A dictionary of practical surgery : comprehending all the most interesting improvements ... an account of the instruments ... the etymology and signification of the principal terms ... / by Samuel Cooper ; with numerous notes and additions ... together with a supplementary index ... by David Meredith Reese.
- Samuel Cooper
- Date:
- 1844
Licence: Public Domain Mark
Credit: A dictionary of practical surgery : comprehending all the most interesting improvements ... an account of the instruments ... the etymology and signification of the principal terms ... / by Samuel Cooper ; with numerous notes and additions ... together with a supplementary index ... by David Meredith Reese. Source: Wellcome Collection.
Provider: This material has been provided by the Woodruff Health Sciences Center Library at Emory University, through the Medical Heritage Library. The original may be consulted at the Woodruff Health Sciences Center Library, Emory University.
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![any assistance from art, in consequence of the acces- sion of some other disease, as aa eruption, a discharge of matter from the ear, bleeding from piles, the men- ses, &c. Also, in most cases, when the surgeon is so for- tunate as to cure amaurosis, either by scientific or empirical methods, there still continues for life a con- siderable degree of amblyopia, more especially if the amaurosis has been complete. Sometimes, by successful treatment, vision is in a great measure, or even entirely restored in one eye, yet the other remains completely blind; or one eye sees again much sooner than iis fellow, although they were both affected together with an equal degree of blindness.^ It x>flen happens, that though a material degree 01 vision returns in the course of the treatment, the faculty is restricted to a circumscribed point of the retina, so that the patient is enabled to see objects plainly only when they are held in a particular direction before him; while in other directions, they are either quite invisible, or very indistinct—,Beer, Lehre von den Augenkr. b. 2, p. 459, 460.) ».\ .. *<•••.'■; Amaurosis following an injury of the supra-orbitary nerve, frequent ly resists every endeavour made to relieve it, and this, whether it come on directly after the blow or some weeks subsequently to the healing of the wound of the eyebrow ; but it is not always absolutely incurable. Scarpa only knows of one such cure, viz. the example recorded by Valsalva.— Dissert. 2, $ 11.> But additional instances are reported by Hey (Med. Obs. and Inq. vol. 5), by Larrey Mem. de Chir. Mili- taire, t. 4, p. 181), and Dr. Hennen Principles of Mili- tary Surgery-, ]>• 346, ed. 2). According to Mr. War- drop, it is only when this nerve is wounded or injured, and not divided, that amaurosis takes place; for the blindness may sometimes be cured by making a com- plete division of the trunk nearest its origin.—(Essays on the Morbid Anatomy of the Human Eye, vol. 2, p. ISO.) Perfect inveterate amaurosis, attended with organic injury of the substance constituting the immediate organ of sight, says Scarpa, is a disease absolutely incurable. Imperfect recent amaurosis, particularly that which is periodical, is usually curable; for it is mostly dependent upon causes which, though they affect the immediate organ of sight, are capable of being dispersed, without leaving any vestige of impaired or- ganization in the optic nerve or retina. When amaurosis has prevailed several years, in per- sons of advanced age, whose eyesight has been weak from their youth ; when it has come on slowly, at first with a morbid irritability of the retina, and then with a gradual diminution of sense in this part, till total blindness was the consequence; when the pupil is motionless, not circular, and not much dilated; when it is widened in such a degree that the iris seoms as if it were wanting, and the margin of this opening is irregular and jagged; and when the bottom of the eye, independently of any opacity of the crystalline lens, presents an unusual paleness like that of horn, some- times partaking of green, and reflected from the thick- ened retina, the disease may be generally set down as incurable. Kieser joins Scarpa in representing this alteration as an unfavourable omen, adding, that it only takes place in examples of long standing, and that when it is considerable, the disease is incurable. Lan- genbeck differs, however, from both these au thors, and particularly from Kieser; assuring us, not only that he has often seen this discoloration of the bottom of the eye in the early Stage of amaurosis, but seen patients in this state soon cured. The cases which he has published in proof of this statement, I have read with care and find them completely satisfactory. Langen- b*ck agrees with other writers in imputing the appear- ance to a morbid change of the retina; and the treat- ment which he prescribes consists in the internal exhibition of the oxvmuriate of mercury in small doses, and friction with mercurial ointment on the eye- brow and temple.