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diff --git a/.gitattributes b/.gitattributes new file mode 100644 index 0000000..d7b82bc --- /dev/null +++ b/.gitattributes @@ -0,0 +1,4 @@ +*.txt text eol=lf +*.htm text eol=lf +*.html text eol=lf +*.md text eol=lf diff --git a/LICENSE.txt b/LICENSE.txt new file mode 100644 index 0000000..6312041 --- /dev/null +++ b/LICENSE.txt @@ -0,0 +1,11 @@ +This eBook, including all associated images, markup, improvements, +metadata, and any other content or labor, has been confirmed to be +in the PUBLIC DOMAIN IN THE UNITED STATES. + +Procedures for determining public domain status are described in +the "Copyright How-To" at https://www.gutenberg.org. + +No investigation has been made concerning possible copyrights in +jurisdictions other than the United States. Anyone seeking to utilize +this eBook outside of the United States should confirm copyright +status under the laws that apply to them. diff --git a/README.md b/README.md new file mode 100644 index 0000000..1689a1d --- /dev/null +++ b/README.md @@ -0,0 +1,2 @@ +Project Gutenberg (https://www.gutenberg.org) public repository for +eBook #50254 (https://www.gutenberg.org/ebooks/50254) diff --git a/old/50254-0.txt b/old/50254-0.txt deleted file mode 100644 index 56ef7cc..0000000 --- a/old/50254-0.txt +++ /dev/null @@ -1,2298 +0,0 @@ -The Project Gutenberg EBook of Treatment of the diseases of the eye, by -means of prussic acid vapour, and other , by Alexander Turnbull - -This eBook is for the use of anyone anywhere in the United States and most -other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms of -the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you'll have -to check the laws of the country where you are located before using this ebook. - -Title: Treatment of the diseases of the eye, by means of prussic acid vapour, and other medicinal agents - -Author: Alexander Turnbull - -Release Date: October 19, 2015 [EBook #50254] - -Language: English - -Character set encoding: UTF-8 - -*** START OF THIS PROJECT GUTENBERG EBOOK TREATMENT OF DISEASES OF EYE *** - - - - -Produced by The Online Distributed Proofreading Team at -http://www.pgdp.net (This file was produced from images -generously made available by The Internet Archive) - - - - - - - TREATMENT - - OF THE - - DISEASES OF THE EYE, - - BY MEANS OF - - PRUSSIC ACID VAPOUR, - - AND OTHER MEDICINAL AGENTS. - - BY - - A. TURNBULL, M.D., EDIN., - - HONORARY PHYSICIAN TO THE INDIGENT BLIND VISITING - SOCIETY; AUTHOR OF "A TREATISE ON PAINFUL AND - NERVOUS DISEASES," "VERATRIA, ACONITINA, - DELPHINIA," ETC., ETC. - - LONDON: - - JOHN CHURCHILL, PRINCES STREET, SOHO. - - 1843. - - - - -PREFACE. - - -Amid a multiplicity of professional duties I have appropriated a few -spare minutes to the preparation of this little work. It must, under -such circumstances, have many literary imperfections, for which I must -crave the indulgence of the Profession. But I trust it embodies some -useful and original principles and facts, that are, at least, entitled -to a dispassionate consideration. I take this opportunity of thanking -those Medical Gentlemen who so kindly, and so patiently watched several -of the cases recorded in these pages. - - 48, Russell Square, Feb. 1st, 1843. - - - - -CONTENTS. - - Page - - Introduction 1 - - Action of Hydrocyanic Acid upon the Eye 3 - - Action of Chlorocyanic Acid upon the Eye 7 - - Remarks on the Action of Carbon, &c. 15 - - Cases of Opacities of the Cornea, &c. 18 - - Cases of Staphyloma 27 - - Case of Inverted Eye-lashes, with Opacity - of the Cornea 33 - - Case of Conical Eye 35 - - Cases of Cataract 37 - - Cases of Amaurosis 41 - - W. H. Newnham, Esq.'s letter 47 - - Professor Forbes's letter 48 - - Case of Staphyloma, treated by - J. C. Atkinson, Esq. 51 - - Dr. Maclean's cases 53 - - Case of Diseased Cornea, treated by - G. K. H. Paterson, Esq. 61 - - CHAPTER II. - - Action of Essential Oils, &c. 67 - - Formulæ ib. - - Amaurosis 75 - - A. Cruikshanks, Esq.'s letters 83 - - Dr. Kent's letter 86 - - - - -INTRODUCTION. - - -In submitting to the public the following interesting cases -illustrative of the effects of my mode of treating diseases of the eye, -I have prefixed to them the original communications transmitted by me -to the _Lancet_ and the _Medical Gazette_. My reason for so doing is -this--I wish it to be seen by actual comparison, that in every instance -the confidence I have expressed in the efficacy of these medicines has -not been overrated; on the contrary, it will be seen that I have said -less than the facts really warrant. - -It will also be found, that the cases which have come under my -treatment are, without exception, such as have been regarded -either as hopeless, or at least such as have previously enjoyed, -without sensible benefit, all the advantages of our best Ophthalmic -Institutions. It cannot therefore be contended, that the ordinary -treatment would have proved equally efficacious if it had been -previously tried. - -I have also given the cases that are at present under my treatment, -in order that all who take an interest in the subject may have ample -opportunity of watching their progress, and forming, from their own -observations, just conclusions. - -I have also added some important observations concerning the action -of the essential oils on the eye, as exhibited both externally and -internally. - - - - -ACTION OF HYDROCYANIC ACID, &c. - -UPON - -THE EYE. - - -In September, 1841, I made the following communication to the editor of -the _Medical Gazette_, which he kindly inserted:-- - -It is a well-known fact, that the eyes of those who have been destroyed -by hydrocyanic acid show none of the usual symptoms of dimness for -a length of time after death.[1] On the contrary, the eye is clear -and the pupil much dilated. This satisfied me that the acid exerted -a specific action upon the eye, which might be made available as a -medical agent for relieving many of the diseases to which that organ is -so subject. - - [1] Morbid appearances produced by hydrocyanic acid in a case related - by Hufeland. - - The inspection was made the day after death. The eyes were still - glistening like those of a person alive; but the countenance - was pale and composed like one asleep. The arteries and left - cavities of the heart were empty, and the veins and right cavities - distended.--_Christison on Poisons, page 708._ - - In most instances venous turgescence and emptiness of the arterial - system is commonly remarked throughout the whole body.--_Christison on - Poisons, page 710._ - - It appears that long after death the eye, as in Hufeland's case, - has a peculiar glistening and staring expression, so as to render - it difficult to believe that the individual is really dead; and - this appearance has been considered by Dr. Paris so remarkable, as - even alone to supply decisive evidence of poisoning by hydrocyanic - acid.--_Christison on Poisons, page 711._ - - Numerous reports have now been made of those who have died in - consequence of this poison, and the most striking effects to be - observed are, the extraordinary state of the eye, which has indeed - been considered as the most characteristic phenomenon, and at once - to point out the cause of death: the shining, glistening, sparkling - lustre of the eye has been, on most occasions, observed. No one has, - so far as I am able to learn, attempted to explain this most striking - appearance; it has, however, been said, that those who die from the - effects of charcoal often exhibit the same unearthly lustre.--_Dr. - Sigmond on Poisoning with Prussic Acid.--The Lancet, August 26th, - 1837, page 797._ - -My first experiment was undertaken in 1837, with the diluted acid, by -dipping a sponge into it, and rubbing it upon the forehead for the -space of a few minutes, which gave the skin a very red appearance; but -the patient experienced not the least sense of heat, and the pupil -was slightly dilated. I continued to use this with very beneficial -effects in incipient cataract, opacities of the cornea, inflammation, -amaurosis, iritis, &c. Of late, instead of the diluted acid I have -applied the _vapour_ of the concentrated acid to the eye with much more -decided effect, and without the slightest danger. The plan I generally -adopt, is to put into an ounce-phial a drachm of the acid, and hold it -in close contact with the eye, the eyelid being open, for the space -of about half a minute, or until such time as the patient feels a -little warmth, or the person holding the phial sees the pupil greatly -dilated, and the vessels of the eye injected with blood, which is the -invariable effect of the application of the acid. The patient is not -sensible of pain from this peculiar state being induced, which appears -to me to result from the powerfully sedative influence of the acid,[2] -thereby showing that two opposite powers--to wit, the stimulating and -the sedative--are exerted at the same time; and thereby the uneasiness -arising generally from a stimulant alone is prevented. Its great power -in removing these diseases chiefly arises from the two powers being so -blended, and thus enabling the eye to bear a sufficient stimulating -action without injury. The person who holds the acid to the eye should -_be careful not to allow the patient to smell it_. - - [2] _Lancet, Sept. 16th, 1837, page 883._--In whatever manner it is - prescribed or administered, either therapeutically or as a poison, - hydrocyanic acid operates directly on the nervous centres.--_Professor - A. T. Thompson._ - -The _Medical Gazette_ and the _Lancet_ gave insertion to the following -statement of mine, of date Oct. 20, 1842. - -SIR,--In October, 1841, I gave an account of the action of the vapour -of _hydrocyanic acid_ upon diseases of the eye. Since that period I -have been engaged in investigating the action of various other bodies -on the same organ, and under the same form. - -One reason why I did not rest satisfied with the effects produced by -the hydrocyanic acid, was, that its action, like that of all other -medicines, decreased in power by continued application; thereby -rendering it necessary to have occasional recourse to other medicines, -in order to insure a more speedy recovery. Another reason was, the -reluctance of many individuals to submit the eye to the action of so -potent a medicine. - -The first medicines to which I shall refer, and which I have employed -with some success, are the _chlorocyanic acid_ and _sulphuretted -chyazic acid_. The plan I pursue is that of putting a drachm of one -of the medicines into a bottle (containing a small piece of sponge) of -about two-ounce size, having a mouth precisely fitted to the eye, and -with a ground-glass stopper. - -The action of these medicines is very different from that of the -_hydrocyanic acid_, in as far as they both stimulate the eye, and -produce much greater warmth and irritation, with less dilatation of the -pupil. Few, however, can bear the _chlorocyanic acid_ to be applied -longer to the eye than half a minute; though, in a minute after its -application, all irritation is removed, and the eye feels perfectly at -ease. - -The next medicine which I have employed in the form of vapour was the -chloruret of iodine. This medicine produces very little warmth or -uneasiness to the eye, if continued for the space of two minutes or -upwards; but a sensation of irritation, accompanied with a flow of -tears, takes place on its removal. It contracts the pupil, and in no -case have I seen it dilate it. Its vapour rises very readily, and does -not leave the yellow disagreeable colouring on the skin produced by the -vapour of iodine when uncombined, which is a great drawback in the use -of iodine in diseases of the eye. - -The last medicine which I have employed is the bisulphuret of carbon, -which is so volatile, that the application of it to the eye, when the -bottle is held in a warm hand for a few seconds, is as much as can be -borne, in consequence of the intense prickling heat and flow of tears -which it occasions. Owing to this fact, I generally use it by causing -the patient to shut the eyelid during its application, which can then -be continued for a minute or two, with the same beneficial effect upon -the eye, without inconvenience to the patient. It generally contracts -the pupil, and very seldom dilates it. - -I used to employ iodine by putting it into the same bottles, and -immersing it in hot water, and in its state of vapour applying it to -the eye; but I find it answers much better when dissolved in the -bisulphuret of carbon. - -It is my intention, shortly, to give a full account of the action of -these medicines upon the various forms of disease to which the eye -is subject, and also what particular disease each medicine is best -calculated to remove. At the same time I shall state such instances -of failure as have occurred in my experience, in order that a just -estimate may be formed of the value and importance of each medicine. - -It may not be out of place here to state, that I have employed, -with great success, the bisulphuret of carbon to enlarged indurated -lymphatic glands. In the first instance, I rubbed equal quantities of -the bisulphuret of carbon and alcohol upon the parts affected, but -without any effect upon the glands. But as its effects were so great -when its vapour was confined to the eye, I was led to apply it in the -form of vapour, and by means of glass bottles similar to those I have -described. By these means I excluded the action of the medicine from -the external air, and thereby prevented its speedy evaporation. When it -had been applied about one minute, the patient felt the part very cold, -but immediately after a gradual heat, accompanied with great prickling; -the heat increasing the longer the medicine was kept in contact with -the part, until it could be no longer endured. On removing the glass, -the part was red to an extent two or three times greater than the part -enclosed. In a few days the change in the size of the glands was very -great; and by its daily repetition, a complete and speedy removal of -the disease was effected. I also find that its action upon diseased -glands is more decided if the surface of the skin is well moistened -with water previous to the application of the bottle to the part. - -The water, in fact, not only prevents the escape of the vapour between -the glass and the skin, but assists the imbibition of the carbon; a -point of the highest importance, inasmuch as all its action on the part -depends upon the exclusion of the atmosphere from the vapour. I may -here observe that these applications