Amblyopia from the abuse of tobacco and alcohol : a clinical paper based upon cases in the practice of C.R. Agnew, M.D., and David Webster, M.D. (read before the Medical Society of the County of New York, November 29, 1882) / by David Webster.

  • Webster, David, 1842-1923.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Amblyopia from the abuse of tobacco and alcohol : a clinical paper based upon cases in the practice of C.R. Agnew, M.D., and David Webster, M.D. (read before the Medical Society of the County of New York, November 29, 1882) / by David Webster. Source: Wellcome Collection.

    11/26 (page 9)
    such pains as I have heard some persons say they experienced from drinking lager beer. I may say, however, that although we have been using nitrate of strychnia hypodermically for over eight years, and often in three or four different pa¬ tients a day, we have never yet seen any alarming symptoms from its use, and we do not think there is much danger attendant upon its use in the way we have described. Cases have been reported, how¬ ever, in which symptoms of decided strychnine-poi¬ soning followed its use in amaurosis and amblyopia. But I have not heard of any fatal results. One very disagreeable complication, however, arose in several cases, and that was a tendency to inflam¬ mation at the site of the puncture. In one case a small abscess formed and persisted for several weeks in spite of such treatment as was employed. When this complication occurs a change in the treatment usually seems to be indicated. We have commonly given our injections in the back of the neck, sometimes in the arm, and less frequently in the temple. The question naturally arises, How long should we continue these hypodermic injections of strych¬ nia? Our practice has been to continue them up to physiological effects, and then to stop them if no marked benefit has ensued. If the vision continues to improve after physiological effects have been reached, the injections may be continued for an in¬ definite period, that is, as long as they seem to be doing any good. The quantity injected should be diminished, however, so as just to fall short of phy¬ siological effects. We have, in some cases, after reaching physio¬ logical effects, stopped the strychnia injections for a few weeks, and then resumed them again, going over the same ground as at first with decided benefit. The largest dose of strychnia I have injected in any one case was, to the best of my recollection, one-fifth of a grain. I have seen one patient, how¬ ever, who, under the c-are of a friend of mine, had the dose increased to one-half of a grain before physio¬ logical effects were produced. Usually pliysiologi-