Gescheidt, of the occurrence of this anomaly in a two-months embryo, must, in the present state of our knowledge, be considered rather as an example of a diseased, than of a merely interrupted condition of the cornea; but whether this membrane is primarily affected, or only consecutively, from an excess of the aqueous humour, is still very uncertain. Although we have thus, in obedience to the strict laws of deductive reasoning, refused our assent to the doctrine maintained by Wimmer and others, in reference to the origin of hyperkeratosis, we must avail ourselves of this opportunity of urging the great importance of numerous anatomical examinations of this, and, indeed, of all other congenital opthalmic affections; the development of the eyeball and of the brain stand in so close and so allied a relation to each other (according to Huschke, the former being only an expansion of the canal of the optic nerve, which proceeds from the cerebral bladder,) that the irregularities of the one may very probably be supposed to be similar to, and also to influence, those of the other organ. As malformations of the cranial bones are more common in hydrocephalic children, so in hyperkeratosis, the structure of the other parts of the eye is more frequently abnormal. If the development of the cerebral mass, from its primitive watery condition, be unusually tedious and imperfect, we can readily understand the reason why the medullary matter of the nerves which issue from it is, in such cases, thin and pulpy, and why the retina, for example, should resemble a serous membrane more than a nervous expansion. We have strong reasons for believing that a great many of the cases of congenital amaurosis derive their origin from this cause. The partial thickening of the cornea in hyperkeratosis is probably owing, in the chief degree, to the pressure of the contained aqueous humour, just in the same manner as the cysts of many watery swellings, and even the bones of the cranium in hydrocephalic children, who have survived for a considerable time, are condensed. Loder has preserved in his museum the skull of a hydrocephalic child, two years old, in which the parietal bones are three quarters of an inch thick, and in case of a patient who lived 42 years, Schneider found one of the parietal bones an inch and a quarter in thickness. A similar remark often holds true, with respect to the membranes of the eye, in other affections besides hyperkeratosis; for in dropsy of the eyeball, the sclerotic is very often found thicker than usual. In cyclopic eyes, the cornea is generally double, or at least exhibits traces of being so. THE CHOROID COAT-CORPUS CILIARE, AND THE PIGMENTUM NIGRUM. The choroid coat, as well as the retina, has been found cleft by Ammon and Gescheidt in the eye of an adult person: this imperfection (coloboma choroidea) is known to be the normal state of the membrane during one period of embryotic life. When the pigmentum nigrum is only partially deficient, the eye of the individual is rather more than ordinarily susceptible to the stimulus of light; and this state may be considered as the transition-stage between health and albinism. Our limits prevent us from following Dr. Seiler, in his interesting account of peculiarities of body which characterize the latter curious affection, and we must limit our remarks to the appearances of the eyeball only. The conjunctiva is usually very pale, or it may have a somewhat red aspect, from the blood vessels which permeate its structure; the sclerotic is thinner, and has a purplish hue; the cornea is generally more convex, the choroid is without its pigmentum, and the iris without its uvea. The iris is usually of a bluish-red colour, the blue prevailing towards the inner, and the red towards the outer circumference; and the surface of this curtain often exhibits a beautiful striated structure, the striæ diverging from the pupil to the outer circle, and being interlaced and connected together by means of transverse striæ or fibres, especially towards the pupillar margin. If the eye be examined when a bright light is permitted to fall upon it, the pupillar part of the iris appears of a pale blue colour, and the outer or ciliary part exhibits a red tinge, which glimmers between the white striæ. The red colour is scarcely perceptible when the pupil is dilated, as in the shade. In most albinos, the eyeballs are perpetually moving to and fro, from one canthus to the other, and the iris is often in a continual state of oscillation. Short-sightedness is very common among albinos. Albinism, as is well known, is sometimes only partial, large patches of the surface of the body here and there being quite white, while the rest retains its natural colour; the eye may be similarly affected. Rudolphi saw a dog, in which one half of the iris was white, and the other half quite dark; but in two or three histories of piebald human albinos which are on record, it is stated that the eyes were black throughout, and, therefore, that they did not exhibit the irregularity alluded to. The proximate cause of albinism, (or, as it has been called by different authors, leucæthiopia, leucopathia, leucosis, or the white malady) is indubitably a deficiency of the colouring matter of the skin and of the eyes; but if we enquire what has probably given rise to this deficiency we shall find ourselves at once perplexed between two theories-the one assuming that it is really, and in truth, a morbid state, or peculiar cachexy, somewhat analogous to the disease known by the names of lepra alba or alphos, and having for its essential character the partial or complete absence of the ordinary colouring secretion, which ought to be deposited between the layers of the