Annual report of the Medical College of Bengal : fourteenth year, session 1848-49 / under the immediate control and superintendence of the Council of Education.

Medical College of Bengal

Date:: 1849

Credit: Annual report of the Medical College of Bengal : fourteenth year, session 1848-49 / under the immediate control and superintendence of the Council of Education. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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$In the next place I proceed to give the plan of treatment, which must be of the most determined and forced descrijition for I repeat again that the destructive nature of the disease being such as to have run through its course to the complete destruction of the eye in so short a time as 21 hours—If you meet with the case in the beginning say in its 1st or even 2nd stage ere any destruction of the eye has taken place, your object will be to repress arterial action which can be done by local bleeding only, and this very cautiously practised from the dangers which are prominent from the abstraction of blood in a young infant— The rule in such cases are to apply one leech to the lower lid, but if the child be a plethoric and healthy one you may emjjloy ij—and this is to be regulated according to the age increasing one for every year,— The nest thing you would do is to administer purgatives, this you must also recollect are to be of a mild nature—Castor oil in doses of a §j. are very useful, or Rhubarb and Magnesia or any such purgatives—after having sub- dued their action you administer mercurials which is the next good indica- tion to prevent the formation of lymph, its effusion, and the aljsorption of that which is already effused, or you may give gr. j of Calomel with i gr. of opium watching it's effects, until some change is effected in the eye or the system affected, and you would then leave off the administra- tion of Calomel and give a milder mercurial to keep up the action as the Hydrarg Cum Creta doses of from ij. to v. gr. apply counter irritation behind the ears as the Liguir lytta. Keep the child from all irritation or stimulus of light—Keeping the eyes well washed and clear which should neVer be neglected as the secretions are able to render the eye worse, for such pur- pose fomentations are very applicable; some recommend cold water, but I have been taught to use warm from its more soothing and laxing eflfects—Again in some cases to obviate the effects of the Chemosis which which would cause pressure on the cornea and its destruction, you are re- commended to scarify the part and let out all the effused scum—When all these objeets are fulfilled and the disease advanced to its 3rd stage, -you are recommended to adopt the stimulating plan by means of the astri- gent and stimulating drops as recommended in the other form of Opthal- mia—I mean the dropping in of nitrate of silver, or sulphate of zinc &c. but suppose the disease has progressed on to the destruction of the eye all remedies are of no avail and little or nothing can be done for the eye, save poultising and the other soothing applications to prove the healing up of the cicatrix whicli is left from the collapsed eye. The 2nd variety of this disease is the Purulent Opthalmia of adults or the Effyplian—Th'is is characterised by the severe inflammation attendant on it and tlie rapid destruction of the eye in a very short space of time— The attack like the one just described, originates in the ])alpebral portion of the conjunctiva, runs on to involve the whole eye, leading to extensive Chemosis, implication of the cornea and the destruction of the eye, the secretion which I think is the most characteristic of the disease, its jiurulent nature, with tlie rapid course it rims and the excessive effusion and bulging of the conjunctiva. Another very characteristic feeling of this affection, is the bursting feel the patient experiences, and the flowing of scalding tears down his cheeks whicl\ he complains of at the beginning, with the great intolerance of light. Some authors describe the Egyptian as a distinct disease, insomuch as they say it is of a mere virulent and an active a nature. Such in short being the characteristic nature of this affection the treatment of it will be purely antiphlogistic at first—If the patient be a$