Treatise on the diseases of the eye : including the anatomy of the organ / by Carl Stellwag von Carion ; tr. from the 3rd German ed. and ed. by Charles E. Hackley and D.B. St. John Roosa ; with an appendix by the editors.
- Karl Stellwag von Carion
- Date:
- 1870
Licence: Public Domain Mark
Credit: Treatise on the diseases of the eye : including the anatomy of the organ / by Carl Stellwag von Carion ; tr. from the 3rd German ed. and ed. by Charles E. Hackley and D.B. St. John Roosa ; with an appendix by the editors. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![It ABSTRACTION OF BLOOD. of the inflamed part is greater than that of the surrounding healthy parts. On the whole, the abstraction of heat is indicated to a very limited extent in the treat- ment of inflammations of the eye. Where it can he used with benefit, we must generally employ it carefully at intervals. Only in very special cases, in certain severe inflammations of the external portions of the visual organs, are continuous applications essential. Linen compresses are the most appropriate means for the application of cold to the eye. Com- presses dipped in cold water and wrung out, or still better, made cold by placing them on a block of ice, are to be recommended. These compresses should not be of much larger size than is suf- ficient to cover the borders of the orbit, in order not to abstract heat from the parts which are in a normal condition. They should not be heavy, except in cases where pressure upon the eye is desired. A piece of fine linen of three to four thicknesses will be sufficient. The compresses should always be well wrung out. If the water drips from the cloths, it becomes a source of un- pleasant chilliness. Besides this, very wet cloths are apt to loosen the epidermis; this is throvvu off, the corium exposed, and thus not rarely a severe erythema or an erysipelas excited. Excoria- tions and their evil consequences occur much more readily when the water or ice employed is salty. Mineral spring waters for this reason have of old been decided to be unfit for applications to inflamed parts. When soft water, or ice formed from it, can not be obtained, we may use dis- tilled water. These precautions are especially necessary in the case of persons with a very soft and sensitive, or relaxed and wrinkled skin. Such patients do not bear cold applications well, and they should therefore not be used, except in case of urgent necessity, and then as sparingly as possible, even running the risk of somewhat delaying the healing process. We may somewhat alleviate this evil effect of the cold compresses by smearing the parts with a little clean fresh fat, before applying them, or by placing upon them a piece of linen, which has been smeared with the fat. If excoriations have already occurred, an erythema, &c, it will be best to stop the application where it is possible, and to favor the healing of the inflammation of the skin by smearing the part with fat or glycerine. 2. Direct abstraction of Blood.—Until recently, venesection was very much es- teemed. The efficacy of venesection is doubtful, nn:l the benefit is very little compared with the destructive influence which it may have upon the nutrition of the whole body ; therefore now-a-days in ophthalmic practice we are nearly restricted to local abstraction of blood. The purpose of this is to favor the exit of blood from con- gested or inflamed parts through the vessels, to remove the hindrances to circula- tion, and in a revulsatory way to regulate the development and increase of a stasis, to diminish the rapidity of the circulation and of the increised molecular at- traction. The means of local blood-letting are the natural and artificial leeches, wet cups, incisions and scarifications of the conjunctiva. Natural leeches as well as the artificial ones are, as a rule, most properly applied on the temporal region. In order to attain any effect in the case of very small chil- dren, one to two leeches should be applied, in those who are older three to four, in adults six to eight of medium size. Care should be taken that the leeches bite as nearly as possible at the same time, and that after they drop off the flow of blood is not interrupted. [In this country, as a rule, the use of leeches in the treatment of eye disease in children is not justifiable. Wet cups should never be applied to young children.] Since the effect of natural leeches is evanescent, and the changes in the current of blood are quickly over, it seems advisable, for the sake of an expansion as far as.pos- sible of the temporary effect, to apply the leeches in the beginning of an exacerba- tion of the inflammation. It is at this time that the process receives an impetus, its products are more abundant, and the pain also increases.](https://iiif.wellcomecollection.org/image/b2107902x_0036.jp2/full/800%2C/0/default.jpg)
