fi40 PROGRESS OF MEDICINE IN THE NINETEENTH CENTURY. 



of Holmlioltz in ]ihysiologic!il optics, with his inv(Miti<)n of theophthal- 

 in()sco})0 ill 1.S52, eti'cctod ii revohitioii in this l)i';inch of nicdical science 

 jind art and have added greatly to human comfort and happiness. A 

 hundred yeai's ago, when the physician saw tlie eyelids of the new- 

 born habe redden and swell and yellow matter ooze from l)etween 

 them, he knew that in a few days or weeks the child would be partially 

 or wholly Idind. ))ut he knew nothing of the simple means ]>y which 

 the skilled physician can now prevent such a calamity. It is luifortu- 

 natelj' true that this knowledge is not even now sufficiently widely dif- 

 fused and that our blind asylums must, for some tune to come, continue 

 to receive those who have been deprived of sight during the first 

 months of their life through the ignorance or neglect of those who 

 should have properly cared for them. 



While it is certain that the death rates in the last century were 

 greater than those of the present day, it is not possible to make pre- 

 cise comparisons. The record of deaths in the city of New York 

 begins with 1S04. and was necessarily very imperfect until the law of 

 1851. which recpiired the registration of all deaths; but it shows a 

 death rate of 30.2 per 1,<»0() in 1805, Avhich means that the true death 

 rate must have been between 35 and 40. At present, for a series of 

 five years, it would be about 20, having been below 19 in l81M),so that 

 the death rate has been diminished by at least one-third. How much 

 of this is due to impro\ed methods of treatment, and how nuich to 

 improved sanitary conditions, it is impossil)le to say. A comparison 

 of the list of causes of death in 1S05 with the list of causes for this 

 year shows great difi'erences. but luuch of this is due to changes in 

 name and to more accurate diagnosis. 



"Malignant sore throat" and "-croup" were well known to anxious 

 parents in 1800, ))ut "diphtheria"' caused no anxiety. "Inflammation 

 of the bowels'" was connuon and fatal, but "appendicitis"" had not 

 been heard of. Nervous fever, continued fever, and low fever were on 

 the lists. l)ut not typhoid, which was not clearl}- distinguished as a 

 special form of disease until 1837, when Dr. Gerhard, an American 

 physician, pointed out the differences between it and typhus, which 

 also prevailed at the commenceiuent of the century. 



One hundred years ago the great topic of discussion in our cities on 

 the North Atlantic coast was the means of preventing yellow fever, 

 which had been epidemic in New York and Philadelphia for two years. 

 Phj^sicians were disputing as to whether the disease was contagious 

 and imported, and therefore perhaps preventable by quarantine and 

 disinfection, or was due to some occult condition of the atmosphere 

 (which was the view taken b}' Noah Webster in his history of epidemic 

 and pestilential diseases, a work which appeared about the middle of 

 the year 1800, although it is dated 1798). The discussions remind one 



