A dictionary of practical medicine : comprising general pathology, the nature and treatment of diseases ... with numerous prescriptions ... a classification of diseases ... a copious bibliography, with references; and an appendix of approved formulae / ... By James Copland.
- James Copland
- Date:
- 1844-58
Licence: Public Domain Mark
Credit: A dictionary of practical medicine : comprising general pathology, the nature and treatment of diseases ... with numerous prescriptions ... a classification of diseases ... a copious bibliography, with references; and an appendix of approved formulae / ... By James Copland. Source: Wellcome Collection.
Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.
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![16. 2d, A congestive or infiammatory state of the vessels of the retina, or parts immediatelq adjoining, or the usual effects of these states.— Portal, Ploucquet, Prochaska, Rousseau, Sanson, Magendie, and other pathologists, have observed varicose states of these vessels ; unusual injection of the minute arteries of the adjoining coats, and of the retina itself; a complete reti- nitis; exudations of lymph under the choroid, near the ciliary circle ; inflammaiion of the ex- ternal surface of the sclerotic; vascular injection, and firm adhesion of the retina to the choroid ; partial detachment of the retina from this coat; and thickening, morbid density, and change of colour of the retina. Ossification; fibrous de- generation, with partial thickening ; wasting, and malignant disease of the retina, and even the development of transparent vesicles in it, have all been noticed by Hali.er, Morgagni, Heis- TER, Sanson, and other authors. 17. 3d, Lesions affecting the optic nerves.— These consist chiefly of tumours of various kinds — osseous, fibrous, encysted, steatomatous, puii form, aneurismal, &c.— formed in their vicinity, either in the brain, the membranes, or in the bones of the cranium, and involving, or compressing them, in any part of their course. They are like- wise, occasionally, the seat of some one, or even more, of those organic changes of their proper structure and sheaths, to which nervous parts are liable. Their vessels may be varicose; their fibres may be infiltrated with serum ; they may be injured by external violence, and they may be wasted ; which last is very frequently observed. Adventitious deposits, as osseous and earthy mat- ter, malignant formations, cysts and hydatids, may even form in their sheaths, although more rarely than the foregoing lesions. The writings of pathologists abound with instances of these changes. When only one eye has been amau- rotic, the optic nerve of that side has been found wasted anterior to its partial decussation ; and on the opposite side, posterior to this union. 13ut this is by no means an uniform circumstance, and, when observed, the atropiiy is not distinctly con- tinuous. Indeed, the wasting has been detected on the same side, after the union of these nerves, as well as before. But if the opinion of Trevi- RANus and VVollaston be correct,— that decus- sation of these nerves at their union is only partial, and that it takes place chiefly between the parts which are nearest each oiher, — wasting of one of them may be in one case more remarkable on the same side, and in another case more observable on the opposite side. When the amaurosis is accompanied with wasting of the optic nerve, from causes not primarily consisting of inflam- mation or its conse(|Uences in the retina or ad- joining coats, this nervous expansion is also generally wasted, transparent, or changed in colour. When the cause exists in the pineal or piiuitaiy glands, the wasting is often chiefly ob- servable at the union of the optic nerves. In these cases, both eyes are afl^ecled. Facts illus- trative of tiiis have been recor(le<l by Vieussens, ]Je IIaen, Rullieh, Rayer, Ward, and San- son. 18. 4th, Lesions seated in the encephalon. — The scope of this article will not admit of further reference to the numerous changes which occa- sionally produce amaurosis, from their afl=ecting the optic nerves in their different connections with various parts of the encephalon. All the alter- ations which are described in the articles on mor- bid structures of the brain and its membranes, will produce the disease, when they impede the functions of the optic nerves, although the struc- ture of these nerves may be uninjured. The most frequent and remarkable of these are, organic lesions of the pineal and pituitary glands (§ 8.), sanguineous and serous efl'usions, various kinds of tumours, abscesses, softening of the brain, &c. 19. 5th, Lesio)is of 7ierves subsidiary to the integrity of the organ and of its functions. — In- juries, compression, and even irritation of the fifth pair of nerves, particularly its ophthalmic branch, of the third and sixth pairs, and of the ganglia or their ramifications, by organic change in the brain, its membranes, bones of the cranium, or parts in the course of their branches, have been shown, in numerous instances, to have been the chief effi- cient causes of amaurosis. 20. III. Symptobis.—The symptoms of amau- rosis are, 1st, those which the patient himself experiences; and 2d, those which the physician detects in the eyes, or in the various organic and animal functions. Each of these classes of symp- toms are to be inquired into separately, com- mencing with either of them. Each eye should be carefully and separately examined; and it will be better that tiie other is excluded from the light, whilst the examination is being made. 21. 1st, The patient complains of impaired vision, which may be of gradual accession, or re- markably sudden, and amounting to almost total deprivation of sight. Hence the disease has been distinguished by the epithets slow and sudden, in- complete and complete, or imperfect and perfect, 22. At the coinmencement, the failure of vision is sometimes only occasional, for a short time,and after longer or shorter intervals (amaurosis vuga). In some cases it assumes the form of day-blind- ness, in othtrs of night-blindness: and it not in- frequently recurs for a time after great exertion of the eyes, either with minute or bright objects. Transient and sudden attacks of the disease are often the consequence of disorder of the digestive organs, or rather tiie result of a state of the vital manifestations which occasions equally loss of sight as well as loss of the digestive functions. The failuie of sight is often at first only partial — extending only to a pait of the field of vision. In some cases, intervening portions of the field are obscured (visas interrupius). In other cases, one half of it is hid from view (heminpia). Oc- casionally objects are only seen in a particular di- rection (visas ohliquus) ; and some patients discern objects in a distorted form—crooked, mutilated, shortened, lengthened, or inverted (visas defigura- tas). Beer states that the flame of a candle will often appear elongated, and as if separated into several portions, to such patients,—a symptom in- dicating disease within the head. 23. In some instances the failure of sight as- sumes a myopic or a jiresbyopic form : but this is not so fref[uent as the occurrence of false impres- sions, in the form either of flashes of light, shining stars, globes of light, and various other lucid spec- tra (pitolopsia), or of musca; volitanles. False impressions of c(dour (chrupsia^ are also frequent attendants on the early stages of amaurosis. Lumi- nous spectra aie commonly met with in plethoric](https://iiif.wellcomecollection.org/image/b2119709x_0060.jp2/full/800%2C/0/default.jpg)
