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liquid is treated with ether to remove fat and other extra-neous bodies. Finally, the residual liquid is made alkaline

with potassium carbonate or hydrate and treated with

chloroform which dissolves the liberated alkaloid. The

chloroform is separated and poured off and on allowing it to

evaporate atropine in a fair state of purity will remain whichcan be tested both chemically and physiologically. This

excerpt from an early number of THE LANCET is interestingin relation to the history of alkaloids.

-

THERE will be a general meeting of the Medico-LegalSociety on Thursday next, April 10th, at 5.30 P.M., at 20,Hanover-square, London, for the purpose of adopting rulesand appointing officers. All who are interested in the workof the society are invited to attend. Particulars may beobtained from the secretaries, Dr. McCallin or Mr. R.

Henslowe Wellington, 20, Hanover-square, W.

IT has been decided to inaugurate a post-graduate courseof clinical demonstrations at Westminster Hospital duringthe coming summer session. The demonstrations will beheld on Tuesdays at 4.30 P.M., commencing on May 13th.

I

SOME ACCOUNT WITH ILLUSTRATIONSOF "CHRONIC GLAUCOMA."

BY ONE WHO HAS IT.

THE records of men who in the cause of humanity andmedical science carry a fierce enthusiasm usque ad mortemare happily ever being brought up to date. The idea thata man should wilfully contract a disease in order that hemay fully grasp its most minute symptoms and be morecompetent to relieve others who suffer from it is no longerconsidered a vain phantasy. There are, however, some

diseases too malignant or exclusive to be assumed at willand among them must rank specific ocular diseases suchas chronic glaucoma which seems to be also known underthe title of "grey atrophy."

"

Pending the time when a medical expert shall contractthis disease and lucidly and scientifically describe its mostminute details a poor layman, whose only merit is that hesuffers from it, gives here his personal knowledge of anundesirable malady in the hope that some reader may seehere and there some further light to guide him in his work ;and also with the idea that the strange vagaries of the eyealluded to may give some slight further inkling to the causeand seat of dreams, which vagaries may be likened to theprobable productions of an automatic photo-camera out ofgear.

Physical condition and appearance.-The patient’s heightis six feet and his weight has never exceeded 11 stones andtwo pounds. He is active in habits, is somewhat restless,and is nervous and slightly irritable. He has a wiry appear-ance and a very meagre flesh covering, is a great walker, andis able to get over 30 miles in a day without distress. Anadvertisement writer, his sight has for many years beentaxed to its utmost, but the eyes had never given very serioustrouble until about five or six years ago, when his work causedhim to live in Manchester, which, on account of its cease-less clatter and humidity, is a stronghold of nerve shatterand rheumatism. After about 18 months’ residence therethe patient was attacked by what was at first called muscularrheumatism but which eventually developed into generalneuralgia, appearing at gradually lessening intervals. Two

years ago the nasal nerves were specially affected, and as aresult twice or three times a week there was a copiouswatery discharge from the eyes and nose. This usuallycame on at night suddenly and was preceded by asharp stinging sensation in either nostril. This preventedsleep and in the daytime made work very difficult, neces-sarily causing considerable worry. Slight failure of the eyethen occurred, of which, unfortunately, little notice wastaken. Rather more than a year ago reading became diffi-cult. the letters appearing to flow into one another, fancy-pointed type being most easily discernible. This appears to

bear out what a writer in a recent issue of THE LANCETstated, as to a man suffering from partial blindness beingbetter able to read Greek than any other language. Onconsulting Dr. C. E. Glascott he diagnosed the disease aschronic glaucoma, a hopeless complaint, always goingfrom bad to worse and liable through influenza or a bad coldto end in darkness. No treatment was likely to be of anyavail, and the only vestige of consolation lay in the fact thata kind of record had been established by the disease beingcontracted at the age of 40 years instead of at 60 years, asusual. The general outlook at this period presented theappearance of a continuous summer haze.

Rapicl development of the disease.-In two months’time aslight mist had grown into a thick fog of a dark grey aspect.Further medical assistance was sought, Mr. E. L. Luckmannof Altrincham Eye Infirmary taking the case in hand andgiving tonics to which iodide of potassium was added. Thistreatment had a decidedly beneficial effect and appeared atleast to arrest the progress of the complaint and even at

times to improve the vision. Unfortunately, however, owingto a very bad chill, caught when making a sea trip toGlasgow, the small hopes of amelioration were dispelled, andwith the exception of a slight appreciation of the light astate nearly approaching to blindness ensued and the patienthad to be led about. The following illustration representsthe patient’s view of part of the country through which hewalked on his first visit to Altrincham. It looks as if thepeaceful fields were being shelled by an enemy. The

phenomena only occurred after much physical exertion andthe bursts of light were accompanied by a very slightcracking noise. (Fig. 1.)

I Fm. 1.

This shows the patient going along a country road, fields oneither hand. The lighter spots locate the apparent positionof the bursts of light referred to.

