EYE-MOVEMENTS DURING DIZZINESS
BY E. B. HOLT
It is a familiar fact that when the head is passively turned about its vertical axis, the eyes do not move with the head but lag behind, keeping their fixation on that object toward which they were directed before the head moved. The eyes move in their sockets in a direction opposite to that in which the head has moved. Now it has been proved beyond a doubt by the experiments of Mach,[2] Crum Brown,[3] and Breuer,[4] that these lagging movements of the eyes are reflex and are governed by the semi-circular canals, which are stimulated directly by the motion of the head. Similar reflex eye-movements are found when the head is turned about some other than its vertical axis, the direction of such movements being always in confirmation of the theory. All these movements, together with the theory, are well described in the summaries of Peters[5] and Nagel.[6] The present paper deals solely with the eye-movements that occur after rotation of the head about its vertical axis.
The mechanism of these lagging, reflex movements is not, then, identical with that which enables us, when the head is at rest, to fix on and follow a luminous moving object,—the "pursuit movements" of Dodge.[7] It is, however, identical with that of Dodge's "fourth type"[8] and that of the compensatory eye-movements described by Brown,[9] Nagel,[10] and Delage,[11] and recently studied by Angier.[12] This function of the semi-circular canals was first suggested by Goltz in 1870. Now if the rotary movement of the head is prolonged, the eyes lag for a while on their first fixation-point, and then dart suddenly forward to a new fixation-point on which they rest for a while as before, until they dart forward again. Therefore if the head continues to rotate, the eyes fall into a regular and well-marked nystagmus. In this the lagging movements, or those opposite to the direction of the head, are called "compensatory," and are relatively slow and long. Their rate coincides closely if not exactly with that of the head-movement. But the movements forward, in the direction of the head-movement, are short and swift. Such are the facts during the rotation of the head.
But if this rotation has been somewhat prolonged, the ocular nystagmus continues after the head and body are brought to rest. But now its phases are reversed, and the slower eye-movements are in that direction in which the head has moved; while the swifter are in what before was the lagging direction. These observations are in accord with the semicircular canal theory, and are well established by various investigators.[13]
This paper presents the results of a photographic study of the reflex eye-movements following after rotation of the head (and body) about the vertical axis.
The subject whose eyes were to be photographed sat in a chair placed on a rotating platform, in such a position that the vertical axis of rotation passed through, or just posterior to the nose. Rays from an arc-lamp of 6 amperes, placed about 60 cm. from the subject's face, were so converged by a lens that when the subject came to rest, after the rotation, his two eyes were brightly illuminated. An adiathermal screen consisting of a dilute solution of copper ammonium sulphate kept the heat from being painfully intense on the eyes. The light fell slightly from one side on the subject's face, when he was brought to rest; and directly in front of him, at a distance of about 40 cm., was a camera of which the lens was on a level with his eyes. The ordinary ground-glass screen at the back of this camera was replaced by a light-proof box, in the front of which, and in the plane which should have been that of the ground glass, was a slit 55 mm. broad and 5 mm. high. Inside the box was a Ludwig kymograph of which the drum rotated on a horizontal axis: the circumference of the drum lay tangentially to the front of the box, and the line of tangency passed horizontally through the long axis of the slit. For each photograph a photographic film of sensitometer 40 was fixed to the drum, as paper is ordinarily fastened, and in moving, the drum carried this film upwards past the slit. It follows from this arrangement that 5 mm. along the length of this film were always exposed at once. The camera was so focused that the images of both eyes were sent through the slit, and fell on the film.
Figs. 1 and 2
The subject's head was rigidly held by a rest: this rest was adjusted, and the camera focused, before the rotation. The adjustment of the head was greatly facilitated by fastening a fine black thread to pegs that projected forward from the head-rest, on either side; the thread was stretched horizontally, and at such a height that its image in the camera coincided with the middle of the long (horizontal) axis of the open slit. If then the subject, on seating himself in the chair, had his head so adjusted that each eye was directly behind the thread, each eye would certainly be imaged on the sensitive film. Neither the shadow of this thread on the subject's face, nor its image on the film, interfered in the least with the exposure that was made after rotation. This thread was further found very useful by the subject himself, who, after the rotation and just before the exposure was made, could make sure by sighting on the thread that his eyes had not slightly changed position during the rather protracted rotation. The subject was ordinarily turned twenty-five times at about the rate of one turn in two seconds. The kymograph was set in motion and the exposure commenced as soon as the whirling chair was brought to a dead stop. This stopping always took two or three seconds, at the very time when the nystagmus was most pronounced, so that the photographs do not show the maximum eye-movements. The exposure lasted through one rotation of the drum, nine seconds.
