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.

    42/1282 (page 30)
    of relieving some obvious marks of bilious dis- order in the stomach. ~ Scarpa’s treatment of the imperfect amaurosis brought on by fevers, deep sorrow, great loss: of blood, intense study, and forced exertions of the eyes on very minute or brilliant objects, con- sists also in removing all irritation from the stomach, and afterwards strengthening the ner- vous system in general, and the nerves of the eye in particular. In the case originating from fevers, the emetic and opening pills are to be given; then bark, steel medicines, and bitters ; while the vapour of the liquor ammoniz is to be applied to the eye itself. When the disorder has been brought on by grief, or fright, the stomach and intestines are to be emptied by means of antimonium tartarizatum, and the opening pills ; and the cure is to be completed by giving bark and valerian; applying the vapour of liquor ammoniz to the eyes; ordering nourishing, easily digestible food; di- verting the patient’s mind, and fixing it on agreeable objects, and recommending moderate exercise. The amaurosis from fright is said to require a longer perseverance in such treatment, than the case from sorrow. (Scarpa’s Osservaz. Cap. 19.) In this country, the emetic practice, which has proved so decidedly efficacious on the con- tinent, has not been attended with much success : Mr. Travers even states, that he does not re- collect an instance of decided: benefit from it, though he has often tried it fairly. He agrees, however, in the indication, as he remarks, that the removal of an irritating, or oppressing cause, will often effect a sudden and marked relief, as by clearing the intestinal canal of vitiated secretions, restoring the digestive functions, or taking away blood where the necessity is indicated. In gastric cases, for which emetics have been particularly recommended, he prefers a long continued course of the blue pill, with gentle saline purgatives, and tonic bitters. (Synopsis, p. 299—304.) The third species of gutta serena, oy that which arises from debilitating causes, is of two kinds; in one, the disease is the consequence of a general ‘weakness of the body; in the other, it is the ‘effect of debility, which is- confmed to the eye itself, and does not extend to the whole con- stitution. i According to Scarpa, the incomplete amau- rosis from general nervous debility, copious he- morrhage, convulsions ab inanitione, and long continued intense study, especially by candle- light, is less a case of real amaurosis, than a weakness of sight from a fatigued state of the nerves, especially of those constituting the im- mediate organ of sight. “When this complaint is recent, in a young subject, it may be cured, or diminished by emptying the alimentary canal with smal) repeated doses of: rhubarb, and then giving tonic cordial remedies. At the same time, the patient must abstain from every thing that has a tendency to weaken‘ the nervous sy- stem, and, consequently,’ the eye-sight. After emptying the stomach and bowels, it is proper to prescribe the decoction of bark with valerian, or the infusion of quassia with the addition of a few drops of sulphuric aether-to each dose, with nourishing, easily digestible food.- “ he aromatic Ophthalmy) may then be topically applied; or if these prove: ineffectual, the vapour of liquor. ammoniz. The patient must take exercise on foot, horseback, or in a carriage, in a wholesome, dry air, in warm weather, and avail himself of sea-bathing. He must avoid all thoughts of care, and refrain from fixing his eyes on minute shining objects. The impression of vivid light on the retina is always to be moderated by means~ of flat green glasses. (Saggio di Osservaz. Cap. 19.) ; One case of temporary palsy of the retina from over-excitement, mentioned by Mr. Travers, yielded to blistering the forehead, and a gentle salivation excited by calomel joined with opium. (Synopsis, p. 164.) Another case, brought on by the use of telescopes and sextants, gave way to a copious bleeding, brisk purging with jalap and calomel,’blisters to the temples, and a course of mercury. (Op. czé. p. 166.) ; Mr. Travers. remarks, that the amaurosis from depletion is sometimes mistaken for the opposite case, viz. that from plethoric congestion : — this is owing to the coincidence of a dilated and immoveable pupil, musez, and a deep seated pain in the head, with occasional vertigo; and its frequent occurrence in a corpulent habit. By a cautious use of tonics, (says Mr. Travers) it is relieved; by whatever lowers, or stimulates, whether diet or medicine, it is decidedly agera- vated. In this form of amaurosis, vision is further enfeebled by the loss of as much blood as flows from two or three leech-bites. (Synopsis, &c. p. 160.) When the weakness is confined to the eye; Richter thinks corroborant applications alone necessary. Bathing the eye with cold water, says he, is one of the most powerful means of strengthening the eye. The patient should dip in cold water a compress, doubled into eight folds, and sufficiently large to cover the whole face and forehead, and this he should keep applied, as long as it continues cold. Orr, else, he should frequently apply cold water to his eyes and face with his hand, on a piece of rag. i The+eye muy: also be strengthened by re- peatedly applying blisters of a semi-lunar shape above the eye-brows, just long enough to excite redness. Richter likewise speaks favourably of. rubbing the upper eye-lid, several times a day, with a mixture of the tinctura lyttse and spiritus serpilli. (Anfungsgr.der Wundarz. B.S, p.452.) When no probable cause whatsoever can be assigned for the disease, the surgeon is justified in employing such remedies, as have been proved by experience to be sometimes capable of reliev- ing the affection, although upon what principle is utterly unknown. (See Gutta Serena.) ‘To this article, I would refer the reader, before he makes up his mind about any empirical method of treatment, because he will there find many cautions and instructions, given by Beer, respect? ing the remedies for amaurosis in general. To his remarks, I have also annexed such others on the same topic, as appeared to me interesting. ” -.In the following view of amaurosis, chiefly’ taken from the valuable writings of Beer, the reader will find a more complete history of ‘the! different forms of the disease, and their varieties, than has previously been drawn up in our lame guage, The only points, on which Beer perhaps