THE THEORY OF VISION.

719 THE LAWLESS COMMITTEE’S " ADDITIONAL DONATIONS." of THE LANCET. was rather conspicuously mentioned in the SIR,—As my’name last LANCET, in reference to a subscription to the National Association, I trust you will publish the following brief statement. Seeing so large and respectable a list of names of gentlemen uniting for the express purpose ’(as I understood) of opposing the objectionable parts of SirJames Graham’s Physic- and-Surgery Bill, and also for obtaining our just rights as members of the College of Surgeons, I called at the Committee Room, in Hanover Square, on the 19th of February last, and, meeting a member of the committee (I believe Mr. Peregrine) in the room, I told that gentleman, that, in registering my name, I protested most decidedly against being a party, in any way, to a new incorporation establishing an inferior grade, and that I trusted that so large a body co-operating together could not fail to effect a satis. factory alteration in the Charter of the College of Surgeons. Mr. Peregrine said he had no doubt that such would be the case. I afterwards received several letters and weekly reports from the Committee, postage free; and, in consequence, on the 21st of April, I called at the office in Regent-street, and paid there a subscription of one guinea, as advertised in their " Transactions" of June 2nd. I must confess that, like yourself and hundreds more, I have been all along deceived by the committee, for had I known what Mr. Ancell, the hon. secretary, so explicitly stated at the last general meeting, " that thefirst and only object of that committee was to form a new incorporation of general practitioners," I should most certainly never have joined the Association in any way.-I am, sir, your most obedient servant, WILLIAM HUGHES. HUGHES, M.R.C.S.E. High Holborn, June 10th, 1845. P.S. I shall instantly withdraw my name from the books of the Association, and regret that I cannot recall my misapplied subW. H. scription. To the Editor

ENFRANCHISEMENT IN THE COLLEGE OF SURGEONS. MR. DENHAM, of Hereford, says, that " the number of signatures to the following petition might have been increased to a hundred or more, if longer time could have been devoted to obtaining them; but (he adds) the country practitioners are often many miles removed from each other, and there is great risk of not finding them at home. There was only one refusal, and that was from an old apothecary about retiring from practice. Every gentleman who could be met with at home, was with us heart and soul. THE COLLEGE, and that alone, was the cry, and nothing more, and we will not have less. You will not find the name of more than one gentleman to the petition who has been connected with the profession less than twenty years: several of them have been in practice longer than that time. " My good and indefatigable friend, Samuel Millard, is a host to us. I wrote to him on the subject of inertness, and the next night found him at my door. We agreed to devote the following day, at all hazards, to the cause, and to him, as he was forced to go home, that day’s ride was a journey of more than fifty miles. One such spirit in each town would ensure success to any cause." The following is a copy of the petition:To tlte Honourable the Commons, 8sc. The humble Petition of Members of the Royal College of Surgeons of England, &c. in the County of Hereford, humbly showethThat your petitioners are utterly opposed to the Medical Bill now before Parliament, and earnestly pray for its immediate rejection, because it proposes to deprive the members of the College of Surgeons of England of their vested rights. That your petitioners cannot and will not be satisfied with anything short of a full and perfect recognition of those rights which, as members of the Royal College of Surgeons, they have by their oath of admission to the College sworn to maintain.

THE RIGHTS OF STUDENTS UNDER THE NEW BILL. To the Editor of THE LANCET.

the dignity of the profession, but still I consider it reasonable to expect that a retrospective view should not be taken as regards gentlemen now attending. lectures, compelling them to submit to the new regulations. I have known it said, that if the ensuing Bill was not (when in force), to embrace- all those who had not passed their examination, hundreds or more would enter their names and claim to be exempt, as having attended lectures. However, the most reasonable plan would be, to ascertain the names of those gentlemen who have registered at theHall or College as late as the commencement of the last winter session, and I consider it an act of great injustice if a retrospective power is to be granted, which will, I know, most seriously militate against those students who are now studying under the regulations authorized by the College of Surgeons. I think, Sir, your own ideas on the subject are in accordancewith mine, and I sincerely trust that further notice on this subject will be taken by those gentlemen who are interested in thewelfare of the present class of young, medical men. I am rather astonished that many of our schools of medicine have not followed the example set them, and protested against the injustice of an act of this kind. A meeting of all the students in medicine, who have been, even during the last session, studying in this. metropolis,, should be convened, and arrangements entered into to protest. against this clause to those gentlemen in whom this power may be vested, and I have not the least doubt, when it is known how seriously this Act will operate against many, as regards their medical studies, attention will be paid to it; all those who have registered their studies as late as October last ought to be ex-

maintaining

empted. I sincerely trust that the injustice of this Act will be farther noticed by those who are interested in it, and at present I leave it to those more competent than myself to expatiate on this anxious point. I am, Sir, your obedient servant, Little St. Thomas

A MEMBER OF THE PROFESSION. Apostle-court, Queen-street, Cheapside.

THE

THEORY

OF

VISION.