In the strongest negatives the movements of the eyes can be fairly well made out from the undulatory curve generated on the film by the dark image of the iris as it oscillated from side to side. But this is true only of the best negatives, and almost never of these if the eyes photographed had the iris blue. In order to obtain better definition in the photographs of the eye-movements, small flecks of Chinese white were tried, as invented and described by Judd.[14] A small square of white was laid with a brush on each cornea, on the side toward the lamp, so that its image on the film should be as bright as possible. The flecks were found to adhere to the eyeball even more perfectly than Judd himself has claimed; and they produced so little discomfort that the subject ordinarily forgot their presence on the eyes. Nevertheless their image as produced on the negatives, although much better than that of the iris, was generally not clearly readable, owing to the brief exposure and the illumination by electric light. This light seems not to be well reflected by the Chinese white: but in all cases where daylight can be employed the use of these flecks must be eminently satisfactory.
Thus it was found necessary to fall back on the image of the arc as reflected from the cornea. This corneal image invariably traced a clear, strong curve on the negative, and would have been appropriated at the outset, were it not that its movements are not, as is well known, a true register of the amplitude of the corresponding eye-movements; a fact that was shown clearly from a comparison in these negatives of the curves produced respectively by the flecks of Chinese white and by the corneal image. The former showed a much greater amplitude of movement. But the corneal reflection is a perfect register of the time and direction of the eye-movements; and in the following tables these features alone are studied. This reflection traced on the film a perfectly readable curve, although in some of the films, owing to a shifting of the carbons in the lamp taking place during the rotation, one of the eyes would be badly illuminated and a good record would be obtained from the other eye alone.
The arc ran on an alternating circuit of 60 phases per second, and owing to these interruptions of the illumination the curve of the corneal image showed on the negative as a dotted line in which the distance between any two dots represented one sixtieth of a second. Since the constancy of this alternation in the current has been measured in the Jefferson Physical Laboratory (of Harvard), and found to vary within a few tenths of one per cent only, the spacing of the dots on the negatives formed the most convenient possible means for determining the durations of the nystagmiform movements. These dots are shown in Figs. 3, 4, and 5 (Plates I and II).
PLATE I.
(By an error Fig. 4 is shown reversed; the lettering is correct.)
Fig. 3 shows a portion of one of the films. The two curves are to be read from below upwards; but at the bottom is a photograph of the slit (showing a part of the subject's face) taken when the drum had made a little over one revolution and had come back to rest. Hence below the image of the slit, the curve of corneal reflection is doubled. "Right" and "Left" refer to the subject's right and left sides, so that the reader looks into the subject's face from in front. In the picture of the slit, the place on the cornea of the corneal reflection is shown; and also a minor reflection, which as may be seen traced no curve, from some other source of light. The fine line that crosses the slit horizontally is the image of the thread, above mentioned, which was used in adjusting the head. The time-dots are seen to be perfectly distinct, so that they could be accurately read with the help of a jeweller's eyeglass. Fig. 4 shows another part of the same negative, a portion subsequent to the single eye-curves of Fig. 3, that is, a continuation vertically upwards of Fig. 3. The rotation had been from the subject's left to his right, a direction that will be termed "clockwise" throughout this paper, and it can be seen that the quick eye-movements are toward the subject's left, while the slow are towards his right: had the photograph been taken during the rotation, the directions of the quick and slow movements would have been reversed. Two points may be observed in this figure which the tables will also bring out,—that the two eyes move together, and that as the nystagmus subsides the quick eye-movements become less frequent but endure no longer, or in other words, the slow movements alone increase in duration. The corneal reflection does not accurately show the amplitude of the movements; but direct inspection of a subject's eyes, as the nystagmus dies away, shows that generally (but perhaps not always) the amplitudes of both quick and slow movements decrease together. When this is the case, it follows that at the end of the nystagmus the rate of the slow movements decreases very much faster than that of the rapid movements.
