On paralytic, neuralgic, and other nervous diseases of the eye / [Arthur Jacob].

  • Jacob, Arthur, 1790-1874
Date:
[1841]
Catalogue details

Licence: Public Domain Mark

Credit: On paralytic, neuralgic, and other nervous diseases of the eye / [Arthur Jacob]. Source: Wellcome Collection.

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    not find it much noticed in the hooks. I think I meet it as often as paralysis from disease of the third nerve. The patients’ cause of complaint is the double vision which attends the disease, and the consequent distress¬ ing confusion of sight, rendered still more distress¬ ing by motion of the body. It occurs suddenly as in the cases of ptosis above alluded to, and is often, if not generally, unattended with any other paralytic affection or symptom of disease of the brain, its mem¬ branes, or vessels. As in paralysis of the muscles supplied by the third nerve, there is squint and dou¬ ble vision when an effort is made to direct the eyes in one direction, while there is none when, the eye is turned to the other side. Seating the patient before me, 1 desire him to look directly at me, which he can do, or nearly do, without squint or double vision. I then direct him to look to the right, if it be the ab¬ ductor or external straight muscles of that side which is affected; upon which the squint and double vision are complete, the left eye being turned toward the nose, while the right remains fixed. On directing him to look to the left, both eyes move correctly, and in unison, the axes preserving their parallelism, and con¬ sequently, there is neither squint or double vision. It is scarcely necessary to say, that this paralysis must be from disease affecting the sixth nerve, somewhere from its origin to its termination in the abductor muscle ; but that the nature and extent of that dis¬ ease is more difficult of explanation than even that causing paralysis of the muscles supplied by the third. The course of the nerve is longer within the cranium, its relation to the cavernous sinus and carotid artery is more intimate, and its connexion with the sympathetic much more interesting and important. It should therefore be more liable to have its functions impaired from disease within the skull, from turgid or ob¬ structed arterial or venous circulation, or from the influence, whatever it is, which appears to be exer¬ cised by disease or impaired function of remote or¬ gans. When this paralysis occurs without any other remarkable symptom of cerebral disease, I think it generally yields to simple treatment, or even disap¬ pears without any treatment at all; but when it is accompanied by blindness, paralysis of the other straight muscles, severe headache, giddiness, or other consequence of disease of the brain, its menu