The ophthalmoscope : its varieties and its use / translated from the German of Dr. Adolf Zander by Robert Brudenell Carter ... with notes and additions by the translator.

  • Adolf Zander
Date:
1864
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Licence: Public Domain Mark

Credit: The ophthalmoscope : its varieties and its use / translated from the German of Dr. Adolf Zander by Robert Brudenell Carter ... with notes and additions by the translator. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    a'^cribe to the ophthalmoscope a greater value, as a source of therapeutic indications, than even to the stethoscope and the pleximeter; since it is, as a means of diagnosis, more immediate, certain, and indispensable than they. For, since the perceptions of sense are more definite in pro- portion to the more direct and complete exhibition of the nature, shape, and material conditions of their object, it is impossible to doubt that the information afforded by sight is more certain and exact than that derived from hearing, or any other sense. The instrument is more indispensable, inasmuch as the practitioner, in his diagnosis of various bodily affections, is not entirely dependent upon physical signs, and may find in functional symptoms a sufficient foundation for his opinion. In the diseases of the internal eye, on the contrary, the numerous symptoms of functional disturbance are inadequate by themselves to indicate the proximate morbid state on which they depend; and they first attain a positive value when the material conditions that cause them have been determined, in the only possible way, by examination with the ophthalmoscope. To the exactness of such examination we are therefore indebted, in fact, for a system of therapeutics in which the rational application of remedies has superseded a blind empiricism. And even when the ophthalmoscope reveals organic changes against which our remedies are useless, it is still of great value in affording positive data for a sure prognosis; and in sparing the patient that course of treatment, often painful and debilitating, and always useless, that the empiricism of former times was accustomed to prescribe for the multitude of amaurotic patients. Lastly, the cultivation of ophthalmoscopy is of no small advantage as an antagonist to the counsels, often ridiculous, often even dangerous, of the quack; since it enables us to recognize the earliest stages of those changes in the internal ocular textures from which amblyopic or amaurotic affections proceed; and to employ, with compara- tive ease and certainty, means to stop their progress, or, at least, to delay their consequences, against which, at a late period, all treatment might be inefficient or wholly useless. (Quaglino.) I shall endeavour to show hereafter, in the Fifth Section, in what manner the ophthalmoscope can be made useful in forensic medicine, and will only mention here, as by no means the least merit of the discovery, that it has been the cause of bringing to perfection other means of objective examination. Of such it is sufficient to remember lateral illumination, the new method of examining the field of vision in affections of the choroid, retina, and optic nerve, and the tests of the quantitative perception of light. After thus reviewing what has been accomplished by the ophthalmo- scope, and is barely indicated above, it is impossible to refuse asseiit to the words of Hasner:— The ophthalmoscope is not only the most valuable boon to ophthalmology, but is also one of the greatest creations