating the point where the instrument entered. « TREATISE ON THE EYE AND EAR. 63 OPERATION TO RESTORE SIGHT IN CASE OF BLIND- NESS FROM CLOSED PUPIL. The above cut represents the appearance of an eye after an operation for Artificial Pupil, in which case sight has been restored. This is considered one of the most difficult, and may also be defined, by a master operator, as one of the most beautiful operations ever performed on the human bod v. The operation for making a new or artificial pupil, is performed in a single moment, without pain to the patient, but with pleasure to the operator; for, like a passing cloud that for a time obscures the sun's rays, in one instant the light of day will burst in upon the chamber of the eye so long enveiled in darkness, and the patient at once beholds with wonder and aston- ishment the objects that surround him. His emotions now become evident, and as if to express his greater satisfaction, unable to utter a word, sinks back upon the couch overcome wTith emotions of joy. This description of blindness is quite frequent, as it results usually from inflammation, that has closed the pupil by the deposition of white adhesive matter, thereby shutting out the light from the chamber of the eye. 64 TREATISE ON THE EYE AND EAR. The operation consists in removing a- small portion of the iris, which immediately admits the rays of light, and consequently sight is at once restored. In conclu- sion, then, I may venture to assert that when a simple closure of the pupil exists without being complicated with any other disease of the organ, sight may be restored in a single minute, and with little or no pain, if, as may be the case, some pointed instrument has entered the organ far enough to wound other import- ant structures, the operation of making a new or arti- ficial pupil would not restore sight. The history of the case and a careful examination of the patient will point out the prospects for a successful operation. ARTIFICIAL EYES. I will here offer a few remarks on the Artificial Eye, and endeavor to explain its advantages. Any one who has lost an eye has probably felt the inconvenience by the falling in of the lids and of the consequent escape of tears over the face. They con- stantly experience more or less inconvenience from the exposure of the socket to the cold air and wind, which has the effect to weaken the sound eye more or less. The Artificial Eye can be inserted without pain, and without previous operation. It will move and roll in exact accordance with the sound eye, and the resemblance will be so perfect as completely to escape observation. They are manufactured for the most part in France, are composed of enamel, are very beautiful and dura- ble, and their resemblance to the human eye is perfect. Nothing can be more gratifying than the effect and TREATISE ON THE EYE AND EAR. 65 feeling of an Artificial Eye,—in fact you do not know any difference of feeling in your two eyes after a few days—and your nearest friends would find it difficult to say, from appearances, whether nature or art had supplied the deficiency. % Artificial Eyes are not only useful in improving the appearance and expression of the countenance, but they protect the cavity from dust or extraneous matter, exclude the cold air, support the lids, and prevent the eye from wasting and closing. They also render essential service to the healthy eye, which often suffers by sympathy with the dis- eased and exposed socket. Persons, therefore, who have had the misfortune to lose an eye, should avail themselves of the advantages of an artificial one, which so completely supplies all apparent deficiency; there is no doubt but it will save them much pain and suffering, and perhaps be the means of preserving sight in the sound organ. CONICAL CORNEA. The Cornea, or front of the eye, is also subject to changes, as may be seen by the above drawing, in which the regular convexity is lost, and elevated into a conical, or sugar-loaf protuberance. It is produced without pain or previous inflamma- 66 TREATISE ON THE EYE AND EAR. tion, or any visible change in structure in any other part of the eye. It occurs in young and healthy sub- jects, and is more frequent with young women than men. The effect of this disease is to render the patient • very short-sighted ; and as the cone increases in full- ness, the sight becomes still shorter, till at last print requires to be held within an inch of the eye to be seen at all, and only then with some difficulty. This condition of the eye may not be very readily detected in its early stages, and even after it is fairly established, it can only be discovered by viewing the eye in profile, as in the preceding figure, when the excess of fullness becomes clearly apparent—espe- cially when compared with another and healthy organ. Much may be done for this condition of the eye if taken in season, and without causing the least suffer- ing. But if neglected till the cornea has become very prominent, there is but little hope for relief, as in this condition the sight is very poor or quite useless. EXTIRPATION OF THE EYE-BALL. The removal of the entire Eye from the socket by a surgical operation, becomes necessary sometimes, in order to save life ; but more frequently for the purpose of arresting a destructive and fatal inflammation which may be going on in the opposite organ. When a dis- ease of a malignant nature attacks the eye or its appendages, it soon affects the opposite organ, and if active measures be not immediately taken, the disease spreads rapidly, and soon the other eye will become blind, and life itself be put in great jeopardy. A case of this description will be found reported at TREATISE ON THE EYE AND EAR. 67 the end of this work, where the entire eye was re- moved, together with a large mass of disease that had been over Thirteen Years in existence. The subject was a young man, twenty-three years of age, named John Wilson, Jr., of Peterborough, Canada. The mass was successfully removed by a careful operation, performed by me in the presence of about twenty physicians. The patient, though seriously affected by the presence of this disease, both mentally and physically, was completely restored to sound health and strength, and was able to return to his family in thirteen days after the operation. See case reported among the cases at the end of this work, with portrait of the patient, just before submitting to the operation. STAPHILOMA. THE ABOVE CUT GIVES THE APPEARANCE WHICH AN EYE FREQUENTLY ASSUMES AFTER THE SIGHT HAS BEEN DESTROYED BY ANY OF THE ORDINARY FORMS OF INFLAMMATION. When an eye has been destroyed by an attack of inflammation, especially if it be of the purulent cha- racter, it not unfrequently assumes the appearance of the above engraving. It will here be seen, by the profile view presented, that the entire front of the organ has not only undergone a complete transform- ation, but by the loss of substance, the front of the 68 TREATISE ON THE EYE AND EAR. eye has given way under the extreme pressure of the globe, and the eye is bulged forward so as to render it impossible to close the lids. This condition is always a growing evil, and sometimes, if not relieved by an operation, the whole globe will become involved in the difficulty—crowding forward continually, until the diseased organ has assumed a frightful appear- ance, too terrible for most persons to look upon. The best course to pursue when an eye begins to bulge forward in this manner, and the sight has been destroyed, is to apply to some skilful person, and have an operation performed, which may be readily done, and the prominent organ brought down to a proper level with the other eye. It is best in such cases to have the operation made with the understanding that an artificial eye is to be inserted; and this can gene- rally be done so well as nearly to defy detection. The operation itself is not attended with a great amount of pain, and is only of a moment's duration. I have several patients in this city as references, where I have removed the diseased part, and subsequently inserted the artificial eye. SHORT SIGHT Is a natural defect of vision, generally from birth. I have known this defect to arise in youth and the middle period of life, from other causes. It is, as a general thing, remedied only by glasses, though when produced by disease, may be treated with success the same as other diseases. TREATISE ON THE EYE AND EAR. 69 This disease consists in a fold of skin projecting in such a way from the side of the root of the nose, over the inner angle of the eye, as to cover the little caruncle, or small red body which occupies the ex- treme inner angle of the eye. The free edge of the fold is somewhat crescentic or semi-lunar in shape, and its extremities are continued into the skin of the upper and lower eye-lid, as may be seen by examin- ing the above figure. It prevents the eyes from being freely opened, and thus interferes with vision. This peculiar conformation is supposed to be con- f genital, though some writers have asserted that it was sometimes the result of disease. However, wherever it exists, it may and should be removed by an operation, which can always be done with very little cost of pain, and with a certainty of success that .admits of no doubt. I have made this operation on several occasions, and was entirely successful in re- moving all traces of the disease, which in many cases 70 TREATISE on the eye AND EAR amounts to a positive deformity. By this operation, not only is the natural appearance of the eyes restored without leaving a blemish, but the eyes themselves are much improved in sight and appearance. CANCER ON THE EYE. Cancers and other malignant growths not unfre- quently appear on some portion of the globe of the eye or its appendages, and frequently they may be seen on the lids. The above figure gives a very good representation of' a Strawberry Cancer, which made its appearance at the inner angle of the eve, in the shape of a small red elevated pimple, and gradually increased to the size of an ordinary filbert. But they much more frequently attack the lids, and some- times the lachrymal gland. I have now an elderly gentleman under my care, who has a malignant • disease of the right eye, which made its first appear- ance in the back part of the orbit, somewhere in the immediate vicinity of the lachrymal or tear gland, and at this moment is causing rapid disorganization of the surrounding pa»ts. There is but little that can be done for these dis- eases, especially when they are seated deep in the orbit; but if upon the outer surface, they may be removed, but with some difficulty, and always with more or less liability to a return of the disease. TREATISE ON THE EYE AND EAR. 71 INVERTED EYE-LIDS, or TURNING IN OF THE EYE- LASHES. A constant state of irritation, as if from the pre- sence of some extraneous or foreign matter, is the first and most marked symptom of this disease; the pain is of a sharp, prickling, and darting kind, felt most severely when moving or rolling the globe of the eye. This is accompanied by a troublesome flow of tears; the vision is so far impeded that the patient can with difficulty direct it to any useful pur- pose, nor can he bear the eye to be exposed to a bright light; even the very mention of light will cause a fresh gush of tears, which will compel him to turn his head involuntarily away. Upon inspection, it will be observed that the free margin of one or both lids is turned inward upon the surface of the globe, so that the eye-lashes are in im- mediate connection with the delicate membrane of the eye, as represented in the above figure. The degree of ophthalmia in these cases depends much upon the duration of the complaint, and in cases of long con- tinuance, that portion of the membrane which covers the cornea or transparent front of the eye, participates principally in the disease; the brilliancy of the sur- face is lost, the transparency diminished from the deposit of fibrinous matter, and frequently large blood- vessels may be seen in numbers, traversing the cornea 72 TREATISE ON THE EYE AND EAR. in every direction. This operates on the eye just like any foreign body, and every time the eye is moved, as is the case in winking, and every attempt to see, the whole range of eye-lashes play against the ball, causing the greatest irritation, and this constantly increases the difficulty in question. This disease arises most frequently from common inflammation, which has been injudiciously treated, or neglected. It may also be produced by the free use of any of the quack nostrums which patients so frequently resort to, who have simple inflammation of the eyes. When this disease is once established, there is no remedy that I know of, short of an operation; which, when skilfully done, will immediately restore the inverted lid to its normal condition, and the patient finds him- self entirely and completely relieved. If much inflam- mation has existed, from the long continuance of this disease, a few days' or weeks' attendance may be necessary to restore the organ to a state of health and usefulness. ISTEUR^lLGI^. ITS EFFECT UPON THE EYE AND SYSTEM GENERALLY. ITS COMPLETE AND PERFECT CURE ^A-ooomplislied. in a few Hours, With a Degree of Certainty that Challenges Dispute. NEURALGIC AND RHEUMATIC INFLAMMATION OF THE EYE. Neuralgia as a disease, has become one of the most prevalent and, I may add, serious diseases that afflict the human race, and, with Rheumatism as its traveling companion, they manage to afflict a large per-centage of mankind with their distress- ingly painful and tedious visitations, coming and going at all times and seasons, oftentimes making a protracted stay, apparently defiant of all efforts to remove, and evidently beyond the reach of the best medical skill, either to remove or subdue. The varied character of these diseases, attacking, * as they do, any portion, part, or locality of the human frame, without any apparent cause or as- signable reason, seizing upon a. most plelicate and vital organ with unconquerable fury, thrusting and darting with painful stabs in every direction, de- 74 NEURALGIA. stroying sight, impairing hearing, and, in some in- stances, depriving Reason of her throne, are some of the excuses, if any are required, why the author of this little volume has made the treatment of these diseases for a few years past the subject of his particular care and attention. It was mainly with the view to combat Neuralgia as it attacked and affected the eye. At length, after two years' experimenting, a suc- cessful combination of medicines was hit upon, which upon trial was found to be a perfect panacea for Neuralgia as it attacked the eye. Subsequent- ly the merits of the " Nervine"1 were tested for Neuralgia, variously located, and whether the attack was slight or severe, or of long or short continu- ance, it proved to possess the same soothing effect, and in most instances completely routing the dis- ease in a few hours, without producing any other effect upon the system whatever, either at the time or at any subsequent period. Numberless cases of Neuralgic diseases of both the eye and ear have been disposed of since the • great potency of this remedy was discovered, and the patients readily cured; while some thousands of others, variously afflicted with painful visita- tions from this mysterious visitor (in some cases, covering a period of from five to thirty years), have been thoroughly relieved by its use in a few NEURALGIA 75 hours, and to all appearance, permanently so, as in many instances no trace of the disease has ever re-appeared, after a lapse of over two years. Hundreds, both in and out of the City, have used it, and given voluntary testimony to its efficacy and perfect reliability as a quick and certain remedy for Neuralgia, in whatever form or shape it may present itself; and for sick, nervous or Neuralgic Headache, its operation is charmingly effective, sel- dom requiring more than a single dose, and from whatever cause produced, it invariably subsides under its use in less than one hour. Parties suffering from any of these painful affections, are confidently assured that the state- ments made with reference to the extraordinary merits of the "Lacteal Nervine," as a speedy remedy for Neuralgia, are strictly true, and without exageration; in proof of which, its merits will be tested, gratuitously, on anyone who will make per- sonal application at my office before 10 A. M To be had of Druggists generally, and at my office, 181 Lexington Avenue, N. Y. F. A. CADWELL, M. D., Prop'r. DEAFNESS AND DISEASES OF THE EAR. THE ABOVE FIGURE REPRESENTS THE EAR WITH A SMALL INSTRUMENT INTRODUCED TO EXAMINE THE ORGAN. HEARING. Hearing is an animal sense, the effect of undulations of airs or fluids, or of vibrations of solids upon a special nerve, produced through the medium of an apparatus, more or less complicated, and by which important perceptions of the outer world are acquired. (77) 78 TREATISE on the eye and ear. So important is sound in conveying information to the brain, that some physiologists have ranked the Ear higher in utility than the Eye; but apparently upon insufficient grounds, for as this organ is not so generally found in the animal series, it would rather seem that Hearing was of secondary importance to Vision, in procuring food, and in avoiding danger. Any deviation of the sense of Hearing from the perfect state of the organ, will be classed under the head of Deafness; whether it arises from sickness or cold, from accident or violence, whether natural or acquired, so long as there exists a diminution of the power of hearing in one or both ears, it must be con- sidered under the head of Deafness. The different degrees and varieties of Deafness will only be touched upon in a general manner, as the nature of this small work will not admit of the author doing more than to make a very brief allusion to some of the most common forms of deafness and disease of these organs, as met with in this country. Volumes might be written on the subject of deafness alone, but it is quite sufficient in the present instance to call attention to some of the most common and dangerous diseases, and to advise means to protect them against the dreadful consequences which too frequently ensue. Any impairment of hearing, from the slightest dullness to the more severe form of deafness, may be treated with more or less success, and if taken in time, the hearing may be restored altogether. Numerous certificates will be found at the end of this work fully corroborative of this statement, from persons of well known veracity and respectability. I do not wish to be understood, however, that all cases of deafness are TREATISE ON THE EYE AND EAE. 79 curable in my hands, but I do mean to say that there are many cases of very severe deafness, that have stood for more than a score of years, that are more easily cured than some of a different description, which have only existed for a few weeks or months. I have myself removed deafness of forty years' standing, by one hours treatment, and made the hearing as good, or nearly so, as it ever was; and by a few days' occasional attendance, the patient not only found his hearing per- fect, but all other morbid symptoms and unpleasant feeling had subsided with it—still again it might require some weeks to cure deafness less severe, that had only recently appeared. The same is true with diseases of the Eye. A disease may attack an eye, of so violent a character as entirely to destroy the organ in two or three days; and another may have disease, with partial loss of sight, for several years together, still the organ may be preserved and the sight made good. This is explained by understanding the nature of the disease and severity of the attack, and is generally understood by all practising physicians. I make this explanation to the reader, that he may sometimes avoid useless and unnecessary inquiry; for- I am constantly receiving letters from different parties, who always make sure to mention some circumstance connected with their case as being (in their opinion) favorable or unfavorable to a cure. They say, '■ I lost my hearing entirely only a few weeks ago, from an attack of Brain Fever, and I therefore consider I may be cured, as the case is so recent." Another will say, " I became deaf, or hard of hearing, some twenty or thirty years ago, from taking cold, or from the measles, or scarlet fever, when I was quite a child, and I there- fore suppose there is no help for me." Now, in both 80 TREATISE ON THE EYE AND EAR. these cases, the patients have judged of their cases by the length of time the disease had existed, and although very natural thus to reason, still they are both incorrect, for a case of total annihilation of the hearing, from an attack of brain fever, I believe to be incurable, and unless some amelioration from complete and entire deafness supervenes upon the subsidence of the cere- bral attack, I do not know of any rational mode of treatment that would be likely to be of service. But if a patient be partially restored after such an attack, I have no doubt but that timely treatment, judiciously practised, would have a decidedly good effect upon him., and ultimately restore the hearing entirely. But deafness following Measles and Scarlet Fever, of twenty, thirty, or even sixty years' standing has been cured by me, and numerous cases of the same description, varying from five to forty years, have been readily cured in a few weeks or months, and the hearing made good. Some interesting and highly creditable certificates will be found appended. ADVICE ON DEAFNESS. Timely attention, such as the generality of people are able to command, would greatly lessen the number of the deaf. Unfortunately, it is common for those who are threatened with loss of hearing to argue, that from the tardy advance of the evil, the causes which are producing it cannot be very powerful or deeply rooted, and they flatter themselves that time will, of itself, bring relief, rather than aggravation. Thus it is, that thousands, by culpable neglect, throw away the invaluable chance of recovery offered by early treatment and prudential self-regard. The tissues of the ear are so solid, and shut out from other organs, TREATISE ON THE EYE AND EAR. 81 that when once a diseased habit has been established within, it is only with the greatest difficulty that the enemy can be dislodged. Nothing more surely proves the slow-stealing ad- vance of deafness (in the general sense), than that very few are able to name the precise date of their misfortune. They can generally remember, that long before they considered themselves deaf, there were times when conversation in a large room, or in the society of several persons, required unusual attention to be correctly comprehended. That in damp weather, or while eating, or when the back was turned to the speaker, the difficulty was increased. That words' containing certain consonants, as tors, were sometimes mistaken for others—this being the case especially with proper names; that the voice of a stranger, or conversation in a strange room, was less intelligible than one to which the hearer had been accustomed. All these facts are interesting as being among the first signs of failing hearing. On their earliest manifesta- tion, it would be wise to place the auditory organ in the best possible state of defence. As the mucous membrane is the chief point affected by injurious influences, all causes that act upon it prejudicially should be held in apprehension; and cold and humidity, being by far the most frequent of these, and affecting the ear in the greatest variety of forms, should be guarded against with the most sedulous care. When deafness has commenced, every fresh catarrh will be sure to add something to its aggravation. Sud- den transitions from heated assemblies to the cold air, or vice versa, are much more likely to occasion cold than exposure to either a uniformly high or low tem- perature, and should therefore be avoided. I have t 6 82 TREATISE ON THE EYE AND EAR. known persons liable to catarrh, who guarded against it by never entering a warm room from the open air in cold weather, without lingering a minute or two in the hall or lobby, and on passing out observing the same precaution. DISCHARGE FROM THE EAR, FROM COLD AND COMMON CAUSES. A purulent discharge from the Ear is of very, fre- quent occurrence in young children, and is not unfre- quently seen in the adult. It arises, generally, from cold, which settles itself in one or both ears, causing considerable pain, and after a few days of suffering, a thin discharge is discovered, and the patient feels relieved. In these cases there is more or less deafness in the affected ear, and a sense of fullness or stuffing is frequently experienced in the other. If no attention be paid to this state of things, permanent deafness will certainly ensue, and moreover, by the time the affected ear has become nearly useless for the purpose of hear- ing, the opposite ear will often take on a sympathetic disease, and destroy the hearing entirely. I frequently see cases like these, and when patients place themselves under treatment in time, the disease can be arrested completely, ana" the hearing made good ; without this precaution, there is great danger of becoming perma- nently deaf, in one or both ears. This discharge arises in the first instance from the passage of the ear, with- out affecting its internal delicate structure,.but if it be allowed to continue, the consequences will be ulcera- tion and perforations through the drum of the ear, causing still greater deafness, and rendering it impos- sible to make the hearing perfect. Much may be done, TREATISE ON THE EYE AND EAR. 83 however, in all such cases, to mitigate the distress and improve the condition of the diseased organ, which, under any circumstances, will arrest the mischief, and do much towards restoring the organ to a healthy state. ARTIFICIAL TYMPANUM, or DRUM FOR THE EAR. It may not be generally known, that in almost all cases where there is or has been a discharge of puru- lent matter from the ears, continued for weeks, months, and in many cases for years, as it frequently does, and which arises from various causes, such as scarlet fever, measles, whooping cough, common colds, injuries, etc., that there is generally to be found an opening in the drum of the ear, which communicates with the inter- nal and more delicate structure of the organ; and that so long as this discharge is allowed to continue, it will entirely destroy the delicate drum of the ear, and leave the middle chamber exposed to the influence of cold. Nothing can be more absurd than the old doc- trine, that these discharges are healthy, and therefore must not be arrested. They are dangerous and destructive to the hearing, and should always be treated and cured if possible. They will, if allowed to go on, completely disorganize the delicate membrane or drum, and leave the patient liable to attacks of increased deafness; and will eventually produce abscess on the brain, and destroy life. I have known many cases of sudden death caused by the discharges taking an inward.course, burrowing and undermining the brain. This is apt to occur when, after a severe cold, the ear swells and closes at its outer orifiGe, confining the matter within, and having no means of external escape, burrows toward the brain, and soon produces death. 