Readable negatives were obtained from four, out of six subjects. Of such negatives there are fourteen, ten of which are of eye-movements after rotation clockwise, and four after rotation anti-clockwise. This distribution is accidental, for the rotations in each direction were about equal in number. With the exceptions to be noted later all the negatives exhibit the same features, so that of the fourteen only four examples are given in full in the tables; while for the others merely the averages of the duration of quick and slow eye-movements respectively are given.
TABLE I
| Subject | Film | Eye | Direction of the rotation. | Slow movements toward Subject's | Rapid movements toward Subject's | Average duration in seconds of slow movements | Average duration in seconds of rapid movements | |
|---|---|---|---|---|---|---|---|---|
| C | 1 | left | clockwise | right | left | .32 | .05 | |
| " | 2 | " | " | " | " | .36 | .06 | |
| " | 3 | right | anti-clock | left | right | .26 | .08 | |
| H | 1 | " | clockwise | right | left | .54 | .07 | |
| " | 2 | " | " | " | " | .45 | .07 | } |
| " | " | left | " | " | " | .45 | .07 | |
| " | 3 | " | " | " | " | .50 | .08 | } |
| " | " | right | " | " | " | .49 | .08 | |
| " | 4 | " | anti-clock | left | right | .49 | .07 | |
| " | 5 | left | clockwise | right | left | .53 | .06 | |
| Ta | 1 | right | " | " | " | .73 | .07 | |
| " | 2 | " | anti-clock | left | right | .48 | .10 | |
| Tu | 1 | " | clockwise | right | left | .50 | .06 | } |
| " | " | left | " | " | " | .49 | .07 | |
| " | 2 | " | " | " | " | .49 | .12 | } |
| " | " | right | " | " | " | .49 | .12 | |
| " | 3 | left | " | " | " | .40 | .07 | |
| " | 4 | right | anti-clock | left | right | .58 | .08 | |
| Av. | .48 | .08 |
Table I gives these averages for all the fourteen negatives. In four of these (H 2, H 3, Tu 1, Tu 2) simultaneous curves for both eyes were obtained. In every curve the slow eye-movements were in the same direction as the previous rotation; the rapid in the opposite direction. The very few single movements that are exceptions to this are noted under Table II. Had the photographs been taken during (instead of after) the rotation, the directions of rapid and slow movements would undoubtedly have been reversed. It is to be noted that when both eyes were recorded, their movements were generally identical, within the accuracy of measurement (one sixtieth of a second). There are a few exceptions to this. The averages of all slow and all rapid movements merely show that in general, and for that part of the nystagmus that was photographed, the slow eye-movements lasted six times as long as the rapid ones. This ratio varies considerably from one case to another, and at best throws little light on the whole nystagmiform series, since during the very first instants after the rotation the ratio of quick to slow movements would be less than one sixth, and at the very end of the series would be considerably more; this because toward the end the slow movements become much slower, while the rapid seem to change very little. The variations from case to case arise, at least partly, because in some cases the picture was taken more promptly, after the rotation stopped, than in others.
