A physician's notes on ophthalmology. 2nd series / by J. Hughlings Jackson.

  • Jackson, John Hughlings, 1834-1911.
Date:
[1875]
Catalogue details

Licence: Public Domain Mark

Credit: A physician's notes on ophthalmology. 2nd series / by J. Hughlings Jackson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    In the case I have to relate it did not. A common termination of optic neuritis is atrophy—what I call its fourth stage—but occasionally the swelling of stage 1 or 2 clears up, and, as in the case here illustrated, the disc resumes a normal or nearly a normal appearance. In this case the optic neuritis would never have been inferred; there was nothing whatever in the man’s complaints or hearing to lead to a suspicion that his optic discs were abnormal. On the contrary, it would he said by most people that there “ could not be ” anything the matter with them. Had I not used the ophthalmoscope by routine the case would have been little more than one of paralysis of the third nerve. I should have ignored the far more important symptom (or, correctly speaking, pathological condition) optic neuritis. I purposely give the case briefly, for without an autopsy it is of little value except as showing— (1) . That sight may he good when there is extreme neuritis, and (2) . That the neuritis may disappear, the disc resuming what is practically a normal appearance. The patient did not recover from amaurosis; he never had any amaurosis to recover from. He took very large doses of iodide of potassium. My opinion is that this treatment pre- vented amaurosis, but as I always give large doses of iodide of potassium in such cases I cannot show more than a post hoc. Whenever I see optic neuritis I always give large doses of iodide of potassium. A remarkably robust and healthy-looking Swedish seaman, 40 years of age, was admitted into the London Hospital on June 20, 1873. He had had a chancre many years ago, but appa- rently no secondary symptoms. He had had pains in the right side of his head for nine weeks, and after admission he had a little deafness of the right ear. One day, ten days before admission, he had some vomiting. There was complete paralysis of the right third nerve which came on the day before admission. There was double optic neuritis. With the left eye he could read the smallest type, and denied that there was anything the matter with that eye; on the right side there was of course the defect of sight producible by palsy of accommodation. The first drawing of the left disc was made by Burgess on June 30. The patient could then as always read Ho. 1^- Snellen. He went out apparently quite well on August 19. The palsy of the third nerve had disappeared rapidly under the administra- tion of iodide of potassium; the neuritis had not disappeared. He went to sea. He came to show himself on October 23. He looked quite well and felt well. The morbid changes in his discs were insig- nificant. Those on the left side are represented in the second drawing, which was taken by Burgess, October 23. Seen for b 2