of his lectures, and may serve as a useful guide to the study of the subject. Almost to the last he continued to contribute articles and reviews on ophthalmic subjects to the journals. Some of these manifest great ability, and perhaps more of original thought and research than his larger works. Among these we may mention an article which he published in the London Medical Gazette in 1834, in which he inferred, from certain observations made on dead bodies, that when the pupil contracts in accommodation for near objects, the ciliary ring expands, and that contraction of the ciliary ring takes place along with dilatation of the pupil when the accommodation is relaxed. This conclusion has recently been verified by observations on living albinos, in whom the ciliary processes can sometimes be seen through the iris by means of the ophthalmoscope.*

In July, 1845, he published an elaborate article "On the Vision of Objects on and in the Eye," in the Edinburgh Medical and Surgical Journal. This was an important contribution to the study now dignified with the title of Entoptics, and the practical remarks contained in it derive additional interest from the circumstance that the writer was an experienced oculist.

Dr Mackenzie's professional erudition was extraordinary, and a singularly accurate and retentive memory enabled him to avail himself of the results of his reading at the shortest notice. With all this, he was a most indefatigable taker of notes, and made jottings of everything that appeared to be of value in his reading, whether professional or general. His ophthalmic notes were generally entered in an interleaved copy of his own book, opposite the appropriate chapter; and he left numerous note-books containing extracts and jottings referring to all sorts of subjects. He was a good classical scholar, and far above the average in point of general literary acquirements.

In his private practice he took notes of almost every case of eye disease that was likely to remain under his care-noting, from time to time, any change in the symptoms or treatment of the case. In this way he was enabled, when an old patient

* O. Becker-Wien. Med. Jahrb., 1863, ii. 159; 1864, i. 3.

returned to him, to ascertain the history of the case, so far as his dealings with it were concerned, with a rapidity and precision which the best of memories could not ensure. The notes themselves were very brief, but comprehensive. The same system was introduced into the Eye Infirmary, where it is still adopted, in the case of out-patients as well as of those living in the house.

As an operator, Dr Mackenzie was cool, deliberate, and adroit. He detested all affectation of dash or brilliancy in operating, but exhibited great resource and dexterity when he met with any obstacle or difficulty. His last cataract operation was performed on the 15th July of this year; and his touch had lost none of its delicacy or firmness.

Like all practitioners of his age, he had witnessed the rise and fall of many vaunted professional novelties, and he was extremely cautious in adopting them. On one or two occasions he even condemned, with considerable asperity, practices which have maintained their ground, and have become generally recognized as valuable improvements in ophthalmic surgery. At the same time, he was eminently candid and open to conviction, and he did not allow his judgment to be so far carried away by controversial passion as to prevent him from calmly reconsidering his views, when he found them to be at variance with contemporary opinion.

He was at first opposed to the operation for strabismus, but he afterwards changed his opinion, and practised it for many years. In like manner he stoutly resisted the introduction of iridectomy as a cure for glaucoma, and certain other diseases of the eye; but in his latter years he modified his views on the subject considerably, recommending the operation in various instances, while he continued to think that its application had been carried too far by many oculists. When the ophthalmoscope was invented, he rather under-estimated its probable value, and was apprehensive that its employment in inflammatory affections of the choroid and retina might prove injurious; but he soon began to work with it, and persevered till he had thoroughly mastered its difficulties. Latterly he used the instrument in all cases in which it was likely to aid the diagnosis, and regularly entered the results of the examination in his private notes.

Whatever may have been the impression produced by some of his polemical writings, he was, in reality, totally free from anything like arrogance or pretension. On the other hand, he was, sometimes, perhaps, rather deficient in a sense of the respect due to the professional distinction of others. When he thought that sound surgery was in danger of being sacrificed to the love of novelty or display, he laid about him without much respect of persons; nor did he suffer the eminence of an antagonist to blunt the edge of his sarcasms. Thus, offence was probably given in some cases where none was meant.

Dr Mackenzie's interest in his favourite study never abated, and, though slow to change his opinions, he was always ready to learn, and always on the look out for information, from whatever source it might come. As he advanced in life his medical treatment of ophthalmic cases became much less antiphlogistic than it was at the date of the publication of his book, and he very rarely employed the lancet for several years before his death; but he never shared in the exaggerated dread of general bleeding and mercury which seems to be the fashion of the present day.

