TRANSACTIONS OP THE SECTIONS. 79 



the whole I feel justified in adopting the remark of the practical and accurate Heber- 

 den : " Praeterea meo judicio opium non tantummodo importuni mali praesidium est, 

 sed multum confert ad ipsum morbum tollendum." 



The following considerations may assist in determining the limits within which 

 these favourable results may be expected. 



The pains of rheumatism generally precede pyrexia, as well as the local redness 

 and swelling, and the fever is in the first instance rather neuralgic than inflammatory. 

 At the onset of such attacks, opium alone might be adequate to eifect a cure. In a 

 short time, however, the fever often assumes somewhat of an inflammatory charac- 

 ter, and we cannot judiciously dispense with bleeding. In this country there is also 

 for the most part another complication, namely, disordered digestive organs with 

 hepatic congestion, rendering the use of a small quantity of mercury expedient, and 

 in every instance it is important to promote perspiration by suitable clothing and 

 diet. In the neglect of such precautions, opium may aggravate the disease and fall 

 into discredit. When, however, they are observed, and the pulse is sufficiently re- 

 duced, the remedy, when freely administered, exhibits peculiar efiicacy, and removes 

 the pretext for renewed bleeding, which reaction might otherwise tempt the practi- 

 tioner to employ, at the risk of aggravating irritation, augmenting the susceptibility of 

 the pericardium to the action of the heart, increasing the tendency to metastasis, 

 and shaking the constitutional strength. 



The remedy under consideration appears peculiarly adapted to rheumatic patients 

 in whom the neuralgic element of the disorder is more marked than the dyspeptic 

 or inflammatory. Pain indeed, if not in most instances the most prominent symptom 

 at the commencement of the attack, usually becomes so after the removal of com- 

 plications by appropriate treatment, and the virtues of opium are signally manifest 

 in those cases in which a slightly soft and bounding character of pulse has been 

 produced by bleeding. The writer ofi"ers these recommendations with hope and yet 

 with diffidence, knowing how much time and care are necessary, especially in medi- 

 cine, to establish a single truth, and how great is the liability to error, even when we 

 seem to follow experience as our guide. 



General Observations on the Pathology and Cure of Squinting. By John 

 Butter, M.D., F.R.S., F.L.S., S^c, Physician to the Plymouth Royal 

 Eye Infirmary. 



The author in this paper pointed out the difi'erent kinds of squinting, their causes, 

 and treatment. He thought that the term " Congenital " was often misapplied to 

 squinting, which he considered to arise generally some time after birth, owing to a 

 contraction of the muscle or tendon produced by some internal disease, as fits, worms, 

 measles, small-pox, hydrocephalus. The real nature of squint he ascribed to an 

 hypertrophy or too great strength of one muscle, or to an atrophy or weakness of 

 the antagonist ; and drew an analogy between this and other muscular affections, 

 as hemiplegia, St. Vitus's dance, locked-jaw, and the like. 



Remedies have been devised in all ages in vain by philosophers, poets, physicians, 

 and mechanics. Some proposed mirrors, reading small print, masks, spectacles, 

 goggles, gnomons, plaisters, funnels, a candle behind the back, bandaging one eye, 

 and even internal medicines. SuflSce it to say that there was no remedy known to 

 the close of the year 1839. 



The year 1840 shed a new light on this subject. A cure now is almost certain 

 from an operation. Dr. Stromeyer of Hanover, and Dr. Dieffenbach of Berlin led 

 the way. Their examples were soon followed by Mr. Bennett Lucas of London, 

 and also by Dr. Franz, Mr. Guthrie, and others. 



The author considered that during the last year (1840) some thousands of squinters 

 were cured perfectly in the United Kingdom, and many hundreds in the three towns of 

 Plymouth, Stonehouse, and Devonport, of whom a great number had been operated 

 on at the Plymouth Royal Eye Infirmary. He considered the operation simple, 

 safe and successful in skilful hands, and had never known an untoward result or loss of 

 vision from it in his own practice, which appeared, from the living instances of pa- 

 tients cured and shown at the meeting, to have been considerable. 



Dr. Butter haa discarded the tribe of instruments recommended by others, and 



