A dictionary of practical surgery: comprehending all the most interesting improvements from the earliest times down to the present period : an account of the instruments and remedies employed in surgery : the etymology and signification of the principal terms : and, numerous references to ancient and modern works forming a "catalogue raisonné" of surgical literature (Volume 1).

  • Cooper, Samuel, 1780-1848.
Date:
1830
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical surgery: comprehending all the most interesting improvements from the earliest times down to the present period : an account of the instruments and remedies employed in surgery : the etymology and signification of the principal terms : and, numerous references to ancient and modern works forming a "catalogue raisonné" of surgical literature (Volume 1). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    rosia, whl(!h occurs suddenly !n consequence of the lx)dy being excessively heated, or exposure to tlie sun, or violent anger in plethoric suiijects. This case n> qiures, in particular, general and topical evacuations of blood, and the application of cold washes to the eyes and whole head. An emetic should next be given, and afterward a purge of potassm tarlras, or small re- peated doses of anliinoniuni tartarizatuin. Ky means of bleeding and an emetic, Scbinucker often restored the eyesight of soldiers who had lost it in making forced marches, with very heavy burdens. In amau- rosis, suddenly occasioned by violent anger, an emetic is the more strongly indicated after bleeding, as the bUndness, thus arising, is always attended with a bit- ter taste in the month, tension of the hypochondria, and continual nausea. RicUter mentions a clergyman, who became completely blind after being in a violent passion, and whose eyesight was restored the very next day, by means of an emetic, given with the view of relieving some obvious marks of bilious disorder in the stomach. Scarpa's treatment of the imperfect amaurosis brought on by fevers, deep sorrow, great loss of blood, intense study, and forced exertions of the eyes on very mi- nute or brilliant objects, consists also in removing all irritation from the stomach, and afterward strengthen- ing the nervous system in general, and the nerves of the eye in particular. In the case originating from fe- vers, the emetic and opening pills are to be given ; then bark, steel medicines, and bitters; while the vapour of the licpior anunoniiB is to be applied to the eye itself. When the disorder has been brought on by grief, or fright, the stomach and intestines are to be emptied by means of anlimoniuin tartarizatum and the opening pills ; and the cure is to be completed by giving bark and valerian; applying the vapour of liquor ammonia; to the eyes; ordering nourishing, easily digestible food ; diverting the patient's mind, and fixing it on agreeable objects, and recommending moderate exercise. The amaurosis from fright is said to require a longer per- severance in such treatment, than the case from sor- row.—(Scarpa's Osservaz. cap. 19.) In this country, the emetic practice, which has proved so decidedly efficacious on the continent, has not been attended with much success; Mr. Travers oven states, that he does not recollect an instance of decided benefit from it, though he has often tried it fairly, lie agrees, however, in the indication, as he remarks, that the removal of an irritating or oppress- ing cause, will often effect a sudden and marked relief, as by clearing the intestinal canal of vitiated secre- tions, restoring the digestive functions, or taking away blood where the necessity is indicated. In gastric cases for wliich emetics have been particularly recom- mended, he prefers a long-continued course of the blue pill, with gentle saline purgatives and tonic bitters.— (Synopsis, p. 299—304.) Beer is also a high authority against the use of eme- tics, even in the amaurosis from disorder of the gas- tric organs. When, says he, the saburrse have a ten- dency to be discharged upwards, as indicated by con- tinual nausea and disposition to vomit, emetics, which never operate without some violence, are to be most carefully avoided in plethoric individuals, or those who have a manifest determination of blood to their heads and eyes, or any acceleration of the circulation. The caution here given must be observed, even though eme- tics may on other accounts seem advisable; and, ac- cording to Beer, the determination of blood and the slate of the system here mentioned, are commonly at- tendant upon this sjiecies of amaurosis. Indeed (not- withstanding the testimony of Schmucker, Richter, and Scarpa, in favour of emetics in this case). Beer posi- tively atlirms, that the violent operation of an emetic frcciuently converts this sympathetic amaurotic weak- ness of sight all on a sudden into blindness. Although I apprehend that Beer may here be somewhat preju- diced against emetics, candour obliges me to add, that in tliis countrj', their