84 TREATISE ON THE EYE AND EAR. After any sickness, accident, or disease, which caused a discharge to be established at the ears, it should receive early and prompt attention. This, if skilfully managed, will not only remove what must be a great nuisance to the unfortunate sufferer, but will avert that which will inevitably follow, if allowed to continue, viz.: the destruction of the drum, with partial or complete loss of the power of hearing. There are but few cases of discharge from these organs but what can be cured in a very short time, with advantage to both health and hearing; and when this has been done, if a portion or the whole of the delicate membrane or drum proves to be destroyed, its place can be supplied by the insertion of an artificial membrane, made to correspond exactly to the size of the opening caused by the disease. This can be done without the least pain, and a patient who could not hear common conversation a moment * before, will frequently be able to hear a low whisper with the. greatest ease. This beautiful discovery has been tested in numerous instances, and has met with universal favor, both in Europe and the United States. Those who have any hesitation about having the arti- ficial drum inserted, can at least have their ears at- tended, and have these destructive discharges arrested, both for their own personal comfort, as well as the future protection and preservation of the organ. NOISE AND SINGING IN THE EAR, A SIGN OF THE APPROACH OF DEAFNESS. This annoying and disagreeable sensation in the Ear is a very certain sign of the approach of deafness, and whenever it appears, and continues, deafness is certain to follow, sooner or later. It is frequently not observed TREATISE ON THE EYE AND EAR. 85 till the deafness itself has become evident, but when it precedes the deafness for a long time, it has been found more difficult to restore the hearing. It indi- cates a morbid condition of the apparatus of hearing, in some part of its complicated structure. It seldom subsides spontaneously, if it has been of long continu- ance, unless the accompanying deafness has been re- moved, or the power of the auditory nerve has become so entirely insensible to the influence of sound as to ren- der hearing extremely difficult, if not quite impossible. These sounds are variable in tone and character, depending on a great variety of circumstances, both local and constitutional. They have been compared to the rushing of water, roaring of the sea at a dis- tance, singing of a tea-kettle, puffing of a steam-pipe, sounds from various insects, ringing of small bells, and almost every other imaginable sound. I once had a patient apply to me, saying she had a mouse in her ear, for she could hear it squeal as plainly as possible; and all the persuasion I could use would not dissuade her from the belief that a mouse, or some moving creature, had found its way into the passage of the ear, producing the noise in question. I mention this circumstance merely to show how strong a re- semblance to certain sounds the morbid conditions of the auditory apparatus are capable of producing. I need scarcely add, that any course of treatment, whether directed to the ear, or operating through the system, that has the effect of removing the noise, will undoubtedly be the means of checking the deafness, if already begun, or avert its threatened approach. 86 TREATISE on the eye and EAR. DISEASES OF THE EAR NOT PAINFUL TO CURE. The treatment of diseases of the Ear is, for the most part, extremely complicated and difficult; and those, therefore, who do not devote much of their time and attention to them, can scarcely expect to understand the managerr/ent of them. It is gratify- ing, however, to be able to add, that notwithstanding their extreme complication, there is seldom any pain given by the treatment. A child three years of age may go through the treatment without evincing the least amount of bodily suffering. I have succeeded, within a few days, in removing a very troublesome and offensive discharge from the ears of two infants, one being ten and the other fifteen months of age. In these little creatures the treatment evidently had a soothing effect, as they remained perfectly passive during the whole operation. The only really painful disease of the Ear is acute inflammation of the Tympanum, or common Ear-Ache, and these cases seldom reach me till after these pain- ful symptoms have passed over, and the patient applies to me to have the hearing improved. VARIETIES OF DEAFNESS. I will not attempt in the present work to classify the diseases of the Ear, or go into a detailed account of the various symptoms peculiar to each, but merely mention some of the leading features and character- istic marks of some of the most common forms of diseases of the ear, as they are generally met with, and enumerate some of the principal causes which unite in producing them. TREATISE ON THE EYE AND EAR. 87 The variety and number of these diseases, in com- parison with those of the eye, are small; and though diminished in number, they nevertheless form a most important branch of study, well worthy the attention of the scientific and industrious observer. Diseases of the Ear, differing in character, may arise from similar causes, and so, various causes may com- bine to produce diseases similar in character. The treatment of these modifications of disease will also vary, according to circumstances, both as regards the disease and the constitution of the patient. DEAFNESS, WITH NOISE IN THE EARS. This is the most common form of deafness, I believe, in the country. It usually arises very slowly, or may come on from the sudden transmission from heat to cold, with but little notice. It is always ac- companied with more or less noise or buzzing in the ears, often resembling various insects, the rushing of water, or the puffing of a steam-pipe. It changes from time to time; the hearing is usually variable, being generally best in clear, warm weather. It arises from cold, exposure to the sun, mental excite- ment, and frequently from a disordered state of the system. This disease I believe to be readily curable, as a general thing, though it may sometimes be tedi- ous to overcome, where it has existed for a long time in a weak and disordered constitution. In some cases the disease has been removed in a few days; of course the sooner it is taken in hand, after it has become established, the better will be the chances for a speedy recovery. 88 TREATISE ON THE EYE AND EAR. DEAFNESS, WITHOUT NOISE IN THE EAR. This is a form of deafness similar to the one before stated, with the exception that there is an entire absence of all noises or sounds in the ear, although many of these cases may at some time or other have presented this unpleasant and annoying feature. The principal pathological difference which these two forms present, is the presence or absence of sound or noise ; which, in the former, indicates an increased or excited condition of the auditory apparatus—while in the latter, diminished power of the auditory nerves, or nerves of hearing. They usually arise from the same causes as the first named, and the principles of treatment are the same, varying, of course, according to circumstances and constitutional peculiarities. THREE HUNDRED CASES OF DEAFNESS TREATED, AND THE RESULT GIVEN. My own opinion regarding the curability of diseases of the ear is founded on the result of three hundred cases, as they have been recorded in my journal, ac- cording to the order in which they have been pre- sented for treatment, after they have been examined in the most careful manner, and without making any selection. This number should certainly be amply sufficient to afford a close approximation to a correct statistical statement of the curability of the ear. Of the 300 patients treated 16 were found quite incurable, 64 received more or less improvement, and 220 were discharged cured. TREATISE ON THE EYE AND EAR. 89 It appears, therefore, by this statement, that one to every eighteen cases is incapable of receiving any bene- fit by treatment; one to five more or less improved; and more than two-thirds of the whole number cured. Of the unrelieved patients, and those who derived but little benefit from the treatment,.the greater num- ber certainly would have had a far more happy result had they given the requisite attention. In fact, many of those referred to did not find it convenient, after two or three visits, to pay any farther attention to it, otherwise a much larger proportion of cured and re- lieved would doubtless have been added to the number. From the very large number of patients which I receive under treatment for deafness, from all parts of Canada and the United States, I am satisfied that the profession elsewhere have had but a small share of success in removing the diseases with which these del- icate organs are so frequently attacked. Nearly, if not quite, every patient who makes application to me for assistance and relief from their deafness, has, at some period or other, been treated by other medical gentle- men, or self-styled Aurists, and without receiving the least benefit whatever. Still, I find in many of these cases, that I have but a few days or hours' work before me, to restore the hearing completely, though a few sub- sequent sittings might be required after the hearing has been restored, to secure the patient against, relapse. By referring to some of the cases at the end of this work, the reader will find a few scattering names reported, the most prominent of which is the case of Jonathan Dean, Esq., who resides at Buffalo, and who was very deaf for forty years, and who could not hear conversation, excepting in a very loud tone, had his hearing completely restored, in two sittings, of one hour 90 TREATISE ON THE EYE AND EAR. each. The first sitting was given on the morning of the 4th of July. 1855, at Buffalo, and the second was on the day following; and no return of deafness since. DEAFNESS FROM SCARLET FEVER AND MEASLES. No disease has probably done more injury to hear- ing than Scarlet Fever, which has, in innumerable instances, completely destroyed all power of hearing, from which patients have never recovered. I have myself examined upwards of 500 cases of total deaf- ness, in Canada and the United States, which is said to have resulted from this fearful disease. Measles has also some effect on the hearing, but more usually it attacks the eyes, and is often trouble- some or even impossible to get rid of by ordinary means. Its effects on the hearing, I think, are gene- rally trifling, and is seldom the means of destroying it altogether. When complete deafness ensues from Scarlatina, I am inclined to look upon it as decidedly unfavorable for successful treatment, unless, as is mentioned in brain fever, some improvement takes place on the breaking up of the disease. Another very common result from Scarlet Fever is running or discharge from the ears, accompanied with more or less deafness. It may arise from cold, measles, accidents, and various causes, and is usually considered by medical men and others as incurable. It is gene- rally thought to be injurious to the constitution to arrest such discharge; but.I take the responsibility of saying that 1 have removed the disease where discharge has existed for forty years, without producing any unplea- sant effect, or in any way impairing the health; on the TREATISE ON THE EYE AND EAR. 91 contrary, the removal of such discharge is invariably attended with a decided improvement in the general health, and always with a most gratifying improvement in the power of hearing. A few certificates to this effect will show the success of treatment on deafness following this disease, may be read with some interest in this work, among the other testimonials. Discharges from the ears, following Scarlet Fever, are not only disagreeable in themselves, and the cause of the most obstinate and severe deafness, but the disease may, at any time, and with but a few hours' notice, terminate by forming abscesses at the base of the brain, and thus suddenly cause death. It is not attended with pain in the forming stage, and on this account is likely to be neglected so long as a patient can be made to hear at all; but at an unexpected moment patients with this disease may be seized with pain on one side of the head, and giddi- ness, and before medical aid can be brought to bear on the case, it proves fatal. This disease, I believe to be curable at any period of life; the discharge can usually be arrested, and the hearing restored or greatly improved, and by this attendance the disease is effedually prevented from making any further inroads upon the constitution, or impairing the hearing to a greater extent, without which it would, in the course of time, destroy alto- gether. Patients who have had this disease for a length of time become very dull, and oftentimes quite stupid —and all this arises from the want of hearing. But when treatment has been successfully used in such cases, there is as much improvement observable in the intelligence of the patient as in the condition of the disease itself. When the discharge from the ears is 92 TREATISE ON THE EYE AND EAR. accompanied with a particularly bad smell, it indicates that some of the bones of the ear are diseased, and the sooner the case is attended to the better. * The reader can with confidence rely on the state- ment above made with reference to this disease, its effects, and its prospects for awe. Several certificates, from highly respectable parties, have been handed in by parents and others who have had practical proof of its efficacy on their own persons—although I am free to admit that it clashes with some of the opinions of the old and new-school practitioners. I may further state, that the removal of this disease is invariably accompanied with an improvement of the general health ; for whenever a discharge is estab- lished in any part of the system; and kept up for any length of time, the constitution suffers by it, and is always in proportion to the strength of the patient, and the extent and nature of the matter so dis- charged. DEAFNESS FROM SEA-BATHING, OR GOING IN THE WATER It is no uncommon occurrence for persons to become deaf from going into the water; and this arises from two principal causes, viz.: from the lodgment of water within the passage of the ear, from which cause in- flammation and discharge from the ear is soon estab- lished, and frequently with ulcerations through the drums. Secondly, by concussion, while diving. When water has been the cause, there is usually experienced a sense of weight and stuffing of the ear, which is soon followed by pain and discharge. If by concussion, there will be noise and singing in the ear, with slight TREATISE ON TI E EYE AND EAR. 93 dullness of hearing; the noise becomes more trouble- some and the deafness increases, and unless some relief be given to the afflicted organ, it will frequently pass into the opposite ear, and render the patient stupidly deaf. Both of these forms of deafness can generally be' removed, if taken in season, but if neglected until an extensive suppuration is established, or until the previously sound organ has become involved in the general difficulty, it will be difficult to remove it altogether, though much may be done at all times to mitigate the more severe forms of deafness arising from such accidents, and to prevent the complete loss of hearing which not unfrequently ensues. Persons who are in the habit'of bathing frequently, and diving far under water, should always take the precaution to introduce a little soft cotton-wool into each ear before venturing under water, as by this simple means they will very frequently avert an accident that would affect their happiness for life. DEAFNESS FROM FOREIGN SUBSTANCE IN THE EAR. Children frequently introduce various substances into the Ear without being sensible of the conse- quences. And sometimes beans, peas, glass beads, small pebblestones, and such like articles, are held against the ear, with the view of performing some childish trick or sleight of hand, when it slips from the fingers and drops into the passage of the ear, beyond their reach. These facts are frequently con- cealed from their parents, from the fear of punish- ment, and the substance so introduced sometimes remains there until inflammation and deafness ensues, 94 TREATISE ON THE EYE AND EAR. which may be in a few days, or possibly may continue for several weeks before it is observed. Oftentimes the circumstance is lost sight of that something was put into the ear, and when the fact has been made known immediately, it is thought nothing of, because it gives no pain; and perhaps, on looking into the ear, it cannot be seen, and may be supposed not to be there at all. I have seen much mischief done by unskilful hands, in attempting to remove substances from the ear. Insects will also frequently get into the ear and cause great distress. Wood-ticks, flies, bugs, ear-wigs, and even worms, are sometimes extracted from the ear, having been there for years. They generally crawl into the ear while a person is sleeping on the ground; and when, on waking, they discover they have pain in the ear, they naturally suppose they have taken cold, when, in fact, the pain is caused by the presence of a living insect. They have been known to remain in the ear several weeks, and be taken out alive. I have known a glass bead, that had been put into the ear of a little girl in Montreal, forced down to the bottom of the ear, in attempting to extract it, and finally the drum was split, and the bead made its way into the middle chamber of the ear, causing great pain and extensive bleeding. The child was then abandoned by the physicians, and a blister ordered to the back of the neck, with the avowed view of draw- ing it out. This child was brought to me in a terrible state of excitement and fear, from the pain she had undergone, expecting to have as much, or more, to bear from me, as the bead was still there. However, by great persuasion and kindness to the little sufferer, I prevailed upon her to allow me to make the effort, which was done by means of a small silver pump, which TREATISE ON THE EYE AND EAR. 95 was so arranged as to draw it up fr jm its bed, and placing it within reach of a delicate instrument, used expressly for removing such substances from the ear. Had this ingenious contrivance failed, the child's life must have been sacrificed. She is now well and enjoys good hearing, though that ear is of course imperfect. This operation was performed in 1849, and the patient was the daughter of Michael Kelly, of Montreal. POLYPUS IN THE EAR. This is also a source of deafness, arising from various causes. It consists in the formation of a fleshy growth, generally taking root at the bottom of the ear; is of a soft, spongy nature, and has a very offensive smell accompanying it. It destroys the hearing in course of time, if not attended to. They can be readily removed, and without giving pain, but their removal should never be attempted by any one who is not well acquainted with their peculiar nature, for by a want of suitable precaution, the drum may be injured, and the hearing destroyed. I have invented a neat little instrument for the removal of these Polypi, which accomplishes the work in perfect safety, and with the most desirable success, in less than one minute, and without the patient feeling more than a trifling uneasiness. DEAFNESS FROM UNKNOWN CAUSES. Diseases of the ear generally, arising from unknown causes, or even from the common causes, such as colds, exposure, etc., can be cured if taken in season. The principal difficulty is to get them under treatment before too much mischief has been done, or before the 96 TREATISE on the eye and ear. sensibility of the organ has been destroyed by the officious interference of ignorant pretenders, or by the voluntary use of sundry vulgar remedies, such as oils, drops, ointments, etc. The less done for such cases, that is not backed up by good judgment and a familiar acquaintance with the ear and its diseases, the more likely will the applicant be to obtain relief from the proper source. The above figure represents one of the instruments which is in daily use for the treatment of some forms of deafness, in certain conditions of the ear, and though it may seem to be a formidable-looking affair, its use treatise on the eye and ear. 97 is not attended with the least pain to the patient; the most delicate person could sit and have the treat- ment used without moving a muscle. The only difficulty in the use of the instrument is in the operator's hands. It has required great practice and much patience to realize the advantages which this beautiful discovery affords. It will no doubt prove a novelty to some medical men themselves, and will perhaps put some of them to their wit's end to decipher the principal object it is intended to fulfil, or to credit the truly magic power with which it triumphs over diseases that have withstood for years the " battle of the brave." The principle of this instrument, I believe, origi- nated with the German physicians, and has only of late years been brought into use on the continent of Europe, and even then by only one or two industrious and skilful operators. The present drawing repre- sents the one which the author invented, and has had in constant use for the last twelve years. Although it is in principle similar to the German instrument, it is entirely a different affair, and far more serviceable. It has been the direct means of restoring the hearing of several hundred patients, within the last few years. No discovery in science has ever proved itself of higher value in alleviating human affliction, than that which revealed the causes of deafness, and furnished means for their complete removal. And to this instrument, under proper management, and well directed experience, is due the fulfilment of these indications. I will here take occasion to mention, that the instrument represented in the foregoing figure is only applicable to certain forms of deafness, and is seldom 98 TREATISE ON THE EYE AND EAR. or never required on young children. Deafness in these young subjects generally arises from Scarlet Fever, Measles, Brain Fever, Influenza, or common, Cold, etc., and is seldom accompanied by any noise or sounds in the ear, like those which arise almost spontaneously in the adult. They are almost always accompanied by a discharge, more or less extensive, and usually of a very foetid odor. The mode of treating these cases is entirely different, and is not attended with the least pain or distress to the patient. Operations in such cases are extremely rare, and when required, are of trifling consequence. Much unnecessary alarm is often felt by those who require treatment for the cure of these diseases, lest they should have to undergo some formidable and painful operation ; and many, no doubt, delay giving their cases attention, from this circumstance. I can assure them, however, that it is not the case. Any operation which I have to go through with, for the restoration of hearing, either in children or adults, is neither painful nor particularly disagreeable. CATARRH OF THE HEAD. This loathsome disease, which frequently lays the foundation for deafness, and which is in itself a most disgusting complaint, when it has become fairly settled, may now be perfectly cured in from three to six weeks, with great certainty. If the disease has been of long standing, and the discharge from the nose is very copious, attended with much foetor, it may still be cured, and the entire nuisance completely eradicated, though it may require a little extension of time in very bad cases. TREATISE ON THE EYE AND EAR. 99 This disease is of common occurrence, and can seldom be removed by the treatment which is usually resorted to. I have never known any permanent benefit to be derived from the various Snuffs asually recommended for their relief. The only legitimate course of treatment is that which acts upon the diseased membrane, and arrests the discharge by re- storing the diseased surface to a healthy action. This can be done with the same success as I treat similar discharges from the chamber of the ear, or from the Eye and Lachrymal passages, for a catarrhal affection of the head is nothing more than a chronic inflammation of the mucous membrane of the nasal passage, extend- ing to the frontal sinus, which occupies the space between the eye-brows, at the lower part of the fore- head, and if long continued or neglected, it eventually affects the bones in that locality, destroys the sense of smell, and lays the foundation for deafness and consumption. Several cases of this disease have been cured by the Author, within a few months past, to whom reference can be given. DEAFNESS FROM EXCESS OF SOUND. Deafness, in various degrees of intensity, very frequently arises from excess of sound, or more properly, perhaps, by over stimiflation of the auditory nerves. In large factories, where there is an incessant rattling of machinery, particularly if the sound be of a sharp metallic nature, and continued for a length of time, deafness, more or less severe, will frequently supervene. Boiler-makers are particularly prone to this species of deafness, and frequently lose 100 TREATISE ON THE EYE AND EAR. their hearing entirely. Any loud report, like the discharge from a heavy field-piece, will frequently produce deafness the most intense and unmanageable. I have frequently been consulted by persons who completely lost the use of an ear by the heavy discharge of artillery. In some cases I have known the drum to be ruptured by the severe concussion, but much more frequently the immediate cause of the deafness is by the excess of sound, which over- comes the power of the auditory nerve. It is well known that too much light in a concentrated form will produce partial blindness, and if persisted in, will completely destroy the sight. Sound being the proper stimulus of the ear, may if too powerfully applied, and frequently does, produce partial or / complete paralysis of the auditory nerve of one or both ears. Military men and others exposed to this excess of sound by the discharge of field-pieces, should take the precaution to fill the ear with dry cotton-wool beforehand: it will at least be the means of protection, and perhaps avert an evil not easy to get rid of. Recoveries from deafness of this sort are usually tedious, and not always certain, though much good may be done if taken in time, particularly if produced by a sudden concussion of the air. Boiler-makers and others who find their hearing failing by the constant sharp sound necessary to their occupation, should also use the same precaution; but when deafness once commences in such persons, it will generally continue to grow worse, from year to year, till the hearing is quite lost. The only sensible advice to such persons is, to recommend them to change their occupation, or the consequences to their hearing will certainly prove fatal in the end. TREATISE ON THE EYE AND EAR. 101 ACUTE EAR-ACHE—DEAFNESS FOLLOWING. Common Ear-ache, which many persons are subject to, arises generally from cold and exposure, or sitting in a draught. It frequently happens that a pain of rather a severe form will attack an ear, and last for several hours, and by the aid of warm fomentations or hot applications, it will subside and pass away entirely, without being followed either with deafness, discharge from the ear, or any other inconvenience. But there is another form of ear-ache—not so frequent a visitor, produced usually by the same causes—which attacks the ear much more violently, and for a time seems almost intolerable. This form of inflammation Is termed Acute Otitis Interna, or acute inflammation of the drum and middle chamber of the ear. It is a most distressing form of inflammation, and those suffering from it do not get relief till the ear suppurates within, the matter breaks through the drum and escapes at the outer ear, thus affording great relief to the sufferer. Sometimes it will take two or three days from the commencement before the process of suppuration is complete, during which time the patient can neithei eat nor sleep, and nothing seems to be of service till the drum breaks by the pressure from behind, and the matter escapes. This, of