skin and on the surface of the choroid coat; Blumenbach, Winterbottom, Sprengel, and others have taken this view, while on the contrary, Hallé, Jefferson, Beclard, Mansfeld, and Meckel (although the lastnamed author hesitates to decide,) regard albinism as the effect of an arrest of the normal development. If, indeed, we include under the term "cachexy" every irregularity or abnormal condition of the system proceeding from a deviation from the usual combinations of the solid or fluid parts, there can be little doubt that leucosis must be reckoned as such, especially since we know that even adult animals may be so affected by certain causes, inducing a drepraved state of the system, that the colour of the skin and hair, becomes speedily changed. Geoffroy St. Hilaire has satisfied himself, by repeated observations, that many animals, and particularly those of the genus simia, when long confined, and when their food is not quite wholesome, gradually lose their wonted colour, and fall into a state of imperfect leucosis. He found, also, that young gold fishes, if kept for some weeks in spring water, became nearly quite white. Every one has heard of the extraordinary effects of a sudden paroxysm of grief and terror in blanching the hair; and the almost constant occurrence of "silver locks" in old age, even among the dark races of mankind, seems to point to the operation of certain changes being effected within the animal system. But certainly it is most erroneous to draw any analogy between leucosis and any exanthematous disease, such as lepra; for the skin of an albino, although of a pearly whiteness, does not exhibit any visible morbid change, save that of its colour; there are no scales, no excrescences, and there is no oozing of any discharge. In some parts, indeed, as in the Island of Sumatra, the albinos have been found affected with the leprosy-but this was a casual, not an uniform occurrence. If, therefore, leucosis be a disease, it is a disease sui generis, and one, too, which is peculiar to fœtal life; for no instance of complete albinism, supervening after birth, in an individual previously unblemished, has been ever recorded. What adds exceedingly to the difficulty of ascertaining positively the remote cause of this anomaly, especially in the human subject, is the rarity of opportunities which ever fall to the lot of any anatomists, of examining very young embryos; and until our knowledge of the various steps or grades of development through which the intra-uterine being passes, before it arrives at its perfect formation, be much more exact than it is at present, there must be of a necessity considerable uncertainty on most embryological speculations. Dr. Seiler has been led to give the preference to the latter of the two theories above mentioned, by the following considerations.-1, Although the pigment of the eye is deposited at a very early period of embryotic life, it is not uniformly or equally so on the whole surface of the choroid and of its appendages; by far the greater portion being accumulated, at first, on its anterior part and on the ciliary processes, while the posterior part is almost quite free from it, and retains, therefore, a red colour; such an appearance is occasionally observable in the eyes of hydrocephalic children. There is, therefore, reason to suppose, that the pigment is altogether awanting in the very early stage of fatal development. 2d, In the eyes of piebald horses, a very evident proof of an arrested formation is exhibited; for, in these, the pigment is limited to the corpus ciliare. 3, The skin of the embryo, in the first month, is destitute of any traces of pigment. 4, Most of the infusoria (those animals which are at the lowest step of the zoological series) are colourless, or have only a greenish hue. 5, The soft white hair (lanugo) of the albino, which remains with him during life, is analogous to the capillary system of a five months' foetus. 6, The debility of body and of mind, which so very frequently characterizes albinos, is indicative of imperfect development of the natural powers. 7, It has often been remarked, that albino children have been in many instances the offspring of feeble and exceedingly delicate parents, whose formative energies, we may, therefore, reasonably believe to be below the healthy standard. Be this as it may, no one can doubt the surprising effects which vehemently depressing agencies will produce in altering, or even in altogether abolishing, the former colour of the body. The limits of this paper prevent us from following our industrious author, in his description of the congenital malformations of the iris, uvea, &c. and leave us room only to allude to the occasional persistance of the membrana pupillaris, for several months, or even years, after birth. Probably, a few of our readers are aware that it is the prevalent opinion among our professional brethren in Germany, that the operation of restoring the blind boy to sight, which has given so much eclat to the name of our countryman, Cheselden, was, in fact, that of forming a pupil through the persistent pupillar membrane, VOL. XXI. No. 41. 7 and not the operation of couching, or depressing a congenital cataract. That, however, the lens has in numerous instances been found to be cataractous at birth, no one will deny, when he regards the names of Beer, Saunders, and Ammon as vouchers for the fact. So long ago as the year 1810, Professor Walther, in his admirable treatises on medical subjects, threw out the idea that the lens was actually opaque during the early stage of embryotic existence, and that it became transparent only at a subsequent period; the inference from this doctrine is very obvious, viz. that in the event of it being proved to be correct, congenital cataract must be viewed rather as the effect of retarded development, than of positive disease. The later observations of Baerens, Ammon, and of Dr. Seiler, are, however, quite opposed to Walther's hypothesis, and do not at all warrant the supposition, that the lens is ever normally clouded. The researches of the second-named philosopher have induced him to trace the occurrence of congenital cataract to one of the following causes :-1, A morbid affection of the arteria centralis retinæ, or of its contents. 