efficacy in the present disease is by no means equal to the representations of Richter and Scarpa. When there is less tendency to vomiting, but the case is attended with an oppressive sense of weight about the stomach, frequent eructations, as if arising ft-om rotten eggs, an inflated belly, and teiise hypochondria, a gentle aperient clyster may be ordered, especially when the bowels have been for some days oonflned, in wtiicli circumstances Beer has foiuid, that J tolerably brisk purgatives are always of the grcateet service, both in regard to the general complahits, smd the amaurotic weakness of sight; the removal of the oflTcnsive matter from the alimentary canal being im- mediately followed by a cessation of the determination of blood already mentioned. Lastly, when this amau- rosis originates altogether from the presence of worms in the bowels, common anthelmintics are to be pre- scribed. In all these cases, says Beer, mere local treatment is quite inapjdicable, and may do mischief.— (Beer, Lelire von den Augenkr. b. 2, p. 517—521.) The third species of gutta serena, or that which arises from debilitating causes, is of two kinds; in one, the disease is the consequence of a general weakness of the body; in the other, it is the effect of debility, which is confined to the eye itself, and does not extend to the whole constitution. According to Scarpa, the incomplete amaurosis from general nervous debility, copious hemorrhage, convul- sions ab inanitione, and long-continued iniense study, especially by candle-light, is less a case of real amau- rosis, than a weakness of sight from a fatigued state of the nerves, especially of those constituting the im- mediate organ of sight. When this complaint is re- cent, in a young subject, it maybe cured or diminished, by emptying the alimentary canal with small repeated doses of rhubarb, and then giving tonic cordial reme- dies. At the same time, the patient must abstain from every thing that has a tendency to weaken the nervous system, and, consequently, the eyesight. After empty- ing the stomach and t-owels, it is proper to prescribe the decoction of bark with valerian, or the infusion of quassia with the addition of a few drops of sulphuric ether to each dose, with nourishing easily-digestible food. The aromatic spirituous vapours (mentioned in the article Ophthalmy) may then be topically applied; or, if these prove ineffectual, the vapour of li(iuor am- moniae. The patient must take exercise on foot, horse- back, or in a carriage, in a wholesome dry air, in warm weather, and avail himself of sea-bathing. He must avoid all thoughts of care, and refrain lioin fixing his eyes on minute shining objects. The impression of vivid light on the retina is always to be moderated by means of flat green glasses.—(Saggio di Osscrvaz. cap. 19.) One case of temporary palsy of the retina from over-excitement, mentioned by Mr. Travers, yielded to blistering the fbreheail, and a gentle salivation excited by calomel joined with opium.—(Synopsis, p. 164.) Another case, brought on by the use of telescopes and sextants, gave way to a copious bleeding, brisk purg- ing with jalap and calomel, blisters to the temples, and a course of mercury.^—(Op. cit. p. 166.) Mr. Travers remarks, that the amaurosis from de- pletion is sometimes mistaken for the opposite case, viz. that from plethoric congestion: this is owing to the coincidence of a dilated and immoveable pupil, muscK, and a deep-seated pain in the head, with occa- sional vertigo ; and its frequent occurrence in a corpu- lent habit. By a cautious use of tonics (says Mr. Travers) it is relieved ; by whatever lowers or stimu- lates, whether diet or medicine, it is decidedly aggra- vated. In this form of amaurosis, vision is farther enfeebled by the loss of as much blood as flows from two or three leech-bites.^—(Synopsis, &c. p. 160.) When the weakness is confined to the eye, Richter thinks corroborant applications alone necessary. Bath- ing the eye with cold water, says he, is one of the most powerful means of strengthening the eye. The pa- tient should dip in cold water a compress, doubled into eight folds, and sufficiently large to cover the whole face and forehead, and this he should keep applied, as long as it continues cold. Or else he should frequently apply cold water to liis eyes and face with his hand, on a piece of rag. The eye may also be strengthened by repeatedly ap- plying blisters of a semilunar shape above the eye- brows, just long enough to excite redness. Richter likewise speaks favourably of rubbing the upper eye- lid, several times a day, with a mixture of the tinctura lyttae and spiritus serpilli.—(Anfangsgr. der Wimdarzn. b. 3, p. 452.) When no probable cause whatsoever can be assigned for the disease, the surgeon is justified in employing such remedies, as have been proved by experience to be sometimes capable of relieving the affection, al- though upon what principle is utterly unknown.—(See Gutta Serena.) To this article I would refer the reader.