occasion no injury whatever to the -skin. - -I have also found the _bisulphuret of carbon_, and the chlorocyanic -acid, valuable medicines in the removal of deafness, depending upon -a want of nervous energy and deficiency of wax. The mode of its -application is substantially the same as that which I employ in -diseases of the eye, with this difference only, that the bottle is -formed with a small neck and stopper adapted to the size of the orifice -of the ear, and held close to the organ until a considerable degree of -warmth is produced. - -The action of these medicines, which contain so large a share of -carbon, arises from the carbon in the vapour permeating the cuticle, -and coming in contact with the oxygen in the vessels, which is conveyed -through every part of the frame by inspiration and otherwise, and -thereby forming carbonic acid gas, which evolves heat in the ratio of -the quantity consumed by the oxygen. - -The following quotations from Professor Liebig, in his work on "Organic -Chemistry," sufficiently prove the correctness of this position:--"It -is only in those parts of the body to which arterial blood, and, -with it, the oxygen absorbed in respiration, is conveyed, that heat -is produced. Hair, wool, or feathers, do not possess an elevated -temperature. This high temperature of the animal body, or, as it -may be called, disengagement of heat, is uniformly, and under all -circumstances, the result of the combination of a combustible substance -with oxygen. In whatever way carbon may combine with oxygen, the act of -combination cannot take place without the disengagement of heat. We can -no longer doubt that gases of every kind, whether soluble or insoluble -in water, possess the property of permeating animal tissues, as water -penetrates unsized paper." - -Does not the action of medicines containing so large a portion of -carbon, which can be brought into contact with the whole external -surface of the body, and thereby capable of being easily disengaged, -suggest a method of relieving pulmonary disease likely to be attended -with no ordinary success, by calling into greater activity the action -of the skin, and thereby materially lightening the labour of the lungs? -Are we not the more encouraged to expect such remedial influence in -diseases of the lungs, from the fact of its great power in removing -indurated glands, which are so common accompaniments of consumption? -There can be no doubt of the usefulness of bisulphuret of carbon in -skin diseases. - -I have submitted these observations under the conviction that they -embody principles which may be carried out, and made of great utility -to mankind. - - I am, Sir, your obedient servant, - A. TURNBULL, M.D. - - 48, Russell Square, Oct. 20, 1842. - -A few weeks after the appearance of the above (Nov. 8, 1842), I wrote -to the Editor of the _Literary Gazette_ as follows:-- - - REMARKS ON THE ACTION OF CARBON, ETC. - - (_To the Editor of the_ "Literary Gazette.") - - 48, Russell Square, Nov. 8, 1842. - - SIR,--I beg leave to tender my sincerest thanks for your kind notice - in the last _Gazette_ of my recent discoveries on the treatment of - diseases of the eye, &c. Allow me to intrude for once in your crowded - columns, by referring to what you accidentally omitted--viz. the - manner of applying the _bisulphuret of carbon_, and also to add a - few reasons illustrative of the fact which you have quoted from me, - that its action depends on its union with the oxygen. The plan I - adopt is this:--I put a drachm of the bisulphuret of carbon into a - two-ounce bottle; the medicine is so volatile that the heat of the - hand causes the vapour rapidly to rise, and come into contact with the - skin. The action is more decided if the skin is previously moistened - with water; as the water not only prevents the escape of the vapour - between the glass and the skin, but also excludes the external air, - a point of the very highest importance. In my paper, which appeared - in the _Lancet_, of October 29th, I stated, that "when it had been - applied about one minute, the patient felt the part very cold, but - immediately after a gradual heat, accompanied with great prickling; - the heat increasing the longer the medicine was kept in contact with - the part, until it could no longer be endured. On removing the glass - the part was red, to an extent two or three times greater than the - part enclosed. These applications occasion no injury whatever to the - skin." Showing that the action of the bisulphuret of carbon depends on - its union with the oxygen in the blood-vessels, I will merely state - the following experiments:--Carbonic acid gas was applied in a similar - bottle, and in the same way, to the skin, the external air being - excluded, and the skin moistened with water, for the space of ten - minutes; but neither redness nor any sensible heat was induced; for - this satisfactory reason, that heat is the consequence of oxidation - with the carbon, which oxidation, in the case of carbonic acid gas, - had of course been previously effected. _Alcohol_, _sulphuric ether_, - _nitric ether_, and many other _ethers_--all of which contain a large - portion of carbon--were similarly tried, but had no effect; for the - same reason--viz. that it is already in a state of union with oxygen - in all these highly carbonized bodies. - - I remain, Sir, your obedient servant, - - A. TURNBULL, M.D. - - - - -CASE 1. - -_Opacity of the Cornea, the sequel of Small-pox._ - - -JOHN WRIGHT, a porter, aged 23, No. 10, Bear Yard, says that he has -been nearly blind in the right eye from small-pox, since he was two -years old. Five years since he was attacked with violent ophthalmia, -in consequence of exposure to cold. He then applied to one of our -Ophthalmic Institutions, where he remained as an out-patient for -eight months. For the first six months he had, thrice a week, caustic -applied to his left eye, after which black ointment for the remainder -of the time; but without receiving benefit. He then went to another -institution, where he remained an out-patient for seven months. The -treatment here consisted in dropping into the eye a liquid, and at -other times a powder was shaken into it, from which he derived no -benefit. He then consulted a private practitioner, who relieved him; -but, not satisfied with this, he went to another surgeon, who said -that the cause of his blindness was owing to a little squint, and he -submitted the eye to be operated upon for that purpose; but no good was -derived from this operation. None of the medical men attempted to do -anything to the right eye. - -In September, when I first saw him, his left eye was very much -diminished in size, and the cornea studded with white spots; the vision -very imperfect, and constantly discharging water. The right eye was so -opaque that neither iris nor pupil was to be seen, and he could only -see the shadow of an object. - -On the 23rd of January the left eye had got tolerably clear and free -from all specks, but still subject to water when exposed to the wind. - -The right eye is now becoming transparent, and vision in it is -improving. He states that it will soon be the best eye. - - - - -CASE 2. - -_Opacity of the Cornea from Inflammation._ - - -ANN FITZGIBBONS, aged 13, daughter of Thos. Fitzgibbons, 11, Stratton -Mews, is a day scholar at the Blind School, Queen Square. - -Her father states that in infancy she lost the left eye, owing to an -attack of inflammation. The right eye four years since became similarly -affected. She has been a patient at two Ophthalmic Institutions, where -she attended for several months without any benefit. She was brought to -me by her father on the 1st of October, 1842, who stated that for the -last four years she had been obliged to be led, and could only discern -the shadow and outline of objects, but could not distinguish them. - -On examining the left eye, I found it shut, and all the humours lost. -The right eye was much diminished in size, and the cornea was very -opaque, excepting at the upper part, where a small portion of light was -admitted. The bottle containing the acid was held to the left eye as -well as to the right, to ascertain what effect would be produced. To -my surprise, in the period of a month the chambers of the eye became -partially filled with aqueous humours, to the extent of at least half -the size of a healthy eye; the pupil was small, but the patient could -not see in the slightest degree. The right eye has become almost -transparent, and she can now see with it sufficiently well to be able -to go anywhere. Indeed, her sight has become almost perfect. The change -is so great that many are disposed to question the identity of the -girl, and the father is frequently asked whether the girl is really his -own daughter, whose eyes were so disorganized. - - - - -CASE 3. - - _Inflammation, ending in Opacity of the Cornea in the right eye and - Staphyloma in the left._ - - -WILLIAM GRINDLEY, aged 37, boot-maker, formerly of 16, Whitecomb -Street, Pall Mall, East, now of St. James's Workhouse, states that he -was attacked with acute inflammation in both eyes in 1839. He at first -had the advice of private practitioners, and subsequently went to two -different Ophthalmic Hospitals. He remained in one eleven months, in -the other fifteen. It appears from his own account that his sufferings -were very great, for he asserts his eyes and eye-lids were swollen very -much. The treatment consisted in bleeding, cupping on the temples, -lancing frequently the eye and eye-lids; caustic was applied to the -eyes, and seatons to the nape of the neck; leeches. The patient had two -caustic issues in the temples; he was salivated, and had administered -to him various potent drugs. - -On the 9th of August he was sent to me from the Board of St. James's -Workhouse, when he could scarcely discern light from darkness. He -said that he had been led about for the last three years. The left -eye was afflicted with staphyloma, and was perfectly opaque. The -cornea of the right eye was covered with a dense opacity, so much so -that no appearance of iris or pupil could be discerned through it. -The right was not so unnaturally prominent as was the left eye. The -vapour in this case was daily applied, and the progress of cure was so -rapid, that in the course of a month he was able to come to me from -St. James's without his accustomed guide. At Christmas he obtained -permission from the Board to be absent for a few days for the purpose -of visiting his wife and children. It was his wish to see the faces -of those near and dear to him; for in his former visits he could only -hear them talk, for not one glimpse of their countenances was he able -to obtain. The cornea of the right eye is rapidly becoming transparent. -The convexity of the left eye is still considerable, but the opacity is -so far removed as to give evidence that a continuation of the medicine -will render it again perfect, although it must take a considerable time -to effect so desirable an object. - - - - -CASE 4. - -_Two cases of ---- Ophthalmia, ending in Opacity of the Cornea._ - - -SARAH HOPPING, aged 15, daughter of Thomas Hopping, boot-maker, 20, -King Street, Drury Lane, and of the Blind School, Queen's Square, about -nine years ago had a violent attack of inflammation in both eyes. She -was taken to an infirmary, and remained there for many months, where -she became perfectly blind. She was afterwards taken to two Ophthalmic -Hospitals as an out-patient--one for six months, another three. The -treatment generally was lancing the inner eye-lids, and applying -caustic to both the eyes and temples, leeching and blistering both the -neck and temples often. The left eye was altogether opaque, and did not -show the least appearance of either iris or pupil when looking at it in -a strong light. The right eye appeared quite lost, for there was only -in the socket a small red tumour, about the size of a pea. - -The vapour was applied, and at the present time the opacity is so far -gone that she can see to walk alone; but there yet remains much to be -removed. - -Her sister Elizabeth, aged 12, was similarly affected, but the disease -had not attained to the same height. She is now almost well. - - - - -CASE 5. - -_Case of Ophthalmia, terminating in an Opacity of the Cornea._ - - -JOHN GADD, aged 31, of 16, Little Britain, bookbinder, states that -he has been blind and unable to guide himself for upwards of twelve -months, but for some months previously he felt himself gradually losing -the sight of his right eye. He went to an Ophthalmic Institution, and -in two or three days he was seized with a violent attack of ophthalmia, -which he attributed to the applications used for his recovery. He did -not know the nature of the ointment inserted in his eyes, but was -told it was black ointment. In ten days he visited another Ophthalmic -Institution, where he remained for two months. In this institution a -liquid was dropped into his eye, leeches were applied every night for -a week, issues were inserted in the temples, carbonate of iron was -administered for six weeks, and counter-irritants were applied to the -neck. - -From this time he became quite blind. He then went to another -Ophthalmic Institution, where he was cupped in the temples; the eyes -were scarified, aperient medicines were given, and lotions used. The -inflammation still continued, and he was unable to lift his head, or -allow the bandages to be taken off his forehead, without experiencing -the most excruciating pain. - -In this state he was brought to me on the 9th of September, 1840, when -I ordered for each eye two drops of the oil of almonds (after being -warmed) to be put into the eyes. The relief that he experienced was -so great, that he said he felt as if he were in another world. In -eight days the pain had greatly diminished. He was enabled to open -his eye-lids, but could discern no object whatever. I then ordered -castor oil to be dropped into each eye, for the purpose of removing the -opacity. He left me at the end of December, at which time he could see -very imperfectly; but returned to me in January, 1843, when the opacity -of the cornea still continued. He has had, almost daily, the prussic -acid vapour applied to his eye. He is at the present time so well that -he can read the smallest diamond print. - - - - -CASE 6. - -_Opacity of the Cornea and Staphyloma._ - - -GEORGINIA LARKINS, aged 10, at No. 25, Grafton Street, Newport Market, -and at the Blind School, Queen Square. Her aunt states that this -patient has been blind since she was six days old, in