one eye from tumour of the brain some time before he was aware of the fact. It was not until he applied his eyes to a telescope, and found that the sight of one was entirely lost, that he became acquainted with the morbid state of his visual powers.

The amaurosis, so often associated with morbid states of the brain connected with apoplexy, occasionally continues after the patient recovers from the acute symptoms of the cerebral attack.

A gentleman, after an apoplectic seizure, lost his sight, and continued in a state of perfect blindness for about seven years. After that period, while one day out in his carriage, he suddenly recovered his sense of vision. It was subsequently found that he had entirely retained his skill in drawing, for which he was previously much distinguished.

The late Dr. Gregory, of Edinburgh, was in the habit of mentioning in his lectures the case of Dr. Adam Ferguson, the celebrated historian, as affording one of the strongest illustrations he ever met with of the benefit to be derived from an early attention to the incipient symptoms of cerebral plethora and apoplexy. Dr. Ferguson experienced several attacks of temporary blindness some time before he had an attack of palsy; and he did not take these hints so readily as he should have done. He observed that while he was delivering a lecture, his class and the papers before him would disappear, vanish from his sight, and reappear again in a few seconds. He was a man of full habit; at one time corpulent and very ruddy, and, though by no means intemperate, he lived freely. I say he did not attend to these admonitions, and at length, in the sixtieth year of his age, he suffered a decided shock of paralysis. He recovered, however, and from that period, under the advice of his friend, Dr. Black, became a strict Pythagorean in his diet, eating

nothing but vegetables, and drinking only water or milk. He got rid of every paralytic symptom, became even robust and muscular for a man of his time of life, and died in full possession of his mental faculties at the advanced age of ninety-three; upwards of thirty years after his first attack. Sir Walter Scott describes him as having been, "long after his eightieth year, one of the most striking old men it was possible to look at. His firm step and ruddy cheek contrasted agreeably and unexpectedly with his silver locks; and the dress which he usually wore, much resembling that of the Flemish peasant, gave an air of peculiarity to his whole figure. In his conversation, the mixture of original thinking with high moral feeling and extensive learning, his love of country, contempt of luxury, and especially the strong subjection of his passions and feelings to the dominion of his reason, made him, perhaps, the most striking example of the stoic philosopher which could be seen in modern days.

Amaurosis dependent upon vascular congestion is marked by some or all of the following symptoms:dilated, sluggish or immovable pupil, ptosis or strabismus, and oblique or double vision of the affected eye; a preternatural action of the carotids, flushed face, sense of weight, pain or stricture of the scalp, lethargy, occasional tinnitus aurium, with greatly disordered and irritable stomach. The patient frequently complains, particularly in straining, stooping, or on first lying down, of seeing luminous sparks and flashes, and a reflection of one or more of the choroidal vessels, the visible pulsation of which is a cause of much distress to him."+

The following case is recorded by Dr. Wigan, and is illustrative of the benefit occasionally derived from sub

*"Lectures on the Principles and Practice of Physic," by Dr. T. Watson. London, 1857. Vol. i., p. 527.

"Diseases of the Eye," by B. Travers, F.R.S. 1825. P. 162.

jecting cases of brain disease connected with morbid states of the vision to medical supervision:-A gentleman had been under treatment about six months before for a severe attack of phrenitis, and had only been restored by the aid of very active remedies administered by a very judicious practitioner. I afterwards saw him in a state which was called perfect recovery. He had for some time resumed his active habits of business; but although considering himself perfectly well, complained confidentially to me that for some time he had been constantly arguing with himself on an increasing apathy towards his wife-not physical apathy, quite the contrary -it was a strange disinclination to be in her society; he found himself frequenting the haunts of his former bachelor state against his intention, and almost against his will, yet received no gratification from any indulgences they afforded, and was constantly harassed by a feeling of remorse for neglecting the society of his wife, whom he had married from choice, whom he respected and thoroughly loved, and who was exceedingly tolerant of his indifference, from a belief that it was caused by pecuniary anxiety. I endeavoured to convince him that it was a moral produced by a physical change, and that it would pass away with the consolidation of his health. He remained some time in this state, when he gradually began to see faces in the dark-afterwards in the daylight; groups of faces constantly changing their shape; sometimes a portion of one face would join itself to a portion of another face; sometimes parts of faces-eyes, noses, mouths, cheeks, and foreheads, would float about in vast numbers before him, and from time to time unite themselves in the most fantastic combinations. The whole occupied his mind, and rendered him incapable of continuous attention to any subject of importance requiring deep consideration. A large bleed

ing and a blister to the nape of the neck immediately restored him to vigorous health, and all his original delights in the society of his amiable and affectionate wife.*

HYPERÆSTHESIA, OR EXALTATION OF VISION.-A morbid exaltation of the sense of sight is occasionally observed among the premonitory symptoms of cerebral disease, the patient complaining either of an acute and sensitive condition of the retina, or of his abnormal expanded visual capabilities. A young gentleman, a few days before an attack of inflammation of the brain, had a painful condition of sight. If his eyes were exposed, even for a minute, to the light, he shrieked with pain. In another case the symptom was precursory of apoplexy for at least ten days! It was, however, associated with severe attacks of vertigo. Andral says, when alluding to this symptom of brain disease, "cases have been observed in which, for a longer or shorter period before the attack, the sight has acquired an unusual degree of fineness."

The existence of important morbid visual phenomena, like those previously detailed, manifesting themselves prior to the occurrence of hemorrhage, incontestably proves, as Andral sagaciously observes, that "Before the

BLOOD IS EFFUSED, THERE IS ALREADY SOME MORBID ACTION, EITHER CONTINUOUS OR INTERMITTENT, IN THE BRAIN, OF WHICH IT WOULD BE IMPORTANT TO DETERMINE THE PRECISE NATURE." How significantly does this sagacious pathologist point out, in this passage, the necessity of carefully studying the principiis obsta of cerebral diseases!

In the following case disease of the brain was first indicated by an acute condition of vision. A painter, aged thirty-two, was admitted, in 1849, into the Hôtel Dieu, at Lyons. This young man, who was possessed of some talent, had been gradually reduced to dis

"On the Duality of the Mind," by R. Wigan, M.D.
† Andral," Clinique Médicale," tom. v.

tress by political disturbances and other causes. Α year before entering the hospital, his sight, which was previously good, acquired greater development. From his window, which opened into a very long street, he could distinguish objects and persons whom he could before neither distinguish nor even see. This circumstance troubled him, and surprised those about him. The exaltation of vision continued until August, 1848, when he was seized with violent continued pains. in the right parietal region; at this time there was a slight weakness in the left arm. The symptoms increased till March, 1849, when there was paralysis and contraction of the right arm, and blindness of the left eye. When he entered the hospital in July, the following was his condition. There was almost profound stupor. The paralyzed eye was almost completely covered by the upper eyelid, and there was paralysis, with contraction, of all the left side of the body. There was complete loss of power over the sphincters. He continued in this state until the beginning of September, when death ensued, preceded by symptoms of low fever. The autopsy revealed partial circumscribed softening of the middle and upper part of the right hemisphere, for the extent of about two centimètres. The convolutions were pale and puffy; the pulp was diffluent, and of a dirty grey colour.

Dr. Brachet relates, when he was interne at the Bicêtre, in 1811, the infirmier of the surgical ward one day astonished him by the extent which his vision had acquired since the previous day. The man could distinguish the most minute objects at an enormous distance. Five hours afterwards he felt a slight headache, and in a few hours more was seized with apoplexy ("une apoplexie foudroyante") and died the next night! A recent coagulum was found in the right optic thalamus. The inflammation

PP