It should be mentioned that this ocular peculiarityoccurred after considerable physical exertion only. Thisnext sketch represents a very crowded Manchester thorough-fare on a clear day as it appears at the time of writing.Nothing is visible except an occasional dark shadow. Theone shown in the sketch represents a man who has passednear enough to tread on the patient’s toes. None of theroad traffic can be seen at all. (Fig. 2.)During the past few weeks, in addition to a chronic

stickiness of the eyelids, a kind of paralysis of the nose,the lips, and the chin has set in, making speech occasionallyquivering. There has also been periodical numbness of theforehead. It may be mentioned that when in Glasgow thepatient attended the Ophthalmic Institute and was seen byProfessor A. Maitland Ramsay who confirmed all that Dr.Glascott had said, calling the disease, however, by a

different name-" grey atrophy."Permanent optical illusion.-In the advanced state of the

disease the only thing capable of being visually appreciatedwith anything like correctness was a large blot of ink onwhite paper held close to the eye. The patient finds it a

great relief to keep the lids closed as much as possible, but

985

he finds that when opening them suddenly at times when,his mind is not specially occupied all kinds of fantastic

designs in black and white appear before the eye, as if

he was looking through a kaleidoscope, and remain for

.a a 1’ew.; seconds and gradually fade away. The figuresshown (are often of familiar animals, fleur-de-lis, black

FiG. 2.

Market-street, Manchester, is here shown. The patient’s son.who leads him, remarks that the street is more thanusually crowded. So far as his (the patient’s) eyes tellhim, however, it presents a deserted appearance, as in thissketch.

’battlements, &c., and are always mixed up with a section of.a "chess-board." A wall-paper designer might get someprofit from glaucoma. On waking from sleep objectsappear visible about which the patient has not recentlythought or dreamt though they were once much in his mind.A woman’s costume fixed on a wire stand has more than once

FIG. 3.

The patient is lying in the bed shown. The figure standing at the footis a sudden apparition of himself when 20 years younger.

appeared in this way and has only very gradually vanished.A most peculiar instance, however, is illustrated below. The

patient being awakened by his wife bringing up a cup of teais conscious before receiving the cup that the space betweenthe door and the bed is occupied by the apparition of him-self as he looked 20 years ago-dressed in cricketing flannels,necktie flying in the wind, the face being flushed andindicating the joy of life. This apparition continued visiblesome time after he had received the cup of tea and hadinformed his wife of what he saw. (Fig. 3.)

The gummy feeling of the eyelids to which reference hasbeen made may be slightly relieved by bathing with warmwater and is an annoyance worth bearing patiently. But atrick played by the eye, as shown in the following sketch(Fig. 4), seems to go a little too far towards the region of

FiG. 4.

Wheel appearance caused by the eyelashes.

insult. The patient’s eyelashes now and then seem to formthemselves into a kind of wheel which will revolve withconsiderable speed for several seconds, the lashes beingmagnified to about three times their right size.The medical dictionaries and handbooks on eye diseases

give very scanty accounts of glaucoma, but it seems to belooked upon as incurable by oculists of great experience.Again and again, always in kind and sympathetic tones,comes the same best possible advice : I Your case is hopele"" ;keep up your spirits and general health."

" He who has doneall things well does for the -asking give a man power to eethe cheerful and even humorous side of blindness. Still,the particular joys of glaucoma are not always apparent andthe sympathetic paralysis with which it is accompanied issympathy not easily appreciated.

MEDICAL GRADUATES’ COLLEGEAND POLYCLINIC.

ANNUAL GENERAL MEETING.

SIR WILLIAM H. BROADBENT, Bart., presided on

March 25th over the third annual general meeting of themembers and subscribers of the Medical Graduates’ Collegeand Polyclinic at 22, Chenies-street, London.The third annual report of the council began by pointing

out that the fact that new names were added almost daily tothe register showed that the Polyclinic filled a long-feltwant. Many of the members had frequently availed them-selves of the opportunity afforded them for obtaining anexpert opinion upon cases of unusual rarity or of peculiarinterest. The recommendations of members who hadattended practical classes had resulted in the attendancesbeing considerably augmented. The number of members andsubscribers for 1901 was 825. Most interesting discus-sions had taken place at meetings of the special com-mittees dealing with leprosy, yaws, climatology, andtuberculosis and much useful information had been brought tforward. It was announced that there were in course ot

constitution two new special committees for the investiga-tion of cancer and vaccination. In October, 1900, shortcourses of lectures on special subjects were inaugurated andthe arrangement worked so well that for the year 1901 thenumber had been doubled. The scale of charges for thepractical classes had been revised and the change had beenmuch appreciated by the members. The vacation session ofthree weeks held in September proved a great success. Thedetermination had therefore been arrived at to hold a similarcourse again. Arrangements had been completed wherebymembers could obtain instruction in operative surgery. Thecouncil felt assured that in the course of time the consulta-tion department would constitute a very special and much-utilised feature of the college work. The report contained9, table showing the nature of the investigations which hadbeen conducted in the laboratory during the past year and