Electro-physiology and electro-therapeutics : showing the best methods for the medical uses of electricity / By Alfred C. Garratt.

1. If the motor oculi, or third nerve, be paralyzed, as it divides into two branches and enters the orbit between the two heads of the external rectus muscle, the superior branch ascends and sup- plies the superior rectus and levator palpebrce muscles, the eye- lid, particularly the outer angle, cannot consequently be raised, from loss of power in these two muscles; and this constitutes ptosis. There is also in such a case a protrusion of the eyeball, which cannot be turned inward, and at the same time the out- ward lateral movement of the eyeball is not impaired, since the rectus externus is supplied by the sixth nerve; there are also a marked dilatation of the pupil, double vision, and only a distant sight, i. e., it is next to impossible for the patient to adjust the eyes to see objects close by. 2. If there is a paralysis of the fourth nerve, (pathetici,~) the symptoms are but slight. The patient experiences some double vision, when looking on a level; and to avoid it, the face is car- ried rather to one side, and that the sound side. When looking upward, the sight is not much disturbed, because the affected pupil is turned a little upward and outward. 3. If the abducentes (sixth nerve) be paralyzed, then the patient has " converging- strabismus," or inward squint, and is also troubled with a double vision when looking in certain direc- tions, and this in proportion to the extent of the affection. If it occurs in connection with the paralysis of the third nerve, as indeed it often does, then the eyeball is immovably fixed, it being drawn forcibly towards the nose, so as to cover the whole cornea at the inner angle of the eye. These three paralytic affections of the eye may arise from brain origin, but not necessarily so. There may be pressure on the trunk of either of those nerves that are affected ; but the trouble is supposed to arise more frequently from a rheumatic or syphi- litic exudation on the sheath of the nerve, or from an over use, or very deficient use, of the eye muscles. For these cases, where not positively contra-indicated, I am in the habit of employing either Faradaic or Galvanic currents directed locally to the mus- cles involved, for two or three minutes, always closing the seance by "washing" the whole face and neck with just bearable 45*