It may be mentioned here that the subject of this notice took the degree of M.D. at the University of Glasgow in 1833; that he became an honorary Fellow of the Royal College of Surgeons, London, in 1843; and that, shortly after the commencement of the present reign, he was appointed Surgeon Oculist in ordinary to the Queen in Scotland.

Dr Mackenzie was long subject to a bronchial affection, which occasionally confined him to the house in winter for a few weeks at a time. His lectures were latterly delivered by deputy; and he ceased attending the Eye Infirmary many years ago, as he found that much speaking aggravated his symptoms. He continued to practise in private to the last, and he was always ready to consult with his hospital colleagues. Last winter he suffered rather less than usual from his old enemy, and in the early months of the season his appearance afforded no indication of decay.

About a month before his death he began to complain of occasional attacks of severe pain in the chest, generally occurring

early in the morning, and he hinted a suspicion that he was affected with angina pectoris. On the 29th of July he was at his consulting room, and saw several patients; but he felt rather unwell, and went home earlier than usual. On his way he called at the Faculty Hall, and took out a volume of the "Encyclopédie des Sciences Médicales," containing an article on angina pectoris by Jurine, part of which he read during the evening. Next morning, about half-past four o'clock, the pain returned with great severity, and continued, in spite of the remedies employed, till half-past two o'clock in the afternoon, when he expired during a paroxysm. He was conscious and intelligent to the last moment, and he spoke with interest about one of his patients only two hours before his death.

He leaves a widow and one child, a boy about 11 years of age.

In private life Dr Mackenzie was genial and pleasant, and he possessed an inexhaustible fund of quaint humour and amusing anecdote, which made him a most entertaining companion. His reminiscences of Glasgow extended over upwards of seventy years, and the accuracy of his memory enabled him to recall with singular vividness the images and tones of the characters of former days. It is to be feared that much local lore has died with him. His recollections of the medical celebrities of London and the Continent in the early part of this century were interesting and characteristic. He was very methodical in his habits, and went through a great amount of work in a short time, not only without hurry, but with a leisurely air which was sometimes almost amusing.

Dr Mackenzie's public services to the poor of Glasgow need no recognition here; but his unostentatious kindliness and charity to many who came under his care in private practice are probably known to few except the recipients.

It would, perhaps, be premature to speculate as to the place which Mackenzie's name will ultimately occupy in the history of ophthalmology. In the field of discovery and original research it must yield precedence to others. But in arranging and systematizing what was already known, in contributing throughout a long life the most valuable additions to the general stock of information, and in bringing sagacity, experience, and

erudition to bear on the discussion of every branch of the subject, he has rendered a service which can hardly be over-estimated.

At the conclusion of an obituary article which appeared in the Annales d'Oculistique, the editor thus expresses his opinion of the loss which the profession has sustained in the death of Dr Mackenzie:

"La morte de Mackenzie laisse, dans la littérature ophthalmologique, un vide qu'il sera difficile de combler. Malgré son grand âge, il n'avait renoncé ni à s'instruire ni à instruire les autres. Il a quitté la vie, sans avoir eu à se survivre à lui-même et sans donner le triste exemple d'un amoindrissement fatal des facultés si brillantes qu'il avait reçues en partage et dont il a su faire, jusqŭ, à sa dernière heure, un si noble et si persévérant usage." G. R.

II. ON THE LIMITS OF ALCOHOLIC STIMULATION IN ACUTE DISEASE.

By W. T. GAIRDNER, M.D., Professor of Practice of Medicine in the University of Glasgow.

(Read before the British Medical Association at Oxford, August, 1868.) In a considerable number of detached papers, ranging over the last ten years, I have made allusion, more or less in detail, to the administration of alcoholic stimulants in the hands of physicians. In one of these papers, in particular, the subject was rather elaborately and specifically discussed in its relation to the epidemic typhus of 1863 and 1864, as observed and treated by me in Glasgow. The discussion, thus limited to one form of disease, was considered to have a special interest, on the ground that "typhus fever is the disease of all others in which the practice of stimulation has been most largely followed;" and further, that "typhus fever, as marked by the eruption, is a remarkably well-defined disease, in which, with proper securities against error, there is likely to be but little difference between the diagnosis of one well-informed hospital physician and another."* On the present occasion I propose, not so much to attempt any new course of research, as to reproduce some of the conclusions of the preceding inquiry in a somewhat different and less statistical form; extending, more. over, in some degree the basis of observation, so as to admit to consideration other diseases than typhus fever, and thus to

* Lancet, March 12, 1864, p. 291.