Treatise on the diseases of the eye : including the anatomy of the organ / by Carl Stellwag (von Carion) ; translated from the fourth German edition and edited by D.B. St. John Roosa, Charles S. Bull, and Charles E. Hackley.
- Karl Stellwag von Carion
- Date:
- 1873
Licence: Public Domain Mark
Credit: Treatise on the diseases of the eye : including the anatomy of the organ / by Carl Stellwag (von Carion) ; translated from the fourth German edition and edited by D.B. St. John Roosa, Charles S. Bull, and Charles E. Hackley. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
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![tractiiiL' the thoracic cavity, or by compressing the lungs, should be removed and avoided. In this is comprehend d, among other things, tight cravats, tight cloth- ing pressing upon the chest, collections of fecal masses in the intestines, overload- ing the stomach with food and drink. Finally it is an important rule that patii ate with congi sfa d or inflamed eyes should eat nothing which renders necessary a trn ;it expenditure of power by the muscles of mastication, on account of the above-de- Bcrib d blood-congesting effect of the facial muscles. The increase of a congestion of the eyes after a full meal is a matter of daily experience. II. The indication* furnished by the disease itself. These may be divided into the following: a. The limitation of the local depositions; b. The lessening of the .-. 'I'll- removal or lessening of febriU action. The means of fulfilling these indications will now be enumerated : 1. Direct removal of heat This limits the local change or nutrition by lessening the temperature of the inflamed tissue, and rendering chemical combinations diffi- cult. Moreover, cold applied for this purpose acts as a powerful irritant upon the contracted portion of the tissue and especially u]3on the muscles of the vessels, for- cing them to contraction, and therewith causing a nan-owing of their caliber, and in this way decreasing the amount of blood carried to the inflamed part. It also diminishes the Bensibility of the parts, and with it their functional power. Sensitive organs lose their sensation, muscles become rigid, secretions are lessened, etc. The application of cold affects not only the surface, but also the tissues, to a greater or less depth, according to the degree of cold employed, and the duration of the appli- cation. The mean- by winch we obtain the effect of cold in the region of the eye are naturally exceedingly various, but cold compresses are the best. Douches were formerly the fashion, but their preparation is generally too expensive for the private patient, and their use has generally been given up in hospitals, a certain evidence that they have only partially, or not at all, answered their intended purpose. This is not at all sur- prising when the effect of douches is more exactly understood. Besides the abstraction of heat, there occurs on the use of the douche, whether it be used in a full stream or in the form of spray by nmans of a nebulizer, a mechanical power or force with which th3 water strikes upon the parts. By means of this mechanical force, the douche acts, first, as an irritant upon the sensory nerves, and increases the afBux of the blood, and the part which is acted on becomes painful and red The next effect of this gradual abstraction of heat is that the part becomes pale, without sensation and cool. Any longer action of the douche, however, will not bs easily borne. If cold exerts only a momentary effect upon a part, the reaction appears more evident: the inflammation is rather increased than diminished. Cold applications act primarily as irritants upon the sensory nerves, and may therefore induce a dilatation of the vese Qa This effect, however, is evanescent and scarcely comes into consideration, it being understood that by means of the cold compresses the warmth is continuously removed, and not merely a high grade of temperature interchanged with a lower one, as is the case when the compresses are so seldom changed that they have time to become warm again before they are replaced by fresh ones. If such contrasts of temperature have an effect upon a part, the result, as a rule, will not be favorable. An important rule therefore is, to quickly change the applications, and the quicker the warmer the part is. If this require- ment is fulfilled, the principal danger in the use of cold is avoided. A second danger springs from an immoderate use of the application. Water of a low tem- perature readily leads to freezing, and this the more easily, the less the warmth is developed in the affected part. The consequences of such a freezing, in the wider](https://iiif.wellcomecollection.org/image/b21002319_0053.jp2/full/800%2C/0/default.jpg)
