Serum and vaccine therapy in connection with diseases of the eye : the Middlemore prize essay, British Medical Association, 1911 / by C.W.G. Bryan.

  • Bryan, Charles Walter Gordon, 1884-1954.
Date:
1912
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Credit: Serum and vaccine therapy in connection with diseases of the eye : the Middlemore prize essay, British Medical Association, 1911 / by C.W.G. Bryan. 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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    weeks had had painful irido-cyclitis of the eye; vision =|-; fundus invisible. Two months of ordinary treatment did not improve the condition. In December, 1909, four injections of tuberculin were followed by ocular reaction, the last also by a rise of temperature. In January and February, 1910, nine injections were later more injections. The irido-cyclitis became much better, the vitreous cleared, the vision improved to When the fundus ^^•as visible there was seen an atrophic patch in the choroid, evidently a cured tuberculous lesion. Choroiditis. Using von Hippel’s method, Weeks'^ has obtained improve- ment in four cases of tuberculosis of the choroid. Ernest Clarke and Wright,^® using the opsonic index as a control, cured a case of conglomerate tubercle of the choroid with tuberculin. The case was diagnosed by the varying tuberculo-opsonic index. Treatment by mercury and potassium iodide was carried on for the first nine months while tuberculin was being used. \V. Kraus and A. Bruckner-® report two cases of tubercle of the fundus treated successfully by tuberculin. Hay-® mentions cases of tuberculous retinitis cured or treated with success by means of von Hippel’s treatment. In internal tuberculosis of the eye, then, we find that the results of treatment by vaccine are good, especial!}' where the iris is the diseased tissue. The iris is favourable for treatment because it has a good blood supply. In tuberculosis of the fundus, where the blood and lymph supply are poor, treatment has to be pro- longed, and is less certainly successful. It may be mentioned here that in disease of the iris it is necessary to use mydriatics to prevent the formation of synechiae, and, the blood supply in this way being diminished, treatment rather tends to be prolonged, owing to the difficulty of getting sufficient opsonins into the diseased tissues. II. Diseases of the Eye due to Pyogenic Organisms. In treating tuberculosis by vaccine, it is necessary to use a “stock” vaccine, whereas, in dealing with other infections, in most cases it is possible to prepare a specific vaccine from cultures of the lernest Clarke and Wright : Trans. Ophthal. Soc. U.K., vol. xxviii, p. 192. Clarke and Mayou : Trans. Ophthal. Soc. U.K., vol. xxviii. -’ Rennert : Dent. rned. Woch., 1905. Dorschleg, Inaug. Dissert., Griefs wald, 1905. Hay : Ophthalmoscope, 1908. Kraus and Bruckner : Arch, f. Augenheilk., May, 1907.