course, is a serious termina- tion of a most painful disease, and I would advise any one having such a condition of the ear, where there is a discharge after an acute ear-ache, to give it the earliest possible attention, for the reason that the open- ing in the drum of the ear is usually small at the onset, but if the putrid discharge is allowed to continue, it will, by its contact with the healthy membrane, com- 102 TREATISE ON THE EYE AND EAR. pletely destroy the xs hole drum, and leave the chamber of the ear exposed to the influence of cold. In cases where there is only a moderate opening in the drum, the discharge should be arrested, and by so doing, very comfortable hearing may be preserved; but if allowed to continue, not only will the drum of the ear be completely destroyed, but the hearing will be ren- dered useless. In severe and aggravated cases, a sym- pathetic action will frequently be established in the opposite ear, and the hearing entirely destroyed, even beyond the chance of recovery. In the early stages of acute internal Ear-ache, the course of treatment applicable to acute inflammation of other organs would be perfectly justifiable, which every practising physician is or ought to be familiar with. After the acute stage has passed over, place yourself in the hands of some competent person, who is familiar with such cases, and you will save your- self much trouble. THE EAR CORNET, OR SPEAKING-TRUMPET. The above cut represents one of the most approved and useful kinds of Cornets. TREATISE ON THE EYE AND EAR. 103 Persons who are very deaf, and who are not able to hear unless by shouting in the ear at the top of the voice, will frequently be able to hear common conver- sation at a distance. Many persons avail themselves of these instruments, and manage to do business with them, not being able to obtain relief from their deaf- ness through other means. THROAT DISEASE FREQUENTLY THE CAUSE OF DEAFNESS. It is a fact not generally known, that many diseases of the ear, and deafness in various degrees, commence in the Throat; hence it is, that some persons find their hearing quite dull during the prevalence of a common cold, which usually attacks these parts, and when the cold passes over, they generally find the hearing restored again. In the same way, those who are deaf, or hard of hearing, find the hearing much worse during one of their catarrhal attacks; in fact, at such times, their hearing is little better than useless. I do not intend, in this work, nor would it be advi- sable, to attempt an explanation of those peculiarities in regard to the hearing. Suffice it to say, that diseases of the throat frequently lay the foundation for deafness the most obstinate and unmanageable; and when par- tial deafness, or an occasional dullness, is discovered, or even a feeling of stuffing is experienced during the prevalence of a cold, or of a continued chronic irritation of the throat and its membranes, it would be in every way desirable that treatment should be resorted to, with a view of allaying it, and by so doing, it will be the means of cutting off an attack of deafness, which would otherwise prove troublesome to get rid of. 104 TREATISE ON THE EYE AND EAR. The air passage, or tube which conveys air to and from one of the chambers of the ear, opens into the side of the throat, and as perfect hearing cannot be enjoyed when this passage becomes the seat of obstruction, so that the air is prevented from passing in and out with freedom, deafness, more or less com- plete, will be experienced ; and when such obstruction takes place, the hearing can never be restored till this condition of the tube has be of this work, to which the fol- lowing letter from a distinguished physician briefly refers : "TO WHOM IT MAY CONCERN. " It affords me pleasure to say that I have exam- ined and used in my family the remedy, discovered and manufactured by Dr. F. A. Cad well, for the cure of Neuralgia, etc., called 'Lacteal Nervine,' and am more than pleased with it. " I regard it a remarkable remedy, containing ingredients that almost instantly control pain, and would recommend persons afflicted with the diseases for which it is recommended, to give it a trial. L. R Herrick, M.D. Albany, N. Y., Nov. 30th, 1867." MEMORANDUM NOTICE. To prevent misunderstanding, and for the better information of those who may wish to make applica- tion to DR. F. A. CADWELL. OCULIST and AURIST, NEW YORK., The following are the only conditions and terms upon which patients will be received for treatment: First.—No charge will be made to any person wish- ing an examination and an opinion respecting the Sight or Hearing. Second.—Patients whose cases are considered incur- able will be so informed on their first visit, and no fee will be required of them. Third.—Doubtful cases will be received conditionally, and treated for a few days as trial cases, and charged accordingly. (114) MEMORANDUM NOTICE. 115 Fourth.—Charity patients will be attended gratis, at the unoccupied moments of the operator, upon their depositing Five Dollars with the Apothe- cary, to pay for their medicine. Fifth.—All other patients received under treatment will be charged a fee, which will be agreed upon before operations are commenced. Sixth.—Where a patient does not attend regularly, the operator will not hold himself answerable if a cure be not performed. Seventh.—No cures guaranteed under any circum- stances unless given in writing, and the full charge paid in advance. Eighth.—Patients leaving treatment without giving notice, and who are rendered worse in conse- quence, will be received only as new patients, and on the same terms. Ninth.—Patients on leaving usually require both treat- ment and instructions, to strengthen and pre- serve the weakened organs, and to prevent a return of the disease. This will always be furnished them on the payment of their fees, which will entitle them to a renewal of treat- ment, (should it become necessary), at any period within a year, without additional charge. Tenth.—All difficult and dangerous operations, involv- ing much responsibility, will be duly considered beforehand, and when approved will always be performed in the presence of, and with the con- currence of, other competent medical gentle- men, LETTER From His Lordship, BISHOP DE CHARBONELL, Roman Catholic Bishop at Toronto. Toronto, 25th April, 1854. Dear Doctor : I thank you for the learned copy you sent me of your work, and for its reference to me. Yet, in- deed, I am indebted to your most experienced eyes for the preservation of mine. Had I not preferred your prophetic decision to the other one given me,— with the best intentions no doubt—I would have lost my two stars, which, thank God and you, are still shining, in spite of their having been condemned to a double dark Cataract. Please to accept my best thanks and wishes, and believe me, Dear Doctor, Your most devoted servant, f Reverend F. M. DE CHARBONELL. To Dr. F. A. Cadwell. (116) REFERENCES. CANADA. The Right Rev. FRANCOIS MA- RIE DE CHARBONELL, D. D., Rom. Catholic Bishop at Toronto. The Very Rev. JOHN CARROL, Vicar General. Hon. J. G. SPRAGGE, Vice Chan- cellor. Hon. MALCOLM CAMERON, Post Master General. GEO. DUGGAN, Esq., City Re- corder. J. BEVERLEY ROBINSON, Esq., Ex-Mayor. JOHN DUGGAN, Esq. WM. CAWTHRA, Esq. JOHN CAWTHRA, Esq. lion. JUDGE GALE. Hon. DENNIS B. VIGER, M. P. P. Rev. F. X. MARCOUX. Rev. ANDREW T. LEGARD. W. II. WILSON, Esq. D. B. PAPINEAU, Esq., M. P. P. E. PARENT, Esq., Assistant Pro- vincial Secretary. Dr. HUNTER. Dr. OGDEN. Dr. SEWELL. Dr. EDDY. Dr. ROWELL. GEORGE L. ALLEN, Esq. ALEX. LEITH, Esq. R. P CROOKS, Esq. CASSIMER S. GZOWSKI, Esq. RICHARD L. DENISON, Esq. J. V. BATTERSBY, Lieut. Royal Navy. CHARLES MAGRATH, Esq. ANDREW DRUMMOND, Esq. MATTHEW SWEETNAM, Esq., Assistant Post Master. W. H. FELTON, Esq., M. P. P. SAMUEL PARKER BIDDER, Esq., Engineer Grand Trunk R. R. Captain PAGE, Royal Engineer Department. (117) MONTREAL: 118 REFERENCES. QUEBEC J. MORIN, Esq., President Que- WM. MARSDEN, Esq., M. D. bee Medical Board. J. Z. NAULT, Esq., M. D. JOSEPH CAUCHON, Esq., M. JAMES SEWELL, Esq., M. D. P.P. KINGSTON: JOHN COUNTER, Esq., Mayor. ROBERT STEWART, Esq., M. D Judge KENNETH MACKENZIE. J. MORTON, Esq. WM. HAYWARD, Esq., M. D. CAMERON & LIVINGSTON- E. J. BARKER, Esq., M. D. BELLEVILLE: WILLIAM HOPE, Esq., M. D. J. H. MEACHAM, P. M. JAMES LISTER, Esq., M. D. E. W. HALTON, Esq. S. S. FINDEN, Esq., Collector of WELLINGTON MURNEY, Esq. Customs. SHERBROOKE: THOMAS C. ALCORN, M. D. T. D. WORTHINGTON, Esq. M. D. BROCKVILLE THOMAS F. McQUEEN, Esq., Dr. GARVEY. M. D. EDWARD C. MALLOCH, Esq. THOMAS REYNOLDS, Esq., C. VANARNAM, Esq. M. D. HAMILTON: Very Rev. E. GORDON, Vicar Gen. Dr. DUGGAN. A. P. McDONALD, Esq. Dr. HUNTER. ALEX. CARPENTER, Esq. A. DRYSDALE, Esq. LONDON: Right Rev. Dr. PINSONEAULT, HENRY C. R. BEECHER, Esq. Rom. Cath. Bishop of London. D. FARRAR, Esq., M. D. Hon. GEO. JARVIS GOODHUE. JAMES DANIELS, Esq. ST. CATHERINES. T. MACK, Esq., M. D. LUTHER CROSS, Esq., M. D. Captain BOYD. J. L. RANEY, Esq. ROBERT FOSTER, Esq., H. B. REFERENCES. 119 NEW YORK. Gov. JOHN T. HOFFMAN. VALENTINE MOTT, M. D. JACOB WESTERVELT, Esq. R. E. HATCH. Esq. R. A. GOOD ENOUGH, Esq. J. B. HERRICK & SON. LOUIS BURLINGAME, Esq. Gen. T. WOODHULL, Albany. SAMUEL ROBINSON, Esq., « J. CONSTANT, Esq. HOWARD G. FORD, Esq. Major GEORGE BOYD. J. J. BOYD, Esq. MELLEN & WILCOX. Dr. JAMES R. WOOD. Surgeon Bellevue Hospital. Dr. N. R. ROVVE, 20th St., N.Y Capt. P. HAMMOND. HENRY J. TRAVER, Esq. A. M. S. CARPENTER.Esq., P. P. LEARNED. Esq. GEO. BUCHANAN, Esq. Major PHILIP OSMONT. JACOB BUR HANS, Esq. W. J. HASKETT, Esq. SILAS C. BEMIS, Ex-Mayor. WM. STOWE, Esq., Postmaster. H. L. HOFFMAN, Esq. P. L. WILLIAMS, Esq. WM. B. WOODWARD, Esq. DAVID R. LEE, Esq. JOHN R. BRIGGS, Esq. SIDNEY ROSS, Esq. GEO. B. CHANDLEY, Esq. RANDOLPH LADD, Esq. W. WHITTIER, Chicopee. JOHN MERRILL, Chicopee. JOHN D. EMERSON, Holyoke Mrs. AUSTIN SMITH, Gran by. DANIEL E MACKEY, Esq. WM. REDWOOD, Esq. GEO. VERMILYEA, Esq. DEXTER B. BRITTON, Esq. E. J. VANDERHOFF, Esq. GEO. W. FARRINGTON. JAMES H. KNAPP, Esq. Gen. JOHN E. WILCOX. ALDEN THAYER, Jr., 0. & N. W. R. R, Co. MILTON St. JOHN, N. Y. Central R. R. JAMES WILKESON, Esq. N J. Central R. R. ROYAL 0. DEAN, Esq. J03IAH BRIGGS, Esq. Rev. JAMES McEVOY. J. N. McINTIRE,Esq., H. D. GOODRICH. Esq. SAMUEL J. LLOYD, Esq. ABM. LIEUGUOR, Newburgh. JAMES RABBITH, Hartford. Capt. W. BOGGS, Brooklyn. C. R. CONNELL, Paterson, N.J. LYMAN BLAIR, WM. A. CHAPIN, Esq. Mrs. R. NORTON. SAMUEL MOSS, Esq. Mrs. ALEX. CHAPIN. DAVID BEACH, Esq. Miss CHARLOTTE WILLARD. FRANCIS TERRY, Esq. Mrs. E. C. WARNER. WM. TUCKER, Esq. JOHN REYNOLDS, Hazz'dville. Mrs. H. B. EGERTON, Agawam ORIN WILLIAMS, Amherst. GEO. GRAVED Amherst. MASSACHUSETTS. SPRINGFIELD. 120 REFERENCES. MASSACHUSETTS. NEW BEDFORD: Capt. JOSEPH C. DELANO. Capt. THOMAS NYE. RODNEY FRENCH (Mayor). Capt, THOMAS HOWL AND. Capt. JOSEPH FULLER. Capt. STUDLEY. CHARLES SLOCUM. EBENEZER SCREEN. NATHANIEL H. NYE. HOLDEN HOWLAND. Capt. FRED. WINSLOW. Capt. CHARLES WOOD. JOHN J. TILLINGHAST. HIRAM WHEATON. THOMAS KNOWLES. ZENUS CHADWICK. CHARLES DUNBAR. Dr. JOHN MACKAY. Dr. SISSEN. WM. P. S. CADWELL. Capt. BENJAMIN B. CHURCH, Cuttle Hunk Island. NATHANIEL MAYHEW, Mar- tha's Vinyard. CHARLES BROWNELL, Little ComDton. CHRISTOPHER BROWNELL, Little Compton. Capt. STEPHEN SWIFT, Ware- ham. BENJ. W. TERRY, Fair Haven. PHILEMON FULLER, do. Capt. ANSEL TRIPP, do. RHODE ISLAND. PROVIDENCE: Dr. NATHANIEL MILLER. Dr. J. BECKWITH. Dr. AMOS PALMER. Dr. HOPPIN. THOS. NIXON. ISAAC SOUTH WICK. EDWARD WALCOTT. MATTHEW SWEET. CHARLES W. CADY. E. H. PECKHAM. JOHN 0. DARLING. GEO. B. JASTRAM. GEO. BRITTON. GIDEON SMITH, Pawtucket. GEO. DOTY, Bristol E DW ARD L. WILKINSON, do. EMOR COE, Woonsocket ALBERT R. COOK, Warren. ELIAS BALCOM do JOHN P. BABCOCK, River Point. Capt. E. A. SWIFT Warren REFERENCES. 121 ILLINOIS. CHICAGO: Hon. STEPHEN A. DOUGLAS. Judge ROBERT S. WILSON. Hon. JOHN WENTWORTH, late Mayor of Chicago. GAGE, BROTHERS & DRAKE, Tremont House. Col. J. A. MARSHALL. GEO. W. WILLIAMS. WM. N. BRAINARD. JUDGE PEASLIE. ZENUS COBB. S. P. ROUNDS, ) Sunday EDWARD BLISS, j Leader. J. J. WRIGHT. L. II. CLARK, Engineer I. C. R. R. R. R. CLARK. R. M. HOUGH. GEO. E. CONRAD. OTHO KLEMM. WM. A. BUTTERS. THOS. DOUGALL. JONES PATRICK. JOSIAH CUTLER. Hon. W. B. EGAN, M. D. ROBERT STUART. Dr. FREDERICK THAYER. BISSELL & GOODRICH, Matte- son House. Dr. E. HONSINGER. J. F. BARNARD. JOHN T. GOLDSMITH. Dr. CHAS. W. DYER. CORNELIUS JOHNSON, Brigh- ton House. HENRY M. SMITH, Local Editor Press and Tribune. Hon. ISAAC COOK, Post Master. JOHN W. MAGILL. F. B. GARDNER. Mrs. BULIA A. McGRATH. WM. M. HOYT. JOSEPH E. MOSS. W. W. MITCHELL. Capt. E. D. OSBAND. J. D. WEBER. GARRY BATES, Cottage Hill. JOHN HOG AN. WxM. BROWN. JOHN G. FISHER. Capt. C. P. BRADLEY. EDWIN L. BRAND. S. D. COMSTOCK. ROBERT EDSON. Capt. C. WHITING. G. C. BRADFORD. R. J. REEKEN & CO. PAUL KELLY. JOHN L. WALSH. SAMUEL SHERMAN. P. W. GATES. WM. SMITH. GEO. D. WOODWORTH. Dr. JOHN HOUSE. JOHN A. JEMISON. JOHN SOLLITT. T. BASSETT. II. K. SMITH. ALONZO J. SAWYER, Professor of Mathematics in Chicago University. Col. JOHN S. KERR. G. T. BEEBE. 8 * 122 REFERENCES. ILLINOIS. Dr. WM. ENGLISH,......Warsaw. SAMUEL MERRITT, Rockford. JORDAN STUART,..........Peru. WM. HAWLEY........Barrington. LUCIUS BOTTSFORD,... Lisbon. GARNER OLIVER,.......Onarga. ISAAC CECIL,..................Peru. Mrs. TITUS.....................Tonica. D. D. MERCHANT, Farmington. L. C. KING.................Princeton. NORTON KELSEY.........Galva. FRANK BARBER,.......Harlem. C. B. WOODRUFF,.... JanesviUe. MILES ALLEN,.............Danby. JASPER HAVEN,.........Seneca. JOSEPH E. NORTON, Liberty- ville. —Continued. JOHN DALE,.... Kankakee City. Mrs. A. B. NICHOLS, do. do. Mrs. FRANK JONES, do. do. GEO. C. STANLEY.......Victoria. JAMES SMITH,.....Washington. JOHN WILLEY...............Flagg. GEO.COURTRIGHT, Middleport. G. B. LARISON.....Bloomington. W. R. McCRACKEN, do. Dr. C. R. PARK....... do. DAVID CRANDALL.....Urbana. CHAS. CRANDALL, do. JNO. STUART, Blackberry Sta- tion. WM. BAXENDALE, Hennepin. JOHN B. FOX......._ Blue Island. WM. A. BOARDMAN, Wauke- gan. MICHIGAN. JULIUS D. MORTON,.... Detroit. Hon. IRA MAYHEW,.... Albion. C. B. BLAIR,......Michigan City. SAML. H. STEVENS, Muskegon. Dr. A. J. PARK..............Detroit. Col. BIDDLE, Biddle House, do. EDWARD DELANY,......... do. GEO. W. DRYER,........Marengo. FRANK SPAFFORD, Manches- ter. EDWARD ORR..............Detroit. GEO. W. HOFF,..........Ypsilanti. JOHN EMERY OWEN, Detroit. Judge BACON,...............Monroe. JOSEPH STERLING, do. ELIZIER CARVER.............Lee. Dr. J. A. SECORD.............Clide. WARREN DUNNING, Pontiac. ALLEN T. HARRIS, Dearborn. Capt. JAS. S. ABEEL, Ordinance Department,..........Dearborn. R. BLACKWOOD,.....Northville. LEVI BABBITT,.....Grass Lake. Mrs.KATE A. ALDRICH. Parma. GILES HUBBARD, Mt. Clemons. WxM. GRACE,...............St. Clair. A. M. KIMMIS.....New Hudson. THOS. E. DOUGHTY,.... Detroit. GARRY GOODRICH,.....Lapeer. Dr. H. R. BABCOCK, New Cle- mons. J. C. LARIMORE,.............Niles. DWIGHT INGRAHAM, Sturges. WM. ALLMAN,............ do. S. L. BAILEY......Grand Rapids. WM. H. RUMSEY,.........Albion. CHARLES FARGO (Am. Exp.), Detroit. REFERENCES. 123 WISCONSIN. HAZAEL NEWCOMB, Two Rivers. JOHN MATHER.......East Troy. PERRY P. SMITH, Manitouwoc. JUDGE SAMUEL HALE.....Ke- nosha. H. B. HINSDALE........Kenosha. MARSHAL A. NORTHROP, Beloit. S. N. BASYE,.................Racine. FELIX DUFFINS, Rail Road Contractor.....Winona, Minn. JOHN T. HALL,.... Clinton, Ind. ISRAEL FISHER, Jones Co., Iowa. HENRY FOOT, Leavenworth City, Kansas. K. W. KERR........La Porte, Ind. Mr. CURRIER, Valparaiso, Ind. Gen. ASHER N. CORSS, Madi- son. JOHN McGILTON,... Eau Claire. Mrs. R. A. Bolster,.........Eureka. JOHN BUCKSTAFF, Oshkosh. JAS. H. FOSTER,..... do. Dr. MARCUS SWAIN, do. J. H. HERREN........Shullsburg. R. D. JENNINGS.....Milwaukee. FERNANDO J. MORANO, U. S. Marshall,.......Key West, Fa. CHANDLER McWAYNE, Michi- gan Bluffs, California. Mrs. Dr. BARTON STREETER, Brownsville, Minn. J. F. MADISON, Davenport, Iowa. HENRY SUMMERS, New Or- leans. MISCELLANEOUS. A NEWLY INVENTED APPARATUS For applying MEDICATED VAPOR to the INTERNAL EAR, in certain forms of Deafness, accompanied with more or less noise, and no discharge. EXPLANATION. A—An upright bellows, which, when in use, is filled with atmospheric air. B—A small flexible tube, which conveys the air from the bellows to a glass retort. C—A spirit lamp. D—A thermometer, to regulate the heat required to varporise the medi- cines. E—Elastic tube, with silver catheter attached, conveying the medicated air to the middle chamber of the ear, which is generally the seat of the disease. (124) RECENT VALUABLE DISCOVERY —IX— AURAL SCIENCE: AN IMPROVED METHOD Of treating those forms of Deafness which generally ARISE FROM COLD, progress slowly, and are accompanied with more or less Noise in the Ears, or Head, but without Purulent discharge. Through the agency of a celebrated foreign physi- cian, I have been put in possession of some very valu- able information of a recent discovery, which has been found of infinite service in the treatment and cure of that class of deafness referred to above. It has been tested abroad in a great many cases, and its effects in removing the mysterious agent which has hitherto defied our utmost skill and ingenuity, and firmly resisted all our efforts, are spoken of in the most glowing terms. The apparatus by which the treatment is admin- istered to the patient for the restoration of hearing, is represented in the preceding engraving. It is per- fectly simple in its construction, and altogether harm- less in its application. The body of the instrument is a bellows of a peculiar construction, having a trea- dle, or foot-piece, by which a constant blast can be kept up, as long as may be required for each sitting. From the centre of this receiver is an elastic tube, (125). 126 VALUABLE DISCOVERY IN AURAL SCIENCE. which leads to a glass retort, in which are placed the different medicines required for use, and this is pro- vided, also, with a thermometer, which enables the operator to regulate the degree of heat necessary to vaporize the articles used, and a small spirit lamp is placed below for that purpose. From the retort, also, leads another elastic tube, which is conveyed to the patient, who being suitably prepared with a head bandage which secures a small silver catheter, pre- viously introduced into the Eustachian tube, is now ready to receive the treatment. There is not the least pain or unpleasantness in the whole operation, but on the other hand, its effects are both soothing and agreeable; and in most cases, the patient finds prompt and speedy relief. We can readily understand that in these days of scientific discovery, when so much has been done by the specialist, in removing and completely curing pulmonary diseases, Catarrh, Bronchitis, and all that class of diseases which affect the mucous membranes about the throat and lungs, that deafness, which gene- rally has its origin in cold, caused by exposure in various ways, may also be treated with equal if not a greater degree of success; for in deafness there is generally but a small surface to act upon, and when this morbid condition once takes place, though it is too insignificant to cause pain, or any physical suffer- ing, it manifests itself in such a manner that it is not very readily forgotten. This form of deafness is nothing more or less than an inflammation of the mucous membrane of the ear, and air passages leading from that organ to the throat When they become diseased, as by cold, they swell, and by that swelling close, and thus shut off the cir- VALUABLE DISCOVERY IN AURAL SCIENCE. 127 culation of air from the chamber of the ear; without which, hearing must be more or less imperfect. De- prive the auditory nerve of its proper stimulus, and it soon becomes enfeebled, and undergoes a steady depreciation as long as the disease continues, and ceases at last to be of any use, rendering deafness complete. In this newly discovered method of treat- ment, nothing more is desired than to reduce the dis- eased membranes again to a normal condition, by which the air passages may be set free, the different avenues opened for free circulation, giving the auditory nerve its proper degree, of healthy stimulation, and by so doing, the natural secretions of the ear are again re- stored, the tympanum soon recovers its lost sensi- bility, the auditory nerve revives in action, and sounds are again received into the auditory chamber with a degree of acuteness that leads the patient to believe (by the great transition) that his hearing is even more acute than ever. ARTIFICIAL EYES. A GREAT REDUCTION IN PRICES. Dr. Cad well, having recently completed arrange- ments with a Paris House for the supply of these beautiful specimens of art, will be able in future to furnish and insert them at a very considerable reduc- tion from the usual prices. Those who have had the misfortune to lose an eye can now have the place supplied by the insertion of an artificial one, which will be so complete an imita- tion to the sound organ as to defy detection. Noth- ing in Nature can be more perfect. They are inserted and worn without the least pain or uneasiness, and partake of all the natural motions of the sound organ, to which they bear an exact resemblance. Parties wishing an Artificial Eye, can have one inserted that will in every particular afford the most perfect satisfaction, and at prices that will be entirely within the reach of every body. All eyes supplied by Dr. C. are warranted to be the best French imported. For particulars on Artificial Eye, the reader can refer to the article under that heading, on page 64 of this Treatise. (128) MEDICAL DIPLOMAS. UNITED STATES MEDICAL DIPLOMAS. [translation.] TO ALL WHO SHALL SEE THESE PRESENTS--Health: Whereas, Academic Degrees have been instituted to this end, that men endued with talent and learning should be rendered illustrious above others by titles, in order that they themselves might be benefited thereby, as well as that the industry of others should be stimulated, and the study of virtue and good learning [Belles Lettres) should be promoted among men ; and whereas, these most ample rights conferred upon our College by Public Charter have this end particularly in view; therefore be it known that we the President and Professors of Jefferson, College, in the State of Pennsylvania, have created and constituted F. A. CADWELL, Doctor of Medicine: an upright man, and most endeared to us on account of his courteous manners, and all those qualities which grace ever the best man; who also by his great skill, both in the Medical and Surgical Art, acquired by him in our College, and made more manifest to us by an examination publicly held, has shown himself worthy 9 (129) 130 DIPLOMAS. the highest Academic honors; and to him, the afore- said F. A. CADWELL, we have most willingly and unreservedly granted and ratified all the rights, honors, and privileges pertaining to the Degree of Doctor of Medicine, both among ourselves and every- where. In faith of which let this Parchment, subscribed to by us, and attested by the seal of our College, be evidence. Given in the Medical Hall, in the City of Philadel- phia, this eleventh day of the month of March, in the year of Human Redemption,' 1837, and in the 61st year of the Independence of the Federated States of America. Signed: ASHBELL GREEN, D. D., L. L D., President. GRANVILLE S. PATTISON, M. D., Prof Anatomy. GEO. McCLELLAN, M. D., Prof of Surgery. J. REVERE, M. D., Prof, of Practice of Medicine. JACOB GREEN, M. D., Prof of Chemistry. S. CALHOUN, M. D., Prof of Materia Medica. SAMUEL McCLELLAN. M. D., Prof, of Midwifery. ROBLEY DUNGLISON, M. D., Professor of the Institutes Medicines and Medical Jurisprudence. PROVINCIAL DIPLOMA. [L. S.] Province of Canada. His Excellency Lieutenant General the Right Hon- orable Charles Murray, Earl of Cathcart, of Cath- cart, in the County of Renfrew, K. C. B., Governor DIPLOMAS. 131 General of British North America, and Captain General and Governor-in-Chief in and over the Pro- vince of Canada, Nova Scotia, New Brunswick, and the Island of Prince Edward, Vice Admiral of the same, and Commander of Her Majesty's Forces in British North America, &c, &c. To all to whom these Presents shall come, or to whom the same may concern—Greeting : Whereas, Frederick A. Cadwell, of the Parish of Quebec, in the District of Quebec, in that part of the Province of Canada which heretofore constituted the Province of Lower Canada, in pursuance of our act or ordinance passed on the thirteenth day of April, in the twenty-eighth year of His late Majesty King George the Third, entitled " An Act or Ordinance to prevent persons practising Physic and Surgery within the Province of Quebec, or Midwifery in the Towns of Quebec and Montreal without license," hath been examined and found qualified to practise Physic, Surgery, and Midwifery in the aforesaid part of the Province of Canada, as more fully appears by the Copy of the Certificate hereunto subjoined among other testimonials, permission is hereby granted to him for that purpose as the law directs. Given under my Hand and Seal at Arms, at Montreal, in the said Province, this Sixth day of Novem- ber, in the year of our Lord, One Thousand Eight Hundred and Forty-Six, and in the tenth year of Her Majesty's Reign. (Signed,) CATHCART. By Command. D. Daly, Secretary. 132 diplomas. QUEBEC MEDICAL BOARD. We, the undersigned, Medical Examiners, for the District of Quebec, have examined Frederick A. Cadwell, Esq., M. D., and find him duly qualified to practise Physic, Surgery, and Midwifery, accord- ing to law, in the Province of Canada. (Signed,) J. MORIN, Chairman. ED. ROUSSEAU, JAS. A. SEWELL, M. D., J. Z. NAULT, FRS. FORTIER, JAS. PAINCHAUD, J. B. BLAIS, J. BLANCHET. Quebec, Hotel Dieu, 3d November, 1846. (A true Copy.) D. Dal7, Secretary. / 134 miscellaneous cases MISS CARRIE MACKEY. Just before submitting to an operation for the re- moval of a diseased eye, resulting from an accident at the age of six months, which was performed Sept. 21st, 1861, by Dr. F. A. Cadwell, at Chi- cago, Ills., assisted by Dr. Dyas. The entire mass, eye included, was removed down to the bottom of the orbital cavity, and presented a mass of fungous matter the size of a duck egg; child recovered rapidly, and returned home with her parents on the 7th day after the operation, apparently much improved by the removal of the diseased mass. AND OPERATIONS. 