To the Editor

ofTHE LANCET. SIR,—When the eye is extracted by the anatomist from an animal recently killed, and an object is placed before it, and a sheet of white paper behind, the image of the object is found, as we know, depicted upon the paper in an inverse position. As the paper for this purpose performs the office of the retina, it is evident that all objects are painted (if I may so use the expression) upon theretina in a position the reverse of that in which they in reality exist. It has been concluded from this, and physiologists have laid it down, that we see objects upside-down, and that it is only by education-that is, by experience, and the exercise of our judgment,-that we are enabled to see correctly, and to place the different objects in their proper point of view ; and this doctrine I heard Mr. Arago, the distinguished astronomer, forcibly insist upon at a public lecture which that learned professor gave in Paris, in the month of March last. When we consider the unquestionable omnipotence of the Creator, which cannot be more beautifully and convincingly exemplified than in the wonderful organization of the human body, it is not a little surprising that scientific men should so hastily have inferred that the impression upon the human mind must necessarily correspond with the position of the image upon the retina, and that the Deity should be wanting in a contrivance to do that which is effected by man in the camera obscura-namely, restoring the objects to their right position. To suppose that the Creator should have allowed so important an organ as the eye to furnish an erroneous sensation, and lead the mind into a delusion, which the experience and fallible judgment of man is left to correct, is a notion so unphilosophical that it is extraordinary how it should have entered into the human imagination, and, still more so, that it should remain to the present

day

as an

undisputed proposition.

That the mind, however, (notwithstanding what philosophers may think proper to assert,) is not left to wander in error until education shall have taught us the fallacy of our vision, and that the Deity has found the means (however undiscoverable we may find the process) of presenting objects to the mind in the situation in which they actually exist, will be found to be unquestionable, when we examine the subject with a little critical acumen.

For example:-Take a piece of polished steel wire, of two SIR,— Permit me, through the medium of your influential fournal, to address a few remarks to those gentlemen who are inches in length, with one of the ends painted red, and place this justly protesting against the intended alterations in medical object before the eye. Or, again, instead of one of the ends affairs, which will seriously militate against them as students. being coloured red, let it receive a mark so minute as not to be The anticipated change may, it is true, prove beneficial in distinguished without the aid of a lens, and let this object be

