PREFACE.

THIS memoir, which received, from l'Académie Royale de Médecine of Belgium, the highest honor awarded for the competition of 1881-1883, is now presented in the English as it was then in the French language.

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The thesis for the concourse was, des faits cliniques et au besoin par des expériences la pathogénie et la thérapeutique des maladies des centres nerveux et principalement de l'épilepsie."

Since this memoir was received by the Royal Academy, in December, 1883, many new views and experiences have presented themselves to the author, which he would have gladly included in this edition of the work.

This would have been inconsistent with the plan of giving it substantially in all particulars as it was submitted to the distinguished body which had already passed judgment upon it. It has been thought best to shorten the work in certain measure, and in

the revision thus made necessary the original form has been retained in every particular as far as possible, and while in a few instances such revisions have been made as were rendered necessary by the haste in which the original manuscript was prepared, the views and methods maintained in the original have been strictly preserved, without modification.

In order to introduce reproductions from photographs of some typical cases of neuroses in which the striking changes of physiognomy resulting from a relief to the tension of the eye-muscles in such cases is shown, the histories of these cases have been introduced. These histories, not in the original memoir, and obtained since its presentation to the Royal Academy, are indicated by brackets [ ], which in each instance permit them to be recognized as new material.

By an unfortunate occurrence, all the negatives from which these photograveurs were to have been made were destroyed by fire while the work was being executed. It then became necessary to reproduce the portraits from very indifferent prints. Under these discouraging circumstances the result, although quite different from what was at first hoped, has been much better than might have been expected.

The supplemental portion of the work has been added, not for the expert in ophthalmology, but for

the general practitioner who would like to make such examinations of ocular conditions as will enable him intelligently to advise and to treat his patients affected with nervous complaints. That part of the supplement devoted to refraction and accommodation is made as comprehensive as possible consistent with brevity. In the treatment of muscular anomalies, much that is not to be found in the text-books on the affections of the eye is given. The subject has, in text-books, received but meager attention, quite insufficient to afford valuable assistance to one who would attempt the treatment of nervous complaints by removal of muscular defects. While the subject is treated here only in outline, it is hoped that the student of this subject will find here a better guide than has been elsewhere offered.

The author is indebted to the publishers for the skill with which the difficulties attending the reproduction of the portraits were overcome, and for the excellent manner in which they have presented the work.

33 WEST THIRTY-THIRD STREET,

NEW YORK, May, 1887.