135 CASE 1. Extirpation of Diseased Eye Entire. Miss Carrie Mackey, aged 4 years, daughter of Joseph Mackey, Esq., of Reedsburgh, Sauk Co., Wisconsin, had a disease of the ball of her left eye, supposed to have been caused by the acci- dental crack of a whip when six months of age, which not only destroyed the sight, but the whole organ became a mass of firm, solid desease, much of the appearance of Fungus Hematodes, as shown on the preceding page. When first discovered it was only a trifling in- flammation, with occasional divergency of sight, and at intervals for a few weeks, since that period and up to the time of the operation it has changed from better to worse alternately, until it has at last assumed its present formidable shape. The child's health is otherwise tolerably good, and has been since the date of the injurv; sight of the right is also good, and the disease apparently not painful, still, the child avoids the light, and the disease is growing rapidly. Am fully of the opinion that an operation must be made, and the whole mass of disease (eye included) removed from the orbital cavity, and in this opinion I am* sustained by other competent medical gentlemen, whose valuable services I secured. The patient having been previously placed under the influence of chloroform and the entire mass of disease removed. Operation made at noon, the 19th of Sept., and on the 20th at same hour saw the patient, found her comfortable, with but little suffering since the operation, and quite cheer- 136 MISCELLANEOUS CASES ful, having rested well all night; returned home with her parents on the 26th, fully recovered from the effects of the operation, and socket filling and healing rapidly. By a letter received from her father some months after their return to Wisconsin, I was informed that my little patient was in the full enjoyment of robust health, with no traces of returning disease. CASE 2. Blindness of a Physician's Daughter. Sight Restored. Miss Sarah, daughter of Dr. -Cornelius Blachley, of Wheeler, Ind., aged 17 years, was brought to me in May, 1861, being then entirely blind in both eyes, by a severe attack of Chronic Granular In- flammation of her eyes, which she had had for several months, and which stubbornly resisted every means of treatment, both at the hands of her fa- ther and others. She was brought to me at date above stated, for treatment, and was cured com- pletely, after two months faithful attendance, and returned to her home sound in sight and free from blemish in either organ, a result that could scarcely have been looked for at the commencement of my attendance. The complete success attending the treatment of this young lady's eyes, both among her friends and the medical profession, in that section of country, was received with as much surprise as it was gratifying to herself, her case having been generally considered as incurable. She still con- tinues to enjoy the blessing she has received. " Facts are stubborn things." AND OPERATIONS. 137 CASE 3. Double Cross-Eyes. Augustus Wood, Grotou Junction, Mass., son Willie, aged 7 years, has Double Cross-Eyes since two years of age, which greatly impairs his sight, and spoils his otherwise fine appearance. Chloro- form was adminsterd and the two eyes made straight in a few moments, without his knowledge or reason, and the result has given entire satis- faction to all who know him. His eyes are now perfectly straight, and sight good, and with his fine intellegent face, so changed by this little operation, that he is scarcely recognized by his young com- panions. CASE 4. Blind Ten Years. Sight Restored by Artificial Pupil Operation. Geo. W. Dryer, Marengo, Calhoun Co., Mich., aged 50 years, lost the sight of his right eye from a severe attack of inflammation, with ulceration and sloughing of the Cornea, which had troubled him for ten years, and the left was materially affected by sympathy, and was in great danger of being lost also. After subduing the severity of the dis- ease by appropriate treatment, which was accom- plished only at the end of several weeks attendance, I proposed to restore the sight of the right eye by the formation of an artificial pupil, which was ac- ceded to by the patient, and on the first of January, I860, I formed a new pupil with perfect success, by which means the light was immediately admit- 138 MISCELLANEOUS CASES ted to the chamber of the eye, and good vision restored. Nine years have elapsed since this operation was made, and sight continues good. Having seen and examined Mr. Dryer's eyes this Friday, June 18th, 1869,1 cheerfully record the above at his own solic- itation, giving his present full address. " The above statement respecting the condition of my eyes, and operation and its result, as made by Dr. Cadwell, nine years since, is perfectly true and correct." GEO. W. DRYER. CASE 5. Blindness from Granulations. Mrs. Gr.W. Whitney, of Farmington, Ills., applied to me in March, 1868, for advice, having been for four years gradually losing her sight, by dis- ease that her physicians were unable to remove or arrest, and was then nearly or quite blind in con- sequence. She was received under treatment at once, and in the course of two months found her- self in possession of both health and sight, render- ing a longer stay from her family and home quite unnecessary. In this case the patient's general health had suffered considerably by the long con- tinuance of her disease, which neccessarily rendered her habits sedentary. As the disease and dense fog which so long obscured her visual organs began to lift, evident signs of general improvement were manifest, and continued until complete. AND OPERATIONS. 139 CASE 6. Disease of the Eye Lids of Fifteen Years' Standing Cured in Four Weeks. J. Hobert Herrick, of the house of J. B. Her- rick Kov 1 of 1 8^0 Master Mechanic and Engineer, uctooer 1st, isoy. 204 North Union Street Little Girl Three Years of Age cured of severe Inflammation of the Eyes. I am most thankful for the opportunity offered me of adding my humble testimony to the numerous cer- tificates you possess, in having within a few weeks past removed a very serious and protracted disease from the eyes of my infant daughter, now but three years of age. She took cold when about four months of age, which settled in her eyes, and from that time until I brought her to you, she has never been free from the disease, and her eyes gradually grew more misty, until the organ seemed almost concealed from view. Having but little confidence in the ability of regu- lar practitioners, I never allowed her eyes to be treated by them; and having also a greater horror of quacks and impostors, I preferred to take my chances that under our own care and attention she would fare much better, until such time as I could find some one more skilled in that particular. Your treatment of her case during the short period she was under your charge, has given me entire satis- faction, as she can now open her eyes to ordinary light, without the least trouble, and bears exposure to the sun with astonishing ease. Her eyes are bright and clear, and possess more strength than I supposed she would ever enjoy, from being in so young and tender a subject. CERTIFICATES. 175 For this great blessing, please accept my most sin- cere thanks, and be assured I shall sound your name abroad, in terms of merited praise, for the very satis- factory manner in which you have treated dear little Clarai our only treasure. HAZAEL NEWCOMB. Two Rivers, Oct. 3d, 1859. Blindness, accompanied with very feeble health, of Four Years' standing.—Health and Sight both restored in One Month. I certify that my wife Margaret, aged twenty years, whose home is in Muskegon. Mich., has been blind for about one year, from inflammation of her eyes, caused by taking cold. I had her eyes treated by several doctors where I reside, but she got worse, from time to time, and at last was so completely blind that I was much afraid she would never recover her sight. Her blindness was also coupled with very bad health, which rendered her quite helpless. When I took her to Dr. Cadwell, about the first of September, she could not stand upon her feet alone, and was also entirely blind. In one month she has recovered both health and good sight, has a good appetite, and is very fast recovering her usual health. Her eyes are also quite well, and free from inflammation, and she will in a few days return to her friends m Michigan. FRANK KUHN. Chicago, Sept. 5th, 1859. LETTERS FROM MEDICAL GENTLEMEN AND OTHERS. Letter from Dr. MARSDEN, of Quebec. Quebec, 18th Sept., 1848. Dr. F. A. Cadwell : Sir :—I have much pleasure, on the occasion of your departure from Quebec, after a residence of up- wards of twelve months, in testifying my opinion of the general success of your practice, as an Oculist and Aurist, in this city, and wherever I have had an opportunity of witnessing it. Having had occasion to assist you in many of your most important and critical operations on the eye, I can bear testimony to the uniformly skilful manner of operation, and the generally successful character of them; and I congratulate the afflicted in either of those organs, on the opportunity that your presence among them will afford, of obtaining as great an amount of relief as human means can effect. Although to particularize any operation in prefer- ence to another, where all are good, may seem invidi- ous, yet I cannot but remark that your operation for 12 (177) 178 LETTERS. fistula lachrymalis (which I have several times wit- nessed), is an unrivalled piece of surgical skill and tact. Wishing you continued professional success, I have the honor to be, Sir, Your most obedient servant, WM. MARSDEN, M. D. Certificate from VALENTINE MOTT, Professor of Surgery in the New York Medical University. Understanding that Dr. Cadwell intends leaving the city for a residence in the country, it gives me pleasure to state that I have had frequent interviews and consultations with him. I feel a confidence in recommending him to the notice of those among whom he may reside. VALENTINE MOTT. New York, July 13, 1844. Another from the same New York, October 10th, 1846. Dear Doctor : Your letter of the 4th instant was received to- day. I am pleased to hear that you have located yourself in Montreal, and shall be glad to hear of LETTERS. 179 your success; and any service I can render you in the way of advice will be cheerfully furnished on all occasions. From the opportunities you have had in this city, of acquiring a knowledge of the profession, I feel confident y©u will be able to establish yourself with character and usefulness in Montreal. With the best wishes for the prosperity of yourself and family, I remain very respectfully yours, VALENTINE MOTT. Letter from the Rev. JAMES COOKE, D. D., Bishop of Three Rivers. [Translated from the French.] Dear Doctor : I hear, with pain, that you are about to leave us. The pleasure of your acquaintance and of your com- pany, and the service you have rendered a large number of my parishioners, by the able exercise of your noble profession, imposes on me the obligation to thank you, and to assure you that the news of your return amongst us will be most agreeable. Miss Cooke, who submitted to an operation by your hands, has now her mind tranquillized as to the danger of losing an eye. Mr. Dostie is highly pleased with the success of your treatment. His eyes are perfectly cured. He will himself explain to you by writing all his acknowledgments. It is the same with our Rev- 180 LETTERS. erend Mother Superior, who has had a more grand evidence of your care and attention in her behalf. Health, happiness, and prosperity be with you and your respectable family, Is the sincere wish of your very Humble and most obedient Servant J. COOKE, Bishop of Three Rivers, To F. A. Cadwell, Esq., M. D. OPINIONS OF THE PRESS. --------------■ ■»«► .------------- Successful Operation on the Eye of a Young Woman, Twenty- One Years of Age, Blind from Birth. [From the London Times, Nov., 1852.J The following account of an extraordinary and successful operation on the eye, related by the Brant- ford Expositor, is certainly calculated to create a hope in the minds of those who may be afflicted with a similar malady, that there may yet be a pos- sibility of getting it removed—at any rate it would be well for all such, while they have the opportunity, to apply to so skilful an operator. The writer says: " Miss Sarah Hawley, of the Township of Malahide, in the County of Middlesex, was born blind, and for twenty-one years she groped her weary way through life, in total darkness. The disease which had entirely obscured her visual organs was Cataract, and in the hope that something might be done for her by Dr. F. A. Cadwell, Oculist and Aurist, of Toronto, the friends of the blind girl brought her to Brantford a few weeks since, where the Doctor was professionally sojourning. An examination was made, and the Doctor pro- (181) 182 OPINIONS OF THE PRESS. nounced his patient curable, and on the 21st he made an operation upon her eyes, with complete success. " To describe the sensations' of the young lady when the first welcome ray of light entered her hitherto sightless orbs, would be beyond our power. In an instant, as if by magic, the idea of material things which she had cherished so many years through the sense of feeling, were entombed in memory. A new and bright world, full of light and life, full of wonder and admiration—terrible, because hitherto unknown, in its realized beauty and grandeur, arose before her. She looked and trembled; she shook from head to foot like an aspen leaf; and unable to utter a word, she gazed in wild astonishment on the scene before her. When her emotion had somewhat subsided, Dr. Cadwell inquired if she saw him. ' Yes,' said she, ' I see you. Oh ! how white you look.' Subse- quently she noticed a pair of brass candlesticks in the room, and inquired what they were. On being informed, she was incredulous. The ideas which she had formed of a candlestick were far different from those which her new-born sight conveyed. The candlesticks were brought to her—she handled them and exclaimed, ' Oh yes! they are candlesticks—how bright they look.' Dr. Cadwell showed her his gold watch, and inquired if she knew what it was. She answered in the negative, and on being informed, she said, ' What a queer thing it is; both sides of it are not alike.' " We may add, that the young lady's sight is daily improving in strength, and that she returned to her home in Malahide, a few days since, rejoicing in the light of life." opinions op the press. 183 HOPE FOR THE AFFLICTED. [From the New York Times. 1837.] A tumor of enormous size, weighing 61 lbs., and measuring nearly thirty inches in circumference, was successfully removed on Thursday last, June 22d, from the breast of a female, 32 years of age, by a promising young surgeon of this city, Dr. F. A. Cad- well, who operated with mature skill and unshaken confidence. The tumor, which included the whole mamma, extended from the breast-bone to the arm-pit of her right side, occupying an immense surface, and connected with the ribs at several points. This great mass of diseased matter was of four years' standing, and for several months its burdensome weight com- pelled the patient to support it in a sort of sack suspended from the neck. Twenty-three arteries were secured during the nice operation. I had the pleasure of examining this extensive morbid speci- men since its removal, at the office of the surgeon, 87 East Broadway, and consider it a great natural curiosity. The patient, whom I have also seen, is in good cheer, and her appearance bespeaks and indi- cates a speedy restoration of famous health. IMPORTANT OPERATION ON THE EYE. [From the Hamilton Gazette, Feb. 28,1852.] On Tuesday last, we witnessed a very difficult and important operation performed on the eye of a Mr. Culham, who resides in the vicinity of Toronto, by 184 OPINIONS OF THE PRESS. Dr. Cadwell, Oculist, of this city. The operation consisted in the removal of a cancerous tumor about the size of a common hickory nut, which had grown from the back part of the socket of the eye, and behind the ball on the side nearest the nose. It was about 1£ inches deep, from the surface, taking root near the optic nerve and artery, and had thrown the eye forward and outward for half an inch either way, causing much pain and uneasiness, and pro- ducing great deformity and partial loss of vision. Dr. Cadwell was assisted in this operation by Drs. Hunter and Duggan, and its removal was successfully completed in about twenty minutes. Much skill and judgment of necessity is required to conduct such an operation, owing to its importance and close proximity to the brain, and we can only say that the operation was skilfully and satisfactorily performed. The dis- ease was of such a nature as to make a surgical operation indispensable to preserve life, and had been only two months since it was first discovered by the patient, who, becoming alarmed for his ultimate safety, sought for relief, which we trust, by his bold and decided measure, he will ultimately obtain. We learn, upon inquiring, that the patient is doing well, and is likely soon to recover both sight and health. We would here take occasion to remark that Dr. Cadwell's practice in this city has, as we have been repeatedly informed, been attended with most desir- able success—and many afflicted with blindness, deafness, and other defects of these delicate organs, have found relief at his hands. We learn that at the solicitation of several patients and others, he has con ented to remain a few weeks longer. OPINIONS OF THE PRESS. 185 AN ARTIFICIAL E7E. [From the Proviocialist.] We witnessed, a few days ago, a very interesting operation. Mr. Isaac Kelly, near Ancaster, who was deprived of the use of one of his eyes when a boy— the part had completely fallen in—placed himself in the hands of Dr. Cadwell, by whom a false eye, a per- fect likeness of Mr. Kelly's good eye, was introduced upon the remains of the injured one. The change was astonishing; it completely transformed a half- withered fellow mortal into a fresh, youthful human being, making him appear at least ten years younger than he was ten minutes before. The operation was attended with very little pain, and the new eye par- takes of the same motions as Mr. Kelly's sound eye. No person could perceive the difference; it has but one defect, it cannot see. We might add that the crowds who daily attend Dr. Cad well's rooms, afford the best evidence of how his skill in operations on the eye and ear are appre- ciated. Indeed, until Dr. C. came amongst us, we never supposed that so many persons were afflicted with diseases of those useful organs. OPERATIONS ON THE EYE AND EAR. [From the London Odd Fellow.] We have no hesitation in stating that this gentle- man's operations on the eye and ear, in upwards of seventy cases, during his stay in London, have been most successful, and have given the greatest satisfac- 186 OPINIONS OF THE PRESS. tion. Many persons will take leave of the Doctor with regret, and some scores of persons have good cause to rejoice and be thankful that he has visited London. The individual cases are too numerous to particular- ize, and those which came under his successful treat- ment have been already multiplied to an extent which requires no additional evidence for convincing the public that Dr. Cadwell is not only a scientific clever man, but a first-rate practical Surgeon. He will visit London early in the Spring. EYE AND EAR. [From the Kingston Whig.] Dr. Cadwell.—This very eminent Oculist and Aurist, after a most successful sojourn in Kingston, will leave this city to-day for Belleville carrying with him the heart-felt thanks and good wishes of his numerous patients, many of whom he has perfectly cured, and all of whom he has most successfully treated. To our country friends and readers in and about Belleville, we can safely and cordially recom- mend Dr. Cadwell as a practitioner who will fulfill all he undertakes to perform. He cannot restore sight to the totally blind, nor hearing to the deaf, but he can and will remove disease wherever it is practicable, and within the reach of art and science. Dr. Cad- well is no Charlatan, but a regularly bred and licensed Physician and Surgeon, who has devoted years of study in obtaining a thorough knowledge of his most difficult branches of the Profession. The irregularity of "advertising," which subjects him occasionallv to OPINIONS OF THE PRESS. 187 ill-natured remarks, in a country like Canada, is an irregularity of necessity—for were he to wait on patients unannounced, such is the jealousy among Medical men here that he would be obliged to leave the place he visits, ere any one would be acquainted with his presenoe. SIGHT RECOVERED, ETC. [From the St. Catherines Constitutional.] Dr. Cadwell.—It has been our privilege, within the last week, to see this gentleman perform several operations of a somewhat serious nature, with the greatest success. Two of the subjects operated on were cases of complete blindness from cataracts on the eyes. The first was that of a young man who was deprived of his sight for the last five years, but who was immediately relieved, and is now doing well. The other case was that of a little boy of five years old, who was born blind, but who now sees clearly, under the excellent treatment of the Doctor. His delight at seeing the different objects seemed great indeed, and he is now doing well, and enjoying all the " blessings of the light." Several important operations have also been made on the ear, with equal success. We advise all those afflicted to avail themselves of Dr. C.'s services, while he is in town. CRITICAL SURGICAL OPERATION. [From the Toronto Globe, March 20th, 1857.] John Wilson, of Peterborough, aged twenty-three years, had an operation performed on his eye by Dr. Cadwell, of this city, for the removal of a large tumor, 188 OPINIONS OF THE PRESS. which was first discovered about thirteen years ago. The disease commenced at the bottom of his right eye, behind the ball, and had attained an enormous size, completely forcing the eye from its socket, and producing dreadful deformity. This diseased mass was successfully removed, a day or two since, by Dr. Cadwell, assisted by Drs. Aikins, Ogden, and Rowell. The patient, we learn, is doing well, and but little doubt is felt as to his speedy recovery. A truthful sketch was made of the patient, exhibiting the ap- pearance of the eye before the operation, which may be seen on application to Dr. C. The disease partook of two characters, viz : fibrous and steotomatous. MAIN ARTEBY OF THE NECK TIED, AND A TUMOR REMOVED FROM THE EYE. [From the Watertown Register.] It is with great pleasure that we give place to the following tribute to professional skill. From our information, had we not believed it richly merited, we should have promptly declined to give it publicity. Regarding it as we do, we invite the attention of our readers to the facts therein set forth : " Mr. Editor :—Allow me, through your columns, to call the attention of the public to an operation per- formed September 10th, 1840, on Mrs. Grout Hoss- ington, of Ellisburgh, by Dr. F. A. Cadwell, of Water- town, for an aneurismal affection of the face, com- monly called an aneurism by anastomosis or pulsating tumor, to cure which it became necessary to take up and apply a ligature to the common Carotid or main artery of the neck. It is an operation which is very OPINIONS OF THE PRESS. 189 seldom performed, and is attended with great risk and danger. I have been myself a practising phy- sician for ten years in the city of New York, and never before had an opportunity of witnessing the operation. The tumor was large, and occupied the whole right side of the face, extending from the orbit, crowding the nose to the left side, and producing great de- formity. It had been about one year in progress, but lately its growth had been so rapid, and became so exceedingly painful, that the patient decided upon an operation as the only means of saving her life. Mrs. IL, though sixty years of age, and of nervous tem- perament, bore the operation with astonishing for- titude, being fully confident that it was a necessary expedient. Doctors Eastman and Jones, together with myself, were present at the operation, and will no doubt cheer- fully bear witness to the skilful manner in which it was performed. I have merely to add, that the result was perfectly successful. I saw Mrs. H. a day or two since; her general health is good, the ligature has come away, and the tumor has entirely vanished. In fact, she is restored to her family—a living evidence of the triumph of surgery. With great respect, I remain, Yours, &c, JNO. BINSSE, M. D. CATARACT OF THE EYE EXTRACTED. We would also call attention to an exhibition of the same gentleman's surgical skill in operating upon the eye of Mrs. Towne, of Factory Village. The 190 OPINIONS OF THE PRESS. lady had been totally blind for six months, and in one eye for four years; she is now 66 years of age. The operation, we are told, is one of the most difficult character, and requiring professional skill second to no operation ever undertaken by surgical hands. We had the pleasure of witnessing the operation, and have frequently heard it spoken of in terms highly complimentary to the professional acquirements of Dr. Cadwell. The disease requiring the operation, is termed, in professional parlance, a cataract. The operation was the "extraction of the cataract," through an artificial opening made by a knife in the anterior portion of the eye. The result, as we are happy to learn, has more than realized the expectations of Mrs. Towne and her friends—no sooner was the con- vex lens of the eye extracted, than the light of day burst in upon the aged matron, who had endured a night so long and tedious. She is now, as we learn, fast recovering, and will, in all probability, ere long, with health and sight, be prepared for the discharge of her duties as a useful member of society. DELICATE OPERATION. [From the Montreal Herald, Sept. 15,1846.] Yesterday we had the pleasure of seeing a patient of Dr. Cadwell, upon whom he had operated for deaf- ness and dumbness. She is a young lady of less than fifteen years of age, and had, as we were informed, been deaf and mute from her birth, although both of these afflictions had been lessened for some years past. Dr. Cadwell having been consulted, was led to believe that the seat of the disease was in the throat, where OPINIONS OF THE PRESS. 191 he remarked two vascular tumors; he accordingly removed these excrescences, and has succeeded, as he believes, in effecting a cure. The young lady appeared to hear the ticking of a closed watch with great facility, though she was unable to do so when it was open previous to the operation. She did not appear able to pronounce more than a few French words, and these with some difficulty, but a gentle- man who accompanied her (her uncle we believe) appeared extremely satisfied with the result in the improvement of. her hearing. OPERATIONS ON THE EYE AND EAR. [From the Montreal Transcript.] It is highly gratifying to learn that Dr. Cadwell, the eminent and skilful Oculist from New York, is Work- ing miracles in the way of restoring lost and injured sight and hearing. We are informed that many hope- less cases of blindness and deafness have been restored perfectly by this gentleman, within the last two or three weeks—and that diseases of the eye and ear of the most formidable character, have been most suc- cessfully treated by him, while many others are under process of treatment. We have heard his operations and their success spoken of in terms highly compli- mentary, and we sincerely hope he will receive merited patronage from those who need such assistance. DR. CADWELL'S LECTURES. [From the Sherbrooke Gazette.] The lectures of Dr. Cadwell on the eye and ear, which were announced last week, were well attended, 192 OPINIONS OF THE PRESS. and, as far as we have learned, gave general satisfac- tion. His illustrations, with anatomical specimens both of the eye and ear, of the structure of these deli- cate organs, and the diseases to which they are sub- jected, were highly interesting, and showed the importance of possessing the highest skill by the practitioner who attempts to treat the complaints to which they are subject. THE EYE AND EAR: [From the Sherbrooke Gazette] We solicit the attention of our readers to the notice of Dr. Cadwell, Oculist and Aurist, from Montreal. Dr. Cadwell brings testimonials of skill and ability in his profession, of the highest character, from such med- ical men as Dr. Marsden, of Quebec, and Dr. Valentine Mott, of New York, and also from a great number of his patients, who all unite in bearing unqualified testi- mony in his favor. Those who are afflicted in either of the above organs, will do well to avail themselves of the opportunity now afforded for obtaining relief. EYE AND EAR. [From the Hamilton Journal.] We are happy to inform those parties suffering from complaints of those delicate organs, that Dr. Cadwell intends remaining in this city until the 15th of April next—therefore all requiring medical aid for defect of either vision or hearing, had better avail themselves of the generally acknowledged skill of this eminent operator. OPINIONS OF THE PRESS. 