better than others. My experience has been that all the fluid extracts which I have prescribed have possessed more or less therapeutic virtues. But there is a wide difference in potency in different manufactures. So I have for some years ceased to prescribe the poke-root. I keep in my office a reliable preparation of the drug and dispense it as required. I have ordered as much as a teaspoonful of the fluid extract procured from a drug store every four hours, without producing any more powerful effect than I now gain from ten drops of a reliable preparation. It is important and necessary to push the remedy in urgent cases to physiological tolerance, though I have never seen any ill effects, in fact, no effect, outside of the subsidence of the mammary inflammation, except a tendency to somnolence.

I also employ the medicine externally, rubbing it into the gland frequently, or applying it on a cloth, and in many cases this appears to add to the efficacy of the medicine.

Finally, gentlemen, the next time you encounter a case of puerperal mammitis, bear in mind the virtues claimed for phytolacca and make a trial of it in the manner above indicated, and it is my opinion that you will not be disappointed.

WHAT IS MODERN SPIRITUALISM?-This question has perplexed many honest people and not a few dishonest ones. At best it has seemed an unknown world of vast impossibilities. Some time since the late Henry Sebert, of Philadelphia, left to the University of Pennsylvania $60,000 to found a chair of Philosophy on condition that the University would lend its name to the inquiry into spiritualism. In pursuance with this condition the University appointed a commission as follows: Dr. Joseph Leidy, George A. Koenig, Prof. of Chemistry, Rev. George S. Fullerton, Professor of Mental and Moral Philosophy; Coleman Sellers, civil engineer; Dr. S. Weir Mitchell, Dr. William Pepper, Prof. Robert F. Thompson and Dr. Horace Howard Furness, one of the trustees of the University. This committee made an exhaustive examination of spiritualism, and affirm that it is made up of equal parts of humbug and jugglery, calculated to deceive only the credulous and the feeble minded. They say they did not discover a single novel fact, and are forced to the conclusion that spiritualism, as far at least as shown to them, presents the melancholy spectacle of gross fraud, perpetrated upon an uncritical portion of the community. In spite of this report spiritualism will continue its baneful work so long as the credulous and dishonest exist.Detroit Lancet.

PLAIN POINTS FOR GENERAL PRACTITIONERS REL

ATIVE TO THE FITTING OF GLASSES.

BY J. W. WRIGHT, M. D., COLUMBUS, OHIO.

Notwithstanding the perfection which has been attained in a knowledge of the irregularities in the refraction and accommodation of the eye, yet a greater interest should be had by the general practitioner in a subject which has so much to do in augmenting the functions of one of the most important organs of the special senses.

There certainly seems to be a want of concern among physicians generally of those affections attributable to defects that are capable of correction with the aid of glasses, and too often they are considered of such insignificant importance as to be referred for correction to the jeweler, who makes some pretensions as an optician, or to the spectacle vender.

The eye presents many difficulties of study, especially that department which relates to departures from its normal refraction, owing to the necessary knowledge of optical principles, without which it is impossible to comprehend the abnormalities to which it is liable.

It is not expected of, nor is it possible for the general practitioner to know all about optics, nor is it necessary for him to know more than is taught of refraction and accommodation in standard works on physiology, to understand why the jeweler, the street spectacle vender, or even the well-informed optician are not qualified to measure the length of the eye or estimate the irregularity in the curvature of the cornea, and adapt suitable glasses to these conditions.

A normal eye possesses in a wonderful degree the power of adjusting itself to view objects at different distances, but when it becomes embarrassed, as is too frequently the case, by certain abnormalities in its anatomical structure, by being too long, or too short, or in having an irregularity in the curvature of the cornea (which in the main constitute the errors of refraction), it is limited in its functions to such a degree that it is exposed to continual strains upon which depend so many of those distressing symptoms, too frequently attributed to obscure nervous affections.

In order to appreciate the cause of a great many of these anomalies in its refractive power, we should impress ourselves with the property of the eye to adapt itself to different distances-in other words, its accom

modation-regulated by the action of the ciliary muscle, which controls the lens in such a manner as to make it more or less convex, according as we desire to view objects near or far. In old age, of course, this action is limited, as the lens becomes less flexible.

It is the abnormal action of this little muscle that plays such an important part in rendering indefinite and mystifying many affections of the eye.

The normal eye may, by reason of a spasm of the ciliary muscle, become abnormal in its refractive powers.

This cramp or spasm of the muscle may be caused in the normal eye by its long continued use at some certain distance. The following case serves as a good illustration:

Miss P., a school girl twelve years of age, who had defective vision, was brought to me for consultation. She had been compelled to study her books very closely, and besides did considerable drawing. She could see tolerably well close, but very poorly at a distance. She suffered almost constantly from headache. She had been fitted with glasses by a traveling optician, and although at first they gave her great satisfaction, in a few days became useless, and she was compelled to discontinue them. I found in making a test with the trial lenses that a concave No.14 for the right eye, and a concave No. 24 for the left eye, made vision perfect. Her father was very much elated with what had been accomplished with the glasses, especially for distant vision, as she had not been able to distinguish persons at a distance of twenty feet.