TABLE II
| All records in seconds. | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Subject C. | Subject H. | Subject H. | Subject Tu. | ||||||||
| Film 3. | Film 2. | Film 3. | Film 4. | ||||||||
| anti-clockwise. | clockwise. | clockwise. | anti-clockwise. | ||||||||
| right eye. | left eye. | right eye. | left eye. | right eye. | right eye. | ||||||
| slow m. | fast m. | slow m. | fast m. | slow m. | fast m. | slow m. | fast m. | slow m. | fast m. | slow m. | fast m. |
| to lft. | to rt. | to lft. | to rt. | to lft. | to rt. | to lft. | to rt. | to lft. | to rt. | to lft. | to rt. |
| .26 | |||||||||||
| .08 | .03 | .05 | .06 | .08 | .06 | ||||||
| .2 | .51 | .58 | .1 | .1 | .45 | ||||||
| .06 | .06 | .06 | .06 | .05 | .08 | ||||||
| .05 | .16 | .16 | .13 | .13 | .75 | ||||||
| .08 | .05 | .06 | .1 | .13 | .06 | ||||||
| .19 | 1.01 | 1.05 | .36 | .33 | .36 | ||||||
| .05 | .06 | .06 | .1 | .06 | .13 | ||||||
| .02 | .26 | .26 | .28 | .3 | .48 | ||||||
| .05 | .05 | .06 | .13 | .13 | .05 | ||||||
| .21 | .26 | .26 | .28 | .23 | .61 | ||||||
| (.19) | .06 | .06 | .11 | .13 | .1 | ||||||
| .16 | .55 | .6 | .35 | .35 | .41 | ||||||
| .05 | .1 | .1 | .08 | .1 | .05 | ||||||
| .03 | .25 | .25 | .33 | .3 | .65 | ||||||
| .05 | .06 | .05 | .06 | .11 | .06 | ||||||
| .18 | .33 | .33 | .25 | .2 | .51 | ||||||
| .06 | .1 | .1 | .1 | .1 | .05 | ||||||
| .03 | 1.65 | 1.65 | .83 | .83 | .66 | ||||||
| .05 | .06 | .06 | .1 | .13 | .16 | ||||||
| .29 | .26 | .26 | .63 | .61 | .66 | ||||||
| .11 | .06 | .08 | .06 | .06 | .08 | ||||||
TABLE II, continued.
| All records in seconds. | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Subject C. | Subject H. | Subject H. | Subject Tu. | |||||||||
| Film 3. | Film 2. | Film 3. | Film 4. | |||||||||
| anti-clockwise. | clockwise. | clockwise. | anti-clockwise. | |||||||||
| right eye. | left eye. | right eye. | left eye. | right eye. | right eye. | |||||||
| slow m. | fast m. | fast m. | slow m. | fast m. | slow m. | fast m. | slow m. | fast m. | slow m. | slow m. | fast m. | |
| to lft. | to rt. | to lft. | to rt. | to lft. | to rt. | to lft. | to rt. | to lft. | to rt. | to lft. | to rt. | |
| .29 | .78 | .76 | .45 | .43 | .68 | |||||||
| .03 | .06 | .06 | .05 | .1 | .15 | |||||||
| .04 | .16 | .2 | .45 | .43 | .23 | |||||||
| .05 | .1 | .1 | .06 | .1 | .11 | |||||||
| .25 | .38 | .33 | .4 | .38 | .36 | |||||||
| .15 | .08 | .11 | .08 | .06 | .08 | |||||||
| .3 | .58 | .56 | .58 | .56 | .35 | |||||||
| .05 | .06 | .06 | .06 | .06 | .06 | |||||||
| .33 | .78 | .78 | .58 | .56 | .38 | |||||||
| .05 | .08 | .1 | .08 | .08 | .05 | |||||||
| .28 | .71 | .71 | .35 | .35 | 1.78 | |||||||
| .11 | .08 | .06 | .05 | .06 | .06 | |||||||
| .41 | .46 | .45 | .51 | .5 | ||||||||
| .06 | .05 | .06 | .06 | .05 | ||||||||
| .43 | .56 | .58 | .6 | .61 | ||||||||
| .11 | .06 | .06 | .08 | .1 | ||||||||
| .35 | .33 | .31 | .73 | .68 | ||||||||
| .05 | .1 | .1 | .06 | .06 | ||||||||
| .23 | .86 | .86 | ||||||||||
| .15 | .08 | .08 | ||||||||||
| .38 | .21 | .21 | ||||||||||
| .1 | .06 | .05 | ||||||||||
| .43 | .8 | .81 | ||||||||||
| .11 | .08 | .08 | ||||||||||
| .38 | 1.53 | 1.58 | ||||||||||
| .03 | .06 | .05 | ||||||||||
| .53 | ||||||||||||
| .2 | ||||||||||||
| .23 | ||||||||||||
| (.18) | ||||||||||||
| .36 | ||||||||||||
| .03 | ||||||||||||
| .23 | ||||||||||||
| .06 | ||||||||||||
| .45 | ||||||||||||
| .11 | ||||||||||||
| .25 | ||||||||||||
| Averages | ||||||||||||
| .26 | .08 | .07 | .45 | .07 | .45 | .08 | .50 | .08 | .49 | .58 | .08 | |
Parentheses indicate time during which the eye did not move at all.