193 [From the Chicago Sunday Leader, Feb. 6th, 1859.] SKILFUL SURGICAL OPERATION A YOUNG GIKL BLIND FROM BIRTH INSTANTLY MADE TO SEE ! We were invited to witness a surgical operation on Thursday last, the results of which were so gratifying to all present—particularly so to the subject—that we take pleasure in giving publicity to the occurrence. Miss Alice C.Wedge, daughter of Joseph Wedge, farmer, of Plattsville, Kendall Co., aged eight and a half years, has been blind from her birth, until Thurs- day last, when she instantly received sight, through a skilful operation performed by Dr. F. A. Cadwell, late of Toronto, C. W., and now of this city. The opera- tion was performed in presence of several distinguished medical gentlemen of this city, and others, who ex- pressed themselves in glowing language over its happy results. The disease which had so completely obscured the vision of the child is termed, in professional par- lance, cataracts ; to remove which requires great skill, a steady hand, and a perfect knowledge of that delicate organ, the eye. The whole time consumed in the opera- tion did not exceed a half minute—the light of day at once burst in upon those hitherto sightless eyes, and she had a realizing sense of the grandeur of mate- rial things before her. It was intensely interesting to witness the surprise depicted upon her countenance, as various articles were exhibited to her. She knew nothing about them ! Even a hand held before her she could not designate by name. But she will not long remain unfamiliar with the beauties which this new- born faculty will disclose to her vision; and among the 13 194 OPINIONS OF THE PRESS. pleasant and delightful objects she will be permitted to look upon, we opine the face of Dr. F. A. Cadwell will be the one most calculated to inspire her with heart-felt enthusiasm and admiration. Dr. Cadwell, a few days since, performed a very successful operation upon the eyes of a Mr. Samuel Sherman, who had been blind for several years, now stopping at the house of P. W. Gates, Esq., of this city. It consisted in extracting a cataract through an artificial opening made with a knife in the front of the eye. In less than ten minutes after the operation, Mr. Sherman could readily recognise those he knew, though he had not been able to do so for years. We take pleasure in adding that Dr. Cadwell's operations during his sojourn amongst us, in upwards of one hundred and, fifty cases, have been most success- ful. As an oculist and aurist, he is unquestionably the most skilful practitioner in the West, and we heartily congratulate him on his success. Those who have been made happy through his timely aid, will doubtless echo our sentiments. [From the Chicago Sunday Leader, July 24th, 1859.] SURGICAL SKILL. The name and fame of Dr. F. A. Cadwell, Oculist and Aurist, of this city, is becoming so extensively known throughout the North-West, that it seems hardly necessary to make farther allusions thereto. But as a just tribute to his skill, the writer of this feels called upon to certify to the unexpected and lasting relief he has experienced from the Doctor's treatment. One of the editors of this paper has been OPINIONS OF THE PRESS. 195 afflicted for thirty years with a very unpleasant and distressing disease of the ears, which has subjected him to much mortification and annoyance, causing partial deafness. Five or six sittings under Dr. Cad- well's treatment has effected a radical cure, and we are now completely restored. A young lady from Kenosha, whose otherwise attractive and beautiful face was seriously disfigured by a pair of " cross-eyes," had them both straightened through an operation at the Doctor's hands, and although Nature had been lavish in her gifts with the lady, her friends all admit that Art has finished the picture most admirably. And yet the operation was almost instantaneous, and unattended with pain. Other instances of extraordinary success in surgery by Dr. Cadwell might be mentioned, but it is suffi- cient to say that wherever human aid is of any avail, the blind and deaf always receive speedy relief by his superior treatment. We are pleased to add that the Doctor's business is a profitable one. JOHN WILSON, Jr., OF PETERBOROUGH. A few minutes before submitting to an operation for the extir- pation of a diseased Eye, which had existed for THIRTEEN YEARS. The entire Eye, with its accompanying disease, was successfully removed by an operation performed on the 17th March, 1857, by Dr. F. A. Cadwell, of Toronto. The mass when removed measured three and a half by two inches, and weighed nearly four ounces. Complete recovery in thirteen days. (196) CASES AND OPERATIONS. The following cases, as drawn from my journal, will give a tolerably good idea of the various causes which operate to promote diseases of the Eye and Ear, and the time that is usually required to effect a cure or produce such change as the nature of the case will admit. Many of these cases will be found highly interesting to the reader, being the most extraordinary on record; and at the same time they furnish ample proof of the almost miraculous triumph of science over disease, and that, too, under circum- stances almost without hope : CASE 1. Description of the Case of JOHN WILSON. John Wilson, Jr., of Peterborough, aged twenty- three years, accompanied by his father, made applica- tion to me on the 10th of March, 1857, to obtain my opinion and advice respecting a disease of his right eye, which made its appearance thirteen years previ- ously, and which had of late years begun to assume a most formidable and alarming character. He had con- sulted with prominent and skilful medical men, both (197) 198 CASES AND OPERATIONS. in the Old Country and likewise here, and as he was greatly alarmed at its enormous size and rapid growth, he sought to obtain my opinion. After a careful exam- ination, I had no hesitation in advising an operation for the removal of the entire mass, the eye included, as the only means of saving life, and stated at the same time that the operation would be attended with great risk and danger to life, as well as being extremely difficult to perform. The father assumed the respon- sibility in behalf of the son, and a consultation of physicians was called, who perfectly coincided with me in my views, and after a few days' preparation, the operation was fixed for the 17th of March, at 12 o'clock. THE OPERATION. The day arrived, and all parties being ready, the operation was performed by myself, with the able assistance of Drs. Aikins, Ogden, and Rowell. There were also present a number of other medical gentlemen and medical students, and a few curious spectators. Chloroform was administered to the patient, but he could not be got completely under its influence, and therefore suffered considerably from the pain. The operation being attended with great danger, owing to the supply of important blood-vessels, was necessarily conducted with great care and caution, and occupied the space of one hour, including several interruptions, for the purpose of resting the patient, and enabling the operator to more carefully examine the progress and condition of the work; and at one o'clock the entire mass was removed, down to the very bottom of the socket, and when examined presented an irregular mass oi fatty and fibrous matter, measuring three and a half CASES AND OPERATIONS. 199 inches in length, by two inches in width, and weighed nearly four otmces. The patient suffered considerably by loss of blood, and pain, but had no bad symptoms follow ; he was attended daily for a week or more, and his wound gave him but little pain. The whole socket rapidly filled with healthy granulations, and without excess of inflammation, and he was able to visit me at my office on the eleventh day after the operation was performed ; and as he was then gaining in health and strength fast, he was allowed to return to Peterborough with his father on the thirteenth day, fully recovered, leaving behind a mass of corruption and disease which had caused him much suffering, both mental and physical, for a period oi thirteen years. The father informed me that he consulted several eminent medical gentlemen before leaving Ireland, in 1850, but that none of them would undertake to re- move it, and therefore the disease had attained a much greater size since, and given more occasion for alarm. This morbid specimen I have preserved, and shall at any time take pleasure in showing it to any of the medical profession, or others who may be curious to see it. CASE 2. Certificate of Miss HAWLEY, Blind from Birth, Twenty- One Years.—Received her Sight by an operation per- formed by Dr. Cadwell. This is to certify that Miss Sarah Hawley, of Mala- hide Township, in the London District, Canada West, aged twenty-one years, (an orphan,) was born with Cataracts, and was in consequence entirely blind. 200 CASES AND OPERATIONS. She remained destitute of sight during the whole course of her natural life, not having the least power of vision, till Thursday, the 28th day of October, 1852. She then submitted to an operation for the removal of her cataracts, which was successfully per- formed by Dr. F. A. Cadwell, of Toronto, then at Brantford, in presence of the undersigned and several of her family, when she instantly received sight in both eyes. With very little suffering from the commencement, she has continued to improve in the strength and power of her vision, until she can now see objects, both large and small, quite distinctly, and is constantly improving. Being now able to return home to her friends with health and sight, she feels confident that she will soon be able to take an active part in the enjoyment of the new and beautiful scenes that con- tinually dance before her new-born vision. I, the subscriber, being uncle and guardian of the aforesaid Sarah Hawley, certify to the correctness of the foregoing statement. (Signed,) DAVID SAGE. The above-named David Sage maketh oath and saith that the above statement is perfectly true and correct. Sworn before me, at Brantford, in the County of Brant, this 10th day of November, 1852. (Signed,) A. K. SMITH, J. P. I, the subscriber, having the office of Assistant to Doctor Cadwell, in operating on the eyes of Miss CASES AND OPERATIONS. 201 Hawley, can testify to the foregoing statement, and to the skill and success with which it was performed. The operation was performed in less than one minute on each eye, and the sight was instantaneously re- stored, far exceeding my most sanguine expectations. (Signed,) JIRA SKINNER, M. D. Sworn before A. K. Smith, J. P. Brantford, Nov. 10th, 1852. CASE 3. Child Five Years of Age, Blind from Birth.—Received his Sight by an operation performed by Dr. Cadwell. This is to certify, that my son, Samuel J. Taylor, has been blind from his birth, having been born with cataracts in both eyes. He was operated on by Dr. Cadwell, at St. Catherines, on the 17th day of April, 1852. I have merely to say that the operation was performed in a minute, in the presence of several med- ical gentleman and others, and the child seemed not to suffer in the least from the operation, or at any time since. I am glad further to state that the result has been entirely satisfactory. His sight was in some degree immediately given him, and has since continued to improve, and we have every confidence that in a few weeks it will be perfect. He can now see the most minute objects, but does not appear to appreciate distances, owingy as we believe, to a want of practice. 202 CASES AND OPERATIONS. He is as cheerful and lively as ever, and has never for a minute complained since the operation was made. (Signed,) WM. TAYLOR. Witnesses: J. Philips Lee, J. Richardson, Editors St. Catharines Constitutional. St. Catharines, May 1st, 1852. CASE 4. Congenital Cataract and Total Blindness in an Infant Thirteen Months old. This was the daughter of William Hill, ot Hay Township, C. W. The operation was made on the 25th of January, 1856, and good vision was the result within ten days from the day of operation. No in- flammation or suffering followed, and the little crea- ture was soon able to follow objects about the room, as they would move before it, and appeared to take great delight in exercising its new-born faculty. There is but little doubt of the success of these cases when they are treated in good time, and the operation has been skilfully performed; and though it may become necessary, under some circumstances, to repeat the operation, it is not attended with danger, and the result is generally of the most gratifying nature. The pain which attends this operation is so trifling as scarcely to be remembered. CASES AND OPERATIONS. 203 CASE 5. This case is interesting, as showing the connection of disease between the membrane of the Throat and the Chamber of the Ear. Miss Priscilla Griffin, aged eighteen years, daughter of Richard Griffin, Esq., J. P., Smithville, C. W., con- sulted me in the month of December, 1856, for a very severe form of deafness, caused by cold, accompanied by a most profuse discharge of foetid purulent matter from both ears, which she had had for upwards of twelve years. This young lady had also a cough, of some years' standing, and of a most violent character, which baffled the ingenuity of the most skilful of the medical profession, many of whom had at various times been consulted, but all had failed in giving any permanent relief. The hearing was very dull when she first applied to me, and the voice required to be elevated considerably to enable her to understand. No ordi- nary conversation could be heard by her, and her eyes, which were dark and full of expression, seemed to perform the office required by comprehending rather than by hearing. At the first examination of this young lady's case, I remarked to her friends that there was a close con- nection between the chamber of the ear and the mem- brane of the throat, for the ear could not be touched without throwing the young lady into a violent paroxysm of coughing, which would continue for an hour. With this view of the case I proceeded to treat my patient, and at the end of two months I had the satisfaction of finding that the cough had been com- 204 CASES AND OPERATIONS. pletely subdued, and the discharge from both ears nearly or quite arrested. Her hearing was good, even better than many who considered their hearing per- fect. She was able to visit me daily, and left me at the end of nine weeks from the commencement, and returned to her family a happier and healthier woman than was ever believed she could be—nearly free from cough, with sound lungs, healthy ears, and good hearing, a model specimen of robust health; cheeks full and rosy, eyes bright and clear, with a voice strong and full, giving additional proof that a most wonderful change had been wrought, to the amaze- ment of all who knew her. We, the undersigned, referred to in the above case, hereby certify, that the statement therein made is perfectly true and correct. (Signed,) PRISCILLA GRIFFIN, RICHARD C. GRIFFIN. Witnesses: F. G. Stanley, Chas. E. Wall. case 6. Chronic Inflammation. Master Samuel Bidder, aged nine years, son of S. P. Bidder, Esq., Engineer of Grand Trunk Railway, Montreal, was placed under my care in the summer of 1854, for a chronic disease of the eyes, which attacked him some two years previously, while resid- ing in London, England. His father had consulted the most eminent medical gentlemen in the Old Country, who gave it as their opinion that it was a CASES AND OPERATIONS. 205 constitutional disease, which would not leave him until he arrived at manhood. He was, however, induced to think otherwise, and after arriving in Canada with his son, he was recommended to apply to me, by parties who had been similarly afflicted, and who had received successful treatment at my hands The lad was left with me for the period of thirty days, at Toronto, when it was thought unnecessary for him to remain longer, his disease having entirely passed away, and his general health, which was pre- viously very delicate, being fully established. He has continued to enjoy the full advantage gained, now five years past, both as regards his sight and general health. CASE 7. Ulcers on the Eye. Miss Amanda Bodine, of Fingal, aged sixteen, was placed under my care by Dr. Travers, of the same place, for a severe attack of Corneal Inflammation of both Eyes, which, at the time I saw her, threatened the destruction of the eyes. The cornea had sloughed, and the delicate membrane was highly inflamed, having a portion of the blue curtain of the eye, or iris, entangled in the opening. However, by timely treatment, I succeeded in sub- duing the inflammation and healing the breach, and at the end of five weeks she returned home with her eyes entirely well, and the sight completely restored. This young lady was treated by Dr. Travers for two years, but without being able to reach the case. In this case the disease was purely local, her general health being perfectly good. 206 CASES AND OPERATIONS. CASE 8. Deafness of Ten Years' Standing. Duncan Sinclair, aged twelve years, son of the Rev. Dougald Sinclair, residing in London District, has been very deaf for ten years, arising, as his parents believe, from measles. At the time I received him under my care, he could scarcely hear my watch at his ears, but at the end of three weelcs he was dismissed cured, being then able to hear the same watch twelve feet distant, and all noise and other unpleasant symptoms had entirely ceased. London, December 15th, 1853. CASE 9. Deafness of Twenty-Five Years' Standing. Charles H----,,aged about forty years, has been deaf for the last twenty-five years, occasioned by cold. Has a constant noise in both ears, and could not hear common conversation, unless very near him. His health was in other respects good. By the regular use of the Press, or Air Douche, for six weeks, the hearing was raised from one inch to twenty inches on the right, and from six inches to ten feet on the left, and the hearing continues to improve. CASE 10. Deafness from blowing Bugle. James C----, of the Royal Artillery, aged twenty years, deaf three years from forcibly blowing a corno- peon, thereby bursting the drum of the right ear. CASES AND OPERATIONS. 207 Hearing entirely gone at the time of commencing treatment, and a profuse discharge is constantly going on. After five weeks' attendance, the patient found the discharge was entirely arrested, and he could hear a watch beat at the distance of several inches from the ear, and all noise had entirely subsided. His general health was improved by the treatment, and in the Spring of 1852 he resumed his place as musician in the band to which he belonged when the accident occurred. CASE 11. Cross-Eye. Edward Fudge, of the Royal Artillery, applied to me for treatment for weak sight, which upon examina- tion proved to be the effect of a Cross-Eye, which had only recently been observed. An operation was made and the eye immediately made straight, and with it nearly all traces of defective vision vanished. In ten days all traces of the operation had disappeared. CASE 12. Artificial Eye. Thomas C-----, a lawyer, had the misfortune to lose an Eye by an accident when a child, and the ball was considerably wasted and fallen in. I was applied to for advice, and inserted an Artificial Eye, which he now wears without the least pain or inconvenience, and but few of his friends are able to tell the natural from the artificial Eye. It performs all the natural 208 CASES AND OPERATIONS. motions of the sound Eye, and its resemblance to it is perfect; in fact it is scarcely possible to perceive any difference between the two Eyes at a few feet distance. CASE 13. # Deafness from Sea Bathing. William Robson, aged fourteen, has been deaf for two years from sea-bathing. Hearing very dull, and both Ears discharging matter of a very foetid odor. Health otherwise good, but looks rathei deli- cate, which is peculiar to those who have a constant discharge from the Ears. Nov. 28.—He is dismissed cured. Hearing raised from a few inches to seven feet, and the discharge is entirely suspended, with a marked improvement in his countenance generally. CASE 14. Deafness with Discharge. Amos Kemp, aged sixteen years, an apprentice tc the book-binding business. Had deafness and discharge from his left ear for several years, produced by cold; hears the watch only three inches with this ear, and finds he is getting worse every year. Continued his attendance for about three weeks from date of entry, when he found his hearing raised to five feet, and the discharge had stopped. Was dismissed from regular attendance, and advised to call once a week, that the case might be watched. May, 1852.—Hearing continues perfect, and no further appearance of discharge. Cases and operations. 209 CASE 15.* Blindness from Measles. Miss Margaret Green, aged fifteen, had inflamma- tion of one eye since she was about four years old, from Measles, and could never get it cured. It was covered with a white film, and the sight is of little or no use to her. Her health being good in other respects, she was put under a regular course of attendance, and was dismissed entirely cured on the first of December, being only three weeks under treatment. CASE 16. Cross-Eye occasioned by a Fall. Charles McMillen, aged thirty-five, had a Cross-Eye since a child, caused by a fall. Sight was very im- perfect in this eye. An operation was made, and the eye was straight- ened immediately. In a few days the slight wound made by the operation healed, and since that time there has been a gradual improvement in the sight of this eye, and it is now nearly equal in strength to the other. No interruption to business was caused by this operation, except on the day of the operation, and no pain or uneasiness followed it. * The persons referred to in Cases 15 to 30, inclusive, were residents of Kingston, Canada West. 14 210 cases and operations. CASE 17. Blindness from Inflammation. Mrs. Maria Curtis, aged twenty-five years. Had suffered for four years with a chronic inflammation of her eyes, supposed to have come from cold. She was nearly blind at the time of commencing treatment with me, being able merely to see dark images before her. Had been treated for several months together, by medical men in Canada and the United States, but to no effect. She commenced treatment with me in November, 1851, and was able in four weeks to see well; could readily recognise any one she knew, and was able to go about without the least trouble or inconvenience. As she resided some distance from me, she was then allowed to return to her home, provided with suitable instructions. She recovered perfect eye-sight in a few weeks, and was greatly improved in her general health, which had previously been very delicate. CASE 18. Deafness from Scarlet Fever. Robert Miller, aged twenty-two years. Deaf since a child, being the result of scarlet fever. Both ears discharged profusely, and his hearing was extremely dull. Dec. 7th.—Returned home with tolerable good hear- ing, the discharge having been entirely arrested, and all other disagreeable symptoms completely removed. CASES AND OPERATIONS. 211 In this case there was an opening formed in each drum, caused by the long continuance of his disease, and this circumstance prevented the possibility of giving perfect hearing. But the treatment had been so effectual in every other respect, that he discon- tinued his attendance, quite satisfied that he could hear well. CASE 19. Deafness from a Fall. Wm. Lane, aged twenty-five years. Had deafness and noise in his left ear, caused by a fall four years previously. By the use of the Air Douche, and other suitable treatment, his hearing was perfectly restored in three weeks, he being then able to hear my watch across the room, and the noise had entirely subsided. CASE 20. Double Cross-Eye from Sickness. Miss Mary Watson, aged sixteen years, had a double convergent Strabismus, or squint, since she was about three years old, caused by sickness. Her sight was very weak and imperfect, and she had double vision. Both eyes were operated on, at intervals of four weeks, and two perfectly straight eyes was the result. No pain or inflammation was experienced from the opera- tion, and the sight was made good, and the double vision disappeared on the eyes becoming straight. 212 CASES AND OPERATIONS. CASE 21. Blindness from Inflammation. Henry Daniels, a child aged three years, blind in one eye, from inflammation, and the other suffering much from sympathy. Child very delicate otherwise. Treatment in this case was directed particularly to the constitution, and some attention was at the same time paid to the eyes. In a fortnight there was a marked improvement in the health and strength of the child, and a proportionate improvement in the condition of the eye. Two weeks' further treatment had the effect to re-establish both health and eye- sight in the child, and it continued to thrive and do well six months after it left my attendance. CASE 22. Deafness from Croup. James Long, aged nine years. Had deafness and discharge from both ears, caused by an attack of Croup. In this case, treatment completely arrested the dis- charge, and made the hearing good in three weeks, and no further trouble has been felt since. CASE 23. Loss of Sight from bad treatment. Miss Francis Gould, aged forty-two years. Is en- tirely blind, requiring a conductor, from a severe attack of inflammation, which has been badly treated by her physician. CASES AND OPERATIONS. 213 By careful attendance, she has recovered her sight, so as to be able to go about, and can recognise her acquaintances, but owing to improper treatment and neglect, she will never recover perfect sight; though, under proper direction, no defect of vision would have been perceptible. CASE 24. Deaf and Dumb from Scarlet Fever.—Hearing restored. Miss Rebecca McAdoo, aged twenty-two years, had Scarlet Fever when four years of age, and at that time entirely lost her hearing. Recovering from the fever slowly, she partially recovered her hearing, but never enough to hear any sound of the human voice, and acquired a facility of understanding what was said entirely by the motion of the lips. At the time I first saw her, which was on the 18th day of Novem- ber, 1851, she could scarcely be said to hear at all, and her speech was so imperfect that but few could understand what she said. This case was too unfavorable to afford much hope to her family, though I was induced to do so from some circumstances connected with the history of her case. Treatment was accordingly commenced, and in less than three weeks she recovered sufficient hearing to be able to hear well. She would no longer watch the countenance, but would always apply her ears, and give attention. She can now hear quite well, and her speech has also improved with her hearing. She con- tinues to use her treatment, and to pay me an occa- sional visit. Her ears, which were discharging pro- fusely at the beginning of my attendance, are now 214 CASES AND OPERATIONS. quite dry, and I have no doubt but that in a few months she will be restored to good hearing, without the necessity of raising the voice to make her under- stand. This case, bad as it was, proves clearly the advan- tages of treatment in those cases of deafness which so frequently result from scarlet fever, measles, and all those diseases incident to children. I may here men- tion an opinion' in reference to the management of such cases, that in no instance could a case of this description be treated, and proper attention given on the part of the patient, without deriving the greatest advantage therefrom. CASE 25. Deafness caused by a Pea in the Ear. Robert Carter, aged seven years. Has been deaf for almost one year, with discharge from both ears, caused by sickness. Can hear my watch only six inches on either side. Upon careful examination, each ear was found to contain a pea, which had been put there by the child many months previously. Owing to the manly con- duct of the little fellow, I extracted the two peas, which were greatly swollen, but not without some difficulty, as from the shape of the ear they had become firmly wedged in the auditory passage. The drum remained entire, though thickened and in- flamed ; but upon the removal of the foreign bodies, the hearing was soon restored as good as ever, and the discharge ceased in a few days. CASES AND OPERATIONS. 