LONDON MEDICAL AND PHYSICAL JOURNAL. EDITED BY JOHN NORTH, ESQ. F.L.S. MEMBER OF THE ROYAL COLLEGE OF SURGEONS, AND JOHN WHATLEY, M.D. A.M. MEMBER OF THE ARCADIA OF ROME; MEMBER EXTRAORDINARY OF THE ROYAL MED. SOCIETY OF EDINBURGH; JOHN SOUTER, 73, ST. PAUL'S CHURCH-YARD, AND TO BE HAD OF ALL THE MEDICAL BOOKSELLERS, 1829. For many fortunate discoveries in medicine, and for the detection of numerous errors, the world is indebted to the rapid circulation of Monthly Journals; and there never existed any work, to which the Faculty, in Europe and America, were under deeper obligations than to the Medical and Physical Journal of London, now forming a long, but an invaluable series.-RUSH. ORIGINAL PAPERS, AND CASES OBTAINED FROM PUBLIC INSTITUTIONS AND OTHER INFLAMMATION OF THE EYES. Continuation of the Cases illustrative of the Practice pursued at the ROYAL WESTMINSTER OPHTHALMIC HOSPITAL, and of the new Remedies latterly employed in various States of Disease. By G. J. GUTHRIE, F.R.S. Professor of Anatomy and Surgery to the Royal College of Surgeons; Surgeon to the Westminster Hospital; and to the Royal Westminster Ophthalmic Hospital. THE first three cases show the superiority of the stimulant ointments in disease of long standing, where other remedies appeared to be of little use, or had failed. The eighth, twelfth, and thirteenth show their efficacy in chronic inflammation combined with ulceration. The ninth, tenth, eleventh, and fourteenth prove the utility of the Ung. Argent. Nitrat. in the purulent inflammation of children. The fifth case is a comparative trial of the merits of the two ointments. The fourun and sixth the rapid manner in which a cure is sometimes effected. The fifteenth and seventeenth are comparative trials of different modes of treatment. The twentieth, twenty-first, and twenty-second deserve particular attention, as showing an influence exerted by these remedies they were not in any way suspected to possess. The twenty-third is added as illustrative of the efficacy of an opposite mode of treatment, and to demonstrate the advantage resulting from due discrimination in the treatment of ophthalmic diseases. CASE I.-Margaret Murphy, aged eleven, admitted August 5, 1828. Has had chronic inflammation of both eyes for three years, No. 359.-No. 31, New Series. B ending in May last, at which time she was put on the use of the Ung. Argent. Nitrat. At the commencement of the three years, and at intervals afterwards, she attended at the Infirmary, but with little benefit. The eyes were red and painful; she was incapable of bearing the light, and the lids were often almost spasmodically closed. She took medicines of every description, but unavailingly. From the first application of the Argentum Nitratum ointment, she received some relief, which each succeeding one increased, until she was quite well. The mother is under treatment with the same disease. Case kept by Mr. GUTHRIE. CASE II.-Ralph Staton, aged fifty-four, has had bad eyes for three years, proceeding (he thinks) from reading a great deal by candle light; had severe pains in his head at the commencement of the disease, and at different periods of the three years; has suffered frequent violent recurrence of acute inflammation. There is now a lippitudinous affection of the lids; redness of the conjunctivæ, which are villous, and almost granulated; a great discharge of hot water and of a glutinous matter, particularly at night; a nebula on the cornea of the left eye; general health very good. He has had leeches and blisters at different times. August 9th.-The Ung. Argent. Nitrat. applied to both eyes. 10th. The smarting from the ointment lasted three-quarters of an hour, after which he could see better than he had done for three months. The discharge greatly diminished. 11th.-Repeat Unguent. 16th.-Absented himself for several days, and the inflammation of the left eye has returned. C. cum ferro, ad 3xij. tempori sinistro.-Ung. Arg. Nitr. dextro oculo. 19th.-Better. Repeat ointment to both eyes. 21st.-Rapidly improving. Repeat Unguent. Discharged cured.-Case kept by Mr. TAYLOR. CASE III.-June 21st: Francis Westbrooke, aged eighteen, has had sore eyes for seven years, better and worse. Four years ago was under Mr. Guthrie's care, for a year and a half, when he got well, but the disease has gradually returned. At present, can scarcely open either eye, particularly the right, and cannot allow them to be touched; the sensibility is extreme to light, and there is an almost constant spasmodic winking of the lid; the discharge considerable; pain great. Ung. Argent. Nitrat. 24th.-Repeat. 26th.-Repeat. July 1st. Repeat. 3d.-Is much better. The ointment continued every second or third day, until the 5th of August, when the spasmodic winking of the lid, and the extreme sensibility, were said to be removed. August 19th.-Nearly well. Sept. 2d. Discharged cured.-Case kept by Mr. TAYLOR. Both eyes than ever. CASE IV.-Elizabeth Espenin, aged four; August 23d, 1828. have been bad for three months, but they are now worse Pustules on the cornea of both eyes, with numerous red vessels running from the conjunctivæ to them; great intolerance of light; pain in the head; bowels very irregular; eruptions about the nose and mouth. R. Hydr. cum Creta et Rheo gr. x. omni nocte. Infus. Sennæ mane.--Ung. Argent. Nitrat. to both eyes. 24th. Both eyes nearly well; bowels very much purged. Omit the Senna. Repeat the powder and the ointment. 27th.-Could not see on the 22d: is now all but well. The ointment to be omitted; the purgatives to be continued until the eruption disappears. Case kept by Mr. TAYLOR. CASE V.-Edward Riley, nine months old; admitted 17th July with purulent inflammation; was taken ill Saturday, 12th July, the eye appearing weak. On Monday, the 14th, a great watery discharge came on, accompanied by matter; the conjunctivæ very red; the eyelids constantly closed. 17th. To the left eye, the Ung. Hydr. Oxymur.; to the right, the Ung. Argent. Nitrat. 19th.-Both eyes are better from the application of the ointments, but the right has improved the most. Repeat the ointments. 21st. The right eye is nearly well; the left is better; the discharge has nearly ceased; the eyes are both open; the cornea of the left muddy. The Ung. Argent. Nitr. to the right; nothing to the left. 24th.-Right eye cured. To the left, the Ung. Hydr. Oxymur. 26th.-Repeat. 29th. In this case a comparison was instituted between the two ointments, the eyes being nearly similarly affected. The Ung. Hydr. Oxym. did not seem to act as well as the Ung. Argent. Nit. which was therefore directed to be applied to the left. 31st. The left eye, since the application of the Ung. Argent. Nitr., is considerably better. Aug. 4, 7, 12, 19.-Repeated the ointment each day, and cured. Case kept by Dr. POCKROWSKY. CASE VI.-Charles Davies, aged sixteen; admitted 16th Aug. Has been ill a month with inflammation and purulent discharge from both eyes; the conjunctivæ of the lids red and swollen, and extending also to that of the globe. Ung. Argent. Nitrat. to both eyes. 18th. Declares himself greatly relieved; the pain and uneasiness less, as well as the discharge.-Repeat ointment. |