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vagina, and the ptint made a perfect recovery. The secondstone is nearly circular in slupe, its long diameter being 2in. and its short, di-tlllett’r 2g in., and its greatest thickness11 in. It weighed two ounces, and I extracted it from awoman aged forty who had long suffered from pain supposedto be uterine. In this case the closure of the wound wasnot entirely suc;’es-fut, and she had slight incontinence whenin the upright position, but declined further interference.The third stone con-istt of one large mass and a quantity ofdebris, weighing alt .gether three ounces and a half, whichI extracted frum a woman aged fifty, who made a perfectrecoveryYou will thus see that there is no difficulty in extracting

very large calculi from the female bladder entire, but it isin some sense a reproach to onr art that stones should beallowed to att’in such a size. Early detection is as desirablein the female as in the male, and the great majority of suchcases can be beht treated by lithotrity at one sitting.

COMPOSITION, RESOLUTION, AND ABEY-ANCE OF SECONDARY PERCEPTIONS.

BY BRIGADE SURGEON T. OUGHTON,ARMY MEDICAL DEPARTMENT.

’ DIRECTIVE phenomena are affected, by muscles influencingone another, as well as by the mechanical arrangement oftheir constituent fibres. Such was a cursory rejoinder ta ahypothetical objection to the motor diathesis of the secondaryperceptions on the ground of the multiform and incongruousdistribution of the fibres of certain muscles-the pectoralismajor, penniform muscles, &c.1 It is a rejoinder meritingcritical examination, since the problem of secondary percep-tional currents being conducted centripetally from a volun-tary muscle during its vital contraction must be incompletelyverified, if not quashed, without its due acceptance. Takingit, then, as a text for the present remarks, I trust thatabundant evidence will be forthcoming in its support, whichwill also have a practical bearing on the further proof of theproblem in question., Composition. --A very gnod and simple illustration of thisnervous process is aff’tdfd by the following observation :-The left e) e may perceive an object eight degrees to theright of the main line of direction, and the right eye fourdegrees; but binocular vision will give it its correct value ofSix degrees by virme of muscular co-operation and theagency of a directive composition."2 It is an absolute essen-tial for the dynamic composition of secondary sensorid.1forces that the muscular fibres engaged in the operation beconsentual—th-tt is, pull in the same direction more or less.1. Note the pira)]e)ism of the elementary fibres of a volun.- tary muscle m contrast to their intricate interlacements inan involuntary and non-directive muscle. They woulddoubtless have been perfectly parallel were it not for the’_convenience in packing, admirably shown by Paley, arisingfrom thin tendinous sheets and delicate cords. Composition. renders perfect p,ral’eli-3m unnecessary, however ; the fibres,agree in their general direction, and the muscle’s contractiongenerates a single directive resultant. 2. Observe how thenumerous muscles of a set (flexors on the forearm) operatesensorially as one muscle would do when unified in onö par-ticular action (flexing the hand). Many muscles are indis-pensable for the attainwent of various distinct ends, butmuscular consent originates a directive unification whereit would be useful. 3. The phenomenon of single visionhas been interpreted by a consentual theory; the ex-

ternal rectil,,4. of one eye pulls in the same direction asthe internal rectus of the other eye, thereby initiating adirective composition. - There is a strict analogy betweenthis case and that of a single muscle or set of muscles.

Hence an objection to the motor diathesis of the secondaryperceptions, on the ground of the extremely irregular form(pecturalis major), -or distribution of the elementary fibres:(penniform) of certain voluntary muscles is a weak one.Should it be sought what single directive message anymuscle (penniform or otherwise) transmits to consciousness,it will be necessary merely to note the relative positions of

1 Vide THE LANCET, July 29th, 1882. 2 Ibid., October 22nd, 1881.

its osseous attachraents, and the direction towards which themovable segment is turned by its shortening, so that thedirective message is determined by the mechanical con-ditions of a muscle’s origin and insertion. But, mark here,nothing will be more natural than to conclude that this.result could not obtain excepting the relative positions ofosseous origin and insertion are known by a sort of innerconsciousness; the superior rectus, for instance, rotates theocular globe upwards, it may be concluded that the resultingupward idea has no points d’appui for its reaiisation in theabsence of a recognition of the sites of origin and in-sertion of the muscle by a latent process of conscious.ness. I regard such a conclusion as erroneous, inasmuchas latent or inscrutable consciousness is incomprehensible;the directive message, although due to mechanical con.

ditions, has no further reference to them, referring onlyto any sentient point or points that may be impressedab externo. Thus, the biceps has a sensorial reference toany impressed sensitive point either on the hand or the fore.arm, and not to its bony attachments ; again, the musclesrotating the body or the head may have a directive refer-ence to an impressed retinal point. From a very simplestarting-point we now find ourselves at the complex border.land where the Ego and the Non-ego meet; there is thenatural cohesion of the insensate tendinous and bonyorigins and insertions (the Non.ego) in juxtaposition withand holding relation to an independent agency-namely,the vitalised cohesion of muscular contraction (one main-spring of the Ego). Nothing remains for us apparently butto contemplate these two stupendous forces standing thusface to face ; a fair simile of the position is to be found in apair of horses drawing a tram-car round a corner, theanimals being guided as it were by the vis a tergo of theheavy tram with its mechanical adjustments.

