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.

    78/978
    On the 10th, he liad a violent convulsive fit, after which he was nearly coma- toso, and respiration stertorous. Pulse about 120, full and throbbing. Tbc nose, light eyelid, and teguments of that side of the forehead erysipelatous; both eyes closed; the parts so tender that the slightest touch gave exijuisite pain, and roused him from his eoma. Some pus had come from the right nostril, and a little had been spit up, mixed with blood. The temporal artery was opened, ^xx of blood were taken from the arm, and sixteen leeches were applied to the temples. The head was kept cool with ice. This last measure appeared to afibrd considerable mitigation to the pain, but no permanent advantage followed. In the evening, ^xx £ more of blood were taken from the temporal artery^. ' . -g On the 1 Ith, he seemed to surt'er much, as he constantly moaned, but was un- ■ able, even when roused, to articulate. A spot over the right eyebrow, to which ■ 3 he with difficulty raised his hand, was the most |iainful part. On opening the 1 jialpcbrie, the jiupils looked large, and immoveable, and a layer of clear coagul- j d able lymph formed a coating over each cornea. Leeches, blisters, &c. were re- 1 sorted to; but he died on the morning of the 12th. 4 On raising the scalp, the pericranium covering the os frontis on the right side, | a|)|H.'ared thicker than natural, and was in some ])arts of a dark-red colour; it was J 1 completely detached from the subjactmt bone, and its inner surface was covereil ^ i with thick purulent matter of a light-green colour. On slitting down the mem- ■ ; ^ brane as far as the superciliary ridge, a considerable quantity of purulent matter ^ ^ ^ escaped from all sides, and a jmobe was easily passed backwards into the orbit l)e- ‘ ; tween the bone and the periosteum, and downwards behind the temporal muscle, i as far as the back of the palate. On raising the skull-cap, the outer surface of the dura mater was found, in an ; extent corresponding to the limits of the detached pericranium, to be separated i from the internal table of the skull: it presented a dull and tlocculent surface, and was smeared with a greenish |)uriform mucus. The structure of the inner surface of the dura mater was less altered, but it wiis more generally covered with puru- : lent matter; this was observed in considerable quantify on that part of the mem- : brane which invests the anterior part of the right hemisphere, but there was no ' part of the internal surface of the dura mater which did not exhibit traces of, su{)])uration. The pia mater was. perhaps, more vascular than usual; but the arachnoid mem- f brane was perfectly transparent, and no eftiision had taken .place upon its surface, | exccj)t upon the upper part of the anterior lobe of the right side, where the pia f i mater, for the extent of about two inches, was in a state of suppuration. This f ■ diseased part exactly corresponded, in situation and extent, with a large patch of f thickeneil and inflamed pericranium of a dark-red colour. The brain was perhaps ^ ; more vgscular than natural, and there was about an ounce and a half of water in f ! the ventricles. f : The right side of the face was somewhat swoln, and the upper eyelid protruded | | beyond the eyebrow. An obscure, fluctuation could be felt beneath the integu- ? ments of the upper part of the nose. On cutting down to the bone, a considerable | j quantity of purulent matter issued from bencatli the periosteum which was found »j to be in a state of suppuration, and so extensively detached from the subjacent ^ parts that a probe could, with great ease, be passed between that membrane 4 * and the bones, cither iq)wards upon the os frontis, backwards along the roof J of the orbit into the cranium, or downwards upon the maxillary bones into the | ’ mouth. ^ Sir P. Crampton, connecting the history of this case with the api)earances after } death, concludes that the disease, in its commencement, was an inflammation of | ■ the periosteum, investing the bones of the nose. In the progress of the dist^ase, t the membrane which covers the bones of the lace and head became affected, and > ultimately the investing membrane of the brain itself. So long as the inflammation was confined to the periosteum of the face, the symptoms were moderate ; but as it extended to the pericranium and the dura mater, the fatal train of symptoms • which uniformly attend inflammation of the latter membrane, immediately set in, and ran their accustomed course.^ In the severe diseases illustrated by the preceding cases, however