THE AMERICAN MEDICAL INTELLIGENCER. Vol. III. April 1, 1839. No. 1. ART. I.-CASES OF AMAUROSIS AND NERVOUS DEAFNESS. BY JAMES BOLTON, A. M., M. D., OF RICHMOND, VIRGINIA. Richmond, Va., Feb. 8th, 1839. Dear Sir,-The following interesting cases having come under my care, I send the subjoined account of them to you, as perhaps they may, in your judgment, deserve a place in your valuable periodical, where I have before been honoured with a space. Very respectfully, Robley Dunglison, M. D. JAMES BOLTON, A. M., M. D. 1. Amaurosis and amenorrhea.-Mary J., a coloured woman, 22 years of age, unmarried, had suffered under amenorrhea for two years, during which time her vision had become very much impaired, and she had been subjected to various modes of treatment, regular and irregular. I found both pupils nearly immovable; with one eye she could not distinguish light from darkness, and the sight of the other was so defective that she could scarcely attend to her ordinary occupation, that of chambermaid. Had severe headaches, and the other ordinary unpleasant symptoms of her principal malady, regularly every month. Treatment.-As the bowels were somewhat costive, they were freely evacuated with pills of rhubarb and aloes. A week after the subsidence of her cephalalgia, &c. I put her upon the use of the following pills: R. Ext. Sabinæ, Sulph. Ferri. äā gr. t, G. Ammoniac gr. iiss. M. for one dose. One pill morning, noon, and night, increased daily by one. On the sixth day from commencing the use of these pills, the menses returned, and with them a great improvement of vision. The discharge continued four days, during which time the pills were discontinued. A fortnight afterwards she could distinguish a broom straw at the distance of six inches with the eye which before was so blind that she could not distinguish light from darkness. The vision of the other eye also was very much improved. At the next period of the usual return of the menses, they did not appear, and she had again headache, &c.—The use of two or three pills immediately reproduced the discharge, and a complete relief from all her unpleasant symptoms. I have since heard nothing further of the case. 3. Erethitic nervous deafness.-T. H., aged 17, son of a highly respectable gentleman of this place (Richmond), for about two years has been much annoyed by tinnitus in both ears, and a gradual diminution of hearing. The disease has been hereditary on his father's side of the family. January 26, 1839, much annoyed by a noise resembling the roaring of a waterfall, especially on going to bed-labouring under a severe catarrh with enlargement of the tonsils. January 31st, catarrhal symptoms nearly removed. The day previously had suffered from severe headach, to which he is subject. Hearing distance of the right ear, as tried by my watch, 44 inches, left 3 inches. Applied the vapour of acetous ether to the left ear, according to the directions of Kramer, and an issue to the arm for the cephalalgia. Tinnitus very rarely heard, and then sounds like the buzzing of an insect. This case is interesting as I have not seen any report of Kramer's treatment having been tried in this country, although his work has been re-published here several months since in the Library which you edit, and the treatment recommended in that admirable work has been astonishingly successful in the case above mentioned. Remarks. The improvement of hearing in the left ear was undoubtedly due to the treatment, and that of the right ear was no doubt owing to the effect of the vapour of the ether, which escaped from the catheter while applying it to the other ear, finding its way into the eustachian tube of the right side. I shall report to you at another time the further progress of this case. Richmond, March 16th, 1839. Dear Sir,-Since my last communication in February, I have continued the treatment recommended by Kramer in this case, then reported to you, and it has been crowned with a success far exceeding my most sanguine expectations. The patient being attacked every five or seven days with severe cephalalgia, I applied a seton to the left arm, which so effectually warded off this unpleasant affection, that he suffered but one slight attack during the month he was under treatment. Report of the case continued. Hearing Distance. Left ear. Right ear. Feb. 9th, 16ft. 2in. 7ft. 10in. Appl. æther. vapor. ad aur. sinist. 11th, 18 9 not measured. do. do. do. Patient remarked that now, for the first time, he was not aware that crickets do not chirp in winter, as he had been much annoyed by a similar sound. Roaring noise changed to a humming like that of an insect-very rarely heard-slightly on going to bed. Hearing Distance. Left ear. Right ear. Feb. 13ht, not measured. Appl. æther vapor. ad aur. dext. 15th, 20ft. 3in. 11ft. do. do. do. do. 16th, not measured. On the 28th, the patient left the city to go several miles into the country, and has not returned, nor have I been able to learn any thing respecting his hearing. The Remarks.