Granular ophthalmia / by Assistant-Surgeon Welch.

  • Welch, Francis Henry, 1839-1910.
Date:
[1870?]
Catalogue details

Licence: Public Domain Mark

Credit: Granular ophthalmia / by Assistant-Surgeon Welch. 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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    ing the disease, followed by a gradual subsidence under favourable sanitary conditions, or an immediate severe exacerbation, provided rude climatic influ- ences are in the ascendant, the latter not incompatible with a retrogression of the morbid follicular elements, e.g., the 1st Battalion 22nd Regiment on trans- ferrence from Malta to New Brunswick in 1866. In the face of the wide-spread existence of ophthalmia in the Army at the present day, in spite of all the means of isolation, segregation, <fcc. (on the presumption of the disease being maintained by contagion) at hand in a strongly disciplined community, it becomes an important point to ascertain, in view of its eradication, whether we are to search for its origin and diffusion in an introduced ingredient disseminated by contact, or as springing up de novo, developed from, and maintained by, a primary independent element, the direct sequel of the combined conditions under which the soldier is placed in certain barracks on foreign stations during his terms of service. The history of the disease is adduced in favour of the former assumption. History of Ophthalmia in the British Army.—The author of “ Practical “ Hygiene ”* states that “ epidemics of military ophthalmia (grey or vesicular “ granulations and rapid purulent ophthalmia) seem to have been uncommon and “ perhaps unknown on the large scale in the wars of the 18th century. The “ disease as we now see it is one of the legacies which Napoleon left to the world. <( His system of making war with little intermission, rapid movements, “ abandonment of the good old custom of winter quarters, and intermingling “ of regiments from several nations, seem to have given a great spread to the “ disease, and though subsequent years of peace have greatly lessened it, it has “ prevailed more or less ever since in the French, Prussian, Austrian, Bava- “ rian, Hanoverian, Italian, Spanish, Belgian, Swedish, and Russian armies as “ well as our own. It has evidently been propagated among the civil popula- “ tions by the armies, and is one more heritage with which glorious war has “ cursed the nations.” Whether the ophthalmia as exemplified in the English Army of the present day is identical with (and dependent on introduction by communication) that characterizing other armies during the early wars of the present century is a fairly debateable ground. Egypt is the assumed focus of diffusion, and that a severe form of ophthalmia decimated the French and English troops in that country cannot be questioned, as well as that in the large standing armies of that period constant opportunities must have been in existence for the wide diffusion of any contagious malady ; yet a study of the characteristic features of the disease then existent as ascribed by Mackenzie, Larry, and Asalini—its excessive virulence and quickness of involvement of the ocular tissues with destruction of the eyeball, and a contrast with the follicular conjunctivitis of the present day—its frequently slow and insidious approach, its postponement of implica- tion of other tissues, and a limitation in the majority of cases to the conjunc- tival membrane, must tend to the inference that either two distinct pathological entities are here in question, or that change of time and place has brought about a strange modification in disease. The nature of the present legion, the elucidation of its early stage, its de novo origin and persistence in spite of all attempts to extirpate by isolation, its prior existence in the Mediterraneanf, Malta (Ilennen), Lapland (Scheffer), “ ophthalmia is bad among them, and sooner u or later, for the most part, they go blind from closeness of their dwellings and “ smoke,” its undoubted presence among the poor of Ireland anterior to the present century (Mackenzie), its general existence at the present day]: wlier- * Dr. Parkes’ “ Practical Hygiene,” 2nd edit. p. 466. f “ Hippocrates, Gfnlen, &c., in the ancient literature of Greece and Italy, describe “ clearly purulent ophthalmia, as well as the chronic form in the watery ophthalmias “ with pains, fungous excrescencies of the lids, externally and internally, called “ fici, which destroyed the sight of many persons.”—Commentaries in Adams’ Translation of Hippocrates’ Works, Sydenham Society, Vol. i, pp. 356 and 503. X Not a town on the borders of the Mediterranean, whether in North Africa, Southern Europe, or Asia Minor, but illustrates the disease among the denizens of the low haunts ; in Egypt the chronic form, common elsewhere, prevails, not the virulent ophthalmia of old. The poorer Irish, the Russian peasant (Weckcr), the degraded drunken specimen of North American Indian, indicate its wide range ; it is a link in the chain of common humanity universal as pauperism.