FAILURE OF SIGHT. FROM RAILWAY AND OTHER INJURIES OF THE SPINE AND HEAD ITS NATURE AND TREATMENT WITH A PHYSIOLOGICAL AND PATHOLOGICAL DISQUISITION INTO BY THOMAS WHARTON JONES, F.R.S., F.R.C.S. PROFESSOR OF OPHTHALMIC MEDICINE AND SURGERY IN UNIVERSITY COLLEGE, VIENNA; MEMBER OF THE ROYAL MEDICAL SOCIETY OF COPENHAGEN; MEMBER OF THE SOCIETY OF BIOLOGY OF PARIS, ETC., ETC. LONDON JAMES WALTON BOOKSELLER AND PUBLISHER TO UNIVERSITY COLLEGE 137 GOWER STREET 1869. [All Rights of Translation Reserved.] 157. n. 125 PREFACE. "Nil fingendum, nil excogitandum, sed inveniendum quod Natura ferat, quod Natura faciat.”—Bacon. THE failure of sight which so often supervenes in cases of concussion of the spinal cord or brain is amaurotic in its character, and appears to depend immediately on a disturbance of the circulation of the blood in the optic nervous apparatus. How disturbance of the circulation in the optic nervous apparatus should be induced by concussion of the brain, seems intelligible enough; but how such an effect should supervene on injury of the spinal cord, is a question which is not so easily answered at first. A consideration of the source, in the spinal cord, of the nervous influence by which the circulation of the blood in the optic nervous apparatus is regu lated, appearing to me calculated to lead to a solution of the question, I have made a physiological and pathological disquisition into the action which the vaso-motor nerves exert on the constrictions and dilatations of the arteries. In this disquisition I have necessarily entered, with some detail, into the subject of hyperæmia, or vascular congestion, in its various degrees, from simple determination of blood to actual inflammatory stasis. While, therefore, the work which I now publish is a practical Treatise on the Nature and Treatment of Failure of Sight from Injury of the Spine and Head, it is offered also as a Treatise on the Physiology and Pathology of the Circulation of the Blood in the Extreme Vessels-a subject which, on account of its fundamental importance in the Science Medicine and Surgery, claims from every Medical man the most careful study, of To turn now to the medico-legal aspect of the question. The present work was originally undertaken for the purpose of aiding in the diagnosis of the existence or non-existence of amaurotic failure of sight in cases of railway injury, in which there was a conflict of opinion on the subject. The observations founded on the cases, and the inferences deduced from them, are such as suggested themselves at the time of drawing up reports for the guidance of those engaged in the legal inquiry. Throughout the work, therefore, the medico-legal bearings of the subject have been constantly kept in view. T. WHARTON JONES. 35, GEORGE STREET, HANOVER SQUARE, London, September 15th, 1869. |