720 placed before the

eye of

of the new practice was established by Mr. Liston himself;" and concludes that it is proper the public " should be told, what is to well known to the medical profession, that the treatment the observer in a position the reverse of that in which they are in question originated with the professor of clinical surgery found upon the retina. But this change of position is evidently in the University of Edinburgh-Mr. Syme." Dr. Cormack the result of a natural mechanical operation, and wholly indepen- further adds, that as Mr. Syme’s 11 observations appeared on dent of our volition, or of any mental act originating with our- the 1st January, 1841, in the London and Edinburgh Journal of selves. For what has the mind in these cases to operate upon? Medical Science, which I have the honour of editing, I think it What reason can be suggested why the red end of the wire in is right in me to make this communication." the first experiment should be upwards or downwards, or in one The claim to the merit of having introduced this improvement position rather than in another? How, then, can the transposi- in surgery, set up for Mr. Syme, cannot be substantiated. Dr. tion be the result of experience, or of any judgment formed in Cormack does not appear to be conversant with all that has the mind of the observer? been written on this subject, or he would have known that In the second experiment, independently of the absence of any the antiphlogistic treatment of certain cases of spontaneous ganmotive which should cause the mind to adopt a position contrary grene had been promulgated, argued, tried, and reduced to practo that depicted upon the retina, there would exist no time for tice, years before that epoch in the history of medical literature, reflection, as the transposition would take place at the instant of when his valuable journal was first published, or Mr. Syme’s the discovery of the mark-it would be contemporaneous. name was ever heard of as a teacher of surgery. The writers in support of this theory appear to have felt a Dr. Cormack, however, is not to blame for the readiness difficulty to account for our seeing objects in a position different with which he has laid claim to the merit of this invention for from that delineated on the retina, without our being conscious of his friend. His fault is, probably, more an over-credulity His confidence in the ambiguous report any effort or act of the mind to produce such change, but which than anything else. they have attempted to give a reason for, by saying that it is the of his friend has led him to confer a positive character result of habit. on what Mr. Syme at first, perhaps, only meant to have If, however, by habit we reverse all objects presented to the a partial signification. The paper of Mr. Syme to which eye, it would follow, that if we should accidentally meet with the Dr. Cormack refers is simply a report of one case, in which model of the human figure placed upon its head, it would appear Mr. Syme, (pp. 1, 2,) after quoting Mr. Pott, in condemnation of to us in an erect position, and as if standing on its feet, but " the warming, invigorating, and stimulating" practice, allows which is contrary to the fact. him the merit of having introduced the soothing and opiate It is, therefore, manifest, that our seeing objects in the position system. This Mr. Syme says has never, " in any instance that in which they really exist, is the natural result or operation of has fallen within his observation, proved sufficient to arrest comthe organ of sight, and its connexion with the mind, and wholly pletely the morbid action." Having thus limited the recommendation of Pott, Mr. Syme proceeds to say that, in order to Independent of any volition or mental effort on our parts. The theory, therefore, is clearly unfounded, and ought to be arrest the morbid action, " it is necessary to lower the tenomitted in all future treatises on natural philosophy. dency to excitement throughout the system, by enforcing a strictly I am, Sir, yours, &c. vegetable diet, abstinence from every sort of stimulant, and the May 12, 1845. W. F. S-n, F.R.S. maintenance of perfect quiet in the horizontal posture." Having thus reiterated the practical doctrine of several of his surgical predecessors, Mr. Syme hints at his claim to the merit of a discovery, and talks of " the proposal of this starving plan as ON GANGRENA SENILIS. being rather startling." As this insinuation of Mr. Syme, and MR. SYME’S CLAIMS TO THE ANTIPHLOGISTIC METHOD OF the positive assertion of Dr. Cormack, are calculated to mislead TREATMENT. those who are not intimately conversant with the real merits of To the Editor of THE LANCET. the case, I will supply you with a few references to surgical SiR,-In the March number of the London and Edinburgh Monthly works, to sho’.v that the practice is comparatively old, and that Journal of Medical Science, in an article entitled Forensic Mr. Syme has nothing to do either with its discovery or introMedicine," the editor, Dr. Cormack, gives an abstract of the duction, whatever claim he may have to its adoption. In addition to Pott, already quoted, as having revived stimutrial of the case, " Baker, surgeon, v. Captain Lowe," in which the plaintiff sued for a bill for professional attendance, which the lating treatment, Heister and Quesnai had previously condemned defendant resisted, on the allegation of mal-treatment, superfluous the practice. Sharp, the preceptor of Pott, and others, lend a visitation, and exorbitancy of charge. With the law or equity of corroborative authority. But, independently of the simple abanthe case I have nothing to do; these would, I presume, be satis- donment of the tonic and stimulating treatment, and the substifactorily settled by Lord Denman and the special jury before tution, in addition, of the opiate and soothing method, antiphlowhom the case was tried. It is only to the medical part of gistic remedies have long been recognised as legitimate and the question, and the assumption to which the trial has given sound practice in certain cases of spontaneous gangrene of the rise, that I propose to direct your attention, and that of your extremities. Several authorities report their successful adoption readers. The case, as your readers may remember, was one of this method, and urge the advantages of bloodletting, the of spontaneous gangrene in the toe of an elderly gentleman, most efective of them all, in the treatment of this disease. which ultimately ended in amputation of the foot. The questions Sauvage and others assure us that they have derived benefit from put to the professional witnesses were, whether the case should its use. M. Margolin, while he advocates the antiphlogistic have been treated on the heating, stimulating, phlogistic principle, treatment, reports a case in which, after all the ordinary tonic and opiate remedies had failed, he had recourse to depletion, with or whether the soothing, sedative, and antiphlogistic plan should the happiest results. have been followed. Margolin published this case : in 1824. After giving a report of the trial, Dr. Cormack addressed M. Avisard, who published his memoir some twenty or thirty a letter, in his journal, to the editor of the Times, in which years ago, may be also fairly quoted as concurring testimony. In the cases recorded by M. Broussais, in 1827, we find that he comments upon a letter from Mr. Liston on the same trial, which had previously appeared in that newspaper. Mr. Liston’s he had recourse freely to the practice of leeching in cases of letter is simply a defence of the opinion he had advanced in evi- gangrene of the lower extremities, with the view of correcting dence, with one or two general remarks as to the treatment in the arterio-phlebite on which he supposed that affection depended. such cases. He stated that the stimulating plan had " generally Dupuytren-in his lecture delivered at the Hotel Dieu, in 1833, been pursued by surgical practitioners :’ that he doubts whether and published in THE LANCET of the same year-advocates the the same method had " not hitherto been uniformly taught by antiphlogistic treatment most strenuously. That eminent sureven some of the witnesses for the defendant;" and is " fully congeon, in speaking of the stimulating plan, says, During fifteen vinced that nineteen out of twenty practitioners would have pur- years in this hospital we have essayed every kind of stimulant, sued the same treatment." Mr. Liston, however, says that he bark, and cordial drink; but whether the disease was arteritis has " seen fit to follow the opposite plan in very many cases, and or ossification, the patient equally felt a victim."—LANCET, has advocated this mode in his surgical lectures for several years 1832-33, p. 747. After reporting on a case or two very similar to that of M. Margolin referred to above, in which he had past." (Times, Feb. 19.) In commenting on the foregoing passages, Dr. Cormack recourse to bloodletting, he says, in his generalization principles remarks that Mr. Liston says, " very truly, that the treatment of of the soothing and antiphlogistic modes of treatment, that since constitutional gangrene has been completely changed within the he has had recourse to depletion, he had °° been able to benefit or last few years," but complains that Mr. Liston " does not mention cure between two-thirds and three-fourths of his patients."-p. 748. the author of that change, merely stating that he had seen fit to The accuracy of this high ratio may be doubted, but still the adopt it; from which (says Dr. Cormack) we are apt to be led- treatment was in use. Dupuytren says, further, " that a wise though I am sure unintentionally on his part-to suppose that combination of antiphlogistic and calming remedies, according to an

observer

ignorant of the position

mark, and let him search it out with a lens. Now, in each of these experiments, the objects will appear

the

"