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.

  • Mackenzie, William
Date:
1854
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.

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    •the touch, or even when gently pricked with a sharp point; the razor skimmed over the left side of the upper lip unfelt; and when he applied a vessel to his mouth, a sensation was imparted as if its edge were broken off at the part touching the affected lip. The expression of the countenance was not at all affected, for when he spoke, laughed, or sneezed, the muscles ol' both sides acted in perfect unison.^ Case 872. — L. A., a healthy girl about 20, came under the care of Sir Charles Bell, in October 1822. Seven years before that period, she had received a blow with a stick on the right eye, after which she thought that the sight was never so good. The dimness had increased, but she could still distinguish small objects till June 1822. At that time, she became affected with pain in the right ear, deafness, and a discharge from the ear; she also suffered from severe headaches, affecting only the right side of the head, and soon after, lost the sight of the right eye altogether. She felt a dull pain at the internal canthus, which seldom abated, and at times there was a copious flow of tears. The motion of the iris remained perfect. Things continued iu this state for about two months, when the pain and discharge from the ear ceased, and in a few days more the suiface of the eye be- came perfectly insensible to the touch. This loss of feeling extended to the lin- ing of the eyelids, to the skin covering them, and to the skin of the cheek and forehead for about an inch round the eye; it did not go beyond the middle line of the face. When she told Sir Charles that her eye was dead, as she expressed it, he drew his finger over its surface, and so far was this from giving her pain, that she assured him she could not feel that he was touching it at all. The eye- lids made no effort to close while he'was doing this, but the conjunctiva appeared sensible to the stimulus, as a number of vessels on the surface of the eye became immediately injected. At this time, a perpetual blister was applied behind the ear, and two grains of calomel given night and morning, with a view of affecting her mouth. After a few days, however, the pain in the ear and deafness increased, but with scarcely any discharge; and, at the same time, the sensibility of the eye and surrounding skin returned. The sight appeared totally gone. Partial headaches continued, and at times the patient felt pain at the inner corner of the eye. She had always .a perfect command over the muscles of the face and eyelids, and there was no affection whatever of the muscles of the face. On the 2oth October, she had a violent hysteric fit, followed by general head- ache. The latter subsided after venesection, a cold embrocation to the vertex, a blister to the nape of the neck, and free purging. Apprehensive lest oi-ganic disease might be extending itself in the head. Sir Charles kept her confined to bed and on the lowest regimen, arid purged her daily. On _ the 2d November, she said she had felt all night as if there was sand in the blind eye, and that sometimes sparks of fire seemed to pass through it. There was no change in the appearance of the eye. On the 3d, when she°awoke these sensations were gone, but she was agreeably surprised to find that her sight was restored. _ When the left eye was closed, she could see large objects very dis- tinctly with the right, but could not read or discern anything very small. On the 4th, she could read small print, and the sight, although not quite so good as in the left eye, soon became pretty much as it had been immediately after the injury. The blow on the eye had probably produced only a predisposition to disease. The gi'adual manner in which sight was lost, and its sudden recovery when the system was reduced by severe evacuation, point out the connexion of the complaint with an increasing fulness of habit. The only nerves affected appeared to have been the optic, and at one time the first division of the fifth. Case 87.3. — A patient, under the care of Dr. Alison, was affected with loss of common sensation in the left side of the face, the left nostril, and left side of the tongue, with insensibility of the ball of the eye, and occasional bloody dischartre from the left nostril; and was liable to attacks of pain, occasionally accompanied with fever, during which the pain was chiefly referred to the insensible parts-. There were frequent attacks of inflammation of the left eye, with dimness of the cornea, which were relieved from time to time by the usual antiphlogistic means • but at the end of two months, a line ibrmed round the base of the cornea, which at length sloughed out, and the contents of the eye were entirely discharo'ed. The muscles of the left side of the jaw were ])aralytic, and felt quite' flaccid wlien the patient chewed or clenched the jaws, but the motion ol' the muscles of the