A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 3).
- James Copland
- Date:
- 1834-59
Licence: Public Domain Mark
Credit: A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 3). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
![ies, or acrid substance brought in contact with the cornea. 106. a. Acute Corncitis may be of various de- grees of severity in different persons. In some, there is but little local uneasiness beyond irri- tation on motion ; while in others, of a full habit, or who are laboriously occupied, expo- sed to heat, or addicted to intoxicating liquors, the inflammation is most intense, and rapidly extends to the sclerotica and whole anterior chamber, with hypopyon. The more severe states usually commence with a pink zone in the sclerotica, around the cornea, which loses its transparency, and becomes minutely inject- ed with delicate-coloured vessels, particularly at its circumference, and dull, turbid, or cloudy. If the inflammation be excited by a foreign body, ulceration takes place around it. If the disease be not soon arrested, the pink zone assumes a deeper tint, and extends farther in the sclerot- ica ; the cornea is rendered more opaque, and suppurates ; and the chambers of the aqueous humour are involved. When the cornea is penetrated either by ulceration or suppuration, the aqueous humour escapes, the iris and cor- nea coming in contact. When the wound in the cornea is small, it unites by adhesion, and the aqueous humour is soon reproduced ; but when it is large, prolapsus of the iris often re- sults. 107. b. Sub-acute and chronic Corneitis are common in young persons of a fair complexion and delicate constitution. The cornea loses its transparency, presents a dull gray colour, or becomes hazy, nebulous, or nearly opaque ; the opacity commencing at the circumference, and gradually, but unequally extending. The nebulous and opaque spots are sometimes yel- lowish, as if matter were formed ; and the sur- face loses its polish, and seems rough. The circumference of the cornea is minutely inject- ed with a multitude of very fine vessels, which impart to it a reddish-brown tint, and occasion- ally elevate it somewhat. The conjunctiva often retains its natural paleness, but the scle- rotica is minutely injected, particularly around the cornea. As the brownish-red tint of the circumference of the part increases, the opaci- ty in its centre becomes greater, and vision more affected. There is generally much in- tolerance of light, notwithstanding the dimin- ished transparency of the cornea, owing to af- fection of the sclerotica. A partial form of cor- neitis, which is generally of very long duration, is sometimes met with. Inflammation com- mences in one or two spots at the circumfer- ence of the cornea, with pain of the eye and nebulosity, others being affected in succession. Redness is first observed in the sclerotica, in one or two points ; and minute vessels extend from these into the cloudy spots in the cornea, more or less of which may become thus affect- ed, or entirely opaque. 108. Although the severe and acute grades of corneitis often run into suppuration or ulcer- ation, the slighter or more chronic states do not terminate in this manner, excepting in sub- acute cases, where partial or circumscribed points of suppuration may occur. The more severe grades are attended by much pain in the eye, temples, and forehead, with tension of the organ, white tongue, and febrile disturbance, particularly at an early stage ; and they often pass into the slighter and chronic states ; but the latter also occur primarily. Chronic cor- neitis presents much less febrile disorder than the acute, and often continues for several months, or remits. The inflammation some- times extends to the iris, occasioning adhesion of its margin to the capsule of the lens. 109. c. Scrofulous Corneitis—Corneitis scrofu- losa.—Inflammation of the cornea in scrofu- lous habits has been minutely described by Dr. Froriep and Mr. Mackenzie ; but its local char- acters do not differ from those of the sub-acute and chronic forms noticed above (^ 107, 108), excepting that it is more obstinate, and more liable to return It is sometimes unattended by redness of the sclerotica, and the pain is not considerable. It is most common about the period of puberty, and is occasionally connect- ed with amenorrhce in the female, and with swollen lymphatic glands. In the more obsti- nate cases, increased secretion of the aqueous humour, and consequent enlargement of the anterior chamber, occasionally supervene. [Diagnosis.—The distinctive characteristic of corneitis is, opacity of the membrane, from enlargement of the vessels, and interstitial dep- osition. At first there is a hazy appearance of the cornea, causing dulness of vision ; then a gradual loss of transparency, and general cloudiness, with increasing imperfection of sight, objects appearing as if seen through a cloud or mist. And this cloudiness may, as sta- ted by Copland, be general or partial. The cornea resembles a piece of ground glass, and the opacity may be so great as entirely to con- ceal the iris and pupil. The other appearances in the external vessels of the eye have been sufficiently pointed out. Prognosis.—This affection may be promptly cured by proper treatment; the interstitial de- posite becomes absorbed, and the sight, conse- quently, restored. We sometimes, however, find the iris to assume a darker hue after re- covery, giving to the eye a somewhat duller hue than natural. If the treatment is not suf- ficiently prompt and energetic, the cornea loses its transparency, and becomes changed in vari- ous degrees, from leucoma to slight nebula. The iris is dull and dark-coloured, the pupil adherent, and there may be opacity in the open- ing] 110. d. Treatment.—a. Acute corneitis requires active depletory and other antiphlogistic meas- ures. Cupping behind the ears or on the tem- ples is always necessary. Purgatives, and af- terward calomel with James's powder, and occa- sionally with opium, until the mouth is affected, are beneficial, especially if the iris be inflamed. In the more obstinate and chronic cases, cup- ping, or the application of a number of leeches to the vicinity of the eye, should be repeated oftener than once, and be followed by open blis- ters, sctons, or issues. Mr. Lawrence advises issues to be inserted in the temples. Astrin- gent and stimulating applications, to remove the opacity, are generally injurious. Warm fomentations are more serviceable, particularly with emollient and anodyne substances. Emet- ics, if the digestive organs be loaded ; and di- aphoretics, assisted by warm pediluvia, if the skin be dry and fever present, are also useful (i. The scrofulous variety, especially its more chronic states, is benefited most by sarsapa-](https://iiif.wellcomecollection.org/image/b21111017_0012.jp2/full/800%2C/0/default.jpg)