215 CASE 26. Blindness from Inflammation. Mrs. Margaret Nichols, aged sixty-four. Has suf- fered for twenty-four years with a chronic inflamma- tion of her right eye, which has never ceased to be troublesome sinx;e its commencement, and no treat- ment has ever %en found of the least' service to her. Sight useless, and the eye very weak, and not able to bear the light of day. General health good for one of her age, but the system a little out of order. Daily treatment was followed by me for four weeks, when it was thought unnecessary to continue attend- ance any longer. The inflammation had entirely vanished, her sight was quite clear, and with the exception of a slight contraction in the sight of this eye, caused by the long continuance of the disease, no perceptible difference could be observed. CASE 27. Deafness from Polypus in the Ear. John F. Ward, aged thirty-two years. Had a Polypus in his left ear for twenty-seven years. His ear discharges constantly a very offensive matter, and his hearing in this ear is entirely useless. I removed the Polypus by an ingenious little instru- ment of my own invention, and without giving the least pain to the patient. The effect was to immedi- ately restore the hearing, which eriabled him to hear a watch two feet off. A few occasional visits put him 216 CASES AND OPERATIONS. in possession of good hearing, and no inconvenience is now experienced. The Polypus was as large as a grape, and completely filled the passage of the ear, giving rise to discharge, etc. CASE 28. * Tear Passage Closed. Mrs. Jessie Patrick, aged twenty-seven. Had the tear passage closed, causing the tears to run over the face, and thereby giving her much trouble, and weak- ening her sight. In a few days I succeeded in open- ing the passages free to the nose, without making an operation, and the tears now pass freely down their proper channel. No further inconvenience has since been experienced. CASE 29. Deafness from a Pea in the Ear. Miss Patrick, aged four years, put a pea in her ear some eight months ago, which could not be got out. It ultimately caused deafness and a discharge, and frequently a severe head-ache supervened. The child being much frightened, I had great diffi- culty in removing it, owing to her wilful resistance. It was, however, extracted, split in halves, and of course the hearing was imperfectly restored. Subse- quent treatment put all right, and she is now quite well. CASES AND OPERATIONS. 217 CASE 30. Artificial Eye Inserted. Miss Sementha B----, aged twenty years. Lost her left eye from a severe attack of inflammation. She now wears an Artificial Eye, which I inserted for her, and the deception is so good that none but her family know but that she had the original eye restored; and although it has been whispered among her young friends that she wears an Artificial Eye, still many do not credit it. CASE 31. Blindness caused by Inflammation, and the injudicious use of Mercury. Hugh Brodie, of Chatham, an intelligent lad fifteen years of age, son of Philip P. Brodie, of the same place, came to me one year since, with a severe disease of his eyes, which rendered him entirely blind. His case was promptly treated by Dr. Severite, and others, of Chatham, but without any satisfactory results, for in a short time he was entirely without sight, and was also crippled by the injudicious use of mercury admin- istered as a means of cure for his diseased eyes. He also states that one of the medical men in attendance endeavored to discourage him from placing himself under my care, as he could himself cure him. His father, however, was induced to think other- wise, and accordingly placed him under my care. The result is, that he can now see well, though not per- 218 CASES AND OPERATIONS. ■ fectly, and has resumed his studies at school; sight is constantly improving, and his general health fully established—a result which no person would have predicted, from the almost hopeless condition he was in when first placed under my care. Toronto, April, 1857. The above statement I have just read, and can fully corroborate what is therein stated. (Signed,) HUGH BRODIE. CASE 32. Deafness from Scarlet Fever. Miss Harriet Dillon, aged ten years. Had deafness and discharge, of five years' standing, caused by scarlet fever. Hearing very bad, and the discharge profuse and very offensive. Three weeks' treatment completely removed all the discharge, and the hearing was raised from the touch to about four feet. Treatment was still further con- tinued, with marked improvement, and with every prospect of having perfect hearing at last. CASE 33. Cross-Eye from Convulsions. Miss Mary Rogers, aged eighteen years, had a Squint or Cross-Eye since a child, caused by convulsions. Sight very weak and imperfect. Operation was made, and the eye straightened in less than one minute. Pa- tient was very nervous: but did not complain of the CASES AND OPERATIONS. 219 operation. In ten days after I saw her; the eye was perfectly straight, and no one could tell that such a defect had ever existed. CASE 34. Artificial Eye. Conrad Jones, Belleville, N. Y., wears an Artificial Eye, which was inserted by me. It gives him no pain or uneasiness whatsoever, and the lost and wasted organ is beautifully supplied with a substitute which answers every purpose of the original except sight. The advantages of the Artificial Eye are many. In the first place, they protect the old socket by excluding the cold air; they support the lids, and thereby prevent the eye from wasting and closing, and protect the eye from the introduction of foreign particles ; and finally, they so .completely resemble the natural eye, both in movement and appearance, that no one would discover the imitation. CASE 35. Deafness of Eleven Years' standing cured. Mrs. Eliza Bullock, of Trafalgar, C. W., aged thirty- two years, has been very deaf for eleven years, caused by cold, and had lately grown much worse. Her health being good in other respects, she was placed under my treatment, and by the use of the Air Douche, and other means, she was cured in eleven days. It is now several years since she was treated and cured. She feels no further trouble, and the noise which was nearly always present in this case, has entirely sub- sided. 220 CASES AND OPERATIONS. CASE 36. Disease of the Eye-Lids. John Carter, of Toronto Township, aged seventeen years, had an affliction of the eye-lids for many years, which came from whooping cough. The edges of the lids were thickened and inflamed, and on waking in the morning, were firmly glued together by the discharge. This case was cured completely by two weeks' attendance, and though the eye-lashes were thinned, and nearly gone, they have again grown quite thick and healthy. CASE 37. Deafness from Cold. Miss Bates, of St. Catharines, aged twelve years, had deafness, and discharge from one ear, from cold, since she was an infant. Her hearing was very dull, and the discharge abundant and offensive. Three weeks' treatment restored good hearing, and entirely arrested the discharge. CASE 38. Deafness from Cold. Eli Oil, of St. Catharines, aged sixteen, had a dis- charge from his left ear, and deafness in both, since he was six years of age, and is getting worse; is very subject to take cold on slight changes of the weather and always gets worse at such times. Treatment in CASES AND OPERATIONS. 221 this case restored good hearing in both ears, and arrested the discharge, after three weeks' attendance. No further trouble has been experienced since. CASE 39.* Tumor in the Eye. Alexander S. Robertson, aged ten years, had an insisted tumor in the left eye, of eight years' standing, the size of a hickory nut. It was painful at times, and growing rapidly. I removed it by an operation, assisted by Dr. Hope, and the wound healed in a few days, in the most healthy manner. CASE 40. Disease of the Eye-Lids. Miss C. Lowery, aged eighteen years. Had a very severe form of disease of the eye-lids, since a child. Lids were highly inflamed, and very much thickened, and the lashes nearly all gone. After three weeks' daily attendance, Miss L. was dismissed cured, with instructions to continue a little mild treatment for a fortnight longer. CASE 41. Double Cross-Eye. Miss Adeline Howard, aged twenty, had a double convergent squint, of many years' standing, which was * The persons mentioned in Cases 39 to 44, inclusive, are residents of Belleville, New York. 222 CASES AND OPERATIONS. operated upon with perfect success on the 26th of June. Eyes are now both straight and much im- proved ; and no pain or inflammation followed. CASE 42. Single Cross-Eye. Miss Sarah McCord, aged fourteen, had a conver- gent squint of one eye since a child, and the sight was nearly useless. Operation was made on the 5th of June, and in ten days the eye was perfectly healed, and the sight greatly improved and imoroving. CASE 43. Single Cross-Eye. Miss Mary A. Wilkins, aged 16 years; had a con- vergent strabismus or squint, and with little or no sight in the right Eye since a child, caused by teething. I made an operation and put the eye straight in one minute. Sight is now good, and the eye looks as well as ever. Eye was weak before this operation, but it is now strong, and the sight is perfect. CASE 44. Blind from Cataract—Lens extracted. Thomas Long, aged 26 ; was completely blind from Lenticular Cataract. One eye was lost by a previous operation. Operation for the extraction of the lens was performed by me on the 27th of June, with entire success, and with complete restoration of the sight. CASES AND OPERATIONS. 223 CASE 45. Deafness from Scarlet Fever. Miss F. P. Gould, of Brantford, aged 10 years; had deafness and discharge from her Ears of a very offensive nature for the last six years, resulting from scarlet fever. After three weeks' daily attendance, her hearing was considered nearly as good as ever, and the discharge had entirely ceased, with a decided improvement of her general health. CASE 46. Disease of the Eye-Lids. Miss N. Farrell of Paris, aged 16 years; had a disease of her Eye-lids from childhood; sight was not much impaired, but the lids were thickened and red, particularly on waking in the morning, at which time a quantity of dry matter was found adhering the lids together, and the lashes had fallen and become quite thin. Much had been done by the parents of this young lady to have her disease removed, but all to no purpose until chance threw her in my way, and though she had some distance to drive each day, during a cold and rainy season, still her disease was completely eradicated in three weeks; and though a year has elapsed, she has had no return of her old companion. CASE 47. Deafness, with Noise in the Ears, of Ten Years' standing. John Fisher, of Vittoria, aged 18 years, had deaf- ness, with more or less singing in the Ears, for the 224 CASES AND OPERATIONS. last ten years. He was not able to hear a watch beat except close to his ears, and was getting worse from year to year. He was treated for six weeks, receiving daily sittings, and was at the end of that time dismissed from further attendance, being able to hear common conversation readily; and all noise and confusion of the head had entirely subsided. His father, Daniel Fisher, aged 56 years, was deaf twenty years in one ear, and was completely cured in one hour, without causing the least pain. CASE 48. Deafness, with Noise in the Ears, of Twelve Years' standing, cured. Henry Williams, cousin of the above-named John Fisher, was also deaf for twelve years. He was similarly afflicted, and had also great noise, which, with his deafness, had never left him during that period. He was also cured of his deafness, and the noise was removed by six weeks' attendance with me, and without submitting to any painful or dis- agreeable treatment. CASE 49. Double Cross-Eyes.—Physician's Daughter. Dr. Bowie, of Brantford, has a daughter aged 9 years who had a double convergent squint, or double Cross-Eye. Operation was made on the young Miss, who conducted herself most heroically through both operations, which were performed by me at an interval of one week between each operation. The result of this young lady's courage was a pair of per- CASES AND OPERATIONS. 225 fectly straight Eyes, which were very badly turned; and her sight is greatly improved also. Though she was only nine years of age at the time the operation was made, it was done with her full consent, and without her offering the least resistance. She well deserves the reward she has received. CASE 50. Tear Passage closed. J. Andrews, aged forty-two years, had both tear passages closed, and the tears constantly passed over his face, particularly in cold and windy weather. He had an operation made, and a gold stylet introduced, which gave him immediate relief. This he wore for a few weeks; it was then removed, and the passage continued pervious and free. Thus, by a trifling operation, he was relieved of a disease that had troubled him for many years. CASE 51. Blind Four Years.—Sight Restored. David Thompson, of St. Thomas, aged fifty-five years, was brought to me nearly blind by a chronic disease of his eyes of four years' standing. He could see but little, and his eyes had been treated by some professed oculist, who subsequently proved to be an impostor. His disease was one which is frequently met with in this Province, and usually arises from cold and exposure. The sight becomes dim and misty after the first stage of inflammation passes over, and this dimness continues till the patient becomes quite blind \ 15 226 CASES AND OPERATIONS. lids look thickened and red, and then the whole ball becomes red, and the sight nearly or quite obscured. This gentleman was completely cured during five weeks' attendance, so as to be able to manage his own business, and to read and write. A slight relapse of inflammation took place in one eye, which required his attendance again, but in a few days it was subdued, and has continued good ever since. CASE 52. Deafness of Twelve Years' standing cured in a few hours. J. P. McD----, of Vienna, Merchant, was deaf, with noise in his ears, for twelve years. He applied to me in the winter of 1852, and was completely cured of all his deafness in one hour; and by a few days' subsequent attendance, he was entirely' relieved of all noise, and returned home with perfect hearing. CASE 53. Deafness from Pebble in the Ear. A small pebble stone was removed from the ear of a little boy, aged six years, son of Gabriel Balfour, of Kingston, which had been there for six months. Hear- ing was restored, and the child perfectly recovered. CASE 54. Blindness from Pustular Inflammation. Miss Anne Perry, of Darlington, C. W., aged fifteen years, was for two years a great sufferer with a pecu- liar form of inflammation of her eye, called pustular CASES AND OPERATIONS. 227 inflammation. It consists in patches of little white pustules or festers, which form on the eye, generally locating on or near the sight, and continuing for some days to grow worse—the eyes being very irritable, and not able to bear the light. In this state the eyes continue to get better and worse, until one or both are quite destroyed. Such was her case, and although one of her eyes was quite blind, she returned home with the sight of both quite restored, and her general health much improved, having been about five weeks under treatment. CASE 55. Tear Passage closed.—No operation. Mrs. Catherine F-----, of Toronto, had an obstruc- tion of the tear passage, of three years' standing, which caused the tears to flow over the cheek whenever she was exposed to the cold or wind, or in using the eyes to read or sew, or do any other work requiring the par- ticular use of the organ. By a few days' attention, I succeeded in removing the obstruction, and rendering the passage free to the eye, without submitting the patient to an operation, so that she can now use her eyes for all purposes, as usual, without experiencing the least inconvenience. When this condition of the eye is observed, it should be attended to before the disease becomes permanent, in which case an operation will be required, and a gold stylet introduced, which has to be worn for some weeks before a permanent cure will be effected. Under any circumstances, this disease can be perfectly and permanently cured. 228 CASES AND OPERATIONS. CASE 56. Tear Passages both Closed. Philip Dunn, aged twenty-five, had both tear passages closed for about five years, and his eyes were in a dreadful condition in consequence. They had gathered and broken a number of times, and he was nearly blind when he consulted me about five years since. I operated on both eyes at the same sitting, and introduced gold stylets, which were worn by him without the least inconvenience, and with immediate relief. At the end of three months they were both removed, his sight being perfect, and the tears taking their proper course. CASE 57. Blindness from Inflammation. David C. Wattles, residing in Michigan, town of Lapeer, was attacked with acute inflammation of both eyes, which had nearly destroyed his sight. Not being able to obtain relief where he resided, and finding his eyes were getting worse by every application that he made use of, he came to Toronto, in January, 1853, and remained under my care for twenty-two days, at the end of which time, his sight was perfectly good, and his eyes were strong enough to enable him to attend to his general out-door business. He returned to Michigan entirely restored, and has had no return of his disease since. CASES AND OPERATIONS. 229 CASE 58. ' Blind from Acute Inflammation. Miss Sarah Roddy, of Niagara, aged thirteen, was brought to me three years since with a severe form of acute inflammation of both eyes, of some months' standing, and was unable to go without a guide. She had been treated by a number of medical gentlemen before she applied to me, but to no purpose, and her case was getting worse from week to week. Her attendance was continued with me for about three months before the disease was broken, but she then rapidly recovered her sight and health, and returned to her family greatly changed in appearance. The young lady has continued to enjoy good sight since the period above stated, until within a few weeks, when she found one of her eyes the subject of a fresh attack of inflammation; she placed herself under my care without delay; and in about twenty days returned to her family entirely restored, able to read, write, or sew, as well as ever. She is now in her eighteenth year. CASE 59. Blindness removed by Ten Days' Treatment. Mrs. Mary Lewis, of Sparta, came to me with a chronic inflammation of her eyes, and was quite blind in consequence, having been in that state for several months. I treated this' lady for about ten days, when I was obliged to leave London; but she was so much 230 CASES AND OPERATIONS. improved b}r it, that, with the treatment and direc- tions she received from me, she completely recovered her sight in about a month after I left her. CASE 60. Cross-Eye in a Child only Three Years old. Sheriff Hamilton, of London, C. W., brought a granddaughter of his to me for treatment. She was a beautiful little black-eyed creature, only three years of age; but was afflicted with a very bad squint or cross-eye, caused by convulsions. I operated on this tender little pet without much ceremony, and was entirely successful in removing all appearance of defect, in less than one minute. There wTas but little pain produced in making this operation; which may be performed at any time without the least risk to the eye. CASE 61. Blindness from Inflammation and Bad Treatment. Robert Foster, of St. Catherines, consulted me in May last, for a disease of his eyes, being then entirely blind, and otherwise so much impaired in health as not to be able to leave his room. He was treated by me for one month, and at the conclusion of my attend- ance could see to read and attend to his business. His health was quite restored; as he continued to visit my office regularly for a fortnight before I left. CASES AND OPERATIONS. 231 CASE 62. Deaf One Year.—Cured in One Sitting. Miss Sarah Ann Leeper, aged sixteen years, had a slight attack of deafness, arising from cold. She was deaf one year, and had noise and other unpleasant sensations in the ears. This young lady was very nervous; but by persuasion she consented to take a sitting, under the promise that she should not be hurt, and her hearing would be restored. This she did; and her hearing was perfectly restored before she left the chair, and without giving her the least pain. CASE 63. Artificial Eye Inserted. Sampson Smilie, of Port Dalhousie, lost his left eye some years ago, by an accident; and is now wearing an Artificial Eye which I inserted for him, and which completely defies detection. It was inserted without pain, is worn without pain, and is so complete a match to his sound eye, both as to appearance and motion, as not to be perceived. CASE 64. Disease of the Eyes, of Twenty Years' standing, cured. John Bowerman, of St. Catherines, aged seventy years, consulted me for a disease of his eyes, of twenty years' standing, which he had tried in vain to get cured since it first commenced. He continued his 232 CASES AND OPERATIONS. attendance with me for about one month, when he felt that it would be unnecessary for him to remain longer. His eyes were free from inflammation, and he was able to attend to his business without the least inconvenience—a fact he had not realized since his disease first made its appearance. CASE 65. Profuse Discharge from the Ears, caused by Scarlet Fever. Miss Ann McKillman, aged sixteen years, had a very profuse discharge from both ears, of a very offensive nature, arising from scarlet fever, which she had had for eleven years. She wras treated and cured in one month, while I was at St. Catherines, and her hearing was greatly improved; but owing to the severity of the case, and the destruction of important parts of the ear within, it was impossible to render the hearing perfect. She could hear common conversation, however, without much inconvenience. CASE 66. Blindness from Inflammation. Miss Mary Ann Creighton, of Brockville, aged sev- enteen, was brought to me entirely blind with inflam- mation of her eyes, in July last, and had been in that condition for several months. She was sent to Mont- real, where she remained for some months, without receiving the least benefit. I treated this young lady CASES AND OPERATIONS. 233 for six weeks, seeing her daily during that period. At the conclusion of my treatment her sight was so far restored that she could see comfortably, was able to come and go without a guide, and could recognise her acquaintances. As she was then doing well, and all inflammation had left her eyes, I presume she has continued to gain till her sight has become entirely restored. CASE 67. Cross-Eye cured. Mrs. Wm. Mickle, of Easton's Corners, aged twenty-five years, had a very disagreeable cast in her right eye, of some twenty years' standing, caused by convulsions when a child. Sight was not good in this eye. An operation was performed, and the eye put perfectly straight, in less than one minute. She now enjoys perfect sight in both eyes, and has as straight a pair of eyes as was ever seen. CASE 68. Blindness from turning in of Eye-Lashes. Mrs. Jane Holden, aged forty-two, had a very severe affliction of her eyes, caused by the turning in of the eye-lashes. This state of things had continued so long that the sight was nearly destroyed by the friction of the eye-lashes against the ball, and which kept up a constant and severe inflammation. I made an operation on this lady's eyes, and in ten days she was perfectly well, v§th her eyes quite strong, and the sight greatly improved, and rapidly recovering. She left for home, entirely satisfied with her improvement. 234 CASES AND OPERATIONS. CASE 69. Double Cross-Eye cured. Master C. Vanarnam, aged thirteen years, residing at Brockville, had had a double Squint or Cross-Eye from birth, which gave him a most disagreeable expres- sion. He was quite willing to have his eye straight- ened, as he was assured it would cause him but little pain, and be only of a moment's duration. Both eyes were operated on, at intervals of one week, and the result was, that he lost all appearance of squint immediately; his sight rapidly improved, and his eyes acquired a perfectly natural appearance. He submitted to the second operation more willingly than the first, finding that it really was not so severe as he had ap- prehended. This operation can generally be performed complete in from half to three quarters of a minute. CASE 70. Brother and Sister Blind from Inflammation.—Both cured. Miss Henrietta and Master Henry Brundage, aged fourteen and eleven years, respectively, children of William Brundage, residing near Merrickville, were sufferers for more than three years, with a strumous inflammation of their eyes. The lad had lost one eye and the other was fast going. The young lady's eyes were also very bad, and became progressively worse. They were placed under my care in the month of August last, and were entirely cured in four weeks; the boy, of course, fating'blind in one eye, which had burst before he came to me, and the young lady was entirely cured. CASES AND OPERATIONS. 235 CASE 71. Cross-Eye cured. Miss Manhard, of Brockville, aged nine years, sub- mitted to an operation in August last for the cure of a Squint or Cross-Eye, which was done, and her eye made perfectly straight in less than one minute. The child sat perfectly quiet during the operation, and did not indicate that she suffered in the least. CASE 72. Deafness from Cold. Shubal Kelly, of Escott, aged forty-nine years, suf- fered for six years with inflammation of his eyes, that rendered him entirely unfit for business. He was perfectly cured of his disease, and his sight restored by four weeks' attendance with me. •CASE 73. Cross-Eye cured. John Malloch, Esq., of Brockville, aged twenty- five, had his left eye injured, which caused him to squint. His eye was operated on by me in August last, and made as straight and perfect as the opposite eye.' This was a case of four years' standing. 236 CASES AND OPERATIONS. CASE 74. Blindness of Thirty Years' standing cured. Mrs. Wm. Manhard, of Brockville, aged seventy years, had a low chronic disease of.the eyes, of thirty years' standing, which rendered her life quite miser- able. She consulted me in the summer of 1S53, and remained under my care for about four weeks. Find- ing her eyes quite strdng, and sight as good as could be expected for one of her age, she returned to her family, looking at least twenty years younger than she did a month previous. CASE 75. Brother and Sister Blind.—Both cured. Sylvester Trickey, of Escott, had two small child- ren, aged two and five years, respectively, which he brought to me blind, having fallen into that state soon after birth. I treated these children and restored them to perfect sight, after four weeks' treatment, and there was also a proportionate improvement in their general health, which in such young subjects is very apt to be impaired, and without this attention ' a cure could not be effected. • CASE 76. Deafness from Polypus in the Ear. M. Higgins, of Prescott, aged seventeen, was nearly destitute of hearing caused by the growth of a Polypus in his Ears. He has suffered for twelve years and CASES AND OPERATIONS. 