soon after in a paper read before the Academy of Medicine in New York, June 15th of the same year. The doctrine had, however, been publicly taught by me in lectures in the Albany Medical College two years previously to the reading of these papers, and several cases in which chorea and other nervous diseases were in relations of effects of ocular disturbances had been exhibited to my classes. Several papers relating to this subject have been given to the public by myself from time to time in which the doctrine has been somewhat more fully developed.* A few writers have, since my first publications on this subject, recognized certain facts relating to it, but it can not be said that any contribution of considerable importance has been added to the literature beyond what has been stated. If it is remembered that pain over the eyes, and even general headache, with feelings of general malaise, have been long recognized as among the occasional * See "Transactions of the Albany Institute, 1874-1876"; "Chorea," "Transactions of the New York Academy of Medicine," 1876; "Refractive Lesions and Functional Nervous Diseases," "New York Medical Record," September, 1876; "Light in its Relation to Disease," "New York Medical Journal," June, 1877; "Clinical Notes of Cases of Neuralgia and Troubles of the Accommodation of the Eye," "New York Medical Record," October, 1877; "Relations between Corneal Diseases and Refractive Lesions of the Eye," International Medical Congress, Philadelphia, 1877; "Enucleation of an Eyeball, followed by Immediate Relief in a Case of Diabetes Insipidus," "Transactions of the American Ophthalmological Society," 1878; "Two Cases of Enucleation of the Eyeball," "Alienist and Neurologist," January, 1880; "Ocular Muscular Defects and Nervous Troubles," "Transactions of the New York State Medical Society, 1880; "Oculo-Neural Reflex Irritation," International Medical Congress, London, 1881; etc. symptoms of asthenopia, it will be understood that, in the treatment of their asthenopic patients, oculists have from time to time casually relieved these more general symptoms while pursuing the rational measures of treatment for asthenopia. Such relief, incidental so far as the design in treatment was concerned, did not, in the minds of oculists suggest the principle that for such general symptoms not attendant upon asthenoria, the condition of the eyes should be examined, and perhaps treated. Thus, while Graefe recognized headache as one of the occasional symptoms of asthenopia, he did not suggest that persons subject to chronic cephalalgia should consult an oculist. If the doctrines taught in the following pages should be accepted by the medical profession, doubtless many oculists might be able to recall relief to headaches as incidental to treatment of asthenopia. It would not be surprising even if the recollection of such an occurrence should induce in the mind of the practitioner the belief that he was then acting upon the principle here developed. A careful and extensive search in the literature of ophthalmology and of general medicine has not enabled the writer to find any mention of the principle that irritations arising from ocular adjustments may act as reflex causes, inducing nervous troubles in distant parts, except in the vague manner already mentioned, prior to his own announcement of it. Should the facts presented in this memoir appear to differ so essentially from the experience of medical practitioners generally as to seem to belong to the marvelous, it can be said that they are all capable of being fully substantiated. The author refers with pleasure to the several wellknown medical gentlemen whose names appear in connection with some of the most typical cases here reported. He is sure that in every instance these physicians will affirm that these cases have been not only not exaggerated, but in every instance understated. Surely we are not to hope for a specific against all neuroses. Our greatest advance must be in the recognition of some new classes of causative influences, and the means of combating those influences. If the author has presented to his profession one such new class of influences which shall be found of signal importance, his purpose will have been fully accomplished. FUNCTIONAL NERVOUS AFFECTIONS. IN the study of nervous affections, the division of such disorders into functional and organic has long been recognized; and while these groups touch and mingle, so that no accurate boundary can be drawn between them, the division is nevertheless practical and necessary. In the first group is found an extensive array of disturbances, characterized by diminution or increase of sensory or of motile power, or by a variety of other phenomena in which we find no evidence of an organic change, either of the nerve affected or of any portion of the central nervous system. In the second group, distinct anatomical lesions are found, which may account for some or all of the peculiar manifestations. There are certain obvious advantages in the study of the etiology of the first group. In case of structural degeneration of a portion of the nervous organization, should the true cause of the disturbance be found and removed, the degenerated structure may not re |