-There are a few points worthy of notice in this case. hearing distance of the right ear was rather greater than that of the left; but after the first application of the ether, the reverse was the case. During the first week the left ear only was treated, and while the hearing of that side improved astonishingly, that of the other improved slightly and gradually, which, as I before remarked, was probably owing to an overflow of the acetous ether filling the esophagus and passing through the eustachian tube into the cavity of the tympanum of the opposite side. On applying the ether to the right ear for the first time, the hearing distance was nearly trebled. During the treatment, the hearing distance, although diminished by a severe catarrh, was about forty times that when diminished by the same cause before the treatment was commenced. The hearing was always worse in damp weather, and as it was very rainy the last few days, this no doubt increased the effects of the catarrh. Cataract in the Horse. Some months since I performed the operation of couching on a filley of about five years old with entire success. The disease had affected both eyes, so as to render her entirely blind. The animal may now be seen in the vicinity of Fredericksburg, and is in the possession of a Mr. Perkins. Very respectfully, JAMES BOLTON, A. M., M. D. ART. II.—ANOMALOUS DISTRIBUTION OF THE VERTEBRAL ARTERIES. BY RICHARD P. CATLEY, M. D., OF OHIO. [Although the anomaly in the subjoined case may differ somewhat from those recorded, there are many examples of a similar irregularity of origin and distribution referred to by Meckel' and other anatomists.-Ed.] Dr. Dunglison. Philadelphia, March 15th, 1839. Sir, On the 8th of February last, whilst attempting the ligature of the innominata on the dead subject, at my residence in the state of Ohio, having exposed the vessel in the manner directed by Mr. Liston, of London, I tried to pass my finger from the division into the right subclavian and carotid along the innominata to the arch of the aorta; but, in so doing, I met with an anomalous arrangement, which, to the touch, seemed like a bifurcation of the arteria innominata. I immediately commenced a careful dissection of the parts, and found that both the common carotids, as well as the right subclavian, were given off by the innominata; and that, on the left side, there were two vertebral arteries, one arising from the arch of the aorta and entering the transverse process of the fourth cervical vertebra, the other arising from the subclavian and entering the transverse process of the sixth cervical vertebra as usual. I have preserved the parts in a preparation, which I have shown to Dr. Pattison, Professor of Anatomy in the Jefferson Medical College, to Dr. Horner, Professor of Anatomy in the University of Pennsylvania, and to Dr. Pancoast, Lecturer on Anatomy in this city-all of whom concur in stating that they have never seen or read of precisely such an anomaly. Should you think this notice worthy a place in your journal you are at liberty to use it. Believe me to be, sir, yours respectfully, Handbuch der pathologischen Anatomie. B. ii. Abth. 1. s. 108. Applied the vapour of acetou's ether to the left ear, according to the directions of Kramer, and an issue to the arm for the cephalalgia. Tinnitus very rarely heard, and then sounds like the buzzing of an insect. This case is interesting as I have not seen any report of Kramer's treatment having been tried in this country, although his work has been re-published here several months since in the Library which you edit, and the treatment recommended in that admirable work has been astonishingly successful in the case above mentioned. Remarks.-The improvement of hearing in the left ear was undoubtedly due to the treatment, and that of the right ear was no doubt owing to the effect of the vapour of the ether, which escaped from the catheter while applying it to the other ear, finding its way into the eustachian tube of the right side. I shall report to you at another time the further progress of this case. Richmond, March 16th, 1839. Dear Sir,-Since my last communication in February, I have continued the treatment recommended by Kramer in this case, then reported to you, and it has been crowned with a success far exceeding my most sanguine expectations. The patient being attacked every five or seven days with severe cephalalgia, I applied a seton to the left arm, which so effectually warded off this unpleasant affection, that he suffered but one slight attack during the month he was under treatment. Report of the case continued. Hearing Distance. Left ear. Right ear. Feb. 9th, 16ft. 2in. 7ft. 10in. Appl. æther. vapor. ad aur. sinist. 11th, 18 9 not measured. do. do. do. Patient remarked that now, for the first time, he was not aware that crickets do not chirp in winter, as he had been much annoyed by a similar sound. Roaring noise changed to a humming like that of an insect-very rarely heard-slightly on going to bed. Hearing Distance. Left ear. Right ear. Feb. 13ht, not measured. Appl. æther vapor. ad aur. dext. do. 15th, 20ft.3in. 11ft. do. do. do. 16th, not measured. On the 28th, the patient left the city to go several miles into the country, and has not returned, nor have I been able to learn any thing respecting his hearing. Remarks.-There are a few points worthy of notice in this case. The hearing distance of the right ear was rather greater than that of the left; but |