I informed him that the glasses were not probably what she needed, and asked him to remain in the city with his daughter until I should thoroughly atropinize her eyes, when she could be properly fitted. He reluctantly consented to do so, as he thought the test made was "good enough." After paralyzing the accommodation, he was again surprised to see his daughter read all the letters on the test card at a distance of twenty feet without the glasses.

I found that there could be no improvement with glasses, and that. the refraction of the eye was normal, which I verified with the ophthalmoscope. I sent her home, advised the atropine solution to be used in each eye every alternate day for a week, when it was to be discontinued. After the paralyzation had passed off, vision both for far and near was good without the aid of glasses.

This is not an isolated case, and suggests the propriety of thorough

ly atropinizing the eyes, especially of children, before an attempt is made to fit with glasses.

By reason of an error of refraction there are frequently unequal spasms of the ciliary muscles, causing striking contrasts in the different powers of refraction in the eyes of the same individual.

This is well exemplified in a recent case: Mr. G., aged twenty-three years, a grocer, consulted an intelligent physician of this city on account of defective vision. He stated that after reading a few moments there appeared a glimmering and running together of the letters and words, which confused him so much that he was compelled to stop. He also complained of headache and dizziness. His physician examined his eyes, finding nothing of a local nature indicating what the real trouble. was. Anticipating an error of refraction he tested one eye at a time. He found that a convex No. 36 improved vision very much in the left eye, and a convex No. 9 gave the best, although not perfect vision, in the right. The physician sent the patient to me, and my examination verified his.

I proceeded at once to paralyze the accommodation by dropping a four grain solution of atropine into his eyes; this was repeated the same evening and the next morning. About noon he again called, when I found the left eye which had before required but a convex No. 36, now required a convex No. 12, with good satisfaction for distant vision. right did best with the convex No. 9, but it gave poor satisfaction.

The

The atropine solution was continued morning and evening, and an examination made each day with the same unsatisfactory result, when on the fifth day a convex No. 12 gave as good satisfaction for the right eye as for the left. I advised the continuation of the atropine solution for a fews days longer, in order to thoroughly relax the accommodation, and gave him a prescription for the glasses, which I understand from his physician are giving good satisfaction. The headaches and dizziness have entirely disappeared, and he expresses himself as being in "another world."

In this case, one eye was intuitively adapting itself for a far point, and the other for a near, which perhaps in a short time could not have been satisfactorily corrected.

This brings into consideration another instance of irregularity in the refraction, whereby a spasm of the ciliary muscles causes one eye to become adapted to a near point and the other to a far one. This occasionally occurs, and no doubt patients have been so afflicted for years, when by accident it has been discovered.

We often hear of aged persons who have never been compelled to use glasses, and who can see well either at a near or far point. An examination in such cases reveals the fact that one eye does the close work and the other that at a distance.

It is popularly believed, and even taught by some oculists, that where there is so great a difference in the refractive powers of the eyes, they should be fitted to the full correction. This is not always good treatment, especially if the patient is not very young; indeed, it is often injurious, and patients so treated are made to suffer considerable inconvenience. While we are to be guided by certain rules in the fitting of glasses, and while it is not expected that we must cater to the whimsical, yet the sensations of our patients are by no means to be ignored.

What I desire so much to impress upon the mind of the physician, is the impossibility of any one but an oculist being able to fit the eye properly with glasses. It is true that in presbyopia, where the lens is losing its flexibility by age, any optician or other person who knows anything about the numbering of glasses can usually make the selection, yet there are many cases of presbyopia that are associated with astigmatism, where the fitting is rendered difficult, and where, for a want of its correction, the patient is compelled to suffer from weakness of sight and untold nervous troubles.'

I was consulted by a lady some years ago for defective vision. She was fifty-four years of age, and from the time she was quite young, suffered very much from weakness of sight and headaches. She consulted opticians, jewelers, physicians, and every one in her reach who made any pretense in treating the eye, all to no purpose. After she became presbyopic, or in other words, after the lens had lost its flexibility from age, she was compelled to obtain glasses for near vision, but still she suffered from the weakness of sight and headaches as she formerly did. A very casual examination with some simple tests was sufficient to determine that there was an irregularity in the curvature of the cornea, that she was astigmatic. The correction of this irregularity gave her the greatest satisfaction. The weakness of sight, the headache, the spasmodic twitching of the lids which she had had for so many years, all disappeared almost magically.

She was so much improved for near vision that she desired glasses for a distance also. She was enabled to read the signs on the buildings on the other side of the street, and could now see the sharp angles on the corners of houses, a thing she had never before been able to do.

The symptoms accompanying defective refraction are so many and so diverse, that the stomach, the liver, and the nerves have often been appealed to medically to no purpose, and the eye has often been med. icated with caustics and strong washes for indefinite periods with equally bad results, when, after having been properly fitted with glasses, all those annoying and obstinate symptoms have at once disappeared.