A practical treatise on the diseases of the eye / by William Mackenzie ; to which is prefixed an anatomical introduction explanatory of a horizontal section of the human eyeball by Thomas Wharton Jones.

Date:
1840
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of the eye / by William Mackenzie ; to which is prefixed an anatomical introduction explanatory of a horizontal section of the human eyeball by Thomas Wharton Jones. 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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    into the maxillary sinus. This fracture was without fragments, and is compared by M. Massot, the narrator ot the case, to the depression which might be produced on the surface ot an egg, hy pressing it inwards with the thumb. On removing the calvaria, the dura mater was seen to be penetrated over the hole made by the fork in the root ot the orbit. The dura mater appeared in a morbid state at that place, the anterior tossiE of the basis of the cranium were covered with jnis, the anterior lobes ot the cerebrum were in a state of suppuration, and the rest of the brain healthy. M. Massot thinks it probable, that when tlie fork was pushed through the orbit into the cranium, the eyeball being fixed and violently pressed between the fork ami the tloor of the orbit, the thin jilate of the superior maxillary hone could not resist this pressure, but sunk by the continued action of the fork upon the eyeball. 4. Falsi/. In those who survive wounds penetrating the sides of tho orbit, we may expect occasionally to meet with paralytic affections. The son ot Gen. E. a student at the Polytechnic School in Paris, in fencing, received the end of the foil through the roof of the orbit, and became hemiplegic on the opposite side of the body. The eye was saved.** A case of this kind is also recorded by Mr Geach of Plymouth. He does not, indeed, say that the wound penetrated into the brain, but merely that the instrument of injury struck against the inner side of the orbit; leaving it a matter of doubt whether the paralytic symptoms which followed were attributable to effusion within the cranium, or to a still more direct injury of the brain. Case. 20.—A midshij)man was wounded in a riot by means of a small sword, which, entering at the external angle of the left eye, ])assed quite through the eyeball, and struck against the inner part of the orbit, lie instantly fell down senseless, with loss of speech, and hemiplegia of the right side. Blood was im- mediately drawn. Next morning he was found lying on his back, with the right ej e widely opened, and, though in a light room, with the pupil considerably dilated. This eye was incapable of discerning objects, never winking at the waving of the hand, or the close application of the finger, though sometimes it was convulsed. The left eye was extruded from its orbit, and though destitute of all its humours, was enlarged to the size of a ])ullet’s egg. The pulse beat at long intervals, with a lazy motion, and stopped upon gentle pressure; the body was not feverish, but preserved a naturaf heat, the paralytic side, arm, and thigh excepted, which were livid, cold and rigid ; the lancet was employed without exciting any sensation, and blisters lay on several days without raising any vesications: the benumbed parts were constantly bedewed with clammy sweat. The patient was devoid of anxiety, or inejuietude, and the powers of life seemed to be almost suspended; purgatives jwoduced no effect, and clysters, though repeatedly injected, were never expelled. Tile urine was in general emitted by drops only, but sometimes it would run off suddenly in a deluge; hearing was considerably impaired ; the patient lay lethargic, and dead almost to every thing, though, by pulling the arms and shaking the body, by loud and frequent calling, and desiring him to extend his tongue, ho would gape widely, and forgetting seemingly what had been said to him, keep Ills mouth wide open, when the tongue might be seen quivering and retracted. Five weeks passed in this state of insensibility ; every thing he took was with voracity, but without relish or distinction. About this time, a new symptom began to threaten ; the jaw seemed to be moved with difficulty, and only liquids could be poured down; the hypochondria were hard and distended, and every effort to procure an intestinal discharge proved ineffectual; when very large eruptions of the miliary kind were suddenly diffused over the sound j)arts. From that critical moment, he pcrspire<l freely, and had an easy motion of the jaw; his urine was rendered in due qiiantity, and purgatives of the lenient kind easily operated ; the hypochondria became soft; the discharge from the eye, which had hitherto been acrid, was now co2>ious and