2, A thickening, the result of intra-uterine inflamation of the anterior, or of the posterior wall of the capsule of the lens. 3, A primitive disease, or dyscrasis, of the substance of the lens. Such a state may be connected with an hereditary taint, as that of scrofula. That cataract may be transmitted from one generation to another will not be doubted, when the following case, authenticated by the testimony of Beer, is read. The father had cataract-so also had his son. This son was twice married, and had families by each wife; and every child (the number amounting to eight or ten), with the exception of one, became cataractous before their twelfth year. Congenital cataract is sometimes only partial, or affects but one point of the lens, while the rest of it is healthily transparent. This opaque spot is usually circular, and is seldom obliterated in after life. Two lenses have been sometimes discovered in a cyclopic eye; but there is no well authenticated case on record, of the entire absence of all traces of the lens at birth. Our abstract of Dr. Seiler's work must here finish, and we trust that, ere long, we shall find him once more in the list of authors. No one, who has perused his present performance as it deserves, will hesitate to acknowledge that he has derived much interesting and valuable information from it. It is an admirable compendium of all that is at present known, respecting the very curious and instructive subject of which it treats. CONSUMPTION CURABLE; AND the Manner IN WHICH Nature as 1834. March, To those who are practically acquainted with the subject of this volume, the first line of the title-page-" CONSUMPTION CURABLE"-will convey an im pression not very favourable to the work; but when it is remembered that its author was the public defender of St. John Long and his quackeriesthe advocate of an illiterate Charlatan, who had been tried for manslaughter, or rather for womanslaughter-the scepticism, if not something worse, will assume the ascendant. But although Dr. Ramadge has few claims on the forbearance of either ourselves or the profession at large, we shall endeavour to dismiss from our minds all circumstances and reminiscences respecting the author, and examine the work solely on its own merits. Our author finds fault with the late Dr. Young for giving a discouraging opinion respecting the curability of consumption. Dr. Y. thought that not more than one case in a thousand recovered without assistance-and probably not more than one in a hundred, even with the aid of medicine. The word consumption includes so many grades and kinds of disease, that little satisfactory can be gleaned from any numerical calculation on this subject. If by consumption, we mean tubercular excavation or ulceration, then we aver that Dr. Young's calculation is, by no means, too unfavourable. And if various other morbid states and conditions of the lungs are included, then there is a chaos of uncertainty, of which Dr. Ramadge appears to avail himself in support of his "CONSUMPTION CURABLE." But what shall we say to the following statement? "It is my intention, in the succeeding pages, briefly to shew that this statement is unfounded in fact; and that medical treatment has, in not a few instances, tended to prevent, rather than advance recovery. I trust I shall demonstrate, in the histories of some of my cases, that recovery has been owing, in a great measure, to the supervention of some catarrhal disease occurring spontaneously through an apparently imprudent exposure to cold, after remedial agents had failed." Introd. iii. First it is insinuated that medical treatment not unfrequently prevents recovery, and then we are told that catarrhal inflammation supervening on consumption is a remedy for the disease!!! This brilliant idea-this real novelty is followed up, and appears to be the vital principle of the whole work!! Speaking of Dr. Young, the author remarks: "Had this hospital physician been accustomed to the examination of dead bodies, he would have discovered, in more than one-fourth of the adult subjects examined after death, cicatrizations indicative of cured consumption; and on finding these appearances, had he enquired of some near relative of the deceased if the individuals, at any period of their lives, had for a time expectorated blood -had been troubled with indomitable cough, night sweats, diarrhoea, with emaciation of the body-or had been regarded by their medical attendants as consumptive, he would probably have arrived at a more favourable conclusion." iv. So, then, one-fourth of the adults who die of other diseases have been previously cured of consumption!! In another place Dr. R. tells us that one-fourth of those who die, die of this disease: thus, as a fourth die of consumption, and a fourth are cured spontaneously of phthisis-leaving out of the question the great numbers saved by St. John Long and Dr. Ramadge, it follows that more than half of our population have consumption some time or other in the course of their lives!! In respect to these "cicatrizations" indicative of "cured consumption," we may observe that some pathologists who are very anxious to find in the |