consequence -of an attack of inflammation, which gave rise to a great discharge -from the eyes. In her infancy fluids of various kinds were injected -underneath the eye-lids, and when four months old she was taken for -three years regularly to an Ophthalmic Hospital, where she was told -that the right eye was destroyed. The left eye had caustic applied -to it for a length of time thrice a week. Ointment was then applied -underneath the eye-lids until the eye became so very large that she -was at last told that it was a hopeless case, and that no more could -be done for her. Her next visit was to an eminent oculist, who said -he would not undertake the treatment of such a case. She then went to -another Ophthalmic Institution, where she remained for about two years -without deriving any improvement in her sight; but she was relieved -from much pain. - -I saw her first on the 6th of April, 1840, when the appearance of the -left eye seemed to be at least twice the size of a natural eye. It -was of a dark-blue colour, standing out beyond the lids; and where the -pupil ought to have been, there was a blue circular ring of lighter hue -than the rest of the eye, and in the centre of this ring was a white -body about the size of a pea. - -The right eye was quite a contrast, for it appeared perfectly white, -without the slightest appearance of iris or pupil. The eyes were -continually rolling about in their sockets. Looking at the little -creature, I said, "What do you expect me to do in such a fearful case?" -Without waiting for a reply, I said, "I will endeavour to diminish the -size of the eye, but unquestionably no hope can be held out that I can -restore the use of sight." - -I at first put, daily, a drop of castor oil into each eye, occasionally -substituting for the castor oil the oil of almonds. This treatment -in about two months diminished much the size of both eyes, and the -opacity of the right eye greatly decreased; so much so that a little -edge of the pupil became visible, and the child began to see, and in -four months she could walk alone. Shortly afterwards the pupil could -be distinctly seen, and there appeared a white speck upon the anterior -capsule of the lens. She ceased to be a patient of mine in December, -1840, but returned in January, 1842, when the prussic acid was daily -applied to both eyes. The left eye is diminished about one-half in -size, and light is becoming perceptible. The right has assumed a -healthy appearance; the cornea is transparent, and there is still a -spot upon the capsule, about the size of the eighth part of the pupil. -This does not appear to impede the vision. She can now read, with the -eye, the raised letters with great quickness. She was formerly taught -to read the letters with her fingers; she is also learning to read -common print. - -When the child came to me I had not had sufficient experience of the -effects of the prussic acid vapour, and I hesitated in using a remedy -of such acknowledged potency until I had, with great care, thoroughly -investigated its properties. This I have been engaged in doing for -several years, and I am now able to state, that in no case in which I -have used it has it been attended with any injurious effects either to -the eye or general health. - - - - -CASE 7. - -_Staphyloma of both Eyes._ - - -MARY ANN GOODMAN, aged 22, of St. Giles's Workhouse, and a scholar at -the Blind School, Queen Square, fourteen years ago was attacked with -violent inflammation of both eyes. To remove this she was subjected -to very active antiphlogistic treatment. The inflammatory symptoms -subsided, after which she was regularly led for five years to an -Ophthalmic Institution, at which place the right eye was operated upon -five times; in addition to which she was cupped three times and bled -from the arm twice; caustic was applied frequently to the inside of -the eye-lids; she was also blistered behind the ear and nape of the -neck. The patient was unable to walk about without assistance; if she -attempted to do so, she was knocked and jostled about. - -On the 4th of March her friends brought her to me, to ascertain whether -I could do anything for her. I could not hold out to her any great hope -of recovery; for both eyes were affected with staphyloma, and perfectly -opaque and studded with blue spots, and standing prominently out beyond -the lids, and having no appearance of iris or pupil in either eye. - -In the space of a fortnight the eye assumed a very different -appearance; each eye became greatly diminished in size. As the opacity -cleared off, a large triangular pupil made its appearance at the bottom -of the iris in the right eye, enabling her to see with the eye with -which, for fourteen years, she had not been able to discern light from -darkness. - -The progress of cure in the left eye is fully equal to that of the -right; so that now she is able to walk about in the crowded streets -with safety, and is intrusted to lead about two or three other persons -in the Blind School. She can distinguish colours, and is able to -perceive large letters. - -In such a state of disorganization as this poor girl's eyes were in, it -is unreasonable to anticipate that she can make much greater progress. - - - - -CASE 8. - -_Inverted Eye-lashes, with Opacity of the Cornea._ - - -DIANA PRIMROSE, aged 32, of No. 2, Benborough Street, St. Giles's, says -she had a violent attack, eight years back, of ophthalmia in both eyes, -accompanied with great swelling and constant discharge of matter from -the eye-lids, arising from the eye-lashes of both eyes being turned in. - -She was an out-patient to one of the Ophthalmic Hospitals for two -years, but, instead of getting better, she became worse. She then -applied to another Ophthalmic Institution, where she was subjected to -treatment for four months, but no improvement took place. Three years -ago her sufferings prompted her to visit a third institution, when one -of the surgeons cut off the upper eyelid of the left eye, which gave -rise to great pain and inflammation, but the opacity was not diminished -nor the vision improved. She was obliged, during the eight years, to -have her eye-lashes constantly pulled out. - -She visited me on the 28th of October, 1842, when the eye-lashes of -the right eye, both above and below, were still turned in, and rubbing -against the cornea. The eye-lids were exceedingly red; the cornea of -both eyes was nearly opaque, and only a small portion of the pupil -could be observed through the opacity. Her vision was so imperfect -that she could do little more than find her way about. She was often -confined to the house for a week at a time, through inflammation. - -The vapour was only applied for the space of a week, after which she -could see much better. The opacity was greatly diminished, and the -eye-lashes began to resume their proper position. She continues to use -the prussic acid vapour three or four times a week, and at the present -time she is able to follow her occupations with comfort, and the eye -is resuming all the appearance of health. She never has had occasion -to pull one eye-lash out since I first saw her. She is now very -comfortable, and can see tolerably well. - -This is the first case of the kind that I have treated with prussic -acid. - - - - -CASE 9. - -_Conical Eye._ - - -WILLIAM STEVENS, aged 25, at No. 20, Gracechurch Street, states that he -had been for several months at two different Ophthalmic Institutions, -where many modes of treatment were adopted to improve his vision; but -he was at length told they could do him no good, as the disease under -which he laboured was conical eyes. - -When I examined him, in May, 1840, I found the right eye so prominent -that it had the appearance as if a large transparent bead had grown -from the cornea. With this eye he could see a short distance. The -conical state was not only greater in the left eye, but there was an -opacity on the apex of the cornea. He could see nothing with it, if the -right eye were shut, unless the objects of vision came in contact with -his face. He continued to visit me, professionally, two or three times -a week, for four months, and had a drop or two of castor oil put into -both eyes each time. This treatment greatly diminished the prominency -of the right eye, and lengthened the vision; but the left eye was only -slightly benefited by it, although all opacity had been removed, and it -had diminished in size. - -In December last he again called upon me and wished to know if more -could not be done for him? He said he had continued to follow his -business with the use of concave glasses, but saw with great difficulty. - -The vapour was employed thrice a week for about three weeks, when -his vision was restored to its natural length. I saw him on the 21st -of January, and he said he was perfectly well, and could follow his -business with great pleasure to himself. - - - - -CASE 10. - -_Amaurosis of the Left Eye, and Cataract of the Right._ - - -GEORGE TROUSDALE, aged 37, horse-keeper, 37, William Street, Hampstead -Road, says, that when he was 8 years of age, a shoemaker's awl was -accidentally pushed through the right eyelid into the eye, which gave -rise to an attack of severe inflammation in both eyes. When the -inflammation subsided he found the vision of the right eye entirely -gone. The left eye became dim in May last, and his sight was much -disturbed by floating clouds passing before the eye. When he looked -steadily at an object the vision almost vanished. He experienced great -pain in the forehead and temple on the same side. - -He applied to an infirmary, where he remained as an out-patient for six -weeks. He was salivated, cupped, and leeched. He was then told that the -right eye was of no use, and they feared the vision of the left also -was destroyed. - -He then went to an Ophthalmic Institution, where he remained as an -out-patient for seven weeks. He was again salivated; a liquid was -dropped into his eye regularly, and he was blistered, but no good -resulted. - -He then went to a private oculist, under whose care he remained for -six weeks. He again was salivated; but still the sight became more -obscured, and the pains in his forehead and temple more acute. - -I saw him first in October; he was then suffering from severe pain -in the forehead and temple. The left eye was so blind that he could -not distinguish, even when placed close beside it, a large bookcase. -He said he could scarcely guide himself in the street. The pupil was -almost immoveable. There was a white cataract in the right eye, and a -total want of vision. - -He has had the vapour of the prussic acid applied to both eyes almost -daily since October. He can now, with the left eye, read ordinary-size -print, and is free from all pain. Nearly the upper half of the cataract -of the right eye is absorbed, and he is beginning to see with it. This -case shows the power of the acid in not only producing absorption, but -in the removal of amaurosis at the same time. Unless the capsule of the -lens had been lacerated by the awl, I do not think that the acid could -have had any power in causing absorption in a case of cataract which -had existed for the long period of twenty-eight years. He is still -under treatment. - - - - -CASE 11. - -_Cataract._ - - -MR. MONRO, aged 28, at No. 16, Featherstone Buildings, twelve years -ago, had violent inflammation, occasioned by the lash of a whip -striking the left eye, from which time he has been unable to see more -than the shadow of an object. He says that many have advised him to -submit to an operation for cataract, but others have recommended him -not to do so as long as one eye remained sound. - -On the 16th of May, when he applied to me, I tried, as an experiment, -the vapour of the prussic acid, which was employed for about three -months. At the end of that time he could see different objects, and -discern countenances, when the other eye was closed. - -Afterwards he went into the country, where he remained without using -any medicine. On his return to town, on the 18th of January, 1843 he -called upon me, when I found the eye was not improved in appearance. -He is now again under my care, and has had the vapour applied five -times. It appears to produce a very decided effect upon the vision. In -three or four parts the cataract appears as if it had been operated -upon with a couching needle. - -This is a case of great interest, and it is impossible for any -unprejudiced person to doubt the great absorbent powers of prussic acid -in many diseases of the eye; but I am certain it will not be a general -remedy for lenticular cataract (unless employed in its incipient state) -without operation, unless aided by rupturing the capsule of the lens by -the needle first. Many are the cases where we want such a solvent power -after operations. - - - - -CASE 12. - -_Amaurosis._ - - -ANN WEEKS, of No. 19, Little Queen Street, aged 14, daughter of Thomas -Weeks, carman, 52, Great Wilde Street, has been blind in her right eye -since she was two years old. The left eye is unaffected. When two years -of age she was taken to an Ophthalmic Hospital, where various modes of -treatment were adopted for the recovery of the eye, until the month of -March, 1842, when she went to another Ophthalmic Hospital, where she -attended for six months, but received no benefit. - -On the 16th of June the Rev. Peter Hall, of Long Acre Chapel, brought -her to me; and when examined in a strong light, with her face towards -the window, we could not perceive the slightest action of the pupil. -Mr. Hall and I tried her with a sheet of white paper, moving it before -her eyes several times, but she was perfectly unconscious of it. After -the eye was exposed to the vapour of prussic acid for a short time the -pupil acted slightly when exposed to light; and she was able, not only -to see the paper, but to take hold of it with her hand, and could walk -round the table when the left eye was shut. She continued the vapour -four or five times weekly for the space of six weeks. - -When she left me the eye was so far recovered as to answer all ordinary -purposes of vision, although not quite equal to the other. - -I have examined her to-day (Jan. 20, 1843), and find the improvement -continues. - - - - -CASE 13. - -_Amaurosis._ - - -FRANCES READ, aged 14, daughter of ---- Read, 71, Fetter Lane, and one -of the scholars at the Blind School, Queen Square. Her mother said that -she took her daughter to an Ophthalmic Institution until she was tired. -No good was effected. The parents of this case were unable to say when -the blindness first developed itself. She has