-See Langenbeck's Neue Bibl. for de Cthruroie, b. 1, p. 64—69, &c. Gottmgen, 1H15.) ■ Cases, lays Scarpa, attended with pain all over the head, and a continual sensation of tightness m the eye- ball; or preceded by a violent, protracted excitement of the nervous system, and then by general debility, and languor of the constitution, as after masturbat.on nremature venery, and hard drinking;or connected PrP. _ anasmodic hemicrama; or which are the consequence of violent, long-co nued, internal ophthalmia, may be set down as ncurable^ Nor can any cure be expected when ainau.osis pro- ceeds from a direct blow on the eye; fmeign bodies, in the eyeball; lues venerea,or exostoses about BwsorD«, or when it is conjoined with a.ruanilest caange m me figure and dimensions of the eyeball. . Becent, sudden cases, in %\ Inch the pupil is not exces- sively dilated, and its circle remains regular, vUm* me bottom of the eye is of a deep black .colour; cases un- accompanied with any acute, continual pain m thelieau and eyebrow, or any sense of constriction in the globe of the eye itself; cases which originate from violent an^er, deep sorrow, fright, gastric disorder, general plethora, or the same partial affection of tlie head, sup- pression of the menses, habitual bleedings Horn the nose, piles, &.c, great loss of blood, nervous debility, not too inveterate, and in young subjects, are all, ge- nerally speaking, curable. Amaurosis is also mostly remediable, when produced by convulsions or the efforts of difficult parturition ; when it arises during the course, or towards the termination of acute or intermittent fevers; and when it is periodical.—(Scar- pa, Osservazioni sulle MaUatie degli Occhi, cap. 20, Venez. 1 02.) According to Mr. Travers, it is rather the degree than the nature and origin of the symptomatic lunc- tional amaurosis, that should in most cases influence- our prognosis; yet the latter circumstances, it is equally clear, afford more or less encouragement, in proportion as the pre-existing states of disease ordinarily admit of relief or not. Thus, says he, the amaurosis from gas- tric d£-cases, from plethora, from irritation, are all of tliciii rclievable, and if treated at an early period, reme- diable. Whereas paralysis, the sequel of fever, or of epilepsy, or severe constitutional diseases, whether acute or chronic, or depending upon habitual cerebral congestions combined with organic visceral disease, or induced by the operation of noxious agents on the system, is a hopeless form of the malady.— Synopsis, p. 296 ) I ma/ remark, however, that various examples of recovery from amaurosis induced by fevers have fallen under my own notice. In general, when the treatment proves successful, the return of the power of vision is accompanied with a regression of the same cliaracteristic effects, which- were disclosed in the gradual advance of the disorder, viz. appearances as if there were before the eyes flashes- of light, a cobweb, net-work, mist, or flaky substances. — Beer, Lehre von den Augenkr. b. 2, p. 460. Wien, 1817.) Upon the commencement of the cure, there is also a return of the obliquity of sight; one of the most con stant symptoms of imperfect amaurosis. This is a circumstance which Hey took particular notice of; he says, that it was most remarkable in those persons who had totally lost the sight in either eye; for in them the most oblique rays of light seemed to make the first perceptible impression upon the retina; and, in pro- portion as that nervous coat regained its sensi ility, the sight became more direct and natural.—(See Med. Obs and Inq. vol. 5.) TREATMENT OF AMAUROSIS. When amaurosis is to be fundamentally cured, not- upon empirical, but scientific principles, all the causes of the disorder must be ascertained, and, if possible, removed, as in the treatment of every othei- complaint. How often, however, it is impossible to accomplish either the one or the other of these objects, must be clear enough from the preceding observations, particu- larly those concerning the etiology of the disease; and hence it is not surprising, that amaurosis should so frequently resist every endeavour to cure it. The plan of treatment is to be regulated, first by the number and kinds of circumstances, wliich determine the form of the disorder; secondly, by its presence, degree, and duration. When only the chief causes can be ascertained, a scientific mode of treatment may always be instituted; though here it is very necessary to pay the utmost attention to those morbid effects in the constitution, and in the eye in particular, which appear to have no connexion with the causes of amau- rosis, and merely exist as accidental contemporary de- fects. If no particular circumstances can be assigned as w?th ^vlTR^t^^^Mo^im^; 1 the cause of amauros's>ltle surgeon has no alternate.](https://iiif.wellcomecollection.org/image/b2103719x_0047.jp2/full/800%2C/0/default.jpg)
