Volume 1

A dictionary of practical surgery / [Samuel Cooper].

  • Samuel Cooper
Date:
1825
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical surgery / [Samuel Cooper]. Source: Wellcome Collection.

    30/1282 (page 18)
    | are nothing more than cases of periodical amau- rosis. But, sometimes, the frequently recurring form of the disease confines itself to no deter- minate type; and, on account of its irregularity, itis then termed by Beer, Amauwrosis Vaga, which, he says, is often of spasmodic origin, and therefore principally met with in persons liable to hysteria, hypochondriasis, convulsions, or epilepsy. Pe- riodical amaurosis, after remaining uncured a certain time, often becomes permanent. (Beer, Lehre, &c. B.2, p. 429.) In amaurosis in general, but particularly when no material knowledge can be acquired of causes, and the treatment must of necessity be conducted on empirical principles, it is of the highest im- portance to recollect what Richter has pointed out, namely, that amaurosis sometimes com- mences with several symptoms, betraying an in- crease of sensibility in the eye, or some irritation affecting this organ. In moderately light places, the patient can discern things very well; but, in a great light, he is not able to see at all. The eye is sometimes so sensible, that a strong light will make it weep and become painful. Patients of this description ought always to wear a shade, however bad their sight may be. Sometimes amaurosis originates with symptoms of weakness and diminished irritability. ‘The sight is cloudy, and the patient finds that he can see better in a light, than a dark situation. He feels as if some dirt, or dust, were upon his eyes, and is in the habit of frequently wiping them. . His power of vision is greater after meals than at the time of fasting. His’ sight is always plainer for a short time, after the external use of tonic remedies, such as hartshorn, cold water, &e. Richter in- forms us of a person, who was nearly quiteblind, but was constantly able to see very well, for the space of an hour, after drinking champagne wine. He also mentions a woman entirely bereft of sight, who was in the habit of having it restored again, for half an hour, whenever she walked a quick pace up and down her garden. — He likewise ac- quaints us with the case of a lady, who had been blind for years ; but, experienced a short recovery of her sight, on having a tooth extracted, (Ai- Singsgr. &c. B. 3, Kap. 14.) * Whether the benefit arose from the stimulus of the operation, as Richter seems to imply, or from the removal of .an irritating cause, doubts may rationally be entertained, A similar fact is re- corded by Mr. Travers, who says, that he has seen an incipient functional amaurosis distinctly arrested by the extraction of a diseased tooth, when the delay of a similar operation had oecca- sioned gutta serena on the opposite side, two years before.’ (Synopsis, p. 299.} ' When the disorder is accompanied with dimi- nished sensibility in the eye in general, Beer joins Richter, with respect, to the temporary improve- ment of the sight after a nourishing meal, or drinking spirituous liquors; or when the patient’s melioration of sight, it is true, is but of very short duration. (See also Vetch’s Treatise on the Diseases of the Eye, p. 137.) ° On the other hand, it may be remarked, that every thing, which tends to depress the passions and spirits, augments the imperfection of sight. Where marks of increased sensibility prevail, the abovementioned circumstances exercisea transient disadvantageous operation; the patient carefully retires from every strong light, and frequently shelters his eye with his hand, &c. (Lehre von den Augenkr. B. 2, p. 430.) Mr. Travers also knows patients, whose vision is benefited, in a high degree, and others, in whom it is much deteriorated, by the quickened circula- tion of a full meal, and a few glasses of wine. The former, he says, are persons of spare and meagre habits; the latter, plethoric. (Synopsis of the Diseases of the Eye, p. 157.) . Amaurosis either presents itself as a genuine uncomplicated affection, or, at least, with the ap- pearance of such a form of disease of the eye, depending solely upon a morbid state of the optic nerve, and cognizable by a diminution, or com- plete abolition, of the power of vision; or the disease is co-existent with other diseased appear- ances either in the eye, its vicinity, or some other organs at a distance from the eye, or in the general constitution. . These appearances merit the most earnest consideration, because they are fur the most part connected with the cause of amaurosis. According to this statement, then, there is a genuine local amaurosis, and a compli- cated amaurosis, which last may be either local, or general, or of both descriptions together, and therefore named by Beer, perfectly complicated. (Vol. cit. p. 431.) Mr. Travers divides amaurotic affections inte: two classes, the organic and the functional. The first comprehends alterations, however induced, in the texture, or position of the retina, optic nerve, or thalamus. ‘The second includes sus- pension, or loss of function of the retina and optic organ, depending upon a change, either in the action of the vessels, or in the tone of the sentient apparatus. As causes of organic amaurosis, Mr. Travers enumerates: 1. Lesion, extravasation of blood, inflammatory deposition upon either of its sur- faces, and loss of transparency of the retina, 2. Morbid growths within theeyeball, dropsy,atrophy, and all such disorganizations as directly oppress or derange the texture of the retina. 3. Apoplexy, hydrocephalus, tumors or abscesses in the brain, or in or upon the optic nerve or its sheath, and thick- ening, extenuation, absorption, or ossification of the latter. As causes of functional amaurosis, Mr. Travers specifies: 1. ‘Temporary determination ; vascular congestion, or vacuity, as from visceral or cerebral irritation ; suppressed, or deranged, or excessive secretions, as of the liver, kidneys, uterus, mammee, and testes; various forms of injury and disease ; and hidden translations of remote morbid actions. 2. Paralysis idiopathica, suspension, or exhaustion of sensorial power from various constitutional and local causes ; from undue excitement or exertion of the visual faculty ; and from the deleterious action of poi- sons on the nervous system, as lead, mercury, &c. From this description, says Mr. Travers, it © will be understood, that organic, and many forms of functional amaurosis are incurable; and the functional, by continuance, lapses into the or- ganic disease. - . Functional amaurosis is subdivided by Mr. Travers, into Ist, the. Symptomatic, or that: _ which is only a symptom of some general disease, _ or disorder of the system ; as for example. generat) plethorayveneral debility; 2dly, the Metastatic,