Resolution.-It is an almost axiomatic observation, whereone finds composition there one may search for resolution;and it would seem that the latter process is in operation toproduce the visible directions of the peripheral portions ofthe retina. Before entertaining this subject, however, let usconsider the direct proofs that visible direction is a motor

physiology in the following condensed argument :-18t. Peripheral retinal points are equally sensitive withthe axial point, noticeable in the observation of mimitestars ; therefore, on the theory that the special nerve ofsinht is a directive agency, the centre of visible directionwill correspond with the centre of the retinal concavity(ocular centre). Sir David Brewster has promulgated thisview.

2nd. Prof. Volkmann and Dr. Griffin have shown, eachby an independent investigation, that the centre of visibledirection is situated at a point considerably anterior to thecentre of the retinal concavity ; therefore visible direction isnot enacted by the retina.

3rd. Every object before the single eye, whether medianor lateral, is seen accurately in position; theiefore the centreof visible direction coincides with the eye’s optical centre.The latter is at a point in the crysta lit e lens near iti1posterior border-that is, anterior to the centre of the retinalconcavity. -

4th. Every object appears to be fixed during the rolling orthe eyeball (Brewster) ; therefore the optical centre and thecentre of visible direction both coincide with the centre ofrotation of the eyeball. Hence (nisi prius) visible directionresults from the motions of the eye—i.e., its muscularapparatus.. Reference being now made to the following figure, c beingthe optical centre, the straight line, m M, will represent the

. median and main line of monocular visible direction. Thisline is regarded as being originated by the recti piilliu theeyeball evenly backwards by’ their normal touicity. Mus-

’ cular tonicity, according to this view, is a directive agentas well as volitional contraction, and the opinion is corrobo-Lrated by the directive phenomena resulting from the erect1po,itiou of the body and the head, both postures being, refr:rable to tonicity. The balance of the recti is destroyedr when the eye is directed laterally. If the eyeball be turnedito.wards the right, the rectus so rotating it is in a morea: active state of tension than its fellows, and consequently the. axial point, m, will now perceive the image deprcted on ity ( along a line of direction inclining to the right. But the. lateral points a, b, z, or y are each equally affected by thef grater tension of a"given rectus, as is point ’In. How is it- that the images impressing these points are not perceivedalong a line of direction that is parallel to, or identical with.

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that of the mage on point m? Herein consists the para-doxical problem of visible direction. I hold that the maindirection, mc, is resolved into the oblique visible directions«C, bc, zc, yc. &c.Such res(ilaiion appears to be warranted when we consider

the instability of peripheral retinal points as compared withthe stability of the axial puint, and that said instability isprogressively greater in the direct rat;o of the distance ofany peripheral point from the axis. Assuming the eye tobe looking forwards, it will be manifest that the backwardpull of the entire recti operating on the axial point, m,would draw the eyeball backwards, whilst if operating on

any oblique point, a or z, it would tend to rotate the eyeball.Again, the mobility of this rotatory influence will be greateras exerted on point b than on point a, on point c than onpoint b, and so on. Further, the tendency of the muscularaction to pull the eyeball backwards will be inversely as thetendency towards its rotation ; hence the forward direction,m c, originating with the backward pull, will be modifiedaccordingly. A visible direction corresponding to anyoblique point, a or z, wilt not originate such a forward ideaas the point m—that is, it will be inclined to right or left inaddition to forwards; neither will a visible direction cor- Iresponding to points b or y originate such a forward idea asthe less oblique points a or z—that is, it will be more in-clined towards the right or left. Thus the causation of theprogressive scattering of visible directions from retinal centreto circumference, as with other directions, is determined bya mechanical condition (the globular shape of the eyeball).The backward pull (the forward idea) will be very slight atthe peripheral pointj c and x, but it is still there ; in otherwords, the main direction, m c, is resolved into the dottedlines indicated in the diagram.In what manner the site of the centre of visible direction

is fixed at point C, correspondent with the eye’s centre ofmotion, is a less abstruse inquiry. That the progressivescattering of visible directions must cause them to intersectat a common point eventually, will be evident on consideringthat the directions are ditft-rent on either side of the medianline me, and that the eyeball is globular. Why, then, atpoint c, or hov are the visual angles m c a, a c b, &c.,generated? Confining our attention to the images m and aof the objective entities, M and A with visual angle m c a :—

