Retinal hæmorrhages and melanæemia as symptoms of ague / by Stephen MacKenzie.

  • Mackenzie, Stephen, 1844-1909.
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: Retinal hæmorrhages and melanæemia as symptoms of ague / by Stephen MacKenzie. Source: Wellcome Collection.

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    of the retinae in malarial disorders are few in number. Dr. Hammond, in a paper published in the Transactions of the American Neurological Society in 1875, * on “ Pigmentary Deposits in the Brain resulting from Malarial Poisoning,” has described ophthalmoscopical alterations from melaneemia, the result of malarial poisoning. In one case Dr. Hammond says, “ Upon examining the fundus of the eye with the ophthal¬ moscope I found double optic neuritis, worse on the left side than on the right, and large deposits of pigment in both retinae, especially the left. These masses were stellate in form, and followed, mainly, the course of the arterial branches. I then punctured the spleen and drew off a few drops of blood. Examined by the microscope it was found to contain a large quantity of free pigment as well as numerous pigment-holding cells.” Professor Roosa examined this patient, and con¬ firmed Dr. Hammond’s observations as to the ophthalmoscopic appearances. Of another case of malaria with choreic symptoms Dr. Hammond says, “ On examining the eyes with the ophthal¬ moscope, I found numerous deposits of pigment, stellate in form, along the course of the arterial branches on both sides.” And of another case he says, “ There were no abnormal ophthal¬ moscopic appearances beyond choked disc on both sides.” Dr. Hammond does not appear to have observed retinal extra¬ vasations in his cases. [Since reading this paper I find that M. X. Galezowski, under the head of “ Affections de la Retine et du Nerf Optique dans la Fievre Palustre,” at page 190 of his “Traite Icono- graphique d’Ophthalmoscopie ” (Paris, Bailliere et Fils, 1876), has described the occurrence of retinal extravasations in con¬ nexion with ague. He writes — “ The accidents which occur in the different forms are proportionate to the gravity of the malarial diathesis. In the common form we have distinguished a kind of apoplectic and exudative retinitis, with peripapillary serous infiltration, which yields readily to antiperiodic treat¬ ment. To give an example which we observed with our dis¬ tinguished friend and colleague Dr. Noel Gueneau de Mussy. A schoolboy was seized with violent headache and intense fever; some days later he complained of defective sight, and on examining him with the ophthalmoscope we found double neuro-retinitis with multiple haemorrhages. After an emetic the disease presented all the characters of a tertian ague, and later fifty-centigramme doses of sulphate of quinine adminis¬ tered for some days produced a cure both of the fever and of the neuro-retinitis.” M. Galezowski also mentions atrophy of the papilla and marked diminution of the central vessels in cases of chronic malarial poisoning.] * Republished in his “ Diseases of the Nervous System.”