always been able to see a -little with the right eye. - -I was first consulted in this case in July, 1842, when the right eye -appeared to have some vision. The pupil acted under a strong light, -but very sluggishly. She could observe objects very indistinctly with -the left eye. - -The prussic acid was employed almost daily, for three months, to both -eyes. The right eye recovered so that she can now thread her needle. -She is also learning to read. - -Upon the pupil of the left eye the prussic acid does not appear to have -the least effect. - -As a general rule, I have found that when prussic acid does not dilate -the eye, in amaurosis, much good is not to be expected from its use. -In such cases I am inclined to believe that the disease is caused by -pressure upon the optic nerve. - -It is my intention to persevere in the application of the vapour to the -left eye, with the view of ascertaining whether the sight may not be -restored. I do not despair of success. - - - - -CASE 14. - -_Congenital Amaurosis._ - - -GEORGE PRITCHARD, aged 7 years, son of Edward Pritchard, cab-driver, -Black Bull Yard, Gray's Inn Lane, and one of the scholars at the Blind -School, Queen Square. - -This patient has been totally blind from birth. His case has been -examined by almost all the eminent oculists of London, and has been -taken to several hospitals; but all the medical men, without one -exception, stated that they would not prescribe for him, as they could -do nothing for him. - -He was brought to me in May, 1840, at which time the eye appeared more -than half sunk in each orbit, and the pupil, when exposed to the action -of strong light, was fixed and immoveable. In fact, he had not the -slightest perception of light. - -Two drops of castor oil were put into his eye daily, for the space of -three months, before the pupil manifested a disposition to act. At -each successive month there was a visible change in the size of the -eye. When he left me, in Dec., 1840, he was not able to discern more -than light from darkness. - -He has visited me since the month of April, 1842, and has had, once -or twice a week, the vapour of the prussic acid applied to his eye. -He is now so improved that he is beginning to distinguish one object -from another, and the eye is assuming a healthy appearance. From -the progress that this boy has made the last two months, I think it -probable that the medicine may ultimately effect much greater good. - -The following letter was forwarded to me by H. Newnham, Esq., for the -purpose of publication:-- - - "January 24th, 1843. - - "MY DEAR SIR,--Having, by the vapour of prussic acid, been nearly - cured by yourself of an opacity of the cornea, which, for twenty years - past, had rendered the sight of my left eye of little worth more than - to distinguish light from darkness; and firmly believing that, when - I shall be able to replace myself under your care, my sight will be - perfectly restored; and having also, during my attendance at your - house, witnessed the beneficial effects of this remedy on many other - persons, the subjects of cataract, amaurosis, staphyloma, &c., I - earnestly beg you will accept this testimony of my high opinion of its - efficacy in these cases. - - "I am yours gratefully, - - "WILLIAM H. NEWNHAM, Surgeon, &c. - - "Late of Alton, Hants." - - "To A. Turnbull Esq., 48, Russell Square." - -Extract from a letter of Professor Forbes, of King's College, Aberdeen, -Jan. 23rd, 1843:-- - -"I seized the first hour which I could command after receiving your -note to call on Milne, that I might see in what state he was, as I -had not heard of him for some time. I was also desirous of having the -particulars of his case accurately from himself. - -"John Milne was a cooper, and in that capacity had gone with the -whale-ships to Davis's Straits and Greenland for sixteen years. - -"In July, 1836, he was seized with a violent inflammation in one of -his eyes, which soon extended to the other. After two years he became -so blind that he could not walk with safety in the streets, and after -meeting with a severe accident from his want of sight, he gave up -attempting to walk out alone. - -"He continued for more than two years in this state, always becoming -worse and worse in his sight. His eye-balls were covered with ulcers; -he suffered extreme pain, except when lying in bed with the room quite -darkened; and was at various times confined for six weeks without -being able to bear the admission of light into his room. During the -whole of this long period he was under medical treatment by different -surgeons without deriving any benefit, but, on the contrary, his case -seemed to become daily more hopeless. The only relief, indeed, which he -experienced was, he says, from the division of the blood-vessels, from -time to time, with which the eye-ball was covered. - -"In these circumstances he was brought to you by a surgeon who had -attended him, and began, under your direction, the application of the -prussic acid vapour. This gave him immediate relief, and in six weeks -the whole ulcers had disappeared, light was no longer troublesome to -him, and he saw quite well to go about his business and to read. - -"This was his state in autumn, 1841, at which time I first saw him, and -he continues equally well down to the present date. A slight opacity -in the cornea of both eyes still remains, and he cannot expose himself -to the blaze of a very bright day or to violent winds for a length -of time without experiencing a return of uneasiness. He is, however, -quite positive, that had he continued under your care for a sufficient -period, he would have quite recovered; and he has been planning a -voyage to London to have your additional advice. I discovered, however, -from him, that he has never got _the prussic acid of sufficient -strength_ since you left this; for it has never had the power of -bringing on the state of the eye which the strong acid did, and which -he found to be attended with so good effects. I have taken means to -get the acid prepared for him of the right strength, and hope that its -application will be as efficacious as he so confidently expects. - -"N.B.--The patient Milne was brought to me by George Rainy, Esq., -Surgeon to the Aberdeen Ophthalmic Institution." - -Extracted from the _Lancet_ of December 31st, 1842:-- - -"PRUSSIC ACID VAPOUR.--Mr. J. C. Atkinson, of Romney Terrace, -Westminster, in a letter to the Editor, dated December 26th, after a -few prefatory remarks, writes on this subject as follows:--A patient, -aged 28, who had rather a severe attack of variola last May, became, -after the recovery, subjected to staphyloma, one of the sequelæ of that -formidable complaint. In this he was treated according to the approved -methods, both at two public institutions and by private practitioners, -for some months, without any apparent advantage, when I was applied -to; I instantly determined on a trial of the prussic acid vapour, -having read in your able journal an account of this new remedy some -time before. After fourteen applications the opaqueness and prominence -abated considerably, and the eye is now very serviceable, and nearly as -useful as the sound one, no inflammation or appearance of irritation -being observable. The plan adopted by me was most simple: the affected -eye, open, was placed over a two-ounce phial, containing about half an -ounce of the acid, while the patient's hand, properly directed, was to -retain it in the position that was thought necessary. The time occupied -in this operation was from five minutes to a quarter of an hour. The -eye became in a short time inflamed, the conjunctiva exhibiting the -appearance of deep injection, which gradually disappeared in a few -hours, but which was not accompanied by any pain. No paralysis of any -of the appendages of the eye has resulted from the application. Such is -the outline of the case. I feel assured that this remedy will prove a -powerful auxiliary in the hands of a surgeon-oculist." - -Extract from the _Lancet_, of January 7th, 1842. Cases in which the -vapour of prussic acid was employed for the cure of Ophthalmic disease, -by Donald J. Maclean, M.D., Lic. Roy. Col. Surg. in Edinburgh. - -"I have been induced, for my own satisfaction, (in consequence of some -observations made by Sir George Sinclair, who had witnessed its effects -on patients under Dr. Turnbull's care), to give a very extended trial -to the prussic acid in cases of ophthalmic disease which might be -considered suitable for its application, and desire that the results -of some of the cases should be submitted to the consideration of those -of our profession who may take an interest in the subject I have, -therefore, made out a report of the following cases. In our present -state of knowledge it is impossible to explain the _modus operandi_ -of the prussic acid; it will be sufficient, meantime, to observe -accurately, and merely give the results of treatment. In what kind of -cases it will be found most suitable can only be determined by further -inquiry and experience. If, however, the results prove permanent, the -prussic acid must occupy a very high place amongst our remedial agents; -and, possessing stimulant properties of a peculiar character, it may -prove useful under many circumstances where diseases of the eye are not -readily amenable to ordinary treatment. - - - - -"CASE 1. - - -"J. MACKAY REAY, aged 11 years. Diffused opacity of the cornea, the -result of a protracted attack of scrofulous ophthalmia. The vapour -of strong prussic acid was applied, daily, for thirteen days, by -exposure of the eye to it, during which period the cornea gradually -got transparent. On the fourteenth day no remains of former opacity -existed, and the vision of that eye was perfectly restored. - - - - -"CASE 2. - - -"MARGARET MACKAY, Thurso, aged 12 years. Severe rheumatic ophthalmia, -of three weeks' duration. She complains of deep-seated aching pain in -the eye-ball, greatly aggravated in the evening and through the night; -no apparent disorder of the general health. The ordinary remedies were -used, viz., leeching, blisters, calomel, and colchicum: they appeared -to give no relief. The prussic acid was applied, daily, for about ten -days; the relief following each application was extraordinary; the pain -was trifling for the rest of the day. At the expiration of twelve days -the intolerance of light, the injected state of the vessels on the -sclerotica, and the other symptoms, entirely disappeared; and since -September the little patient has continued quite free from any symptom -of her former ailment. - - - - -"CASE 3. - - -"A girl, named MUNRO, from Mount Pleasant. Albugo of corneæ in both -eyes, the result of an attack of acute conjunctival ophthalmia, -which she had about two years ago, whilst residing in Dundee, where -various means were tried for her relief. Vision was almost completely -destroyed; she could not distinguish the outlines, form, or colours, -of objects presented to her. At her own urgent request, but without -holding out any prospect of her being benefited by it, the prussic acid -was applied, daily, for about six weeks. - -"11th day.--She states that she can see some objects. The corneæ appear -more transparent. At the end of another week she was able (in the -presence of Sir George Sinclair) to state the names of some objects, -and to recognise, with accuracy, the colours of a variety of flowers -which were presented to her in order to test the degree of progress -that had been made. She can now walk out and home to her own residence -(a distance of a mile and a half from Thurso) without assistance. -The improvement continues to be progressive, and the corneæ are now -comparatively translucent. - - - - -"CASE 4. - - -"SINCLAIR SUTHERLAND, a labourer, aged 26 years. Staphyloma of one eye, -and occlusion of pupil in the other, from effused lymph. In the centre -of this there was a small opening which would admit the point of a fine -needle. The prussic acid was applied, daily, for about three months. -Felt great relief in the staphylomatous eye since its application; the -prominence of cornea diminished at least one-half, and though formerly -opaque, from repeated attacks of inflammation and ulceration, it is, at -this date, quite translucent. The effusion of lymph in the other pupil -has been disappearing gradually, and the pupil is now about four lines -in diameter. The patient is quite sensible of the improvement taking -place, and can now name various objects presented to him. - - - - -"CASE 5. - - -"MR. ALEXANDER MACDONALD, jun., merchant, Thurso, has suffered for the -last six months from an affection of the retina, characterised by the -following symptoms, viz., obscurity of vision, excessive intolerance -of light, and deep-seated pain in the orbit. The external appearance -of the eye is quite healthy, and the motions of the iris are natural; -ascribable, he says, to too great application to business, and night -reading: and, in many respects, the symptoms resemble those of -inflammation of the retina. The ordinary treatment of this affection -was resorted to with some benefit, and the eye kept constantly shaded; -but the deep-seated pain continued, and the patient was getting -uneasy. The prussic acid was applied, daily, for about six weeks. The -relief obtained was great, and at the expiration of one month all the -former distressing symptoms had totally disappeared; but I thought it -advisable to continue the remedy for some time longer. The patient can -bear a strong light with impunity, and exert his eyes on any object, -however minute, without uneasiness, and is now quite well. - - - - -"CASE 6. - - -"MRS. M'KENZIE. Capsular cataract of one eye, of three or four years' -duration. By way of experiment, the prussic acid was applied for about -five weeks, daily. Absorption of the diseased structure was slowly -taking place all this time; it has now entirely disappeared, and -vision of this eye is quite restored. The result in this case was very -satisfactory. - - - - -"CASE 7. - - -"MRS. M'BEATH. Suffered for many years past from a disease combining -the characters of conjunctival and sclerotic ophthalmia. The prussic -acid was applied, daily, for about three weeks, and at the expiration -of that time the redness and angry appearance of the eye disappeared; -the organ looked clear and healthy, and no pain whatever was felt. The -patient can bear a bright light without uneasiness, and is now free -from any symptom of her former ailment. - - "Thurso, Caithness, Dec. 20, 1842." - -Extracted from the _London Medical Gazette_, of January 13th, 1843:-- - -PRUSSIC ACID IN DISEASED CORNEA. - - "_To the Editor of the Medical Gazette._ - - "Perth, December 31st, 1842. - - "SIR,--If you deem the following case of diseased cornea, &c., worthy - of a place in the _Medical Gazette_, I shall feel myself obliged, - while I have the honour to be, &c. &c., - - "G. K. H. PATERSON, - - "Surgeon." - -"CASE.