(1) Retinal points are impressed by light for one-eighth of asecond. (2) The glances of the eye must be considerablymore rapid than this, since even the movements of the handare more rapid ; an ignited piece of charcoal revolved in thehand deceives the retina by producing the semblance of afiery circle. (3) Therefore, in directing the eye rapidly fromobject M to object A, the retinal points m and a will be im-pressed by the images of these objects simultaneously for adefinite period. (4) Therefore the visual angle m C a willbe identitied by perception, and this angle will be formed atpoint c, the eye’s centre of motion. (5) Therefore everysingle visible direction into which the main visible directionis resolved wilt have a fixed value for a certain retinal point;thus, a C for the lateral point a. Let it be understood thatmuscular traction reacting on the mechanical sphericity ofthe retina generates visible resolution, whilst ocular rotationeffects monocular visible direction.

Other phenomena hat are probably determined by direc-tive resolution may be briefly alluded to : I Jefer to thevisible area correspondent to the punntum caecum, and tothe resolution of main tactile directions correspondent to themanifold sentient poiuts on the skin’s surface. The latterforms a fit subject for reflection and analytical investigation.

Abcyancc.—There are two varieties of this process-viz.,the subordinate and the insubordinate. The directive andpositional percep io is of the sense of touch are subordinatedto those of vision, as indicated in the following original ex-periment : Holding the thumb and forefinger midway be-tween and a few inches before the eyes, let them be rubbedtogether. Looking now with both eyes at a remote andmedian position, two spectral thumbs and forefingers will beseen, and with these siugular results : When the optical axes(still divergent) are inclined to the right side, the forefingerwill feel the thumb at the site of the right spectrum ; on in-clining the axes leftwards, the thumb will be localised on theleft side. The same tactile abeyance may be proved bystudying one’s face in a distorting mirror; however much theforehead is seen to recede abnormally, its parts will be accu-rately felt by the fingers just wheresoever they may be seen.Brewster’s well-known experiment with the cane-chair,3 inwhich the octagonal perforations of the seat are felt in adifferent poSitlOu to which they are seen, does not invalidatethe above statement; this is apparently an example of singlevision, but really one of double vision with a sensorial anta-gonism operating between the ocular muscles. Is it possiblethat a tactile positional perception can be in abeyance tovisual positional perceptions that are at variance so as toneutralise ettch o her ? Certainly not ; in such an event, asa result of the first experiment, the thumb would be feltby the forefinger at the sites of both the visible spectrasimultaneously.Another example may be instanced in viewing objects

behind by binding the body forwards and looking betweenthe legs ; the superior rectus now localises objects below andthe inferior rectus above, because these muscles are inabeyance to those bending the trunk. Muscular abeyanceexhibits many manifestations in the upper extremity, con-cerning which it may be said generally that a given distalsegment is subordinated to any given proximal segment-the fingers to the hand, the fingers or hand to the forearm,and this to movefuents of the arm. The index finger indi-cates direction or position only through the abeyance of theindicator muscle to wrist, elbow, or shoulder movements,which clearly modify its indications. Analogously taking anatural skeleton of the upper extremity, the phalanges maybe moved independently of the metacarpal bones, but notvice versd; aLd the carpus may be moved independently ofthe humerus, but not vice versâ. Hence a practical illustra-tion is afforded of a statement made elsewhere that"the muscular organism of the secondary perceptionsis correlated to the mechanical forces of nature in likemanner as that of the primary perceptions is correlatedto the sense essences of nature";4 other facts endorsingthe same doctrine are contained in the present thesis.A single instance of insubordinate muscular abeyance

must suffice—namely, it is the usual province of the rightexternal rectus to give rise to a rightward perception ; but,rotating the face over the right shoulder, the resultant per-ception of this muscle is a backward one. In this experi-ment the rectus is not in abeyance to the rotatory muscles ofhead, but it co-operates with them, whilst remaining per sean efficient factor throughout. The result is due t) an ab-sence of inconsistency or antagonism between rightward andbackward directive perceptions. A mechanicat equivalentof the process is afforded by two rulers that are fixed end toend at right angles, and that rotate on the free extremity ofone of the rulera as on a centre.

Derby-villas, Forest-hill, S.E.

3 Brewster on the Stereoscope, p. 95, 1856.4 Vide THE LANCET, July 29th, 1882.

THE Visiting Committee of the Holborn Infirmaryat Highgare have reported that, in order to meet the demandfor admission at. the present time, they have made arrange-ments t) provide tifty-two additional beds, and instructedthe clerk to write to the district medical officers, calling at-tention to the crowded state of the infirmary and asking themto treat cases as far as practicable in their own disLricts, andsend only urgent cases to the infirmary.