Treatise on the diseases of the eye, including the anatomy of the organ / by Carl Stellwag von Carion ; translated from the fourth German edition and edited by D.B. St John Roosa, Charles S. Bull, and Charles E. Hackney.
- Date:
- 1873
Licence: Public Domain Mark
Credit: Treatise on the diseases of the eye, including the anatomy of the organ / by Carl Stellwag von Carion ; translated from the fourth German edition and edited by D.B. St John Roosa, Charles S. Bull, and Charles E. Hackney. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![especially necessary when stronger solutions of argent, nit., or the mitigated stick, are used; still, even in weaker solutions the neglect of this precaution is not entirely without danger. A neutralization of the excess by penciling the cauterized portion with a solution of common salt is superfluous, but was formerly generally recommended. Cauterizations with crystals of sulphate of copper only require a wiping off of the excess, when there is some disposition to severe irritation. The fluid running off in making an application to the eyes injures the cloth- ing and furniture very much. In order to prevent this, a piece of oiled muslin bound about the neck of the patient, and reaching to the knees, becomes very useful. The surgeon protects himself best by an apron. Dusting irritating powders in the eye should only be done once or twice during the day: the irritative ointments should never be used *but once a day. On the contrary, the weak astringent collyria may be used twice or three times a day, and even oftener, according to the desired effect, and the sensitiveness of the part. The astringent caustics are never to be applied but once a day, and even in those cases where a very powerful cauterization is not desired, or when the reaction following is very considerable, they should only be repeated after the lapse of two or more days. A slight irritation always follows the use, even of the weaker of these agents. This is even necessary in order that their effects may be developed. If it remains within the bounds of moderation, and if it passes rapidly over, it is not to be resisted. If, on the contrary, it becomes annoying by severe nervous symptoms, or the reaction is serious from the degree and duration of the vascular symptoms, the use of cold applications until they are overcome is indicated. After cauterization, it is, under all circumstances, advisable to use cold applica- tions, since we then wish to favor the throwing off of the slough. If the part has been severely cauterized, or if the patient is very sensitive and subject to inflamma- tions, the throwing off of the slough, which generally follows within one to two hours, should be carefully observed. It not unfrequently occurs that portions of the slough only partly detach themselves, roll up in the act of winking, and then, as foreign bodies, irritate excessively. We may readily guard against this, by separating the loosely hanging eschar by a camel1 s-hair brush, or a piece of fine linen. Special attention should also be paid, after a cauterization, to the adhesion of some parts of the palpebral fold, which not unfrequently occurs. If the parts be severely cauterized, excoriated surfaces come in contact after the throwing off of the slough, and finally completely adhere, so that the conjunctiva is considerably shortened. If such an adhesion is discovered, it should be immediately separated by the finger- nail, or by something similar. We should afterwards frequently examine it, to see that the adhesion has not again occurred. In this way it is easy to prevent the ad- hesion. If the reaction after appropriate and careful use of the irritant be excessive, and if, in the course of some hours after the use of antiphlogistic means, it does not yield, the agent is too severe. We should then not repeat the application, but after the reaction has been subdued, we should begin with a weaker preparation, and in case of necessity, pass on gradually to the stronger. In America a mixture of tannin with glycerine is very much thought of by some, as an ap- plication to the lids in trachoma. [The tannic acid is mixed with glycerine in the proportions of from ten to sixty grains to the drachm of glycerine. ] Very recently astringent pastes are also used (.Heymann). From one-half to one drachm of the salts that have been named is rubbed up with the cooked white of an egg and mixed](https://iiif.wellcomecollection.org/image/b21987634_0075.jp2/full/800%2C/0/default.jpg)