--M. J., æt. 29, of a strumous diathesis, has been repeatedly -attacked with inflammation in both eyes alternately, accompanied with -more or less intolerance of light, and pain of head, ever since she had -small-pox, about her ninth year: to relieve this her friends sought -various means, but without any avail, and on entering her eighteenth -year she became blind. The catamenia had never appeared before she -was twenty; and from that period onwards, till about four years ago, -menstruation had always been scanty, and attended with the usual -symptoms of dysmenorrhœa. - -"On the 28th September, 1842, her eyes presented the following -state:--The right cornea transparent, with an unusual quantity -apparently of aqueous humour on the anterior chamber, so as to give -it externally a somewhat conical aspect; iris of a dark red colour, -and its pupillary edge contracted to the size of a pin-hole, and in -close contact with the capsule of the lens. No vision in this eye -remaining. That of the left cornea was all but opaque, from coagulated -lymph between its layers, with the exception of a small lucid segment, -at the upper and outer margin of its circumference; behind which, on -the eye being turned downward and inward, the pupil could be seen -contracted also, and of an oblong shape, along with a great increase of -aqueous humour in the anterior chamber, and the cornea, to external -appearance, much more bulged forward than that of the right. With this -eye she could only distinguish an object when it was rolled downward -and toward the inner canthus, on being passed between her and the light. - -"This ill-fated woman being altogether an object of charity, her -friends solicited me to take up her case, of which I was not at all -sanguine. However, having previously perused, with much pleasure, -a brief extract by Dr. Turnbull, on the fumes of prussic acid as a -valuable remedy in certain diseases of the eye, I was led to make trial -of a few applications of it in the above case, according to his method; -and I must candidly confess, that ere long I was completely astonished -on observing the rapid effect it produced on the opaque cornea before -mentioned; more so, as the longer I cautiously and perseveringly -used it, the greater in proportion did the inspissated lymph become -absorbed, and the layers of the cornea, over a wide space, begin to -assume their natural transparency, as also in dilating the pupil to -a considerable extent; so much, indeed, that before one month under -its use, she could observe objects in a very different light, and ere -another had elapsed, she could find her way out of doors by herself, -and come to my residence for any medicine she required; since which -she has gone on gradually to progress favourably, without any more -applications, and the vision is now sufficient to enable her to go -about free from the dread she had before, or the use of a guide. - -"During the use of this potent remedy, it struck me very forcibly that -the extract of belladonna might assist the case considerably (more -especially when one had reasons for suspecting adhesions to exist), -in keeping up a greater effect on the pupil than that arising from -the use of the acid, which every one will admit at once, who has seen -its powers depicted upon the human eye, to be only temporary, and, -I believe, still less so in disease of the cornea and iris than in -any other incident to such an organ. With such an object in view, and -after once applying the extract, smeared round the eye, at bed-time, I -soon found it to be also of considerable service, along with the daily -use of the fumes of the acid, which were both, afterwards, employed -assiduously in this manner, for the rest of the treatment. - -"But in drawing my remarks to a close at this time, I cannot refrain -from saying less, in regard to the utility which is likely to arise -from this medicine, when properly applied, than that, in such a -similar case as I have stated, I would not for a moment hesitate -again in giving it and the extract of belladonna a fair trial, so -convinced am I now, after employing it pretty freely by itself, in -different affections of the same organ (in all of which more or less -improvement of vision was manifested), of its potency to remove many -of those formidable diseases of the eye, more especially that of the -cornea, which are so often the opprobium of our art. However, before -I have done, it is but justice to ascribe this noble discovery to Dr. -Turnbull, whose indefatigable research has not failed to find out -others, no less wonderful in their effects, as they are useful to -mankind; and for such he cannot but claim to himself the best thanks of -the profession at large." - - - - -CHAPTER II. - -ON THE ACTION OF ESSENTIAL OILS, &C. - - -In October, 1835, a paper of mine appeared in the _London Medical and -Surgical Journal_, stating the beneficial action of a concentrated -tincture of capsicum for diseases of the eye, by rubbing it for a few -minutes daily over the forehead and temples with a sponge. - -Soon after this I was induced to try what effect essential oils, -possessing powerful stimulating properties, might possess in removing -amaurosis and diseases generally of the eye. The formulæ which I use -are-- - - EMBRO. CARYOPH. CO. - - ℞--Ol. Caryoph. - -- Lavand _āā_ Ʒiv. - -- Cinnamom. Ʒss. - Sp. Vin. Rect. ℥iij. - M. Ft. Embro. - - EMBRO. PIMENT. CO. - - ℞--Ol. Piment. - -- Rosmar. _āā_ ℥ss. - -- Cinnamom. Ʒss. - Sp. Vin. R. ℥iij. - M. Ft. Embro. - -Finding great utility to arise from the use of the cloves and pimento, -it appeared by no means undesirable or hopeless to administer them -internally for the same complaints. In order to shield the pungency -of these oils I united them with calcined magnesia, which, by its -very strong affinity with these essential oils, forms a body nearly -solid, and thereby removes all pungency, warmth, and even smell; for, -in this state, it requires to be held in the mouth for a considerable -time before it produces any warmth or pungency. They are thus rendered -easily taken, in sufficient quantity, without heat or uneasiness. - -Some children are the subjects of many diseases of the eye, producing -blindness from opacities, &c. I ordered the same to be made into a -powder, in which form it can be taken easily in any vehicle, without -exciting disagreeable warmth. The formulæ are-- - - PIL. CARYOPH. C. - - ℞--Ol. Caryoph. - Magnes. Cal. _āā_ Ʒi. - Ol. Cinnamom. qtt. vi. - M. Ft. Pil. xxiv. - - PIL. PIMENT. CO. - - ℞--Ol. Piment. - Magnes. Cal. _āā_ Ʒi. - Ol. Cinnamom. qtt. vi. - M. Ft. Pil. xxiv. - -The dose of these pills is one or two thrice a day. - -Expedition is required in the making of these pills, otherwise it -becomes a solid mass, and unable to be formed into pills. - -I have found an alcoholic extract of cloves and pimento, made into -pills with magnesia, equally efficacious. - - PULV. CARYOPH. C. - - ℞--Ol. Caryoph. - Magnes. Calc. _āā_ ℥i. - Ol. Cinnamom. Ʒi. - M. Ft. Pulv. - - PULV. PIMENT. CO. - - ℞--Ol. Piment. - Magnes. Calc. _āā_ ℥i - Ol. Cinnamom. Ʒi - M. Ft. Pulv. - -The dose of these powders is from four to eight grains thrice a day. - -In the making of these powders, the oil and the magnesia ought to be -well mixed and allowed to remain for half-an-hour, then reduce the mass -to fine powder, and keep it in glass bottles with stoppers. - -These medicines, by their local application, increase the circulation, -and give a greater supply of blood to the deficient organs, and thereby -produce natural tone and power. They are equally useful in removing -chronic diseases, where thickening and opacity have taken place, by -rousing into activity the absorbent and nervous influence by their -stimulating power. Among many others possessing the same power, is a -concentrated tincture of pepper nigrum, ginger, &c. - -The internal administration has been found much more serviceable in -chronic diseases of the eye, such as opacities, &c., than in amaurosis. - -The manner of using the embrocations is, by rubbing the forehead and -temples with a sponge saturated with the liquid. This plan alone, kept -up daily, is beneficial; but the efficacy is more than doubled if -another sponge, with warm or cold water, is rubbed upon the forehead -for a minute afterwards. By this the energy of the medicines in -inducing a free circulation is greatly augmented, and greater warmth -is rapidly developed. The rationale, in my opinion, is, that the large -quantity of carbon in some of the essential oils, and its solubility -in alcohol, permits it, by the friction, to pass through the cuticle -and unite with the oxygen. As the oils are very insoluble in water, and -as the alcohol has a strong affinity for the water, the carbon is more -readily disengaged, and forms a union with the oxygen in the vessels, -and thereby produces heat and great activity of circulation. I have no -doubt that that is the reason why many bodies are so pungent, when put -into the mouth. I have only given two cases--viz., John Plunkett and -William Dale--as illustrative of the action of the essential oils. - -It will be seen in the following extract from Tyrrell on the Eye, -"Functional amaurosis arises from a deficient supply of red blood." He -says-- - -"In these cases there always exists, I believe, a want of general -power and vigour of circulation at first; but in some instances of -long-continued affection of this kind, the local circulation never -regains its proper force and fulness; and the supply of blood is -inadequate to support the functions of the part, although the general -system recovers its natural tone and power." - -I think this statement very correct, and therefore the embrocations -producing so much additional circulation, point out at once the -essential oils, along with the water, as its proper remedy. I here -quote Magendie, who corroborates the plan which I adopt--viz., the -medicines being most useful when applied to the forehead and temples in -amaurosis:-- - - -EXTRACTS. - -"Lectures on the Physiology of the Nervous System, delivered in 1836, -in the College of France, by Majendie."--_Lancet, April 29th, 1837, -page 186._ - -"The integrity of both the optic and the fifth nerves, then, is -indispensably necessary for the exercise of vision, which is lost -whenever either of these nerves is separately destroyed." - -_Lancet, May 20th, 1837, page 279._ - -"Nervous pains of long duration and the greatest intensity have been -quickly removed by topical applications to the temporal region." - -_Lancet, page 280._ - -"Amaurosis cannot be considered as a simple affection of the optic -nerve; at least, in the actual state of the science, it is generally -impossible to say that the fifth nerve has no connexion with the -loss of sight, and in many cases the connexity is evident. Hence -a rule which I invariably follow of addressing my remedies, in the -first instance, to some of the branches of the frontal nerve; and -I have frequently had the satisfaction of observing some of these -cases of incomplete amaurosis improve sensibly under the influence of -therapeutic agents applied to the fifth pair. I would go even further -and say, whenever you have a case of incipient amaurosis, commence -by acting on this nerve, for it is at once the most expeditious and -efficient method. I cannot, however, quit this point without assuring -you that no physician is capable of treating diseases of the eye -unless fully in possession of the facts I have just had the honour -of explaining to you. These facts are daily becoming more numerous -and more convincing, and already a considerable number of our younger -practitioners, who devote themselves to the study of diseases of the -eye, are fully aware of the immense influence of the fifth pair of -nerves over the exercise of vision." - -_Lancet, page 281._ - -"To resume, then, what I have said concerning the sense of vision and -our several experiments, allow me once more to impress you with the -idea that sight can never be exercised in a complete and perfect manner -without a certain influence of the fifth pair of nerves; destroy that -influence, and you destroy vision. This is all we know upon the matter; -for up to the present moment we have been unable to determine how far -this influence extends, or in what manner it is communicated." - - -_Case of Amaurosis._ - -JOHN PLUNKETT, Mermaid Gardens, Hackney, formerly an attorney's clerk, -visited me in May, 1837, and stated that he had been blind and obliged -to be led about by his children for the last four years. For five years -previously his sight had been gradually diminishing. He further stated -that he was much troubled with floating images before his right eye, as -well as with clouds resembling animals, strange goblins, and sometimes -with flashes of lightning, vivid red, changing into light blue. One -great peculiarity of this miserable man's case was, that when he threw -back his head there appeared a stream of blood flowing from the top -of the right eye to the centre, where it formed into a circular pool -about the size of a split pea, but ultimately it became as large as a -shilling. It often remained a considerable time, and then diminished -gradually in red streaks. This was a matter of great alarm to him. He -had been at several Ophthalmic Institutions for nine years previously -to his visiting me. He has had electricity, tartarate of antimony, -blisters, issues, stramonium, mercury (until it produced dysentery), -and almost every kind of treatment that could be suggested, tried, but -to no purpose. - -When I saw him the pupil was immoveable, and the eye dull in the -anterior, and very obscure. The left eye was destroyed. He could not -discern, in a bright light, the shadow of white paper when it was moved -between him and the light. - -The compound embrocation of oil of cloves was used by rubbing it upon -the forehead and temples daily, and in the space of twelve days he was -able to discern objects and could touch them. In two months he could -put his finger through a ring when held by another person. He continued -occasionally under my care for about a year, during which time the -embrocation was regularly used. He could walk alone, and the eye was -generally useful, but he was not