Gouty retinitis, chorio-retinitis, and neuro-retinitis / by Charles Stedman Bull.

  • Bull, Charles Stedman, 1844-1912.
Date:
[1893]
Catalogue details

Licence: Public Domain Mark

Credit: Gouty retinitis, chorio-retinitis, and neuro-retinitis / by Charles Stedman Bull. 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.

    3/24
    NEURO-RETINITIS, By CHARLES STEDMAN BULL, M.D., OF NEW YORK. During the last few years my attention has been attracted by certain lesions occurring in the fundus in gouty patients, and the more I have studied these cases the greater has my interest in them grown. The pathological condition of the blood in gout does not always work in a way that readily at- tracts attention, and this is particularly true in regard to the eye. Most authors who refer to retinal complications occurring in the course of gout only mention a hemorrhagic retinitis as being the most frequent retinal complication. Thus Nettleship says: “ Hemorrhagic retinitis is more commonly met with in gouty persons than in others. It may be uniocular or binocular. The children or descendants of gouty persons, without being them- selves subject to gout, are liable in early life to this insidious form of eye disease.” (Diseases of the Eye, 4th edition, p. 445.) Other authors refer to the subject in a still more casual or general way. F. Gaute says that there is a gouty retinitis which strongly resembles certain types of syphilitic retinitis, and which may or may not be accompanied by opacities of the vitreous, retinal hemorrhages, migraine and zona ophthalmia. (These de Paris, 1881.) Lychon speaks of intraocular hemor- rhages and neuro-retinitis as due to gout. (These de Paris, 1885.) Jonathan Hutchinson, in an article on primary intraoc- ular hemorrhages, says that gouty persons are prone to hemor- rhages, venous obstruction, and irregularities in circulation due to a too large arterial pressure and a relaxed condition of the vas- cular walls, and that vitreous opacities may in these cases be con- stantly present. According to him there are four possible sources of these phenomena, viz.: First, changes in the blood; second, increased arterial tension ; third, disease of the walls of the blood vessels; fourth, hypertrophy of the heart. He con- siders that both low tension and high tension are alike compat-