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, remedies and applications employed in surgery : the etymology and signification of the principal terms : ... forming together a "catalogue raisonné" of surgical literature (Volume 1).

Samuel Cooper

Date:: 1823

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, remedies and applications employed in surgery : the etymology and signification of the principal terms : ... forming together 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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$>y previous dims* of o of the eye. I'rum this definition, which comprehends 5 form of amaurosis, it is evident that this affection does not uniformly take place le independent disorder; but not [infrequently presents itself as a sympto- matic effect of some other disease of the eye ;. a fact exemplified in cases of hydroph- thalmia, cirsnphlhalmia,glaucoma,&B. And ■' W ardrop obsenes. amaurosis, in its usual acceptation, signifies a symptom of well as a distinct affection. (Es- says on the Morbid Anatomy of the Human Eye, vol. 2. p. 165. 8ro. Land. 1818.) With respect to the mere name of the kind of disease, which is here implied by amau- its correctness will remain the same, whether the iris be moveable or immove- able ; whether the pupil be pieternaturally enlarged or contracted ; and whether it be perfectly clear and transparent, or more or turbid ; for the name only refers to the morbid state of the retina and optic nerve, and not to the condition of the sight in general. When the long-established name of amaurosis is received with this precise meaning, there will not be the slightest danger of confounding this disease with other affections of the eye. However, when it is wished to make out the very different forms and kinds of amaurosis, the ;oing appearances of the iris and pupil are considerations of great importance. (See Beer's Lehre von den Augenkrankheiten, t>. 2. p. 420, $-c. It'iui. 1817.) Amaurosis does not constantly attack both eyes at the same time. Frequently one is attacked some time after the other; and it is not unusual even for one eye to remain sound during life, while the other is com- pletely blind. This depends in part upon the disposition to the disease in one eye being quite local, and in part upon the causes giving rise to the complaint eitend- ing their operation only to the eye affect- ed. Where, also, the origin of amaurosis seems to depend altogether upon constitu- tional cause;,, as in gouty and syphilitic patients, fcc., one eye is not unfrequently attacked much sooner than the other; though, in these examples, it is more rare to find the eye, w Inch does not suffer at first, continue perfectly unaffected. (Beer, b. 2. p. 422.) As a general observation, Mr. Wardrop thinks it may be remarked, that, when only one eye becomes at first amau- rotic, from a sympathetic affection, there is little danger of the other eye becoming blind; but, that when amaurosis is pro- duced by auy organic change in one eye, the other is in danger of becoming sympa- thetically affected. (Essays on the Morbid Anatomy of the Human Eye, vol. 2. j> I Amaurosis does not completely hinde sion, a diminished power of seeing often remaining during life. Hence the di\ i of cases into perfect and imperfect, which latter, however, sometimes attain a d< in which the patien' Am distinguish light, the direction ol its Wh anditsdegn . l„_. Imperfectamaurosis, besides beingcnarac- terized by a considerable weakness o sight, pproaching to real blindness (Amblyopia bnaurotica,) is mostly complicated with a greater or lesser number of other morbid Appearances, which merit serious attention. Among the most important of these symptomatic appearances of imperfect amaurosis, is a defective interrupted vision (visas inlerruptus.) For instance, when the patient is reading, single syllables, words, or lines, cannot be seen, unless the eye be first directed to them by a movement of the whole head, and greater or lesser portions of other objects are, in the same manner, undistinguishable. Sometimes amaurotic patients can see only the upper or lower, or the left or the right half of objects. (Vi- sus dimidialus; Amaurosis dimidiata; Hemi- opia; Hemiopsia.) Sometimes, when the patient shuts one eye, he can only distinguish the halves of objects ; but, if he open both eyes, he sees every thing in its natural form. In this case, according to Schmucker, one eye i- sound, and only some fibres of the nerve of sight are injured in the other. (Vermiscldt Chir. Schrift. b.2.p. 12.) There are likewise some not very un- common cases of imperfect amaurosis, in which the patient cannot see an object, un- less it be held in a particular direction before the eye; but when the eye or head is moved in the least, he loses all view of the thing, and cannot easily get sight of it again. (Beer, Lehre von den Au- genkrankheiten, b. 2. p. 424.) On this part of the subject, it is remarked by Richter, that patients who may be said to be entire- ly blind, sometimes have a small pai the retina which is still susceptible of tlie impression of light, and is usually situated towards one side of the eye. This obliquity of sight was long ago pointed out by the late Mr. William Hey of Leeds, as common in the present disease. (See Med. Observa- tions and Inquiries, vol. 5.) Richter men- tions, that, in one man, who was in other respects entirely bereft of vision, this sen- sible point of the retina was situated ob- liquely over the nose, and so small, th was always a considerable time befon situation could be discovered. He a tnat it was so sensible, as not only to disiLi ? Y1' but even the spire , . ant steeple. According to this author, he first an'] * °f. the e*e lhat S,:r;ls to b« eutta l? m°o seri0s'y affected in the amaurosis ™ T° * ^'S ^perfect amaurosis, can always see objects laterally situated better than those ,S la!erd,,i diately before them /T/• ' are lm,e' dor J. b. :i V^' ,4(t&gf: ? % Obs.andrnq.vot.fi) Hey l Med- One of the most common symptom- of. beginning amaurosis i3 an anpSS ■ the patients fancy, as if gnats or n-''Ce '$

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