PLATE II.
Fig. 5
Table II gives in detail the data yielded by four of the most instructive films. C 3 is the longest record that was obtained; Tu 4 is among the shortest, though it is not the very shortest. H 2 and H 3 show how nearly alike are the simultaneous movements of the two eyes: .07 sec. is the greatest difference recorded on any film between simultaneous movements. All four records show how much less the duration of the slow movements is at the beginning of the record than at the end, and how little the fast movements vary in this respect.
H 2 is given because it is not typical; and about one half of the film itself is reproduced in Fig. 5 (Plate II). It will be seen that at four points there intervened between slow movements (toward the right) a rapid one that was also toward the right. This is the only record in which such a thing happened: and its explanation is problematical. With the subjects C and H, and only very rarely with these, a rapid movement sometimes took the place of a slow one, that is, occurred in the same direction as the slow movements (e. g., Table II, C 3). And a trifle more often, yet very seldom, a rapid movement was relatively slow (e. g., ibid.). With every subject there are a few cases in which the eyes stood still for a small part of a second (e. g., ibid.), and these moments of rest seem to come after a rapid or a slow movement indifferently.
McAllister[15] and others have shown that the eyes are seldom at rest even when voluntary fixation is attempted, and these anomalies in the nystagmiform series may well be the result of such random factors, which instead of being always inhibited by the afferent impulses from the semicircular canals, which govern the nystagmus, operate along with these latter, and sometimes even inhibit them. With the exception of these anomalies, the movements recorded in the photographs confirm the observations of Purkinje, Mach, Breuer, Delage, and other investigators.
In conclusion, the sensations of vertigo and of nausea seem not to be essentially connected with the nystagmus. Several subjects were so disagreeably affected by a preliminary rotation that it seemed best not to continue the experiment with them. With those, however, whose eyes were photographed, while they experienced a mild degree of vertigo and nausea during and after the first few rotations, these sensations soon wore off with further practice, while so far as could be observed their eye-movements were as ample and rapid as at first. The introspection of these subjects was that after the rotation the body seemed at rest and the stomach quite settled, while the visual field alone whirled rapidly in the direction opposite to that of the previous rotation.
VISION DURING DIZZINESS
BY E. B. HOLT
During and after a prolonged rotation of the head, the visual field seems to spin around before one's eyes,—a phenomenon that is ordinarily called the "dizziness of Purkinje." Delage describes it as follows:[16] "In the experiment of Purkinje, while we are rotating in a positive sense, space seems possessed of a motion in the opposite direction.... This phenomenon is explained by the direction of the nystagmus."
"In the nystagmus," he continues, "the eyeballs execute two well-differentiated motions: one, a compensatory, relatively slow motion, during which images pass across the retina so as to give the appearance of a movement of space in the opposite direction; two, a swift motion opposite to the slow one, and so rapid that the images passing across the retina leave no sensation of their movement."
Now, in a previous paper[17] I have shown that there is a central anæsthesia, or central inhibition of visual sensations, during about the latter two thirds of the time occupied by every voluntary eye-jump; and in view of this I was led to enquire whether in fact, as Delage so confidently asserts, it is the speed of these more rapid movements, or some other factor, that causes them to leave no visual sensations. There can be no doubt that they do leave none, since, aside from the statement of Delage, in dizziness the visual field whirls always in only one direction; whereas it should otherwise appear to swing now to one side, now to the other, as the eyes move back and forth across the objects. I have found but one other mention of this point in the literature. In his Analyse,[18] Mach says, parenthetically, "(the jerky eye-movement leaves no optical impression)"; but he does not suggest that this is because of its greater speed.
In order to test this point, a 2 c. p. incandescent lamp was so arranged that it could be moved vertically in front of, and about four metres distant from, a rotating chair. Since after a rotation the eyes are oscillating from side to side, if the lamp is moved up and down an obliquely inclined after-image streak must be generated on the retina; and clearly there are four possible positions in which this may lie, as shown in Fig. 1.
