Volume 1
Cooper's dictionary of practical surgery and encyclopaedia of surgical science.
- Samuel Cooper
- Date:
- 1861-1872
Licence: Public Domain Mark
Credit: Cooper's dictionary of practical surgery and encyclopaedia of surgical science. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
35/1104 (page 23)
![ratively innoxious. Burnt alum is a principal ingredient in many styptic powders. ALVINE CONCRETIONS. See Intestinal Concretions. AiMAUROSIS (from a/xavpSu, to darlcen) Gulki Serena. Sii^usio n!yra. Genu. Schvarxer Stuur. That diminution or total loss of sight which immediately depends upon the morbid state of tho retinaand optic nerve, whether this morbid state exist as the only defect, or be complicated with other mischief ; whether it be a primary affection, or tt secondary one, induced by previous disease of other parts of the eye. (Beer.) All those imperfec- tions of vision which depend upon a morbid condi- tion, iv/tet/ier (tffecli)ig stnioiure or function, of the sentient apparatus proper to the organ. (Travcri's Synopsis of the Dis. of the Eye, p. 293.) Obscurity of vision depending on a morbid con- dition of one or several portions of the optic nerve, its root, its course, or its termination. It is an eilect therefore depending upon causes entirely dili'ercnt from those which prevent the rays of light from entering the eye or passing through it to the retina. {Mackenzie on Dis. of the Eye, ■p. 1015, ed. 4.) Any great imperfection or loss of vision existing independently of any change in the natural transparency of the parts anterior to the retina, or of any manifest varicose enlargement of the vessels of the choroid, or of any material alteration in the con- iiguration of the eye-ball. (i?. Middlemore on Dis. of the Eye, vol. ii. p. 242.) The imperfection or loss of sight, which results from affection of the nervous apparatus belonging to the eye, whether that affection be seated in the retina, the optic nerve, or the sensoruium; whether it be idiopathic or primary, sympathetic or second- ary : whether it consist in vascular congestion, or organic change, or simply in functional disturb- ance. {Lawrence on Dis. of the Eye, ed. 3, p. 506). By the expression gutta sercva, is usually sig- nified the complete or fully developed form of amau- rosis, that in which the patient has little or no power of distinguishing light from darkness. The term took its origin in the notion which formerly prevailed that the blindness was caused by the elFusion of a humour or fluid at or behind the pupil, and as the latter opening retained its natu- ral blackness in amaurosis the effused drop was said to be clear. Amaurosis then does not uniformly take place as a single independent disorder ; but not unfre- quently presents itself as a symptomatic effect of some other disease of the eye : a fact exemplified in hydroplilhalmia, cirsophthalmia, glaucoma, &c. And as Mr. Wardrop observes, amaurosis, in its usual acceptation, signifies a symptom of disease, as well as a distiact afiection. {Essays on the Alorhid Anaitmy of the Human Eye, yo]. ii. p. 165, 8vo. Lond. 11(18.) With respect to the mere name of tho kind of disease here implied by amaurosis its correctness will remain the same, whether the iris bo movcablo or immoveable ; wlicthcr tho pupil be prcternaturally enlarged, or contracted, and whether it be perfectly clear and transparent, or more or less turbid ; for the name only refers to the morbid state of the retina and optic nerve, and not to the condition of the sight in general. When the long established name oi amaurosis is received with this precise meaning, there will be not the slightest danger of confounding tho disease with other afFcctious of the eye. However, when it is wished to make out the different forms and kinds of amaurosis, the appearances of the iris and pupil are considerations of great importance. (See i^eer's Lehre von den Augenlcrankhciten, b. ii. p. 420, &c. Wien, 1817.) Amaurosis does not constantly attack both eyes at the same time ; frequently one is attacked some time after the other, and it is not unusual even for one eye to remain sound during life, while the other is completely blind. This depends, in part upon the disposition to the disease in one eye being quite local, and in part upon the causes giving rise to the complaint extending their operation only to the eye affected. Where, also, the origin of amaurosis seems to depend altogether upon constitutional causes, one eye is not unfrequently attacked much, sooner than the other ; though in these examples it is more rare to find the eye which does not suffer at first continue perfectly unaffected, {Beer, b. ii. p. 422.) Mr. Middlemore represents amaurosis as com- monly attacking one eye first, and not commencing in the other until vision in the one first attacked is either much impaired or totally destroyed. It is (says he) by no means an usual occurrence for amaurosis to take place in each eye at the same time, and to advance in both with an equal pro- gress. Still, he admits, that this matter will be mainly determined by the nature of the cause producing the amaurotic affection. {On Dis. of the Eye, vol. ii. p. 251.) Indeed, since amaurosis may arise from affections of the sensorium, optic nerve, or retina, we can understand how it happens that it sometimes appears in both eyes at once ; that it may be confined to one, or that, having taken place in one it may in the other also, after a longer or shorter interval. {Lawrence, op. cit. p. 507.) Amaurosis may not completely hinder vision, a diminished power of seeing often remaining during life. Hence the division of cases into perfect and imperfect; which latter, however, sometimes attain a degree in which the patient is only just able to distinguish light, the direction of its rays, and its degree. Amaiurosis may take place in an instant, even so as to be attended with entire blindness ; or it may come on quickly, that is, it may be complete in a few days or weeks ; or, lastly, what is most fre- quently the case, it may be produced gradually, and several years elapse before it attains its utmost degree ; circumstances of great moment in the diagnosis and treatment. The type, which the disease assumes in its course and development, is also subject to great variety, and claims the utmost attention ; for amau- rosis may cither be permanent or temporary. It is sometimes intermittent, making its appearance at regular or irregular intervals. In certain exam- ples, it prevails at particular times, commonly all day, till a certain Imur ; or from one day till the next; or at a stated time every month. Sometimes it is plainly a symptom of a confirmed ague, the patient being attacked with an ordinary nitcrmittent, and blind during each paroxysm, but always regaining his sight as soon as each lit is over. Sometimes the frequently recurring form of tho disease confines itself to no determinate type ; and, on account of its irregularity, it is then termed by Beer, Amaurosis Vaya, which, he says, is princi- pally m ct with in persons liable to hysteria, hypo-](https://iiif.wellcomecollection.org/image/b21461806_0001_0035.jp2/full/800%2C/0/default.jpg)