able to read with it. He could see -objects at the distance of thirty feet. - -The last month he has visited me once or twice a week, for the purpose -of having the prussic acid vapour applied to his eye, to ascertain if -the sight could be restored sufficiently to enable him to follow his -occupation as a clerk. In this case an advantage has been gained. The -patient is now able to read a little, which, previously to the use of -the prussic acid vapour, he was unable to do. - - -_Amaurosis._ - -WILLIAM DALE, boot-maker, of 14, Clarence Gardens, Regent's Park, -visited me in July, 1837. He stated, that with his right eye, for the -last year, he could only discern light from darkness; and that for -several months before he was much troubled by clouds and spots floating -before his eyes. The evening gaslight produced a continued flashing -of light from his eye. The light looked as if surrounded by all the -colours of the rainbow. - -He first went to an Ophthalmic Hospital, where he was blistered on -the temple and salivated. Nux vomica produced such an effect upon him -that all his limbs were involuntarily twitched, so as to alarm them -exceedingly. He then left, and went to another institution for three -months; and at length was told that the optic nerve was injured, so -as to render a restoration of vision impossible. The left eye, when -looked into, had a dark green, muddy hue, and the pupil was exceedingly -dilated and immoveable. He was unable to distinguish an object placed -before his eyes; yet he states that he could distinguish light from -darkness. - -When he applied to me I had the compound embrocation of pimento applied -occasionally to the forehead and temples, by means of a friction -sponge. During the first month he was able to discern objects and -colours. The pupil acted under the impression of light almost equal to -the good eye. It was not until this application had been used for a -year that the patient was enabled to read with the eye. - -I saw the patient this day (the 25th of Jan. 1843). The eye, upon -examination, appeared to be in a healthy state. The sight was not so -good as when he left me, and after he left off the applications, but -this he attributes to the circumstance of his general health not being -good, owing to his having suffered from intermittent fever. - - * * * * * - -In January, 1834, I published the first edition of my work upon -Veratria, and gave an account of two cases of amaurosis, combined with -tic-douloureaux, cured by the external application of veratria. I -there suggested that it was probable that amaurosis, uncombined with -tic-douloureaux, might be removed by applications of a stimulating -nature to the branches of the fifth pair of nerves. No notice of this -suggestion having been taken by medical men, I determined to put the -plan into execution, and employed a surgeon to carry it into effect -in St. Giles's Workhouse, where blind cases were given me for that -purpose. I here extract the case of Eleanor M'Cartney, for the purpose -of showing the power of capsicum when rubbed upon the forehead and -temples. I select this case of amaurosis for several reasons; she was -the first patient on whom I tried the efficacy of capsicum. She had -had, seven years previously, a stroke of palsy, which removed all power -of the right side. The only power recovered was that of the right -arm. The hearing was perfectly gone; and she had not had the least -perception of sight for seven years. It is now nearly eight years -since her recovery; and, at the present date (27th of Jan. 1843), she -can read perfectly well; and has never had another application since -the three first days. It will also satisfy the minds of many that a -recovery by stimulating applications of this description, is not of a -temporary nature. - -I here quote the case as given in my work on "Painful and Nervous -Diseases," page 131. - -"ELEANOR M'CARTNEY, aged 40, an inmate of St Giles's Workhouse, -was attacked, seven years ago, with palsy of the right side, when -perception of light and sound, in the right eye and ear, was -extinguished. There was a constant and profuse flow of tears, and the -pupil was immoveable. - -"The treatment commenced on the 19th of October, 1835, and was -continued for three days only. On the first day after the commencement -of the treatment there was a great abatement of the flow of tears, and -she could perceive light and light-coloured objects. On the second day -she could see a watch, and direct her hand to it, and distinguish the -palm from the back of the hand. On the third day she could distinguish -objects with great facility. There was no further application of the -remedy after the third day. On the fifth day she could read a duodecimo -prayer-book with ease. On the seventh day the flow of tears ceased, the -pupil moved readily, and her sight and hearing were perfect. She is -still an inmate of the workhouse, and may be seen on application to the -matron, Mrs. Bailey." - -The next case which I select from the same work is that of ALEXANDER -CRUIKSHANKS, Esq., of Strathcathro Castle, Forfarshire. When this -case came under my care he was undergoing the necessary preparation -for an operation for cataract. The peculiar difference in the removal -of cataract without operation is, that the person afterwards needs -no cataract glasses, as will be seen from the extracts of two of Mr. -Cruikshank's letters to the author. It is now seven years since his -recovery, and he is at the present date perfectly well. - -"March 8th, 1836.--My right eye was affected with dimness, or defect of -vision, so long ago as the year 1810, and commenced by the deceptious -effect of seeing two objects distinctly where there really was but one. -This deception of double vision gradually disappeared as the vision -of the eye became imperfect. The other eye was not affected until -about four or five years ago. The affection of this, like the other, -commenced and continued, with the double vision, until Dr. Turnbull's -remedy was continued six weeks, when it totally disappeared. The right -eye, by this time, was restored to such a healthy state, that I could -read 'Blackwood's Magazine,' or the leading article of a newspaper, -without glasses, and the smallest print with them. By the way, it may -be proper to mention that it was not till July last, 1835, that I -ascertained, beyond question, the nature of the complaint with which I -was affected. In that month I applied to an eminent oculist, who, after -two examinations, informed me the complaint was cataract." - - * * * * * - -"May the 10th, 1836.--I am favoured with your letter of the 3rd -instant, intimating that you had heard it reported that the benefit I -had derived from your treatment of my eyes had disappeared. The only -person with whom I have had any communication on the subject is my -friend, Mr.----, whom I informed that the remedy was applied to my -forehead and temples, by friction only, without your having prescribed -or administered one grain of medicine, or having confined me to the -house, or directed the slightest change in my former habits of living, -either as to drink or diet; and that my sight was good enough to read, -write, fish, shoot, and to see a pin on the floor at the most distant -corner of an ordinary-sized room. What more can, or ought, a man of 67 -years of age wish for in this respect? But if any are sceptical as to -your mode of treatment, let them produce a testimony like this of a -superior method. - - "My dear Sir, - - "Yours very faithfully, - - "ALEXANDER CRUIKSHANKS." - - "A. Turnbull, Esq., M.D." - -The only other case which I intend to quote, in order to show that the -recoveries are lasting when the essential oils have been employed, -is the case of Dr. Kent. This gentleman continues perfectly well. -It is now nearly seven years since his recovery. He had, alternate -days, rubbed upon his forehead and temples, with the friction sponge, -the compound clove and pimento embrocation, quoted from page 136, on -"Painful and Nervous Diseases." - -[Illustration: Friction Sponge] - -The following case was communicated to me, by letter, from the patient, -DR. KENT, who was for several years a physician in extensive practice -at Walsall, in Staffordshire, now residing in Harley Street, Cavendish -Square. - - "39, Duke Street, St. James's, - "April 19th, 1836. - - "MY DEAR SIR,--Thinking that an outline of the principal features in - my case might be perused with advantage by many who take an interest - in the success of your efforts, I have subjoined it in as concise - a form as justice to the subject would admit. Upon my return from a - very cold ride in a violent storm of snow and sleet, on the evening - of the 29th of January, 1836, I discovered that the sight of my right - eye was gone. In a few hours violent inflammation supervened, and - continued several weeks, in spite of the most vigorous and energetic - treatment, its principal seat being the optic nerve, and subsequently - the iris. The inflammation was at length overcome, but vision was - not restored; and the irritability in both eyes was so great as to - render it absolutely necessary not only to avoid all attempts to use - them, but also to exclude them from the light. The sight of the right - eye was entirely, and, as I feared, irrecoverably gone; its pupil - contracted almost to the size of a pin's point, and immoveable. I - removed to the country, by the advice of the professional friends who - had attended me, in the hope that, as my general health improved, the - irritability would subside, although they gave me no reason to expect - that the organ, originally diseased, would ever again prove of much - use to me. In this opinion a medical gentleman of high celebrity, in - Oxford, coincided; but he strongly recommended me to consult some of - the most eminent oculists in the Metropolis. A much esteemed friend - having mentioned your success in the treatment of many obstinate and - almost inveterate cases, I placed myself under your care on the 2nd - of April, and had the satisfaction to find, that after the lapse of - three or four days, a very considerable alteration was observable in - the appearance of the right eye, and that my perception of light, and - afterwards of objects, became more distinct. The improvement has been - regularly progressing, and I am now (the 19th of April) able to read - with ease with that eye which, only three weeks ago, could scarce - distinguish light from darkness. I may also add, that the irritability - which so long annoyed me, ceased almost immediately after your first - application, and I have not since been troubled with it. - - "I am, my dear Sir, - - "Yours, very sincerely, and much indebted, - - "BENJAMIN ARCHER KENT, M.D." - - "A. Turnbull, Esq., M.D., &c. &c." - - - THE END. - - - - - CITY PRESS, LONG LANE: D. A. DOUDNEY. - - - - - FRICTION SPONGE. - - See Plate, page 66. - - - - - _Preparing for Publication_, - - In One Vol. - - - SUGGESTIONS - - FOR AN - - IMPROVED TREATMENT OF THE - DISEASES OF THE HEART - AND LUNGS, &c. - - BY A. TURNBULL, M.D., EDIN. - - - - -WORKS BY THE SAME AUTHOR. - - -Price 6s. boards. - -ON THE MEDICAL PROPERTIES OF THE NATURAL ORDER RANUNCULACEÆ; AND MORE -PARTICULARLY ON THE ALKALOIDS, VERATRIA, SABADILLINE, DELPHINIA, AND -ACONITINE. - -"In our last number we expressed a hope that the experience of others -might confirm that of the author, promising at the same time that we -should communicate the result of our own trials. It is unnecessary -to assure our readers that on this, as on every other subject of -professional inquiry, our minds have not been biased either by -prejudice or partiality. Truth and justice are ever the only guides of -our conduct. - -"We are satisfied that the medicine exerts a very peculiar effect as a -counter-irritant; it seems to differ from all others in this respect, -that its operation is confined solely to the nerves of the part, the -blood-vessels being scarcely affected. - -"It is therefore our decided opinion that Veratria is a useful and -very potent medicine in certain nervous affections, and that it -deserves to be, and no doubt will become, an established member of -the Materia Medica."--_Editorial Remarks on Veratria, Dr. Johnson's -Medico-Chirurgical Review, July, 1834._ - -"I have often cured most successfully cases of Tic-Douloureux of the -face, by sprinkling small blisters, made in the course of the affected -nerves, with one or two grains of Veratria, and repeating it every -three or four days. I use the same means, and with equal advantage, in -cases of paralysis. I need not add, that in these cases the application -should be made in the course of the facial nerve."--_Majendie's -Formulary, 8th edition, 1835._ - -"I have now made a very considerable trial of the Veratria ointment as -an external application in gout, and with such share of satisfaction -in its effects, that I acknowledge myself much indebted to the work of -Dr. Turnbull for the possession of a very useful remedy. - -"My conclusive opinion of the action of the Veratria ointment in gout -is, that we may consider it to be entirely a local remedy. I have not -detected any constitutional effects to be produced by it in any case of -gout in which I have prescribed it. Probably the absorbents of a part -affected with gout are in a torpid state. It is no small praise of the -application, that it does not produce any inconvenient effects, and the -patient is pleased with its mode of operation."--_Sir C. Scudamore's -Principles of the Treatment of Gout, 1835._ - -"Veratria has, since the last year, become so important a medicine, -having been recommended first by Dr. Turnbull; and now fairly ranking -among the most salutary ingredients in Materia Medica, it must -naturally be of great interest to the pharmaceutical and medical world -to obtain so valuable a substance in its purity."--_Silliman's American -Journal, April, 1836._ - - -Price 3s. 6d. boards. - -ON THE PREPARATION AND MEDICINAL EMPLOYMENT OF ACONITUM NAPELLUS AND -ITS ALCALOID ACONITINA. - -"Aconitine will cure a local pain where every description of depletive -and counter-irritant has failed."--_London Medical Gazette, Nov. 5, -1836._ - -"Dr. Turnbull's work will be read with great interest by persons -afflicted with neuralgia and other painful diseases. The profession -is certainly indebted to him for drawing the attention of the -public to an important, very potent, and much-neglected class of -substances."