The ophthalmoscopic appearances of the optic nerve in cases of cerebral tumour / by C.E. Fitzgerald.

  • Fitzgerald, Charles Edward.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: The ophthalmoscopic appearances of the optic nerve in cases of cerebral tumour / by C.E. Fitzgerald. 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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    Boston,® which iUustrates very forcibly the value of the ophthalmoscope to the general practitioner. The author has just been speaking of some of the more abstruse and difficult points in connexion with ophthalmoscopy. “ But now,” he says, aside from the nicer points in medical ophthal- moscopy, to be appreciated and used in diagnosis, perhaps still a long time, only by those familiar and expert with their presence and meaning— is the eye-mirror of as direct practical value to the general practising doctor as the microscope in determining vegetable parasites or urinary casts ? I would reply most certainly, and especially to all at work away from centres of population, where till now ophthalmic surgeons alone find enough remunerative work, and to whom a patient may be readily sent. Let me here give a few examples in proof of my assertion. A patient awakes in the morning, seeing only the half, or a portion, of an object. This is a natui-al cause of fright to him and to the physician called in, who endeavours hurriedly to recall the cerebral troubles in which half vision occurs. At last, however, his wit is baffled, and the terrified man or woman is sent, perhaps, hundreds of miles by stage-coach, steam-boat, or car to some ophthalmic surgeon. A glance with the eye-mirror shows him a partially detached retina, to become wholly so, very likely, by the necessary journey home. Surely, it would have been worth something to that village doctor, and still more to the patient, had the former been able to look into the globe, and diagnosticated what is as apparent as a torn or rumpled shirt-bosom—namely, separation of the retina.” In these days of educational reform, when it is apparent we are on the eve of some important changes with regard to medical education,it might be worth considering whether a course of ophthalmoscopy should not form a necessary part of every medical man’s study, at all events before he is admitted to the higher degrees. The undoubted services rendered by the ophthalmoscope, both in the study and practice of medicine, warrant the belief that the day is not far distant when the physician’s education will be considered incomplete till he has mastered its use. The ophthalmoscope appears to be specially adapted for assisting in the investigation of the large class of diseases known by the title of intra- cranial disorders, and the subject of the present paper has reference to what it reveals in cases of tumours situated within the cranium. I shall, first of all, describe the appearances presented by the optic nerve in cases of cere- bral tumour, and then endeavour to give a resume of the theories which are held regarding the mode in which the condition giving rise to these appearances is produced. ^ The Value of the Ophthalmoscope to the General Pi actitioner. By B. Joy Jeffries, M.D., Harv, June, 1872.