A dictionary of practical surgery : comprehending all the most interesting improvements, from the earliest times down to the present period : an account of the instruments and remedies employed in surgery : the etymology and signification of the principal terms : and numerous references to ancient and modern works, forming a "catalogue raisonné" of surgical literature / by Samuel Cooper.

  • Samuel Cooper
Date:
1825
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical surgery : comprehending all the most interesting improvements, from the earliest times down to the present period : an account of the instruments and remedies employed in surgery : the etymology and signification of the principal terms : and numerous references to ancient and modern works, forming a "catalogue raisonné" of surgical literature / by Samuel Cooper. 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.

    38/1282 (page 26)
    during the remainder of the patient's life. ( Lelire von den Augenkr. b. 2. p. 458.) Richter also thinks, that the moveable or immoveable state of the pupil can neither be considered as a favour- able nor unfavourable circumstance. Sometimes, says he, an amaurosis may be cured, which is attended with a pupil extraordinarily dilated, and entirely motionless; and sometimes the disorder proves incurable, notwithstanding the pupil be of its proper size, and capable of motion. There are likewise examples, in which the pupil reco- vers its moveableness, in the course of the treat- ment, although nothing will succeed in restoring the eyesight. (Anfangsgr. der Wundarzn. b. 3. ;?. 424. 8vo. Gntt. 1795.) In some very rare instances, says Beer, amau- rotic blindness has been cured by some apparently accidental, or indeed morbid effect, without any assistance from art; by hemorrhage from the nose, an intermittent fever, a blow on the head, &c. The same experienced writer operated suc- cessfully upon both eyes of a patient with cata- racts, which had been previously depressed too far against the retina, so that their pressure gave rise to amaurosis, which, after continuing eight years, had been suddenly removed by the patient's accidentally falling out of bed, and pitching upon the top of his head. (Lchre von den Augenlcr. b. 2. p. 458.) The following observations, made by Beer, re- specting the prognosis, cannot fail to prove inter- esting. There is a species of amaurosis, which gradually diminishes of itself; for instance, that which arises from hard drinking, or the effect of narcotic poisons, belladonna, opium, hyoscyamus, <S.e. Sometimes imperfect amaurosis goes away, without any assistance from art, in consequence of the accession of some other disease, as an eruption, a discharge of matter from the ear, bleeding from piles, the menses, &c. Also, in most cases, when the surgeon is so fortunate as to cure amaurosis, either by scientific or empirical methods, there still continues, for life, a considerable degree of amblyopia, more especially if the amaurosis has been complete. Sometimes, by successful treatment, vision is in a great measure, or even entirely, restored in one eye ; yet the other remains completely blind ; or one eye sees again much sooner than its fellow, although they were both affected together with an equal degree of blindness. It often happens that, though a material de- gree of vision returns in the course of the treat- ment, the faculty is restricted to a circumscribed point of the retina, so that the patient is enabled to see objects plainly only when they are held in a particular direction before him ; while, in other directions, they are either quite invisible, or very indistinct. (Beer, Lchrc von den Augenkr. b. 2. j). 459, 60.) Amaurosis, following an injury of the supra- orbitary nerve, frequently resists every endeavour made to relieve it, and this, whether it come on directly after the blow, or some weeks subse- quently to the healing of the wound of the eye- brow ; but, it is not always absolutely incurable. Scarpa only knows of one such cure, viz. the example recorded by Valsalva. {Dissert. 2. § II.) But additional instances are reported by Hey (Med. Ols. and Ina. vol. 5.), by Larrey (Mem. de Chir. Militaire, t. 4. p. 181.), and Dr. Hennen. (Principles of Military Surgery, p. 346. ed. 2.). According to Mr. Wardrop, it is only when this nerve is wounded, or injured, and not divided, that amaurosis takes place ; for the blindness may sometimes be cured by making a complete division of the trunk nearest its origin. (Essays on the Morbid Anatomy of the Human Eye, vol. 2. p. 180J Perfect, inveterate amaurosis, attended with organic injury of the substance, constituting the immediate organ of sight, says Scarpa, is a disease absolutely incurable. Imperfect, recent amau- rosis, particularly that which is periodical, is usually curable; for, it is mostly dependent upon causes which, though they affect the immediate organ of sight, are capable of being dispersed, without leaving any vestige of impaired organiza- tion in the optic nerve or retina. When amaurosis has prevailed several years, in persons of advanced age, whose eyesight has been weak from their youth ; when it has come on slowly, at first with a morbid irritability of the retina, and then with a gradual diminution of sense in this part, till total blindness was the consequence; when the pupil is motionless, not circular and not much dilated; when it is widened in such a degree, that the iris seems as if it were wanting, and the margin of this opening is irre- gular and jagged ; and, when the bottom of the eye, independently of any opacity of the crystal- line lens, presents an unusual paleness, like that of horn, sometimes partaking of green, and re- flected from the thickened retina, the disease may be generally set down as incurable. Kieser joins Scarpa in representing this alteration as an unfavourable omen, adding, that it only takes place in examples of long standing, and, that when it is considerable, the disease is incurable. Langenbeck differs, however, from both these authors, and particularly from Kieser, assuring us, not only that he has often seen this disco- loration of the bottom of the eye in the early stage of amaurosis, but seen patients in this state soon cured. The cases which he has published, in proof of this statement, I have read with care, and find them completely satisfactory. Langen- beck agrees with other writers in imputing the appearance to a morbid change of the retina, and the treatment, which he prescribes, consists in the internal exhibition of the oxymuriale of mercury in small doses, and friction with mercurial oint- ment on the eyebrow and temple. (See Langen- beck's Neue BiU.f'ur ds Chirurgie, 1 b.p. 64 —69, $c. Gottingen, IS]5.J Cases, says Scarpa, attended with pain all over the head, and a continual sensation of tightness in the eye-ball; or preceded by a violent, pro- tracted excitement of the nervous system, and then by general debility, and languor of the con- stitution, as after masturbation, premature venery, and hard drinking; or connected with epileptic fits, or frequent spasmodic hemicrania; or which are the consequence of violent, long-continued, internal ophthalmia, may be set down as incur- able. Nor can any cure be expected, when amaurosis proceeds from a direct blow on the eye; foreign bodies in the eye-ball; lues venerea, or exostoses about the orbit; or when it is conjoined with a manifest change in the figure and dimensions of the eye-ball.