The results were absolutely uniform (the author alone as subject); the after-image streak always lay on that side of the moving light toward which the slow eye-movements were directed, that is, the lamp appeared to drift obliquely up or down and in a lateral direction opposite to that of the slow eye-movements. Apart from its vertical displacement, then, the lamp behaved like the less intensely illumined parts of the visual field, seeming to be totally invisible during the swifter eye-movements. Now since the experiment was done in a partially darkened room and the eyes were partly adapted to darkness, the lamp should have been intense enough adequately to stimulate the retina even during the more rapid movements, and might be expected to leave an after-image streak on that side toward which these rapid movements were directed, and differing only from the streaks seen during the slow eye-movements in being inclined at a less angle from the horizontal. Yet no such streaks were visible.
These observations were made at about the same number of seconds after the rotation stopped, as the photographs were taken that are recorded in the preceding paper of this volume. The rapid movements were therefore about one sixth as long in duration as the slower ones. Since the respective amplitudes of rapid and slow must average very nearly the same, the rapid movements must have been about six times as swift as the slow movements. It needs therefore to be shown beyond a doubt that the 2 c. p. lamp was bright enough, in view of the briefness of stimulation of any one retinal element during the rapid eye-movement, to be above the threshold of perception. For this reason the experiment was not continued with other subjects.
The certainly adequate degree of illumination was realized during the photography of the eyes described in the preceding paper. Here during the post-rotary dizziness an arc lamp (of 6 amp.) was in front of the face and but a little to one side of the primary line of regard; it was 60 cm. distant from the eyes and on a level with them; a lens condensed the rays on the two eyes, and the light was diminished only just enough as not to be painful, by a dilute screen of copper ammonium sulphate about 3 cm. thick. Of course such an illumination must adequately stimulate each retinal element even during the most rapid eye-movements. Nevertheless with the four subjects that were photographed the arc lamp, like the rest of the visual field, seemed always to swim in one direction, and that opposite to the slower eye-movements. In one case where the eyes were photographed without the adiathermal screen, and the light was rather painfully intense, the lamp was still seen to drift in one and the same direction. There was never any trace of its moving to and fro, as there should have been had it been visible during both phases of the nystagmiform movements.
Fig. 1
This absence of visual sensation during the more rapid eye-movements might conceivably depend on either peripheral or central inhibitory factors. But the anatomy and physiology of the eye offer no point of support for the supposition that during such movements the irritability of the rods and cones is momentarily reduced, or that the retinal layers posterior to the rods and cones suffer an interruption of function during a movement of the eyeball in its socket. Indeed, during some such movements, the "pursuit" movements (Dodge's second type), vision is unimpaired.[19] In view of these facts, and of the many known cases of the mutual inhibition of sensations where undoubtedly the process is a central one, it is by far most probable that this visual inhibition is also a central process; as was certainly the visual inhibition during voluntary eye-jumps, previously reported by me.[20]
The conclusion above reported that the visual inhibition during the more rapid phase of the nystagmus in no wise depends on an inadequate stimulation of the retina, due to the greater speed of the rapid movements, and that the inhibitory process is purely central, is further supported by the following phenomenon. If before the rotation has commenced, the eyes are so strongly stimulated that a lasting after-image is obtained, this after-image will, during the rotation, always be seen to swim in the direction opposite to the rotation, that is, with the slow eye-movements; but when the rate of rotation begins to decrease, and as Mach, Breuer, and Delage have shown, the slow eye-movements reverse their direction, the after-image also reverses its direction, and now swims in the direction of rotation, that is, still with the slow eye-movements. If the after-image persists long enough, it may still be observed, after the rotation has ceased, swimming in the same direction as the surviving slow eye-movements. If, for instance, the slow movements are from left to right, the after-image (best seen with the eyes closed) swims from the left to the right hand side of the field and disappears, reappears at the left and swims again toward the right, and continues to do this until the nystagmus entirely ceases.
