The chemistry of metabolism in its relation to ocular disease / S. Lewis Ziegler.

  • S. Lewis Ziegler
Date:
1911
Catalogue details

Licence: In copyright

Credit: The chemistry of metabolism in its relation to ocular disease / S. Lewis Ziegler. 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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    be affected by these metabolic disturbances; the uveal tract most frequently, the retina and optic nerve less often, the cor- nea and sclera infrequently, and the muscular apparatus occa- sionally. As we approach the question of what is the chief physiologic factor in perverted metabolism we are constrained to answer, suboxidation. When the oxidizing power of the blood is normal, when the ductless glands are actively furnishing their quota of internal secretion to stimulate this function, when the individual is in full possession of unimpeded respiratory powers, and when the air which he breathes is pure, there is no pabulum on which to breed disease. But when the oxygen in- take is limited by respiratory obstruction, when the air is drawn from poorly ventilated rooms, and when the habits are sedentary, then every grain of coffee becomes a drachm of xanthin poison, every ounce of food becomes a pound of toxic proteid and every germ of disease becomes a giant of destruc- tion. The origin of suboxidation is of so complex a character that it is somewhat difficult to outline its various ramifications. Respiratory obstruction is probably the most important etio- logic factor; it matters not whether this lies in enlarged tonsils, in adenoid vegetations, in hypertrophied turbinates or in the intranasal congestions that accompany mouth breathing. They are all foes worthy of our steel. But while we are studying these problems the collateral problems of perverted secretions in the nose and accessory sinuses, of disturbed digestion, and of intestinal toxemia are forced upon us as a part of the pathogenic whole that requires our most careful consideration. Nothing can illustrate the relation of suboxidation to the perverted metabolism of ocular disease more characteristically than the clinical picture of corneal ulcer in the child, which is familiar to us all. The local ulcer is the smallest part of the symptom-complex. It is the sequel rather than the cause. Aside from the lacrimation, photophobia and blepharospasm there is but little evidence that the eye is involved. On the other hand, the nasal obstruction is pronounced. The secre- tions exuding from the nose are viscid, acrid and chemically irritating, often hanging down on the lip and causing eczema- tous excoriation. The nasal mucosa is so sensitive that 3 slight draft on the body or the raising of an eyelid will cause
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