A practical treatise on the diseases of the eye / To which is prefixed, an anatomical introduction explanatory of a horizontal section of the human eyeball, by Thomas Wharton Jones. From the 4th rev. and enl. London ed. With notes and additions by Addinell Hewson.
- William Mackenzie
- Date:
- 1855
Licence: Public Domain Mark
Credit: A practical treatise on the diseases of the eye / To which is prefixed, an anatomical introduction explanatory of a horizontal section of the human eyeball, by Thomas Wharton Jones. From the 4th rev. and enl. London ed. With notes and additions by Addinell Hewson. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
612/1074 (page 604)
![to take two grains of calomel with one of oi^ium, on going to bed. On the 24tli, he felt the eye better, although there was not much evident ciiange in its appearance. The iris was discolored, and there was a lymphatic effusion into the pupil. He was ordered to take tlie calomel and opium morning and evening, to apply a blister to the nape of the neck, and to continue the other remedies. On tlie 27th, the mouth was affected, but the onyx had increased. Eight leeches were applied to the left temple ; the morning dose of calomel and opium was omitted. On the 31st, the pupil appeared to be contracting. On the 2d of June, the upper part of the cornea was observed to be nebulous, and the eye felt more uneasy. The nitras argenti solution was applied in the place of the vinum opii. By the 5th, the exterior lamina3 of the cornea had given way, and a considerable quantity of matter had been discharged from the onyx. The pupil was still more contracted. He complained of a feeling of sand in the eye. He was ordered an aqueous solution of ex- tract of belladonna as a collyrium. On the 7th, the blister was reapplied. By the 0th, the aqueous humor had evacuated itself, and the iris fallen forward into contact with the cornea. The matter of the onyx had almost entirely disappeared, and he said he saw a little better. On the 12th, the pupil, still in contact with tlie cornea, appeared clearer, sind vision was more distinct. On the 14th, a little aqueous humor was present between the upper part of the iris and the cornea; the ulcer of the cornea was covered with lymph : and all the pus gone. On the 26th, the pupil was considerably larger and clear; more aqueous humor was present between the iris and the cornea. By the 30th, the pupil was clear, and of considerable size. A minute adhesion between the slight leucoma on the cornea and the lower edge of the pvipil was observed when the eye was examined lat- erally. The vision of the eye was good. In this instance, then, I left the abscess of the cornea to itself, and certainly no case could have been more alarminj^in its progress, nor more unexpectedly favorable in its results. The causes of such success I have endeavored to ex- plain at page 504. When the abscess, however, does not incline to open of itself, but appears about to involve the whole cornea, an artificial exit must be afforded to the matter, were it merely to save the patient from the continuance of the violent pain which attends this symptom. The incision may be made conveniently with the iris-knife, and ought to comprehend only the external laminte of the cornea. No pus is in general discharged at the moment of making the inci- sion ; but it forms, in the course of some minutes, a small drop, which may be wiped away from the cornea. The operation, in most cases, requires to be several times repeated, before the onyx is entirely evacuated, and ought to be held out to the patient more as a palliative for the pain, than as a means of saving the sight, which, in such circumstances, is generally lost. The effect of evacuating the aqueous humor, by puncturing the healthy part of the cornea in the early stages of onyx, does not appear to be ascertained. It would, at least for a time, relieve the tension which attends severe inflam- mation of the eye ; and as onyx makes its appearance only in severe cases, it miglit have a good effect upon this dangerous symptom. To trust, however, almost solely to this, or to any other local means, without assiduously com- bating by general remedies, the ophthalmia in which the onyx has originated, would be highly improper. Mr. Guthrie's plan of dividing the whole thickness of the cornea, in cases of onyx, I have already explained at page 504. SECTION II.—HYPOPIUM. Hypopium, from l-no, under, and ttu'ov, pits. Sijn.—Occulus purulcutus. Das Eiterauge, Ger. Fig. Dcmours, PI. XXX. Figs. 2, .3. PI. XXXI. Fig. 1. Ammon, Thl. I. Taf. VIII. Fig. 3. Dal- rymple, PI. XVIII. Figs. 2, 3. Sichel, PI. IX. Figs. 5, G. Hypopium is a much rarer disease than onyx. We distinguish two varieties of it ; the true, and the spurious. 1. By true hypopium is meant a collection of pus or of puro-]ym})h in the](https://iiif.wellcomecollection.org/image/b21014760_0612.jp2/full/800%2C/0/default.jpg)
