Pemphigus of the conjunctiva / von Prof. Dr. Wicherkiewicz.

  • Dickinson, William.
Date:
[1886]
Catalogue details

Licence: Public Domain Mark

Credit: Pemphigus of the conjunctiva / von Prof. Dr. Wicherkiewicz. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    covering the entire surface. The general integument was nowhere affected, nor had blebs as yet attacked the globe. I now destroyed the bulbs of the abnormal cilia by electrolysis, and also those of the normal that became incurved and irritated the globe. In this, with constitutional treatment, I persisted till December 1. At this time a small vesicle invaded the upper part of the conjunctiva of the right globe just above the corneo-scleral junction, which later assumed the conditions of an ulcer and being treated as such kindly healed. Soon after a large bleb developed in the lower fornix of the left eye. This in a few days passed through the various stages and ultimately healed, and left a cicatricial con- tracting surface. Directly afterwards a bleb occurred on the con- junctiva of the right eye, which had the same history. March 1, I observed a large bleb on the conjunctiva of the left globe occupy- ing the upper and outer quadrant, extending to and invading the corneal edge. Simultaneously a bleb of similar dimensions, and in corresponding location, attacked the right eye. This was the last visit made by the patient; reasons of discontinuance unknown. Gratitude and satisfaction had always been expressed, notwith- standing I had frequently informed her that the disease was re- fractory and oftimes intractable. Vision, as the result of pemphi- gus, was intact, except as embarrassed by trichiasis and lachryma- tion. Treatment. Generous diet and tonic regimen from the first was presistently pursued. Quinine and iron, singly and combined, were administered in full doses, and during the last three months arsenic was added. Local treatment by collyria of ac. boracici. and to the blebs local applications of mild solutions of arg. nit. and ox. hydrag. flav. (amorph). Galvanism was also employed through the closed lid, one rheophore being applied to the nucha or held in the hand, and during the last month I applied it directly to the conjunctiva, it having been first rendered insensible by instillations of cocaine. By this agent I hoped to re-inforce the vaso-motor factor of the great sympathetic, which had become paretic, and which gave rise to the chronic congestion, the extravasation of serum and the resulting formation of blebs. Eserine was also at periods instilled. Inci- pient cataract was present in both eyes. As a summary, and in conclusion, I am not convinced that any agent employed proved itself curative, though temporary benefit was often manifest. St. Louis, 1322 Olive St.