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.

    34/1282 (page 22)
    than old persons thus attacked. Amaurosis spares no age—not even the newborn infant. — ) Four forms of congenital organic amaurosis are noticed by Mr. Travers. One, in which the eye is preternaturally small, soft, and even flaccid ; the iris tremulous, and not influenced by bella- donna; and the globe affected with tremor, and not subject to the control of the will. A second, depending on a deficiency of the pigmentum nigrum; the organ is tremulous, strong light produces uneasiness, and vision is dazzled and confused. ‘The vessels of the choroid give the interior of the eye a deep red tinge. ‘A third case is that, in which the s¢lerotica so encroaches upon the cornea, that the latter is scarcely wider than the pupil. - In the fourth kind of congenital amaurosis, described by Mr. Travers, the eyes move in concert, as if attracted by a faint percep- tion of light; but, the infant is blind: no marks of organic derangement can be seen; but, Mr. Travers apprehends, that the disease must be connected with a morbid state of the thalami, or optic nerve. (Synopsis, p. 153-154.) Neither does sex nor race appear to have any influence over the origin of the complaint ; but, it would seem, that dark eyes, especially those which are called black, are more disposed to amaurotic blindness, then such as are light -co- loured. According to Beer’s experience, for every gray or blue eye affected with amaurosis, there are five-and-twenty or thirty brown or black ones, thus diseased. In the peculiar constitution of the eye, then, as well as in a sanguineous and the disorder, More frequently, than cataract, amaurosis is found to be a true hereditary disease :—this is so much the case, that most of the members of a family, for more than one generation, may lose their sight from amaurosis at a certain period of life. Beer says, that he is acquainted with more than one family, in which this has happened, and, what merits attention, the women of one of these families, down to the third generation, became completely and permanently blind from amaurosis on the cessation of the ‘menses, while all the others, who had had children, were unaffected. But, the males of this unfortunate family, who, as well as the females, have very dark brown eyes, all seem to be weak-sighted, though none of them are yet blind. (Lehre von den Augen= In women, especially those with black eyes, the time when the menses stop is a dangerous period for the commencement of amaurosis. . According to the same writer, patients, whose pies used to bleed periodically for a long time, but are now suddenly stopped, and whose eyes are dark, are very liable to amaurosis. One of the less common causes of amaurosis is an idiosynerasy, in relation to this or that sort of nutriment or medicine, or this or that particular state of the body. Here is to be reckoned the amaurotic weakness of sight, or the perfect amau- rosis, which comes on at the very commencement of pregnancy, and subsides after delivery, but al. ways attended with dyspepsia and insuperable vo- miting. ‘This species of amaurosis, however, should be carefully distinguished from that which some- times first originates in the final months of preg- nancy, and chiefly from strong and long conti- nued determination of blood to the head and eyes, particularly when the bowels are at the same time loaded, and the patient constipated. This latter case usually continues till after delivery ; or, if the labour be tedious, difficult, and attended with considerable efforts, the blindness may first attain its complete form at the time of delivery, and not afterwards subside. Beer saw a young Jewess, who, at the very beginning of her first three pregnancies, which followed each other quickly, regularly used: to lose her sight, becoming completely amaurotic between the third and fourth months, and, on the two first occasions, she continued blind till after delivery ; but, in the third instance, the power of vision never returned at all. Beer twice had under his care another woman, who was attacked with amaurosis whenever she drank chocolate ; but, upon leaving off that drink, she never after- wards had any complaint in her eyes. If we are to believe the generality of writers on this subject, the abuse of bitter substances, as of chicory in coffee, bitter malt liquors, and bitter | medicines, especially quassia, is unquestionably a predisposing cause of amaurosis. The abuse of narcotic poisonous substances may induce amaurosis; immoderate doses of opium ; hyoscyamus; belladonna, &c. Lead will do the same thing. Beer mentions a:case, in. which the only assignable cause was the ex- hibition of pilis, containing the extractum cy- noglossi. One not unfrequent, and very important, cause of amaurosis is hysteria and hypochondriasis, with which must be mentioned infarction gene- rally, and induration of one or more of the abdo- minal viscera, especially the liver. (Beer, Lehre, &c. B.2, p. 444-46.) ass According to Richter, the remote causes of amaurosis may be properly divided into three principal classes, the differences of which indicate three general methods of treatment. The first class of causes depends upon an ex- traordinary plethora and turgidity of the blood- vessels of the brain, or of those of the optic nerves and retina, upon which last parts a degree of pressure is thereby supposed to be occasioned. A considerable piethora, especially when the patient heats himself, or Jets his head hang down, will frequently excite the appearance of blaek specks before the eyes, and sometimes complete blindness. A plethoric person (says Richter), who held his breath, and looked at a white wall, was conscious of discerning a kind of network, which alternately appeared and disappeared with the diastole and systole of the arteries. Richter thinks it likely, that the disease is thus produced, when it proceeds from- the suppression of some habitual discharge of blood, not being bled according to custom, the stoppage of the menses, and the cessation of hemorrhage from piles. In the same manner, the complaint may be brought on by great bodily exertions, which must determine a more rapid current of blood to the head. Richter informs us of aman, who be- came blind all on a sudden, while carrying a heavy burden up stairs. He tells us of another man, who laboured excessively hard for three days in succession, and became blind at the end of the third day. Pregnant women, in ‘like manner, are sometimes bereft of their sight