A dictionary of practical surgery: comprehending all the most interesting improvements up to the present period: also an account of the instruments, remedies, and applications employed in surgery; the etymology and signification of the principal terms; a copious bibliotheca chirurgica; and a variety of original facts and observations / [Samuel Cooper].

  • Cooper, Samuel, 1780-1848.
Date:
1818
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical surgery: comprehending all the most interesting improvements up to the present period: also an account of the instruments, remedies, and applications employed in surgery; the etymology and signification of the principal terms; a copious bibliotheca chirurgica; and a variety of original facts and observations / [Samuel Cooper]. Source: Wellcome Collection.

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    plaints, &e. There is no reason, why a person should not become blind about the time, when another disorder gives way; hut, we ought to have some other ground for the doctrines, to which allusion is made, before we can presume to offer them as en- titled to confidence. Worms in the alimentary canal are al- leged to be sometimes the cause of amauro- sis, and, since a disordered state of the gastric organs is universally acknowledged to be frequently concerned in the produc- tion of blindness, we can have no difficulty m conceiving, that worms may likewise have the same effect. Besides gastric ir- ritations, there are some others, which class as causes of this disease. A violent frigid, which is considered as being a fre- quent remote cause of the gutta serena, is supposed by Richter to operate chiefly by irritating the nerves. The blindness sometimes proceeds from a mechanical kind of irritation. A man received in his right orbit, a small shot, which pierced the upper eye-lid, and lodged at the upper part of the socket, between the eye-lid and eye-ball, so that it could be felt externally. Richter adds, that this patient shortly afterwards became blind in the left ej®; but recovered his sight in it again, upon the excision of the shot. ( Anfangsgr, der Wundarzn, Bond 3, p. 439.) Sometimes, says this experienced sur- geon, the irritation, exciting amaurosis, seems to have its seat in the mucous mem- brane of the nose and frontal sinuses. We have already adverted to the unusually dry state of the nostril, that has been sus- pected of being occasionally conducive to this species of blindness. The gutta serena is generally difficult of cure. However the degree of difficulty, in relieving the disease varies in different eases, according to the way in which the malady originates, and the nature of the cause. Professor Scarpa, of Pavia, has given an excellent account of the prognosis in eases ol amaurosis. Some of his doctrines, however, founded on the humoral patho- logy, are hypothetical, and, consequently, are purposely omitted in the following account, it also deserves notice that the ease supposed to originate from injury of the supra-orbitary nerve, is not always incurable, as the experience of Hey con- firms. (See Med. Obs. and Inq. Vol. 5.) Amaurosis is divided by Scarpa into the perfect, or imperfect; inveterate, or recent; and continued, or periodical. The perfect, inveterate amaurosis attend- ed with organic injury of the substance, constituting the immediate organ of sight, says Scarpa, is a disease absolutely' in- curable. I he imperfect, recent amaurosis, particularly that which is periodical, is com- monly-curable j for. It is mostly sympa- thetic with the state of the stomach and primae vi®, or dependent on causes, which though they affect the immediate organ of sight, are capable of being dispersed, without leaving any vestige of impaired organization in the optic nerve, or retina. When amaurosis has prevailed several years, in persons of advanced age, whose eyesight has been weak from their youth ; when it has come on slowly, at first with a morbid irritability of the retina, and then with a gradual diminution of sense in this part, till total blindness was the conse- quence ; when the pupil is motionless, not circular, and not much dilated ; when it is widened in such a degree, that the iris seems as if it were wanting, and the margin of this opening is irregular aud jagged; and, when the bottom of the eye, independently of any opacity of the crys- talline lens, presents an unusual paleness, like that of horn, sometimes partaking of green, and reflected from the thickened re- tina, the disease may be generally set down as incurable. Cases may be deemed irre- mediable, which are attended with pain all over the head, and a continual sensation of tightness in the eye-ball, which ar© preceded by a violent, protracted excite- ment of the nervous system, and then by general debility, and languor of the con- stitution, as after masturbation, prema- ture venery, and hard drinking. There is no remedy for cases, connected with epileptic fits, or frequent spasmodic he- rn i crania ; nor for such as are the conse- quence of violent, long-continued, inter- nal ophthalmia. Cases are incurable, also, when produced by violent concussions of the head, direct blows on the globe of the eye, or a violent contusion, or other injury of the supra-orbitary nerve, and this, whether the disease take place im- mediately after the blow, or some weeks subsequently to the healing of the wound of the eye-brow. Amaurosis is also incur- able, when occasioned by foreign bodies in the eye-ball, lues venerea, or exostoses about the orbit. Lastly, amaurosis is absolutely irremediable, when conjoined with a manifest change in the figure and di mensioas of the eye-ball. On the contrary, all cases of imperfect, recent amaurosis, whether the blindness be total, or partial, are mostly curable, when not produced by causes, capable of contusing or destroying the organic struc- ture of the optic nerve, and retina. This is especially true, when the retina is in some degree sensible to the impression of light. Recent, sudden cases, in which the pupil is not excessively dilated, and its disk remains regular, while the bottom of the eye is of a deep black colour, cases, unaccompanied with any acute, continual pain in the head and eye-brow, or any