--_London Medical Gazette, April 1st, 1837._ - -"As a topical remedy, aconitine is most valuable for the relief of -neuralgic and rheumatic pains. In neuralgia no remedy, I believe, -will be found equal to it. One application of the tincture produces -some amelioration, and after a few times use it frequently happens -that the patient is cured. In some cases the benefit seems almost -magical.--_Pereira's Elements of Materia Medica, vol. II., page 1808._ - -"Of the great efficacy of aconitina in neuralgic and rheumatic -affections, no one can entertain any doubt who has submitted the remedy -to trial."--_Pereira's Elements of Materia Medica, vol. II., page 1812._ - -_Aconitine, discovered by Geiger and Hesse, in Aconitum Napellus and A. -Ferox._--Our knowledge of this base is very limited. There is reason -to think, from the experiments of Dr. Turnbull, either that the plant -contains two bases, or that the aconitine of Geiger and Hesse is an -_altered product_. - -"Dr. Turnbull has succeeded in producing, but with difficulty and in -small quantity, an aconitine possessing in perfection all the active -properties of the plant. It produces _numbness_ of the _tongue_ when -applied to it, and is said to _contract the pupil_, whereas Geiger's -aconitine _dilates_ it. In obtaining the aconitine of Turnbull, much -appears to depend on the freshness of the plant; and the alkaloid -itself is easily decomposed, especially by alkalies. - -"As a remedy in neuralgia and similar painful and obscure diseases, -the aconitine of Turnbull possesses most valuable powers. Could it be -obtained at a reasonable price, it would be extensively employed. At -present, however, only one manufacturer has been able to obtain it, -and that in small quantity. The aconitine of Geiger and Hesse does not -appear to possess the same action on the system.--_Turner, Leibeg, and -Gregory's Elements of Chemistry, 1842, page 1167._ - - -CORRIGENDA. - -In part of the impression the following errors occur:-- - - Page 37, line 14, _for_ "28" _read_ 8. - Page 38, line 15, _for_ "months" _read_ weeks. - - * * * * * - -Transcriber's Notes - -Obvious typographical errors have been silently corrected, other -variations in spelling and punctuation remain as in the original. - -The original began with an unidentified illustration. This appears -to be the Friction Sponge referred to at the end of the book. The -illustration has been placed on page 86 where its use is described and -a caption has been added. - -In the heading of CASE 4, "Two cases of ---- Ophthalmia, ending in -Opacity of the Cornea." ---- represents a word crossed out in all -available copies of the book. - -The first of the corrigenda has been implemented, the second had -already been corrected in the original. - - - - - -End of the Project Gutenberg EBook of Treatment of the diseases of the eye, -by means of prussic acid vapour, and , by Alexander Turnbull - -*** END OF THIS PROJECT GUTENBERG EBOOK TREATMENT OF DISEASES OF EYE *** - -***** This file should be named 50254-0.txt or 50254-0.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/5/0/2/5/50254/ - -Produced by The Online Distributed Proofreading Team at -http://www.pgdp.net (This file was produced from images -generously made available by The Internet Archive) - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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Turnbull, M. D. - </title> - <link rel="coverpage" href="images/cover.jpg" /> - <style type="text/css"> - -body { - margin-left: 10%; - margin-right: 10%; -} - -h1 -{ - margin-top: 2em; margin-bottom: .5em; - text-align: center; - font-size: x-large; - font-weight: normal; - line-height: 1.6; -} - h2,h3{ - text-align: center; - clear: both; - } - - -h3.invisible {visibility: hidden; font-size: small; line-height: 1;} -div.chapter {page-break-before: always;} - -h4 {text-align: center;} - -p -{ - margin-top: .75em; - text-align: justify; - margin-bottom: .75em; -} - - -.pi20 {margin-left: 20%} -.pi30 {margin-left: 30%} -.pi60 {margin-left: 60%} -.break-before { - page-break-before: always; -} - -.space-above {margin-top: 3em;} - -hr.tb {width: 45%; margin-left: 27.5%; margin-right: 27.5%;} -hr.chap {width: 65%; margin-left: 17.5%; margin-right: 17.5%;} - - -table { - margin-left: auto; - margin-right: auto; - margin-top: 20px; - margin-bottom: 20px; -} - -.pagenum { /* uncomment the next line for invisible page numbers */ - visibility: hidden; - position: absolute; - left: 92%; - font-size: smaller; - text-align: right; -} /* page numbers */ - - -.blockquote { - margin-left: 5%; - margin-right: 10%; -} - -div.hangsection p {text-indent: -3em; margin-left: 3em;} - -.center {text-align: center;} - -.right {text-align: right;} - -.smcap {font-variant: small-caps;} - -.xxs {font-size: xx-small;} -.xs {font-size: x-small;} -.small {font-size: small;} - - -/* Images */ -.figcenter {margin: 1em auto; text-align: center;} -.caption {font-size: smaller; font-weight: bold;} -img {border: none; max-width: 100%} - -/* Footnotes */ -.footnotes {border: dashed 1px;} - -.footnote {margin-left: 10%; margin-right: 10%; font-size: 0.9em;} - -.footnote .label {position: absolute; right: 84%; text-align: right;} - -.fnanchor { - vertical-align: super; - font-size: .8em; - text-decoration: none; - white-space: nowrap -} - - -/* Transcriber's notes */ -.transnote {background-color: #E6E6FA; - color: black; - font-size:smaller; - padding:0.5em; - margin-bottom:5em; - font-family:sans-serif, serif; } - </style> - </head> -<body> - - -<pre> - -The Project Gutenberg EBook of Treatment of the diseases of the eye, by -means of prussic acid vapour, and other , by Alexander Turnbull - -This eBook is for the use of anyone anywhere in the United States and most -other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms of -the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you'll have -to check the laws of the country where you are located before using this ebook. - -Title: Treatment of the diseases of the eye, by means of prussic acid vapour, and other medicinal agents - -Author: Alexander Turnbull - -Release Date: October 19, 2015 [EBook #50254] - -Language: English - -Character set encoding: UTF-8 - -*** START OF THIS PROJECT GUTENBERG EBOOK TREATMENT OF DISEASES OF EYE *** - - - - -Produced by The Online Distributed Proofreading Team at -http://www.pgdp.net (This file was produced from images -generously made available by The Internet Archive) - - - - - - -</pre> - - - -<h1>TREATMENT<br /> - -<span class="xxs">OF THE</span><br /> - -DISEASES OF THE EYE,</h1> - -<p class="center"><span class="xs">BY MEANS OF</span></p> - -<p class="center">PRUSSIC ACID VAPOUR,</p> - -<p class="center"><small>AND OTHER MEDICINAL AGENTS</small>.</p> - -<p class="center space-above"><small>BY</small></p> - -<p class="center">A. TURNBULL, M.D., <span class="smcap">Edin.</span>,<br /> - -<span class="xs">HONORARY PHYSICIAN TO THE INDIGENT BLIND VISITING<br /> -SOCIETY; AUTHOR OF "A TREATISE ON PAINFUL AND<br /> -NERVOUS DISEASES," "VERATRIA, ACONITINA,<br /> -DELPHINIA," ETC., ETC.</span></p> - -<p class="center space-above"><small>LONDON</small>:<br /> - -JOHN CHURCHILL, PRINCES STREET, SOHO.<br /> - -<small>1843</small>.</p> - - -<hr class="chap" /> - - - -<div class="chapter"><h2><a name="PREFACE" id="PREFACE">PREFACE.</a></h2></div> - - -<p>Amid a multiplicity of professional duties I have -appropriated a few spare minutes to the preparation -of this little work. It must, under such circumstances, -have many literary imperfections, for which -I must crave the indulgence of the Profession. But -I trust it embodies some useful and original principles -and facts, that are, at least, entitled to a dispassionate -consideration. I take this opportunity of -thanking those Medical Gentlemen who so kindly, -and so patiently watched several of the cases recorded -in these pages.</p> - -<blockquote> - -<p>48, Russell Square, Feb. 1st, 1843.</p></blockquote> - - - -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_v" id="Page_v">[Pg v]</a></span></p> - - - - -<div class="chapter"><h2><a name="CONTENTS" id="CONTENTS">CONTENTS.</a></h2></div> - - - -<div class="center"> -<table border="0" cellpadding="4" cellspacing="0" summary=""> -<tr><td align="left"></td><td align="right"><small>Page</small></td></tr> -<tr><td align="left"><a href="#INTRODUCTION">Introduction</a></td><td align="right">1</td></tr> -<tr><td align="left"><a href="#ACTION_OF_HYDROCYANIC_ACID_c">Action of Hydrocyanic Acid upon the Eye</a></td><td align="right">3</td></tr> -<tr><td align="left"><a href="#Action_of_Chlorocyanic_Acid">Action of Chlorocyanic Acid upon the Eye</a></td><td align="right">7</td></tr> -<tr><td align="left"><a href="#ACTION_OF_CARBON">Remarks on the Action of Carbon, &c.</a></td><td align="right">15</td></tr> -<tr><td align="left"><a href="#Opacity_of_the_Cornea">Cases of Opacities of the Cornea, &c.</a></td><td align="right">18</td></tr> -<tr><td align="left"><a href="#Case_of_Staphyloma">Cases of Staphyloma</a></td><td align="right">27</td></tr> -<tr><td align="left"><a href="#Inverted_Eye-lashes">Case of Inverted Eye-lashes, with Opacity of the Cornea</a></td><td align="right">33</td></tr> -<tr><td align="left"><a href="#Conical_Eye">Case of Conical Eye</a></td><td align="right">35</td></tr> -<tr><td align="left"><a href="#Cataract">Cases of Cataract</a></td><td align="right">37</td></tr> -<tr><td align="left"><a href="#Amaurosis">Cases of Amaurosis</a></td><td align="right">41</td></tr> -<tr><td align="left"><a href="#W_H_Newnham">W. H. Newnham, Esq.'s letter</a></td><td align="right">47</td></tr> -<tr><td align="left"><a href="#Professor_Forbes">Professor Forbes's letter</a></td><td align="right">48</td></tr> -<tr><td align="left"><a href="#Case_of_Staphyloma">Case of Staphyloma, treated by J. C. Atkinson, Esq.</a></td><td align="right">51</td></tr> -<tr><td align="left"><a href="#Dr_Macleans_Cases">Dr. Maclean's cases</a></td><td align="right">53</td></tr> -<tr><td align="left"><a href="#DISEASED_CORNEA">Case of Diseased Cornea, treated by G. K. H. Paterson, -Esq.</a></td><td align="right">61<span class="pagenum"><a name="Page_vi" id="Page_vi">[Pg vi]</a></span></td></tr> -<tr><td align="left"><a href="#CHAPTER_II">CHAPTER II</a>.</td></tr> -<tr><td align="left"><a href="#ON_THE_ACTION_OF_ESSENTIAL_OILS">Action of Essential Oils</a>, &c.</td><td align="right">67</td></tr> -<tr><td align="left"><a href="#ON_THE_ACTION_OF_ESSENTIAL_OILS">Formulæ</a></td><td align="right">ib.</td></tr> -<tr><td align="left"><a href="#Amaurosis">Amaurosis</a></td><td align="right">75</td></tr> -<tr><td align="left"><a href="#A_Cruikshank">A. Cruikshanks, Esq.'s letters</a></td><td align="right">83</td></tr> -<tr><td align="left"><a href="#Dr_Kents_Letter">Dr. Kent's letter</a></td><td align="right">86</td></tr> -</table></div> -<hr class="chap" /> -<p><span class="pagenum"><a name="Page_1" id="Page_1">[Pg 1]</a></span></p> - - - - -<div class="chapter"><h2><a name="INTRODUCTION" id="INTRODUCTION">INTRODUCTION.</a></h2></div> - - -<p>In submitting to the public the following interesting -cases illustrative of the effects of my -mode of treating diseases of the eye, I have prefixed -to them the original communications transmitted -by me to the <cite>Lancet</cite> and the <cite>Medical -Gazette</cite>. My reason for so doing is this—I -wish it to be seen by actual comparison, that in -every instance the confidence I have expressed -in the efficacy of these medicines has not been -overrated; on the contrary, it will be seen that -I have said less than the facts really warrant.</p> - -<p>It will also be found, that the cases which -have come under my treatment are, without exception, -such as have been regarded either as -hopeless, or at least such as have previously<span class="pagenum"><a name="Page_2" id="Page_2">[Pg 2]</a></span> -enjoyed, without sensible benefit, all the advantages -of our best Ophthalmic Institutions. It -cannot therefore be contended, that the ordinary -treatment would have proved equally efficacious -if it had been previously tried.</p> - -<p>I have also given the cases that are at present -under my treatment, in order that all who take -an interest in the subject may have ample -opportunity of watching their progress, and -forming, from their own observations, just conclusions.</p> - -<p>I have also added some important observations -concerning the action of the essential oils -on the eye, as exhibited both externally and -internally.</p> - -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_3" id="Page_3">[Pg 3]</a></span></p> - - - - -<div class="chapter"><h3><a name="ACTION_OF_HYDROCYANIC_ACID_c" id="ACTION_OF_HYDROCYANIC_ACID_c">ACTION OF HYDROCYANIC ACID, &c.</a><br /> - -<span class="xs">UPON</span><br /> - -<big>THE EYE</big>.</h3></div> - - -<p>In September, 1841, I made the following communication -to the editor of the <cite>Medical Gazette</cite>, -which he kindly inserted:—</p> - -<p>It is a well-known fact, that the eyes of those -who have been destroyed by hydrocyanic acid -show none of the usual symptoms of dimness for -a length of time after death.<a name="FNanchor_1" id="FNanchor_1"></a><a href="#Footnote_1" class="fnanchor">[1]</a> On the contrary,<span class="pagenum"><a name="Page_4" id="Page_4">[Pg 4]</a></span> -the eye is clear and the pupil much dilated. -This satisfied me that the acid exerted a specific -action upon the eye, which might be made available -as a medical agent for relieving many of the -diseases to which that organ is so subject.</p> - -<p>My first experiment was undertaken in 1837, -with the diluted acid, by dipping a sponge into<span class="pagenum"><a name="Page_5" id="Page_5">[Pg 5]</a></span> -it, and rubbing it upon the forehead for the -space of a few minutes, which gave the skin a -very red appearance; but the patient experienced -not the least sense of heat, and the pupil -was slightly dilated. I continued to use this -with very beneficial effects in incipient cataract, -opacities of the cornea, inflammation, amaurosis, -iritis, &c. Of late, instead of the diluted acid I -have applied the <em>vapour</em> of the concentrated acid -to the eye with much more decided effect, and -without the slightest danger. The plan I generally -adopt, is to put into an ounce-phial a -drachm of the acid, and hold it in close contact -with the eye, the eyelid being open, for the -space of about half a minute, or until such time -as the patient feels a little warmth, or the person -holding the phial sees the pupil greatly -dilated, and the vessels of the eye injected with -blood, which is the invariable effect of the application -of the acid. The patient is not sensible -of pain from this peculiar state being induced, -which appears to me to result from the power<span class="pagenum"><a name="Page_6" id="Page_6">[Pg 6]</a></span>fully -sedative influence of the acid,<a name="FNanchor_2" id="FNanchor_2"></a><a href="#Footnote_2" class="fnanchor">[2]</a> thereby -showing that two opposite powers—to wit, the -stimulating and the sedative—are exerted at the -same time; and thereby the uneasiness arising -generally from a stimulant alone is prevented. -Its great power in removing these diseases -chiefly arises from the two powers being so -blended, and thus enabling the eye to bear a -sufficient stimulating action without injury. -The person who holds the acid to the eye should -<em>be careful not to allow the patient to smell it</em>.