Partial optic nerve atrophy and central scotomas (so-called central amblyopia), apparently due to chronic lead poisoning / by G. E. de Schweinitz.

  • George Edmund de Schweinitz
Date:
[1898]
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Credit: Partial optic nerve atrophy and central scotomas (so-called central amblyopia), apparently due to chronic lead poisoning / by G. E. de Schweinitz. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    PARTIAL OPTIC NERVE ATROPHY AND CENTRAL SCOTOMAS (SO-CALLED CENTRAL AMBLYOPIA), APPARENTLY DUE TO CHRONIC LEAD POISONING.* BY G. E. DE SCHWEINITZ, M.D., OF PHILADELPHIA. Illustrated. The following cases of central amblyopia present certain clinical features of interest, and in one of them lead, so far as chemical tests are concerned, appears to have been the cause of the ocular symptoms: Thomas Ryan, aged 35, born in England, single, a house-painter, was admitted to the medical wards of the Philadelphia Hospital on the 24th of December, 1897, on account of progressive weakness in the legs,chronic constipation, some cough with expectoration, and dim vision. History.—The patient suffered from the usual illnesses of childhood. He denies syphilitic infection, but confesses to having had a chancroidal bubo and one attack of gonorrhea. He has been accustomed to drink spirits, and has used tobacco freely, especially by chewing, but had used neither tobacco nor liquor for two months before admission. The man is a painter by occupation, and has followed that calling for fifteen years. His last work, however, was done five months before he entered the hos- pital. He has suffered at times from colic, but never typically from painter's colic, nor has he ever had wrist-drop. For the past two years he has been ailing, and for a number of years he has suffered much from persistent constipation, always requiring laxatives to secure a movement of the bowels. About Novem- ber, 1897, he began to notice that his vision was failing, his attention being first directed to this symptom by his inability to read ordinary print. The failure in vision was unassociated with pain or other sign of inflammatory action. Exa7nination.—The patient is a somewhat emaciated, pallid man, with purplish eyelids and weak, discouraged voice. There is retraction of the left apex and harsh breathing, but no tubercle bacilli could be found in the sputa. On admission, it is stated that examination of the urine did not reveal abnor- malities, but three months later an examination by the resident, Dr. George M. Purves, gave the following result: Reaction acid; specific gravity 1017; trace of albumin with the nitro-magnesium test; no sugar; microscopically a few pale, granular casts and bladder epithelium. There is no special disturbance of the mental faculties, except that the patient is rather slow in answering questions, this slowness being apparently due more to *Read before the Ophthalmic Section of the College of Physicians of Philadelphia, April 19,1898.
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