Lectures on nervous diseases from the standpoint of cerebral and spinal localization, and the later methods employed in the diagnosis and treatment of these affections . confirm me in it. I believethe time will come when the tests employed in eye-examinations willrank in importance in neurology with the knee-jerk test, which forgenerations, as Gowers remarks, simply amused school-boys. THE USE OF THE OPHTHALMOSCOPE. 149 The OrHTHALMOSCOPE.—In connection witli the eye, it may be wellto mention the instrument wliich is employed to detect abnormalities ofthat organ, viz., the ophthalmoscope. All
Lectures on nervous diseases from the standpoint of cerebral and spinal localization, and the later methods employed in the diagnosis and treatment of these affections . confirm me in it. I believethe time will come when the tests employed in eye-examinations willrank in importance in neurology with the knee-jerk test, which forgenerations, as Gowers remarks, simply amused school-boys. THE USE OF THE OPHTHALMOSCOPE. 149 The OrHTHALMOSCOPE.—In connection witli the eye, it may be wellto mention the instrument wliich is employed to detect abnormalities ofthat organ, viz., the ophthalmoscope. All forms of this instrument consist (1) of a concave mirror whichis perforated at its centre, in order that the observer may look directlyinto the illumined field; (2) a series of lenses by which it is possible tocorrect errors of refraction in the eye of the patient or observer; (3) abi-convex lens,whicli brings tlie deeper parts of the eye into prominence,and enables the observer to inspect them minutely. Hutchinson (as quoted by Hamilton) gives some concise and prac-tical suggestions respecting the use of this instrument, which will bearrepetition. He says:—. Fig. 40—The OtHTHALMOscoPE. (Lorings Pattern.) Plaving placed the patients head in such a manner that the light (alamp, candle, or gas-light) is on a level with his temple, and slightly be-hind it and his face, as a consequence, in shadow, the observer sits infront and applies the ophthalmoscope mirror to his own eye. He shouldkeep both eyes open that he may see w-here the light falls, and then movethe mirror until the light falls full upon the pupil of his patient. In amoment he will perceive the first fact which this instrument reveals, thntthe fundus is not black, as it has always appeared to be before, but thatit is of a brilliant fire-red. He will, however, see nothing of the fundusdistinctly, only a general reflex Now at this point the student must !)(• LECTURES OX NERVOUS DISEASES. stop :i\vhiK iiiul use his
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