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
Catalogue details

Licence: Public Domain Mark

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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    «Vtbe eye. Ion • of physical «od moral education, protracted bad habits <> f youth, orthc unmanageable behaviour of the patient. Fourthly, we must take into the account the unconscientious indolence of the practitioner, who so often positively declines rendering the patient any assistance at all; or, if (or the sake of lucre he at- tempt any thing, it is only an empirical mode of treatment, by which means every chance of benefit is annihilated, while an active and intelligent surgeon might per- haps preserve vision, and bring it to perfec- tion again. When there is a probability of relieving amaurosis, the cure is mostly tedious, and beset with many difliculties, though the blindness has originated and formed sud- denly, the utmost attention, and the great- est practical skill, being requisite on the part of the surgeon. Hence, as Beer observes, even in favourable cases, cither the patient himself, the surgeon, or both of them, lose all inclination to persevere in thetreatment, and the unfortunate victim is either left to his fate, or consigned to impudent, merce- nary quacks. In amaurosis, the difficulty of cure is na- turally in proportion to the variety and num- ber of causes of the complaint; and the more readily the surgeon makes himself acquainted with them, and the more certain- ly he obviates them, the more surely and <juickly does the cure follow. It may be considered as generally true, that every amaurotic weakness of sight, and every completely formed amaurosis, are at- tended with the greatest probability of cure, where they began suddenly, and were quickly developed ; for experience proves, that, in these cases, the whole of the causes of the disease are much more frequently and earlier comprehended than when the complaint has been several years in forming. — (Beer, Lehre von den Augenkr. b. 2. p. 454 —56.) This observation perfectly coincides with the account given by Schmucker, who says, that many of these suddenly formed cases have fallen under his notice, and been more easy of cure, than when the disorder had come on in a more gradual way. (See Vermischte Liar. Schriften, b. 2.) A case may happen, nay, it happens not unfrequently, says professor Beer, (which considering the imperfect etiology of amau- rosis, cannot be wondered at,) that the. sur- geon, after the most careful investigation, ran absolutely detect no particular cause of the existing amaurotic blindness, in which event, the prognosis must in every respect be very uncertain and unfavourable, since only empirical treatment can be tried, which rarely answers; and, even when a cure in this even tbougha degree of vision may now beThiw^ amaurotic patients in whom every treatment does harm, the d.sease ma- kb^ uninterrupted advances to perpetual b indncis This observation especially re- e to local remedies, of the danger of which, under certain circumstances, the pa- tient should be carefully warned In general, the more complete the amau- rosis is, and the longer the patient has been deprived not only of vision, but of all sen- sibility to light, the less hope is there of sight being ever re-established. H hen one eve has been completely bereft of sight by amaurosis, and the surgeon can find out li'ttle or no cause for the infirmity, there is strong reason for apprehending that the other eye will sooner or later become blind. This is a fact amply proved by ex- perience, and the exceptions are very rare. According to Beer, the idea entertained by some writers is not built upon experi- ence, that amaurotic patients, in whom the iris is still moveable, and the pupil not very much dilated, are more easily and frequent- ly cured than others in whom the iri perfectly motionless, and the pupil exceed- ingly dilated. For sometimes, during the treatment, or even spontaneously, the after being quite immoveable, recover power of motion, yet the patient may not, at the same time, regain the slightest degree of vision ; and on the other hand, many cases of perfect amaurosis are cured, with- out the iris recovering any of its mobility, and the pupil remains dilated during the remainder of the patient's life. (Lehre von den Augtnkr. b. 2. p. 458.) Richter also thinks, that the moveable or immoveable state of the pupil can neither be consi- dered as a favourable nor unfavourable cir- cumstance. Sometimes, says he, an amau- rosis may be cured, which is attended with a pupil extraordinarily dilated, and entirely motionless; and sometimes the disorder proves incurable, notwithstanding the pupil be of its proper-size, and capable of motion. There are likewise examples, in which the pupil recovers its moveableness, in the course of the treatment, although nothing will succeed in restoring the eyesight. (An- fangsgr. der Wundarsn. b. 3. p. 424. 8tw. Gott. 1795.) In some very rare instances, says Beer, amaurotic blindness has been cused by some apparently accidental, or indeed morbid effect, without any assistance from art; by hemorrhage from the nose, an intermittent fever, a blow on the head, &.c. The same experienced writer operated successfully upon both eyes of a patient with cataracts, frrwm8;♦£een.-previous,y ^Pressed too far against the retina, so ,hat their pressure this manner does follow, it is frequently gave rise to amaurosis whi, quite accidental. Suing eight years was s„]JhJ i ' ' C°,n. As will be seen in the account of each the patie'nt'^ccYdeSy^fS?.™?.0^^ particular species of amaurosis, the affected and pitching upon the ton of h* • i a eye is sometimes so conditioned, that the (Lehre von den Augenkr. 6.2 » 458 x complete incurability, sooner or later, may The following observations made 1 be prognosticated with entire certainty, and fervor Beer, resnectinsr the nro?no=isy Pr°