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.

    36/1282 (page 24)
    24 sive prospect must be hurtful to an irritable eye, though the bad effects may only be very slow. Here is also to be included every kind of over irritation of the eye by light, as happens to typhoid patients, when they lie with their eyes open all the day in a large sunny chamber. Very often the cause of amaurosis consists in local or constitutional debility, proceeding from impairment of the nerves in general, or of the nerves of the head, especially those of the forehead and eyebrow; either from a concussion of the spinal marrow, falls from a considerable height with the weight of the whole body upon the heels; concussions of the eye-ball, sometimes caused by violent sneezing, but more generally by contusions of the eye with blunt weapons, &c. Some cf the cases of amaurosis from blows on the temple, or the eye, observed by Mr. Travers, were attended with signs of disorganization; some were super- ficially inflamed ; and others presented no external appearance of injury. We learn also from the same_authority, that it is not always the eye on the struck-side of the head that is affected. (Sy- nopsis, &c. p. 152.) If we are to believe Beer, and other foreign practitioners, considerable direct weakness may arise from cholera, long continued diarrheea, salivation, and the incessant spitting of tobacco-smokers; bleedings; injudicious tapping of the abdomen ; excessive indulgence in venery, and the misemployment of issues. A general debility, which has the worst effect on the eyes, may also arise from long trouble, especially when the diet is poor and bad; also from a deficiency of proper food ; long watching; violent and sudden fright; imprudently washing the eyes with very cold water, especially when they are already weakish and irritable ; and keeping them long in a dark place, particularly, when they are also exerted a good dealin some particular kinds of labour, a case which, Beer says, is very frequent in Vienna. The amaurosis, following typhus, without any unusual irritation of the eye by light, Beer also refers to general debility. (Lehre von den Augenkr. B. 2. p. 449.) Like nervous deafness (says Mr. ‘Pravers) amaurosis sometimes follows typhus and scarlet fever, and the various forms of acute constitutional disease. He has several times met with it as a consequence of infantile fevers. He observes, that it is also sometimes a consequence of chronic wasting diseases, in which organic changes inter- rupt the nutrition of the system. He has seen a rapid and severe salivation, instituted for a remote affection, and where no disease had previously affected the eyes, terminate in gutta serena of both. (Synopsis, p. 155.) The third class of causes consists of irritations, most of which are asserted to lie in the abdominal viscera, whence they sympathetically operate upon the eyes. The observations of Richter, Scarpa, and Schmucker, all tend to support this doctrine. Many amaurotic patients are found to have suf- fered much trouble, and long grief, or been agitated by repeated vexations, anger, and other passions, which have great effect in disordering the bilious secretion, and the digestive functions in general. Richter tells us of a man, who lost his sight, a few hours after being in a violent passion, and recovered it again the next day, upon taking an emetic, by which a considerable quantity of bile was evacuated. A woman is also cited, who became blind, whenever she was troubled with what are termed acidities in the stomach, (See Anfangs. der Wundarzn. B. 3. Kup. 14.) However, according to Beer, imper- fect amaurosis seldom depends upon disorder of the gastric organs, excepting the case from worms: (Lehre von den Augenkr. B. 2. p. 4563) a very important difference from the sentiments enter- tained by Schmucker, Richter, and Scarpa. Amaurosis sometimes proceeds from mechanical . irritation. A small shot pierced the upper eye- lid, and lodged at the upper part of the right orbit between the eye-lid and eye-ball, so that it could be felt externally. The patient shortly afterwards became blind in the left eye; but. re- covered his sight after the excision of the shot. (Anfangsgr. der Wundarzn. Band 3, p. 439.) According to Beer, several constitutional dis- orders, but more especially gout, are frequently concerned in the production of amaurosis. Respecting the causes of amaurosis, the fol- lowing remarks by Beer claim attention. Various swellings in the orbit, as, for instance, encysted tumours, tophi, hydatids in the sheath of the optic nerve, may, and must gradually produce complete amaurosis by their pressure upon the optic nerves and yetina. These cases are usually characterized by a protrusion of the eye from its socket, (See Exophthalmia.) In the same manner, different morbid changes in the brain itself, and in the bones of the cranium in particular, may be the direct cause of amauro- sis: for example, hydrocephalus internus, caries, and exostoses at the basis of the skull. Just as amaurosis is frequently a pure sym- ptomatic effect of various disordered states of the constitution, so may different morbid changes, occasioned in the eye by those states of the health, become the proximate cause of amaurosis, as hydrophthalmia, cirsophthalmia, fungus he matodes, dissolution of the vitreous humour, glaucoma, &e. From a contagious atmosphere, which is gene- rally injurious to the eyes, an amaurotic blindness may originate, though but very rarely, and, as it would seem, only through the powerful influence of such state of the air over the whole sanguiferous and nervous system. Debilitated, nervous, weak- | sighted persons, by remaining long in the atmo- sphere of a privy (Chomel, Mém. de Paris, 1711, Obs. Anat. 5. and Ramazzini, De Morbis Ar- tificum, c. 13.), that of a deep cellar, or exposed to coal-smoke, may be suddenly attacked with amaurosis; and Beer assures us, that his expe- rience confirms the truth of these reports. (Lehre, &c.b. 2,p.452.) A sympathetic affection of the nerves of the eye, with a carious grinder in the upper jawbone, is one of the most uncommon causes of amaurotic blindness. A case, not yet duly considered, and very like the amblyopia senilis, consists of an incessantly diminishing secretion of the pigmentum nigrum upon the tunica Ruyschiana, choroidea, and uvea, which secretion indeed, in some individuals, earlier and more considerably ; in others, later and in a slighter degree, recedes with other secretions of a different nature. (See Deer's Lehre von den Augenkr. B. 2. p. 451, &c.) As Mr. Travers has correctly explained, the hi- story and concomitant appearances of amaurosis, usually denote whether the case is organic, or funce