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.

  • Cooper, Samuel, 1780-1848.
Date:
1844
Catalogue details

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.

    49/1188
    of the neck As already stated, however, Mr. Law- rence does not wish it to be supposed, that all amau- rotic patients require to be bled and salivated. Amau- rosis, he says, ollen comes on in a slow and very insi- dious manner in persons of enfeebled constitution : the organ suffers from habitual excessive exertion at the same time that the general powers are depressed by residence in confined dwellings, bad air, sedentary oc- cupations, unwholesome diet, costiveness, and the other injurious influences of such causes. If you should see a thin, pallid, and feeble woman, who had destroyed her health by close confinement to needle-work, and whose eyes were beginning to fail, the same active measures would by no means be admissible. You would empty the alimentary canal, perhaps take a little blood by cupping, or by leeches to the temples, and then use mercury in the alterative form, together with mild aperients A few grains of Plummer's pill may be given every night, or every second night, and the bowels may be kept open with electuary, castor oil, or rhubarb and magnesia, taken occasionally. The blue pill may be taken in combination with aloes or colocynth. It may be necessary, says Mr. Lawrence, to persevere with the mercury, slowly increasing the dose until a slight influence is visible in the mouth. A nutritious diet without stimuli, good air, and exercise, and repose of the affected organ, are important auxilia- ries, and ^succession of moderate-sized blisters may be advantageously combined with these meaiis. Thus, observes Mr. Lawrence, you see, that the same princi- ples regulate our treatment, but that it is modified in degree according to the violence of the symptoms, and with a little mucus, but, if it be repeated, a few^days after the resolvent powders have been administered, it then occasions a discharge of a considerable quantity of a yellow, greenish matter, to the infinite rcliet 01 the stomach, head, and eyes. The stomach having been thus emptied, the lollow ing aperient pills are to be ordered: Jji. Gum. sagapen. ) Galban. > an. 3j. Sap. venet. ) Rhei optim. 3iss. Tart. emet. gr. xvi. ^ Sue. liquerit. 3 j. fiant pilulae gran, quinque. Three are to be taken every morning and evening, for a month or six weeks. When the state of the stomach has been improved, and the restoration of sight partly effected, such reme- dies must be employed, as strengthen the digestive or- gans, and excite the vigour of the nervous system in general, and of the nerves of the eye in particular. With this intention Scarpa prescribes bark and vale- rian in powder, and recommends a diet of tender suc- culent meat, and wholesome broths, with a moderate quantity of wine, and proper exercise in a salubrious air. For exciting the action of the nerves of the eye, the vapour of liquor ammoniae, properly directed against the eye, he says, is of the greatest service. This remedy is applied by holding a small vessel con- taining it sufficiently near the eye to make this organ feel a smarting, occasioned by the very penetrating va- pours with which it is enveloped, and which cause a copious secretion of tears, and a redness, in less than the natieiit's stVn-th In the latter description of I half an hour after the beginning of the application uie iidueiua • ™ ' 1 i __j ,v„ <«, ,„■......- tn «tnn nnH rpneat. tbfi arm ication t case's; after mild; ntiphlogistic means', and clearing the aliuientarv canal, .ie admits that it may be expedient to comome tonics with aperients, or rhubarb with bark, columba, or cascarilla: and to allow a little por- ter and wine. We come now to the consideration of that species of the gutta serena, which is regarded as the effect of some unnatural irritation. Here, according to the pre- cepts delivered by Richter, we should endeavour to discover what the particular irritation is, and then en- deavour to effect its removal. When it cannot be ex- actly detected, we are recommended generally to em- ploy such remedies as will lessen the sensibility of the nerves, and render them less apt to be affected by any kind of irritation. Sometimes the irritation is both discoverable and re- moveable and still the effect, that is to say, the blind- ness, continues. In this circumstance, Richter thinks that the surgeon should endeavour to obviate the im- pression which the irritation has left upon the nerves, by the use of anodynes; or else try to remove the tor- por of the nerves by stimulants. I But, according to Sehmucker, Richter, and Scarpa, the curable imperfect amaurosis commonly depends on some disease or irritation, existing in the gastric sys- tem, occasionally complicated with general nervous debility, in which the eyes participate. Hence, in the majority of cases, we are assured that the chief indi- cations are, to free the alimentary canal from all irri- tating matter, improve the state of the chylopoietic viscera, and invigoiate the nervous system in general, and the nerves of the eye in particular. For an adult, dissolve three grains of antimonium tartaruatum in four ounces of water, and give a spoon- ful of this solution every half hour, until nausea and copious vomiting are produced. The next day some opening powders are to be exhibited, consisting of an ounce of the supertartrate of potash, and one grain of antimonium tartari/.atum, divided into six equal parts. The patient must take one of these in the morning, another four hours afterward, and a third in the eve- ning for eight or ten days in succession. They will ft iitf.a tiiusea, rather more evacuations from create a llUfe mH perhaps, in the course of a the bowels th4n u.ua. a i j , few days, t0 Comit, complain of bitter: 8Uould mak; va n efforts to , ^ renovat;on ness m his mouth, loss oi n w ^ of sight, the: emeti, g^™^ a tnird and fourth scribed again. This mo o>e iy system, time should the ^/^^ tension of theW It is now proper to stop, and repeat the application three or lour hours afterward. The plan must be thus fol- lowed up till the incomplete amaurosis is quite cured, The operation of these vapours maj; be promoted by other external stimulants, applied to 'such other parts of the body as have a great deal of sympathy with the eyes. ' Of this kind are blisters to the nape of tho neck; friction on the eyebrow with the anodyne liquor; the irritation of the nerves of the nostrils by sternuta- tive powders, like that composed of two grains of tur- beth mineral, and a scruple of powdered betony leaves; and, lastly, a stream of electricity.—(See Gutta Se rena.) Bark, which is efficacious in intermittent fevers, and other periodical diseases, far from curing periodical amaurosis, seems to aggravate it, rendering its return more frequent, and of longer duration. On the other hand, this disease is most commonly cured, in a very short time, by exhibiting, first, emetics, then the above laxative pills, and lastly, corroborants, and even bark, which was before useless and hurtful. Such is Scarpa's statement, which agrees with that of Richter, respecting the effect of bark in periodical amaurosis. As if, however, practitioners were doomed always to differ, and learners to be puzzled, Beer tells us, that he has seen only two cases of periodical inter mittent amaurosis, both of which were soon perfectly cured by large, doses of bark. Other periodical amau- rotic affections he has seen, however, attendant on in- termittent fever, but they spontaneously subsided with the febrile paroxysms, without any particular treat ment being applied to the eyes. Sometimes, when the paroxysms recurred frequently, a considerable weak ness of sight remained after them; but this always went off of itself, except in a single instance, in which the functions of the eyes were perfectly re-established by the exhibition of arnica joined with bitters.—(Lehre, von den Augenkr. b. 2, p. 535.) In the two cases, which were unaccompanied with fever, the vitreous humour had the appearance W be- ing turbid during the attacks, but regained its natural clearness on each return of vision, the loss of which used to be complete. Here we see another instance, in which a cloudiness behind the pupil in amaurosis did not impede the cure, and went away in the most ready manner. Possibly, the opacity, which, in speaking of the prognosis, I said that Langenbeck had not found to prevent the cure of certain cases, might also have had its seat in the vitreous humour, and not depended upon disease of the retina. Cases, in the formation of which many other causes operate, demand the employment of particular curative means, in addition to those which have been already described. Such is, for example, the imperfect arrtau-