237 could scarcely be made to hear at all. I made an operation and removed this excrescence from each ear, which greatly improved his hearing, and also arrested a very offensive discharge, which had never left him for twelve years. It was caused by a fall, which also gave him a cross-eye. This defect was also removed at the same time, and the young gentleman was rendered very useful to a widowed mother, by the improvement of his sight and hearing. CASE 77. Blind from Inflammation. John Mcintosh, of Pickering, aged twenty-eight, has suffered for about eighteen months with a disease of his eyes, which he has not been able to get cured. He consulted various persons who professed to treat such diseases, and finding his eyes failing, he went to New York in the summer of 1853, where he consulted an Oculist of some eminence there. After a fair and patient trial in the great City of Gotham, where he considered he was almost certain of obtaining relief, he returned to Toronto, and placed himself under my care, on the 14th day of December last, and was dis- .missed, entirely cured, on the 20th of January inst., being but a day or two over five weeks under my care. CASE 78. Blindness from Closed Pupils.—Sight restored by an Operation. James McFadden, a farmer, residing near Brock- ville, aged forty years, consulted me for a very extraordinary state of his eyes, which had been attacked with inflammation many years previously, 238 CASES AND OPERATIONS. and left him as I then saw him, almost entirely blind, and with a large family to support. He had lived in that way for nine years. In this case the pupils of his eyes had closed by the severity of his previous inflammation, and left him blind. On the 8th of August, 1853, I made an operation, and formed an Artificial Pupil, with complete success. He immediately had his sight restored, and after a few days was able to return to his family, with sight nearly as good as ever, and has continued ever since to do well. In this operation, which was extremely difficult and important, I was ably assisted by Dr. Thomas McQueen,, and Dr. Garvey, of Brockville. CASE 79. Blindness from Cataract. S. P. Thomas, Esq., of Augusta, aged eighty-two years, consulted me in August last for a Tailing of his sight, which on examination proved to be a Cataract. He was entirely blind in one eye, and the other was fast failing. Nothing could be done short of an opera- tion ; and though he had passed four-score years, he cheerfully submitted to the operation, with the pros- pect of again enjoying his sight. He was operated on, and the cataract successfully removed on the 18th day of August last, and in less than two weeks he was known to walk from Brockville to Prescott, a distance of twelve miles, with as much activity and buoyancy of spirits as a young man of twenty. Nothing has since occurred to interfere with his more perfect sight, and he can see to read, with the aid of glasses, as well as he could thirty years previously. CASES AND OPERATIONS. 239 CASE 80. Lad Blind from Congenital Cataract. Robert Moses Wilson, aged fourteen years, son of Elizabeth Wilson, of Dorchester, County of Middlesex, (London) had Cataracts formed on both his eyes soon after he was born, which were soon so complete as to blind him. He remained in this state till about two years ago, when he was taken to New York, where, by the aid of the best counsel there, he was operated on for the removal of one Cataract, which was only partially successful; and not having sight enough by what was then done to educate him, he was recommended to my notice, and on the 10th of May 1853, I performed an operation on his right Eye, and removed the Cataract. The operation was most complete, for in an instant he found his sight restored, and suffered none by this operation. I saw.him on the following day, and found him still improved and doing well. Being obliged to leave London about that time, I did not see this lad again till the 14th day of February 1854, being about nine months after. I then found his cataracts were entirely gone, and nothing remained visible in either of his eyes to indi- cate that he had ever been afflicted with any disease of those delicate organs. He told me he could see perfectly plain and clear, was going to school, and he was making rapid progress with his education; giving another and most striking illustration of the good old maxim, "better late than never." It is just to remark in this last case that so soon as the sight of the right eye had been restored by my operation, the opposite eye began to improve also, and is now 240 CASES AND OPERATIONS. nearly as good as the right, giving another and beau- tiful illustration of the sympathetic influence of one eye over the other; for the left eye was operated on one year before the right, and yet the sight was nearly useless or at least very feeble. CASE 81. Double Cross-Eye removed by an Operation. Mrs. Maria Murray, of Dorchester, aged forty-four years, school proprietress, had from her infancy ac- quired a squint or Cross-Eye, by looking at the light obliquely while in the cradle or bed, and she found both her eyes badly inverted since her earliest recol- lection. On this account she was obliged to take to the use of glasses, at an early period of life, and could not read, write, or sew without them. More recently, she discovered, that even with the aid of her spec- tacles she could not perform the duty incumbent on her situation as formerly, and therefore made appli- cation to me in London, C. W., in the month of Feb- ruary, 1854. I operated on both Eyes at the same sitting, and put them perfectly straight; and in less than one week after, she assured me she could see any kind of print perfectly plain without the aid of her spectacles, a pleasure she had not enjoyed for many years before. CASE 82 Severe Wound of the Eye.—Complete Recovery. Robert McCullough, aged thirty years, residing at St. Thomas, C. W., a carriage maker by occupation, met with an accident on the 16th of April, while cut- ting a piece of iron with a cold chisel. A portion of CASES AND OPERATIONS. 241 the ragged fragment flew from the vice, and struck him full in his left eye, laying the front open in three different directions, cutting the cornea, and lacerating the iris, or curtain of the eye, so severely that a por- tion of this delicate membrane protruded through the ragged wound, and had to be removed. The blow was so severe, also, as to produce a cataract instan- taneously, leaving his eye, of course, entirely blind. I saw this gentleman about four hours after the ac- cident occurred, and placed him under my treatment, merely with a view of preserving the eye in as good shape as possible, but without offering him any hope of ever rendering the eye again useful. However, the treatment was commenced in good time, and took good effect, for in about two weeks the wound had entirely healed, and his eye was preserved in good shape, though completely blind from the cataract. I prevailed on him to allow me to remove this by an operation, which he readily assented to, and in a few weeks after, his sight was found to be good in this eye, and the organ preserved, under circumstances that could scarcely have been credited at the com- mencement of his misfortune. CASE 83. . Blind Thirty Years.—Sight restored. Mrs. Hannah Gates, of Ripley, Chautauque County, N. Y., aged sixty-four, had a severe chronic inflam- mation of both eyes, for upwards of thirty years, and though she had been treated by a number of medical gentlemen of the first standing, she could find no relief. On the 1st of May, 1855, she made applica- tion to me for advice, and was received under treat- 16 242 CASES AND OPERATIONS. ment, and was dismissed on the 26th day of the month, being quite cured, able to use her eyes in the usual way, and was much improved in her bodily health. She has had no return of her disease since. Here is a disease which had existed for upwards of thirty years, in a very wTeak and debilitated constitu- tion, resisting every form of treatment previously used, but was completely subdued in twenty-six days, and has not since relapsed. N CASE 84 Diseased Eye removed, and an Artificial one inserted. Miss Frances Perrine, of Newstead N. Y., aged twenty-one, had lost her left eye by disease, and the right was also blind from sympathetic inflammation, and it became necessary to make an operation in the lost eye, which was done, and an artificial eye inserted; this done, the diseased eye soon healed, and her most intimate friends are not aware that she wears an arti- ficial eye, so close is the imitation. CASE 85. Accidental or Traumatic Cataract in a Child.—The Sight restored. Stephen C. Millard, of Houghton Township, Port Rowan, a child aged five years, had cataract of both eyes, caused by having an apple thrown at him and accidentally striking one eye, producing cataracts in both. I made an operation on this child's e}^e, not- withstanding his youth, at Buffalo, in May, 1855, CASES AND OPERATIONS. 243 and he had so little trouble afterwards, that he returned home in five or six days. I saw this lad in March following, and found that one eye had first-rate sight, and by a repetition of the operation, which was instantaneous, he now enjoys good sight in both eyes, though he was entirely blind when he came under my care. He suffered very little by the operation, or after, and can see as well as ever. CASE 86. Double Cross-Eye. Miss Mary Drysdale, of Hamilton, a young lady of prepossessing appearance, aged eighteen years, was during her childhood precipitated through a trap-door, and was taken up for dead. She rallied, however, and finally recovered, but it was discovered that both her eyes were turned crooked by the fall, which was so bad as to render sight almost useless. Thus she con- tinued till the Spring of 1856, when she was placed under the author's care, who made an operation on each eye, at intervals of about ten days, and the result has far exceeded the most sanguine expectations of herself and friends; the eyes, which were so badly turned as scarcely to be visible, are now as straight and natural looking as though nothing had ever disturbed their equilibrium, and her sight, which was very imperfect and weak, is now strong and good, and her nearest and best friends are at a loss to recognise in her the companion of their youthful days. 244 CASES AND OPERATIONS. CASE 87. Deafness of Forty Years' Standing cured in Two Hours. Jonathan Dean of Buffalo, toll-gate keeper, aged sixty-four years, applied to me at Buffalo, on the 4th of July, 1855, for a very severe and obstinate deafness of both ears, which had afflicted him for forty years. He placed himself under my care, after getting a very favorable opinion of his case, and was completely restored to perfect hearing by two hours' treatment. He suffered nothing by the treatment, nor has he had the least return of his old complaint, now more than four years past. He could only hear a watch when in contact with his ears at the commencement of treat- ment, but in ten days could hear the same watch ten feet distant, and all noise and other unpleasant sensa- tions have entirely passed away. CASE 88. . Cataract removed and Sight restored in an aged person. Richard Weston, of Maraposa, C. W., aged sixty- six years, applied to me in the month of March, 1857, being then entirely blind with Cataracts, which commenced to form about fourteen years ago. I commenced an operation on his right eye with success and removed the Cataract, which immediately re- stored sight in that eye, and but for an oversight in leaving his window open at the head of his bed the same night, would doubtless have been satisfactory— the inflammation arising therefrom spoiled the opera- tion. In the course of a few days after this accident, I operated on the left eye, with equal success, and CASES AND OPERATIONS. 245 with a far more satisfactory result, for he scarcely knew that the eye had been touched, and on the third day, when the bandage was removed, he was not a little amazed to find his sight clear and good, as it was in his youthful days. He returned to his family in about a week after, able to read ordinary news- paper print with the aid of Cataract glasses. CASE 89. Deafness from Cold.—Hearing restored. Miss Wingfield, daughter of Mayor Cook, of Buffalo, had a discharge from her ears, of several years' stand- ing, caused by sickness, which rendered her quite deaf. She was treated for about six weeks, during the sum- mer of 1855, and all the difficulty entirely removed. CASE 90. Two Sisters nearly Blind from Inflammation. Mrs. Mary Falkner, wife of Isaiah Falkner, farmer, of Caledon, and her sister, Miss Matilda Clark, applied to me one year ago, being then both blind from inflam- mation of the eyes, which had existed for about eleven years. The skill of their regular physician, and others who had been consulted, failed to render the least assistance. In both cases these sisters recovered their sight at my hands, after a period of five weeks' treatment in one case, and seven weeks' in the other, and have both continued to do well, now one year cured. I saw Mrs. Falkner on the 29 th May, 1856, and found her sight good, and her sister, Miss Clark, is also sound both in sight and health. IMPORTANT SURGICAL OPERATION. Miss LYDIA L. SUTTON, aged fourteen years, as she ap- peared on the 28th of June, 1859, immediately before submit- ting to a double operation, for the removal of a DISEASED EYE, and a LARGE TUMOR which had been growing for FOUR YEARS. (246) CASES AND OPERATIONS. 247 CHICAGO CASES AND OPERATIONS. CASE 91. Double Operation, for the removal of a Diseased eye, and Large Tumor of Four Years' growth. Miss Lydia L. Sutton, of Niles, 111., aged fourteen years, daughter of Mrs. Coats, toll-gate keeper of same place, has been a constant sufferer for upwards of four years frohi a very formidable disease of her right eye, and its appendages, which had (at the time her parents made application to me—which was in June 28th, 1859) entirely destroyed her sight, and was making serious havoc with the eye-ball; and had, furthermore, destroyed a portion of the bony socket. The preceding engraving is from an ambrotype taken from life by Brigham, just before the operation was performed. The upper lid was thrown completely out of place, and had grown fast to the eye-brow. The eye itself was staphilomatous and protruding, and a large tumor, growing rapidly, was throwing out a most profuse and foetid discharge, quite sickening to the patient herself, and very weakening to her already enfeebled constitution. Her parents had consulted several very eminent surgeons and physicians, during the period of its formation, up to the time of my seeing her, but none of them were willing to take the responsibility of an operation that to them appeared both complicated and formidable, and not very likely to be attended in its results with a very great amount of professional eclat. 248 CASES AND OPERATIONS. This young lady had suffered most severely by this disease since its earliest commencement, and her suffer- ings were borne with great patience. Notwithstanding her youth, she was willing and even anxious to submit to any course of treatment which might be thought best and safest to relieve her of her long-tried affliction. After a careful examination of her case, I advised an operation for the removal of a portion of the diseased eye-ball, which was readily accomplished while the patient was under the influence of chloroform. She felt nothing, nor did she know that anything had been done for her until it was all over, and she was restored to consciousness. In the course of about three weeks after the first operation, a second operation was per- formed for the removal of a large tumor which had grown deep in the socket of the eye, and formed a strong adhesion to the bony structure above and the eye-ball below, throwing the upper lid out of its place, and causing an adhesion between the lid and eye-brow. This tumor was readily removed while the patient was for a second time under the soothing influence of chlo- roform, and every particle of the morbid growth was carefully dissected from its close attachment, above and below, and to all parts of the organ. Its completion was attended with the most immediate relief from her long sufferings, and nothing occurred afterwards to interfere with the complete healing of the wound, and she was soon restored to health and happiness; and although the eye was sacrificed by the disease, which would have ultimately caused death, she is now free from all pain and suffering, the disease has been re- moved, and an end put to its destructive course, not- withstanding she had been a silent and patient sufferer for upwards of four years. Three months have passed CASES AND OPERATIONS. 249 since the last operation, and she is still free from all suffering, and her health continues to improve. CASE 92. Young Lady nearly Deaf and Dumb from Scarlet Fever. Good Hearing and Speech recovered. Miss Maria S. Currier, of Valparaiso, Ind., aged sixteen years, had scarlet fever at the 'age of six years, which so completely deprived her of hearing that she could scarcely be said to hear at all, and she gradually lost her speech, or became so deficient in articulation that she could only be understood by those who best knew her. I considered her case as a very doubtful one, and received her as such, merely with the view of testing the possibility of restoring her hearing again. I treated her for a period of about three months, and had excel- lent success in raising her hearing and restoring the organs to a state of health and usefulness, and she can how readily hear any ordinary conversation, if not too distant, with comparative ease. Her speech, which was so imperfect, has also undergone a pro- portionate change for the better, and she takes a part in conversation with much animation, and seems greatly delighted at the power she possesses to hear and respond to all questions put to her. This is an interesting case in many points, for it shows that much may be done, where the effort is made, to restore hearing, even in cases where the organs seem destitute of the power of ordinary impressibility; and it also explains the fact that where the hearing is very much depreciated, either by sickness or injury, that 250 CASES AND OPERATION'S. speech will also become imperfect, or altogether lost, according to the absolute amount of hearing retained Speech is nothing more than imitation of sound, and can only be acquired by those who hear and under- stand. When the hearing is destroyed altogether in young subjects, they invariably lose the power of speech in a very short time. Should a degree of hearing be retained enough to enable the child to hear, even in a loud tone, speech may still be retained to a certain degree, but the voice Is always weak and faltering, and the articulation quite imperfect. CASE 93. Granular Inflammation of Eight Years' standing. John Hogan, 223 Randolph Street, Chicago, aged forty-five years, has suffered for eight years with severe granular inflammation of his eyes, which for much of the time deprived him of sight, so as to completely unfit him for his business, and at times was quite blind. He in good time sought the advice of some renowned humbug, and of course obtained the usual amount of relief—which was to relieve his purse of a few dollars, but failed to remove a proportionate share of his dis- ease ; and poor John soon made his way to my surgery, on my arrival here. Suffice it to say that no man ever had a more successful course of treatment than said Hogan; for although his business was such as to expose him to the most injurious consequences, he is still in the enjoyment of perfect sight and health, and though six months have elapsed since his cure, has had no return of his old disease, which had been his constant companion for eight years. CASES AND OPERATIONS. 251 CASE 94. Cataract Extracted. Samuel Sherman, aged sixty years, had cataracts form in his eyes some years since, which completely destroyed sight. He submitted to an operation for the removal of one cataract, which, though partially successful at the time, proved a failure in a short time, which left him again blind. In this case the cataract was not removed from the eye, but merely displaced, and thrown out of the axis of vision. In January last I made an operation on the opposite eye, and removed the cataract bodily from the eye by an operation called extraction. This was a most com- plete success; for in a few minutes after the cataract was taken from the eye he could see well, and with the usual amount of care which operations always require, the eye was restored, sound and good, and with the aid of cataract glasses he could see to read ordinary print. Cataracts removed in this way can never appear a second time, as they are taken from the eye bodily, and placed in a small bottle of spirits, where they remain preserved, to be examined by the curious, and rejoiced over by those who by their removal have had their sight restored. CASE 95. Ulcerated Cornea. Thomas Hall, of Chicago, a butcher, suffered for three years with inflammation of the eyes, which he in vain tried to get rid of by the use of all the vulgar 252 CASES AND OPERATIONS. prescriptions usually resorted to, for the use of sore eyes. It was of no use; nothing would cure them, but he was often relieved. At length his sight became alarmingly worse, and on the last day of the last year he heard, through a friend who had been cured—who was indeed much more seriously afflicted than himself—that he would undoubtedly find complete relief from all his sufferings by placing himself under the author's care, and he accordingly did so, and was entirely and per- fectly cured in less than six weeks. He has doubtless continued to enjoy the benefits derived, as he has not called upon me for the last eight months. This I think rather unkind in Hall, especially as he resides in the city, and knows I am anxious to see him. CASE 96. Inflammatory Ulcer in the Eye. Miss Jennie A. Nichols, of Waukegan, aged four and one-half years, was brought to me in June last with a large inflammatory ulcer on her right eye, which at that time threatened to destroy the organ. She was brought to me daily by her father, for about a month, when it was considered unnecessary to continue longer, the ulcer having in the mean time healed, and her eye preserved. CASE 97. . Double Cross-Eye. Miss Jennie A. Birch, of Racine, Wis., aged twenty years, had a very severe double cross-eye since she was an infant, caused by convulsions. Her sight was very CASES AND OPERATIONS. 253 poor, as is always the case where both eyes are turned, and her affliction had caused her a great deal of mental distress, since she was old enough to realize her unfortunate condition. She applied to me on the 26th of August, and the double operation was performed, with complete success, and her eyes made perfectly straight, in less than two minutes. She bore the operation with that courage which is so characteristic of her sex, and now has her reward in a pair of straight clear black eyes, without a fault or blemish, and added to this she has found a great improvement in her sight, as the result of the operation. Who, that regards their looks, or their sight,would shrink from an operation so trifling, and yet so promising in its result, and which can be done without confinement or loss to business ? CASE 98. Inflammatory Ulcer. Miss Melvina Weber, aged eleven years,daughter of John D. Weber, on Lake Street, has for the last two years been afflicted with inflammation of her eyes, on oneof which a large ulcer had formed, which threatened soon to destroy her eye. She was brought to me by her friends on the 26th of July, not being then able to open her eye, even for a moment's examination, while the water was gushing from between the lids as if the humors were escaping, and the pain was intense. She had been treated for several months before coming to me by one who professes ocular science in this city, but the increase of her disease, and the dangerous aspect her case assumed, led her parents to consult me. I am 254 CASES AND OPERATIONS. pleased to say that though still an occasional visitor, she is quite well and free from pain, her ulcer has healed, and her eyes are clear and strong. CASE 99. Strumous Inflammation. Miss Kate Dooley, aged fourteen years, residing on the Corner of Polk and Rooker Streets, was born of healthy parents, and blessed with pleasing features and bright blue eyes, but for ten years past her hitherto sparkling optics have been the seat of a most distressing inflammation, which for most of the time prevented her from seeing at all, and never with the least ease or comfort; and two very dense opaque spots had formed upon her sight as the result of the severity of her dis- ease. This somewhat alarmed her parents, and she was brought to me on the 15th of September of the present year, and she now rejoices in the power she possesses in. being able to hold up her head and look through as bright and pretty a pair of blue eyes, as ever graced the orbits of the fairest of Adam's race. CASE 100. Diseased Eye-Lids cured. Miss Mary E. Titus, of Tonica, La Salle County, Ills., aged eleven years, has had for nearly ten years a disease of her eye-lids, growing out of measles. The lids were greatly thickened and swollen, the margins of which were studded with small white festers, disfig- CASES AND OPERATIONS. 255 uring the eyes, and causing the lashes to fall out, and otherwise weakening and irritating the organs. Dur- ing sleep, they would become firmly glued together, requiring an hour's labor in the morning to get them open. She was completely cured in less than a month by mild and gentle treatment. The removal of this disease has effected a remarkable improvement both in her appearance and feeling, and has added much to her personal comfort, besides removing a trouble, the continuance of which would have dis- figured her for life, by the irretrievable loss of the eye-lashes. CASE 101. Blindness from Granulated Eye-Lids. Mrs. Margaret J. Power, of Chicago, aged fifty years, applied to me in May last, being then blind from granular inflammation of the eyes, of three years' standing. In vain had she sought for advice in rela- tion thereto, and paid dearly for it, but no relief could be had, and when she came to me she was despairing of ever being again made sound in sight. She was dismissed from treatment in five weeks, perfectly and entirely cured, and has continued since to enjoy the full and complete use of her eyes, for all purposes, as well as ever. CASE 102. Double Cross-Eye.—Faulty Operation by a Professed Surgeon. Miss L. E. W., of Galesburg, aged twenty-two years, was born with straight and beautiful eyes, but at an early age she was discovered to have both eyes crossed, 256 CASES AND OPERATIONS. and when ten years old, was operated on by a pro- fessor of surgery in New York State for the purpose of removing the unpleasant defect. This operation proved a failure, and the two organs soon took the opposite direction, and there remained, leaving the young lady with her two eyes each looking towards the temple, rendering her sight extremely weak and imperfect. I saw this patient in March last, and made an operation on both eyes, which had a most charming effect. She returned home to her friends in a few days, with her eyes occupying an entirely new position, completely changing the character of her face, and nearly if not entirely placing her eyes in their proper position, giving increased strength to see, and power to control the movements of this won- derful little organ. From letters received I have reason to be assured that this young lady is entirely satisfied with my modification of the original operation. CASE 103. Eye wounded by Percussion Cap. R. R. Clark, Esq., of this city, wounded his right eye while hunting, by which a small portion of the copper from the cap penetrated his eye and lodged on the iris, near the pupil. It was exceedingly small, and was so located as to render the removal of it impossible, without incurring greater risk than its presence might create. I therefore treated it as a simple wound, and soon subdued the inflammation. No injury to the sight has since been experienced, and the organ remains sound; but a bright, shining speck of copper is still visible in the eye, securely imbedded in the fibres of the iris, where it has been CASES AND OPERATIONS. 