Cases of syphilitic affection of the third nerve, producing mydriasis, with and without ptosis / by Victor de Méric.

  • Méric, Victor de, 1811-1876.
Date:
[1869]
Catalogue details

Licence: Public Domain Mark

Credit: Cases of syphilitic affection of the third nerve, producing mydriasis, with and without ptosis / by Victor de Méric. 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.

    11/12 (page 9)
    the syphilitic taint had the effect, not of paralysing the iris, but, on the contrary, of producing myosis, the patient not having had any attack of iritis. Harriet E., aged 30, came to Mr. Tait July 22nd, 1869, for a tumour on the clavicle: this he recognised as a node, and, on inquiry, ol> tained the following history. Eleven years ago her husband contracted a chancre and communi- cated the disease to his wife. A few weeks after she felt the sore, she was covered with a roseola rash, and had sore throat, with periosteal pains. These lasted a long time, and she underwent no treatment. Within four years after the disappearance of the rash, she had five con- secutive miscarriages, varying in period from the third to the sixth months. Three years ago, she suffered severely from photophobia, which did not appear to have been iritic, as there were no adhesions. The left pupil was much smaller than the right, and was very sluggish in action, whilst the right was not so. The right eye was moderate in size; the left was affected with ptosis, the patient saying that the latter affec- tion had been in existence since midsummer 1868. In January last she suffered from severe neuralgia of the malar branch of the left oph- thalmic nerve, which was relieved by hypodermic injection of morphia, the syphilitic history not having been elicited by the medical man who then had charge of her. Mr. Tait ordered ten grains of iodide of potassium three times a day. On August 6th, there was slight improvement of the ptosis, the node of the clavicle, and the nocturnal pains. August 27th. The improvement continued, but there was no altera- tion in the relative sizes of the pupils. September 3rd. Atropine paper was put into both eyes ; the two pupils dilated freely and regularly, but the left still remained less in diameter than the right. Ophthalmoscopic examination showed that the fundus was normal in both eyes. A blister was applied on the left temple. September 17th. The effect of the atropine had gone off, and the left pupil had again resumed its myotic condition ; the ptosis was much less ; the clavicular node had disappeared ; and the general health was much improved. October 7th. The myosis had given way, and the patient was now perfectly well. She was ordered to report herself once a month. T. RICHARDS, 37, GREAT QUEEN STREET, W.C.