This experiment was repeated several times, with four subjects, and with both clockwise and anti-clockwise rotations, and the results were uniformly as described above. In order to see whether this motion of the after-image really depended on the slower nystagmiform movements, the following variation was tried. It will be recalled that if the head is rotated not about a vertical (longitudinal) axis, but about a transverse axis, as, say, one passing through the ears, a nystagmus is produced in which during the rotation the slower eye-movements are opposite to the direction of rotation, while when the rotation is checked or stopped, the nystagmus, as before, reverses. The same is true if the rotation is about a sagittal axis. These conditions were approximately realized by having the subject sit as before on the rotary chair, but during the rotation hold his head horizontally to the right or left, forward or back. With any of these positions of the head, however, the rotation produced, on all of the subjects tried, extreme dizziness and a feeling of nausea that lasted in some cases for several hours. This fact made it impossible to ask for a set of the four possible positions of the head from any of the subjects. The following are the records that were obtained:
| Subject Fl. | Head horizontally to left; rot. anti-clockwise. |
| During rot.; after-im. moved clockwise, i. e., from subject's brow to chin. | |
| Eye-mov. not observable during rot. | |
| After rot.; after-im. moved anti-clockwise, chin to brow. | |
| Slow eye-mov. anti-clockwise, chin to brow. | |
| Vis. field clockwise, brow to chin. | |
| Subject H. | Head horizontally to right; rot. anti-clockwise. |
| During rot.; after-im. clockwise, chin to brow. | |
| Eye-mov. not observable. | |
| After rot.; after-im. anti-clockwise, brow to chin. | |
| Slow eye-mov. anti-clockwise, brow to chin. | |
| Vis. field clockwise, chin to brow. | |
| Subject H. | Same repeated, with same results. |
| Subject H. | Same as case of Fl., with identical results. |
| Subject K. | Head horizontally to left; rot. anti-clockwise. |
| During rot.; after-im. not observed. | |
| After rot.; after-im. anti-clockwise, chin to brow. | |
| Slow eye-mov. anti-clockwise, chin to brow. | |
| Vis. field not observed. |
So far as these records go, they entirely confirm the results of other investigators as to the direction and the reversal of the nystagmus. In each of the cases the after-image moved with the slow eye-movements, reversing its direction with these slow movements, while the visual field whenever it was observed (the eyes were kept closed during the rotation) moved in the opposite direction to that of the after-image and the slow eye-movement. It is well known that after-images move with every involuntary eye-movement, and although they disappear during voluntary eye-jumps,[21] they reappear at the end of the jump in a position that is related to the new fixation-point exactly as the old position was to the former fixation-point. These after-images, then, are seen during the slow eye-movements whose direction they follow; but are not seen during the quick movements, when they must naturally move in the direction of these quick movements. And aside from this it is possible to observe introspectively that the after-image disappears at that side of the visual field toward which the slow eye-movements tend, and is for a moment invisible before it reappears on the other side of the field. As was shown above, the visual field always moves opposite to the direction of the slow eye-movements, as must of course be the case if there is no inhibition of vision during these movements. The simultaneous appearance of the after-image moving with, and the rest of the visual field moving contrary to, the direction of the slow eye-movements, with a uniform absence of the converse phenomena, seems to prove that vision is unimpaired during these slow movements, while it is completely inhibited during the rapid phases of the nystagmus.
Purkinje himself[22] called the slower phases "involuntary and unconscious," meaning by "unconscious" not that the visual field was not seen (for it just then is seen), but that the movement of the eyeball during the slow phases was not felt. I have observed, with the confirmation of several subjects, that this movement can also not voluntarily be inhibited; whereas the swift movement is so far voluntary that it can be inhibited at pleasure. It is possible, that is, to fix the eyes on that side of the field toward which the slow movements are directed, but not on any point at the other side of the field. The slow movements, then, during which vision is possible, are purely reflex. These slow movements, purely reflex and yielding clear vision, with the rapid movements, partly under voluntary control and attended by an inhibition of vision, present a parallelism, that may be not without significance, to the "pursuit" eye-movements (Dodge's "second type"), that are likewise relatively slow, are reflex, and yield remarkably clear vision, and the ordinary voluntary eye-jumps (Dodge's "first type"), that are relatively rapid, and are, like the rapid nystagmiform movements, attended by a central inhibition of vision.