257 snugly ensconced for the last four years. This must be considered an exceedingly fortunate termination of an injury of such a character, to so delicate an organ. In most cases like the above, the whole eye would become the seat of extensive inflammation, which would only terminate by suppuration, and complete loss of the organ. CASE 104. Deafness and Discharge from the Ears, from Scarlet Fever. Polypus removed. K. W. Kerr, of La Porte, Ind., aged seventeen, had an attack of Scarlet Fever when only four years old, which left him very deaf and with a profuse discharge of foetid matter from both ears. I saw this young gentleman for the first time in February last, when I commenced treating his case. A large Polypus filled the right ear, being the pro- duct of his long-continued disease. This was readily removed, and subsequent treatment, which was con- tinued for less than a month, found my patient with no discharge from his ears, the Polypus removed, and good hearing restored. CASE 105. Granulation and Ulceration of the Eyes. Mrs. Frank Jones, of Kankakee City, 111., has suf- fered for three years from the above disease, which rendered life miserable to her most of the time. In vain had she endeavored to obtain relief from her troublesome disease, through the usual means resorted 17 258 CASES AND OPERATIONS. to in such cases. In the early part of the present year, I treated her for a few weeks, and have much pleasure in stating that she is now entirely cured, and in the enjoyment of much better health than she usually had, during the whole period of her ocular affliction. CASE 106 Pterygium removed from the Eye. Chandler McWayne, of Michigan Bluffs, California, had a Pterygium on his left eye for twenty-three years, which deprived him of the perfect use of the organ, besides presenting a very visible blemish, and at times giving him a great deal of trouble from the increasing inflammation. In February last, a momentary oper- ation completely removed the entire disease, which had existed for more than a score of years, and a few days more healed the wound, and left my California friend with a sound and faultless eye. CASE 107. Chronic Inflammation of the Eye, of Twelve Years' stand- ing.—Perfect Cure in Six Weeks. Mr. R. M. II----, of this city, suffered with inflam- mation of his right eye for twelve years, and could find no cure, though he paid liberally for both treat- ment and advice. I treated this gentleman for a few weeks, during the Spring of the present year, and he is now entirely relieved of a most troublesome and painful disease, with which he had been afflicted for more than twelve years. It is now entirely removed, and his sight is good. CASES AND OPERATIONS. 259 CASE 108. Chronic Inflammation. Capt. John Enright, of Bloomington, 111., has for many years endured great hardships by inflammation of his eyes, which baffled all skill to cure, or even to furnish hiin with permanent relief. In April last, when I first saw him, he was nearly blind, and his eyes looked more like masses of disorganized flesh than human optics, intended for useful purposes. He now rejoices in a pair of bright and clear eyes, and I hope he may live to enjoy the long-looked-for blessing many years. CASE 109. Capsular Cataract removed.—Sight restored. Ira Haggart, of Galesburg, Ills., aged twenty-eight, was born with Cataracts in both eyes. He had an operation performed on one of his eyes for the restora- tion of sight, when only ten years old, which was only partially successful—a portion of the capsule remaining, as large as the pupil itself, with a central opening not larger than a pin-hole, and this was all the sight he had. In February last I made an opera- tion, and removed the opaque capsule, which, in the course of a short period afterwards, found him with as good sight as could be given after such an opera- tion. With the aid of his glasses, (which are always required after the removal of cataracts,) he can see to read, and transact business, though nearly blind for twenty-eight years. 260 CASES AND OPERATIONS. CASE 110. Granular Inflammation. Mrs. Margaret Gray, of Blackberry Station, Ills., has suffered severely with inflammation of her eyes for several years, which gave her great distress, and at times rendered her quite blind. I treated her in March of the present year, and in a very few weeks completely removed the entire disease, since when she continues to enjoy all the advantages gained by the cure at my hands. This lady had been treated by different operators, at various times, but all to no effect, and she now rejoices over the " long looked for, come at last." CASE ill. Blindness from Closed Pupil.—Sight restored by Operation. Mrs. Mary Streeter, wife of the late Dr. Barton Streeter, aged sixty-four years, lost her sight about three years ago, by a severe attack of inflammation, which eventuated in complete blindness, after many weeks' treatment, at the hands of her attending phy- sicians, causing a closure of the pupils. In this state and with feeble health, I received her under my care, in February, 1859, and after due preparation made an operation on her right eye, restoring sight immediately. The age and otherwise unfavorable condition of this lady did not daunt her in this most important under- taking, and she is now in the enjoyment of good sight, and has returned to her friends in Houghton County, Minn., there to pass the remainder of her CASES AND OPERATIONS. 261 days in the enjoyment of one of the greatest blessings which can be bestowed upon helpless humanity, and of which she had been deprived for nearly three years; viz.: sight—blessed, comforting, consoling sight! CASE 112. Double Cross-Eye. John G. F----, of this city, aged eighteen, had a double operation performed on his eyes, to remove double cross-eye, which he has had since a child. His sight was poor, and the eyes appeared very much turned. In less than one minute, however, he was looking through as straight eyes as ever graced the face of youth, and he has continued since to realize all that heart could desire, by the enjoyment of perfect sight, through a pair of perfectly straight eyes. The sight and strength of the organ continued to increase for months after the operation was made. CASE 113. Blindness from Granular Inflammation. Frank Miller, aged about thirty-two years, butcher by trade, contracted an inflammation of his eyes about eighteen months before applying to me, which, at the time I saw him, in November, 1858, had completely destroyed his right eye, and his left eye was entirely blind from the same disease. He had submitted to the usual routine of treatment, such as caustic and blue stone, prescribed by those who claimed to be master* of the healing art, until he had scarcely a remnant 262 CASES AND OPERATIONS. of an eye in his head, and his condition was so extremely critical that for several days I doubted my own ability to restore sight. However, I received and treated him, and I doubt not but he will join me in saying that he has at least one good sound and clear eye, with the aid of which he has been and is still able to provide for the wants of his little family, and has had no trouble with his eyes since the cure was effected, now more than six months past. CASE 114. Internal Inflammation of the Eyes, from suppressed Eruption. S. W. Hotchkiss, 275 South Clinton Street, applied to me in April last, for an inflammation of his eyes, which threatened at one time to destroy his sight altogether, by closing of the pupils. The attack was superinduced by the suppression of a cutaneous eruption, with which he was attacked some time previously. In this case treatment brought out the eruption, which received appropriate attention, and his eyes soon recovered their usual strength and clearness, without leaving a blemish. CASE 115. Granular Inflammation. Felix Duffins, of Winona, Minn., Railroad Con- tractor, aged forty-five years, had a severe attack of inflammation of his eyes, of four months' standing, which nearly or quit' deprived him of sight. His eyes CASES AND OPERATIONS. 263 were very painful, and gave him, a great deal of trou- ble, and for most of the time he was confined to the house, in a dark room. He was completely cured by me, after five weeks' treatment, and has since con- tinued to enjoy uninterrupted good sight. CASE 116. Double Cross-Eye. Miss Sarah Cusack, of Chicago, Ills., had a double cross-eye since she was a child ten years of age, caused by convulsions, which not only gave her a very awk- ward appearance, and deprived her of the free use of the eyes, but rendered her extremely short sighted. At the age of twenty years she applied to me for ad- vice, and before leaving my room submitted to an operation, which, in a few moments, found her with a perfectly straight pair of eyes, and with an immediate improvement in her sight. Her right eye was so badly turned in, that but a small portion of it could be discovered, and the sight of this eye was therefore of little or no use to her. It is now a little more than one year since the operation was performed, and she still enjoys perfect sight, without obliquity. This may be said to be the invariable result of this most important, though in itself trifling, operation. CASE 117. Pustular Inflammation of the Eyes. Henry B. Hinsdale, Jr., of Kenosha, aged seventeen, has for one year had a troublesome inflammation of his eyes, which was always increased by any attempt 264 CASES AND OPERATIONS. to read, or use the organ for any such necessary pur- pose. It is a disease peculiar to young subjects of both sexes, and is generally very tedious and trou- blesome to remove, frequently adhering to the organs for years, fluctuating from better to worse, but never entirely passing away. Treatment at my hands, for about one month, found this disease among the things that were. This young gentleman is now, as I under- stand, enjoying a feast in the way of reading, a luxury which he fully enjoys, as he is anxious to pursue a literary course. CASE 118. Severe Disease of the Eyes, of Six Years' standing.—Perfect Cure. , Garry Bates, Esq., of Cottage Hill, Ills., aged fifty- nine years, has suffered for six years with a very irritable and painful inflammation of his eyes, which he has in vain tried to get cured, up to the time of making application to me, which was the middle of September last. He is now entirely well, and his eyes are clear and strong; and this great and most desirable end was brought about by less than six weeks' attendance. CASE 119. Ear discharging for Twenty-Eight Years.—Perfect Cure. Samuel H. S----, of Muskegon, aged twenty-eight years, contracted an inflammation of his left ear when a child, which soon terminated in suppuration, and the ear has discharged constantly since that time, the hearing of this ear being quite useless. I treated CASES AND OPERATIONS. 265 this gentleman for about five weeks, when it was found unnecessary for him to continue his attendance any longer, the discharge having been completely arrested, and his hearing much improved. CASE 120. Severe Inflammation of the Eyes, of Fifteen Years' standing, cured. Mrs. A. B. Nichols, of Kankakee City, aged thirty- five years, applied to me about the 20th of September, for inflammation of her eyes, of fifteen years' standing, which had caused her a great deal of suffering, and, for weeks and months together, had confined her to a dark room, she being entirely unable to bear the light of day. In vain had she been treated by the various travelling pretenders, and in vain did her parents, at an early period, count over the dollars in hopes of having their daughter relieved, till at last it was considered by her family as a useless expenditure, and it was resolved by her paternal parent not to pay another dime for such purpose, as he considered it was not among the things possible that her disease, of so long standing, could be cured, and to this end he exerted himself against the employment of men or means, even up to a very recent date. She had, how- ever, in the course of her afflictions, found room to get married, and after twelve years of domestic joy, with a devoted husband, was strongly recommended to visit me at Chicago, which, with the willing con- sent of her kind husband, she did at the day and date above stated. It is sufficient to say that she left here, after five weeks' treatment, in company 266 CASES AND OPERATIONS. with her husband, to join her little family, rejoicing in a pair of sound and healthy eyes, and will not re- gret, that she was,/dr once, so undutiful as to disobey her dear kind old father, who will no doubt this time forgive his daughter. CASE 121. Double Divergent Cross-Eye.—Both Eyes looking outward. Prof. Alonzo J. Sawyer, of the Chicago University, aged thirty-nine years, has been affected since a child with a turning out of his eyes, supposed to have been caused by inflammation. This very unnatural posi- tion of his eyes gave him quite an unfavorable expres- sion of countenance, besides having the usual effect of weakening the sight materially, and causing the eyes to shrink from ordinary use much sooner than sound and straight organs would otherwise do. He applied to me for advice a few days ago, and said at the same time that he had never had confidence enough in any physician or professor of ocular science to submit himself to his care, but as my opinion was so clearly given, he had no doubt but all would go well, and at once submitted to the necessary opera- tion. Both eyes were operated on at the same sitting, and in less than two minutes, his optical organs, that had been so long at variance, were brought together, and stood side by side in perfect harmony. By this operation, a most unpleasant blemish has been removed, separated friends have been again united, and sight made much more perfect than it could otherwise have been. With his two eyes occupying their natural position, I trust he will fully realize all he has antici- pated by a complete operation. CASES AND OPERATIONS. 267 CASE 122. Accidental or Traumatic Cataract in one Eye of Twenty-Four Years' standing, cured by Operation for Solution. Mrs. R. A. Bolster, of Eureka, Wis., aged twenty- 'seven, met with an accident when a child, by being struck in the right eye with a stick, which produced a Cataract instantly, leaving the eye entirely blind. The iris or curtain of the eye being naturally very dark, and the pupil white, (by means of the Cataract,) it gave the eye a very disagreeable appearance, and of course caused the patient at times much annoyance. I made a very slight and instantaneous operation on this lady's eye about the last of July, which was scarcely felt by the patient, and in a few weeks the cataract was nearly absorbed, and the pupil in part quite natural. The operation has since been repeated, with the view to hasten the cure; and the moment the remaining portion of the opaque body was disturbed a second time, it instantly disappeared, and is now entirely obliterated. She has at present a clear and natural-looking eye, with sight restored, and has by this means removed a blemish which was plainly visible to every observer, and which had for twenty-four years maintained a position too promi- nent for admiration, besides depriving the patient of the use of the organ. Note.—The subscriber, brother of the above patient, and the one who in boyish frolic caused the cataract, feeling grateful to Dr. Cadwell for his skill and success in this case, takes great pleasure in stating that the above is strictly true; and further, that at the time and after the accident occurred which destroyed sight in my sister's eye, several Oculists at the East were consulted, some of whom pronounced it utterly incurable, while others decided that an operation would be attended with such great danger as to render it inadvisable. I take great pleasure in adding my testimonial as to the Doctor's science as an Oculist and Physician, and genial qualities as an intelligent and agreeable gentleman. S. P. ROUNDS, YA. Chicago Sunpat Leader, and Printers' Cabinet. MISS MARY FRANCES FOSTER, OF OSHKOSH, "WIS., (Prom an ambrotype taken by Brigham, of Chicago, Nov., 1859.) # As she appeared on the 7th day of November, 1859, just before submitting to an operation for the extirpation of a disease connected with the right eye, which required the removal of the entire organ, with the disease appended. The operation was completed in about twelve minutes, in the presence of a large number of witnesses, and was entirely successful in its result. (268) CASES AND OPERATIONS 269 EYE AND TUMOR EXTIRPATED. CASE 123. Description of the Case of Miss MARY F. FOSTER. Miss Mary Frances Foster, aged eight and a half years, daughter of Jas. H. Foster, County Register, at Oshkosh, Winnebago County, Wis., was born of healthy parents and enjoyed exceedingly good health up to the middle of July last, when it was discovered by her parents that her right eye presented an unusual degree of fulness. No reason could be assigned for this unnatural condition of the organ, and it was not at first regarded as a serious matter. It increased in growth, however, quite rapidly, and when I first saw her, about the middle of October, her eye presented the appearance given in the pre- ceding engraving. It caused no particular pain or uneasiness, but its rapid increase and growth caused serious alarm to her parents, who consulted me in Chicago at the time above stated. My opinion was then given, to the effect that a tumor had formed at the bottom of the socket of the eye, which by its continued growth was forcing the eye from its natural position, and would not only destroy the sight of the eye altogether, but would completely displace the organ, and cause great deformity. I also stated that an operation for the removal of the entire mass (eye and disease) would be necessary, to put an end to more serious mischief. I also r.uvised the parcuts to obtain the opinion of other responsible surgeons in 270 CASES AND OPERATIONS. the mean time, for the purpose, if possible, of satis- fying their own minds, and as a protection to me in the event of my receiving the case for treatment. All this was done to the entire satisfaction of the parents and myself, and on the 7th day of the present month, November, I made the OPERATION. At half past twelve o'clock, with the very able assistance of Dr. Irving J. Pollock, Oculist, of this city, I administered chloroform, and performed the operation, removing the entire eye, and all the disease connected therewith, down to the very bottom of the socket, leaving no particle of the morbid growth remaining, by which to produce a renewal of the disease. It proved to be what it was pronounced on the first examination, a mass of fatty matter, (a Stealomatous Tumor,) being in bulk more than twice the dimensions of the entire globe and its appendages. It was completely removed from its bony cavity, together with the eye, in one mass, in about twelve minutes; the patient, in the mean time, being completely under the influence of that soothing tranquilizer, chloroform, neither knowing nor feeling anything that was being done to her, until some time after the operation was completed. It is but just to say that this little sufferer was fully sensible of hci situation, and was aware that an operation was at hand, and that it was a matter of serious importance to her. She in due time dis- covered that while the preliminaries were being discussed, and opinions advanced, her parents were often afflicted to tears, and she seemed to sympathize CASES AND OPERATIONS. 271 deeply with them; but notwithstanding the full knowledge of all these facts, and with her tender years, she never for a moment shrank from the operation, or hesitated to submit to the frequent calls to the operating table, without knowing what moment she might be requested to prepare for the great work, which would, for a time at lease, deprive her of her senses, and place her powerless in the hands of the surgeons who had undertaken the great and good work. Such mature decision of character and womanly courage is only to be met with in those of riper years, and but few of any age can boast of more undaunted courage than was exhibited by this sensible and tender little girl, only eight and a half years of age. Her case is now progressing most favorably, and she will without doubt be able in the course of a few days to return home to her friends in Oshkosh, there to meet the other members of her family, who are waiting in breathless silence to learn whether science or disease has been triumphant. The eye and its disease has been preserved, and may at any time be seen by physicians, friends, or others curious to see such morbid specimens, which have been removed by the knife and preserved in spirits. OPINIONS OF THE PRESS. (SUPPLEMENTARY.) [From the Chicago Sunday Leader, Not. 13th, 1859.] ANOTHER SKILFUL SURGICAL OPERATION. Extirpation of a Diseased Eye.—On Monday last, Dr. F. A. Cadwell, Oculist and Aurist. 93 Randolph Street, performed a surgical operation of a most diffi- cult and dangerous character, the complete success of which establishes beyond cavil his claims to superior skill as a surgeon. The operation consisted in the extirpation of the right eye of Miss Mary Frances Foster, aged eight and a half years, the removal of which had become neces- sary from the formation behind that organ of what is called a steatomatous tumor. The effect of this unnat- ural growth had been to force the eye forward from its socket, and give it a wild and unsightly appear- ance ; and as the disease was located where it could not be reached without loss of the eye, and its con- tinued presence involved sooner or later the safety of the child's life, there was no other alternative than the complete removal of the eye with the disease attached. The presence of the disease was first discovered in July last, since which time its growth has been alarm- 18 274 OPINIONS OF THE PRESS.—SUPPLEMENTARY. ingly rapid, impairing the sight of the eye but with- out causing much pain. The parents of the child, after consultation with several eminent physicians and surgeons, applied to Dr. Cadwell, who very promptly gave a diagnosis of the disease, and advised its speedy removal by a surgical operation. It was a distressing alternative to adopt, for the child was not only pre- possessing in personal appearance, but combined all those qualities of sweetness and amiability of temper, intelligence, and the attractive characteristics which serve to strengthen, with more than usual firmness, the affectional relations between parents and children. The operation was performed at Dr. Cadwell's office, in presence of several gentlemen, among them Dr. Pollock, of this city, who assisted in the operation. The child was placed under the influence of chloro- form, and the eye, with the tumor attached, was re- moved without pain to the patient. The whole time consumed in dissecting and extirpating the organ was only twelve minutes. This is extraordinary despatch, when it is remembered that the ball of the eye and the tumor were packed closely, and filled the entire cavity, rendering it necessary for the surgeon to be guided in a great measure by the sense of feeling instead of sight. The profuse flow of blood also interfered with the manipulations of the operator, but notwithstand- ing all these impediments, every particle of the tumor was dissected, and that, together with the eye, brought away in a collected mass. All present united in pro- nouncing it a most skilful and successful operation. We cannot forbear an allusion to the heroic forti- tude of the little patient. She was fully aware, for several days previous to the operation, that her eye was to be sacrificed, and yet she never for a moment OPINIONS OF THE PRESS.—SUPPLEMENTARY. 275 betrayed the least timidity. She witnessed prepara- tions which moved others to tears of sympathy, with- out any outbreak of feeling, and promptly acquiesced in the necessary requests of the surgeon. After all was over and she had recovered from the effects of the soporific, she conversed calmly about the loss she had sustained, never uttering one word of complaint or regret. Such extraordinary composure and resig- nation could hardly be looked for in a man of iron nerve—much less in a child of only eight years. Although several days have elapsed since the oper- ation, no unfavorable symptoms have intervened, and the child is rapidly recovering. The parents of the child reside at Oshkosh, Wis., and will only be too happy to bear testimony to the skill and kindness of Dr. Cadwell. [From the Chicago Press and Tribune, Not. 9th, 1859.] Operation upon a Child.—A day or two since Dr. Cadwell, of this city, performed a difficult but entirely successful surgical operation, in the entire removal of an eye, the patient being a bright, intelligent little girl about eight years of age, daughter of James H. Foster, Esq., of Oshkosh, Wis., the disease being the formation of a steatomatous tumor in the orbit, by which the ball was protruded forward—a painful and serious disfigurement of the features. Chloroform was administered, and while in a state of entire un- consciousness, little Mary Frances was relieved of the disfigurement and the disease, the mass being re- moved in about ten minutes. It will be among the easiest appliances of the surgical art to supply an artificial eye to the empty socket, and restore to the 276 opinions of the press.—supplementary. countenance every appearance of naturalness. Dr. Cadwell has made the eye and ear and their diseases a specialty, and with such success that his patients are drawn from a wide tract of country, centering in this city, seeking at his hands relief from the nu- merous painful afflictions to which these organs are subject. His rooms, on the corner of Dearborn and Randolph streets, are a perfect museum of casts, plates, and drawings, illustrating the well nigh limitless affections, to the relief of which he devotes his skill. Some of these are of great rarity and value. THEIR DISEASES AND MEANS OF CURE,, 0' BY ■I- i- $ DR. F. A. CADWELL ©tttliff an& Mmk% OPERATOR ON THE EYE AND EAR, Hoi.r Brothers, Printers, 87 Nassau St., N. Y. »*■»$) & /c> \ Special Notice,...........................................Page 113 Memorandum Notice.................................. " U4 References,................................................. " *17 Granulated Eye-Lids,............................... " 23 Artificial Eyes—Reduction in Prices,..... ,c 128 CROSS-EYE, OR SQUINTING. WS&^s3t Br 'Hi (See page 53.) •©■* This Treatise will be sent by mail FREE to any person writihgnj^enclosing TWENTY-FIVE CENTS in stamps, to pay postage on the same. NEWLY INVENTED APPARATUS FOR THE TREATMENT OF DEAFNESS. (For particulars refer to page 125.) o- <-C *c <- Cc. c ccr■< Cc cc^^cc, c cc i c c c c c C c C^< >- COM CC.V«:C C . CI<3T CC"a <C CCCC ^Ll-CC C , = Cv C " - -'V.'c: n ■ *.fC ' '• c c \ c<9®: -; Cc cc c-^a cr cc c c c r c c c c c< cc cc V KT'_ CI c CI <_>' C23 C7 i c c «c« S- cc c CL "cc C ccc* «8Lcc < *.«■ *«C c ° aCcc '- *. «o c «c: cc c*CI* ,c*d ■ C cc C C< Cc CC cc I Cc Cc C CC C Cc •ic:<*3c?c. cc C*. .<«LCi. C C*.. c