</p> - -<hr class="chap" /> -<p><span class="pagenum"><a name="Page_7" id="Page_7">[Pg 7]</a></span></p> - -<div class="chapter"><h3 class="invisible"><a id="Action_of_Chlorocyanic_Acid"></a>Action of Chlorocyanic Acid</h3></div> -<p>The <cite>Medical Gazette</cite> and the <cite>Lancet</cite> gave -insertion to the following statement of mine, -of date Oct. 20, 1842.</p> - -<p><span class="smcap">Sir</span>,—In October, 1841, I gave an account of -the action of the vapour of <i>hydrocyanic acid</i> upon -diseases of the eye. Since that period I have -been engaged in investigating the action of -various other bodies on the same organ, and -under the same form.</p> - -<p>One reason why I did not rest satisfied with -the effects produced by the hydrocyanic acid, -was, that its action, like that of all other -medicines, decreased in power by continued application; -thereby rendering it necessary to have -occasional recourse to other medicines, in order -to insure a more speedy recovery. Another reason -was, the reluctance of many individuals to -submit the eye to the action of so potent a -medicine.</p> - -<p>The first medicines to which I shall refer, and -which I have employed with some success, are -the <i>chlorocyanic acid</i> and <i>sulphuretted chyazic<span class="pagenum"><a name="Page_8" id="Page_8">[Pg 8]</a></span> -acid</i>. The plan I pursue is that of putting a -drachm of one of the medicines into a bottle -(containing a small piece of sponge) of about -two-ounce size, having a mouth precisely fitted -to the eye, and with a ground-glass stopper.</p> - -<p>The action of these medicines is very different -from that of the <i>hydrocyanic acid</i>, in as far as -they both stimulate the eye, and produce much -greater warmth and irritation, with less dilatation -of the pupil. Few, however, can bear the <i>chlorocyanic -acid</i> to be applied longer to the eye than -half a minute; though, in a minute after its -application, all irritation is removed, and the eye -feels perfectly at ease.</p> - -<p>The next medicine which I have employed in -the form of vapour was the chloruret of iodine. -This medicine produces very little warmth or -uneasiness to the eye, if continued for the space -of two minutes or upwards; but a sensation of -irritation, accompanied with a flow of tears, -takes place on its removal. It contracts the -pupil, and in no case have I seen it dilate it.<span class="pagenum"><a name="Page_9" id="Page_9">[Pg 9]</a></span> -Its vapour rises very readily, and does not leave -the yellow disagreeable colouring on the skin -produced by the vapour of iodine when uncombined, -which is a great drawback in the use of -iodine in diseases of the eye.</p> - -<p>The last medicine which I have employed is -the bisulphuret of carbon, which is so volatile, -that the application of it to the eye, when the -bottle is held in a warm hand for a few seconds, -is as much as can be borne, in consequence of -the intense prickling heat and flow of tears -which it occasions. Owing to this fact, I generally -use it by causing the patient to shut the -eyelid during its application, which can then -be continued for a minute or two, with the -same beneficial effect upon the eye, without -inconvenience to the patient. It generally -contracts the pupil, and very seldom dilates -it.</p> - -<p>I used to employ iodine by putting it into the -same bottles, and immersing it in hot water, and -in its state of vapour applying it to the eye;<span class="pagenum"><a name="Page_10" id="Page_10">[Pg 10]</a></span> -but I find it answers much better when dissolved -in the bisulphuret of carbon.</p> - -<p>It is my intention, shortly, to give a full account -of the action of these medicines upon the -various forms of disease to which the eye is subject, -and also what particular disease each medicine -is best calculated to remove. At the same -time I shall state such instances of failure as -have occurred in my experience, in order that a -just estimate may be formed of the value and -importance of each medicine.</p> - -<p>It may not be out of place here to state, that -I have employed, with great success, the bisulphuret -of carbon to enlarged indurated lymphatic -glands. In the first instance, I rubbed equal -quantities of the bisulphuret of carbon and alcohol -upon the parts affected, but without any -effect upon the glands. But as its effects were -so great when its vapour was confined to the -eye, I was led to apply it in the form of vapour, -and by means of glass bottles similar to those I -have described. By these means I excluded the<span class="pagenum"><a name="Page_11" id="Page_11">[Pg 11]</a></span> -action of the medicine from the external air, and -thereby prevented its speedy evaporation. When -it had been applied about one minute, the patient -felt the part very cold, but immediately after a -gradual heat, accompanied with great prickling; -the heat increasing the longer the medicine was -kept in contact with the part, until it could be -no longer endured. On removing the glass, the -part was red to an extent two or three times -greater than the part enclosed. In a few days -the change in the size of the glands was very -great; and by its daily repetition, a complete -and speedy removal of the disease was effected. -I also find that its action upon diseased glands -is more decided if the surface of the skin is well -moistened with water previous to the application -of the bottle to the part.</p> - -<p>The water, in fact, not only prevents the -escape of the vapour between the glass and the -skin, but assists the imbibition of the carbon; -a point of the highest importance, inasmuch as -all its action on the part depends upon the ex<span class="pagenum"><a name="Page_12" id="Page_12">[Pg 12]</a></span>clusion -of the atmosphere from the vapour. I -may here observe that these applications occasion -no injury whatever to the skin.</p> - -<p>I have also found the <i>bisulphuret of carbon</i>, and -the chlorocyanic acid, valuable medicines in the -removal of deafness, depending upon a want of -nervous energy and deficiency of wax. The -mode of its application is substantially the same -as that which I employ in diseases of the eye, -with this difference only, that the bottle is formed -with a small neck and stopper adapted to the -size of the orifice of the ear, and held close to -the organ until a considerable degree of warmth -is produced.</p> - -<p>The action of these medicines, which contain -so large a share of carbon, arises from the carbon -in the vapour permeating the cuticle, and coming -in contact with the oxygen in the vessels, -which is conveyed through every part of the -frame by inspiration and otherwise, and thereby -forming carbonic acid gas, which evolves heat in -the ratio of the quantity consumed by the -oxygen.</p> - -<p><span class="pagenum"><a name="Page_13" id="Page_13">[Pg 13]</a></span></p> - -<p>The following quotations from Professor -Liebig, in his work on "Organic Chemistry," -sufficiently prove the correctness of this position:—"It -is only in those parts of the body to -which arterial blood, and, with it, the oxygen -absorbed in respiration, is conveyed, that heat is -produced. Hair, wool, or feathers, do not possess -an elevated temperature. This high temperature -of the animal body, or, as it may be -called, disengagement of heat, is uniformly, and -under all circumstances, the result of the combination -of a combustible substance with oxygen. -In whatever way carbon may combine with oxygen, -the act of combination cannot take place -without the disengagement of heat. We can no -longer doubt that gases of every kind, whether -soluble or insoluble in water, possess the property -of permeating animal tissues, as water penetrates -unsized paper."</p> - -<p>Does not the action of medicines containing so -large a portion of carbon, which can be brought -into contact with the whole external surface of<span class="pagenum"><a name="Page_14" id="Page_14">[Pg 14]</a></span> -the body, and thereby capable of being easily -disengaged, suggest a method of relieving pulmonary -disease likely to be attended with no -ordinary success, by calling into greater activity -the action of the skin, and thereby materially -lightening the labour of the lungs? Are we not -the more encouraged to expect such remedial -influence in diseases of the lungs, from the fact -of its great power in removing indurated glands, -which are so common accompaniments of consumption? -There can be no doubt of the usefulness -of bisulphuret of carbon in skin diseases.</p> - -<p>I have submitted these observations under the -conviction that they embody principles which -may be carried out, and made of great utility to -mankind.</p> - -<p class="pi20"> -I am, Sir, your obedient servant,</p> -<p class="right"><span class="smcap">A. Turnbull</span>, M.D.</p> - -<p><small>48, Russell Square, Oct. 20, 1842</small>. -</p> - -<hr class="chap" /> -<p><span class="pagenum"><a name="Page_15" id="Page_15">[Pg 15]</a></span></p> -<div class="chapter"><h3 class="invisible">REMARKS ON THE <a id="ACTION_OF_CARBON"></a>ACTION OF CARBON, ETC.</h3></div> -<p>A few weeks after the appearance of the above -(Nov. 8, 1842), I wrote to the Editor of the -<cite>Literary Gazette</cite> as follows:—</p> - - -<p class="center">REMARKS ON THE ACTION OF CARBON, ETC.</p> - -<p class="center"> -(<i>To the Editor of the</i> "Literary Gazette.")</p> -<p class="right"> -<small>48, Russell Square, Nov. 8, 1842</small>.</p> - - -<p><span class="smcap">Sir</span>,—I beg leave to tender my sincerest -thanks for your kind notice in the last <cite>Gazette</cite> -of my recent discoveries on the treatment of diseases -of the eye, &c. Allow me to intrude for -once in your crowded columns, by referring to -what you accidentally omitted—viz. the manner -of applying the <i>bisulphuret of carbon</i>, and also to -add a few reasons illustrative of the fact which -you have quoted from me, that its action depends -on its union with the oxygen. The plan I adopt -is this:—I put a drachm of the bisulphuret of -carbon into a two-ounce bottle; the medicine is -so volatile that the heat of the hand causes the -vapour rapidly to rise, and come into contact with -the skin. The action is more decided if the<span class="pagenum"><a name="Page_16" id="Page_16">[Pg 16]</a></span> -skin is previously moistened with water; as the -water not only prevents the escape of the vapour -between the glass and the skin, but also excludes -the external air, a point of the very highest importance. -In my paper, which appeared in the -<cite>Lancet</cite>, of October 29th, I stated, that "when it -had been applied about one minute, the patient -felt the part very cold, but immediately after a -gradual heat, accompanied with great prickling; -the heat increasing the longer the medicine was -kept in contact with the part, until it could no -longer be endured. On removing the glass the -part was red, to an extent two or three times -greater than the part enclosed. These applications -occasion no injury whatever to the skin." -Showing that the action of the bisulphuret of -carbon depends on its union with the oxygen in -the blood-vessels, I will merely state the following -experiments:—Carbonic acid gas was applied -in a similar bottle, and in the same way, to -the skin, the external air being excluded, and -the skin moistened with water, for the space of<span class="pagenum"><a name="Page_17" id="Page_17">[Pg 17]</a></span> -ten minutes; but neither redness nor any sensible -heat was induced; for this satisfactory reason, -that heat is the consequence of oxidation -with the carbon, which oxidation, in the case of -carbonic acid gas, had of course been previously -effected. <i>Alcohol</i>, <i>sulphuric ether</i>, <i>nitric ether</i>, and -many other <i>ethers</i>—all of which contain a large -portion of carbon—were similarly tried, but had -no effect; for the same reason—viz. that it is -already in a state of union with oxygen in all -these highly carbonized bodies.</p> - -<p class="pi20"> -I remain, Sir, your obedient servant,</p> -<p class="right"> -<span class="smcap">A. Turnbull</span>, M.D.</p> - -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_18" id="Page_18">[Pg 18]</a></span></p> - - -<div class="chapter"><h3 class="invisible"><a id="Opacity_of_the_Cornea"></a>Opacity of the Cornea</h3></div> - -<h4>CASE 1.</h4> - -<p class="center"><i>Opacity of the Cornea, the sequel of Small-pox.</i></p> - - -<p><span class="smcap">John Wright</span>, a porter, aged 23, No. 10, Bear -Yard, says that he has been nearly blind in the -right eye from small-pox, since he was two years -old. Five years since he was attacked with -violent ophthalmia, in consequence of exposure -to cold. He then applied to one of our Ophthalmic -Institutions, where he remained as an -out-patient for eight months. For the first six -months he had, thrice a week, caustic applied -to his left eye, after which black ointment for -the remainder of the time; but without receiving -benefit. He then went to another institution, -where he remained an out-patient for seven -months. The treatment here consisted in dropping -into the eye a liquid, and at other times a<span class="pagenum"><a name="Page_19" id="Page_19">[Pg 19]</a></span> -powder was shaken into it, from which he -derived no benefit. He then consulted a private -practitioner, who relieved him; but, not satisfied -with this, he went to another surgeon, who said -that the cause of his blindness was owing to a -little squint, and he submitted the eye to be -operated upon for that purpose; but no good -was derived from this operation. None of the -medical men attempted to do anything to the -right eye.</p> - -<p>In September, when I first saw him, his left -eye was very much diminished in size, and the -cornea studded with white spots; the vision very -imperfect, and constantly discharging water. -The right eye was so opaque that neither iris nor -pupil was to be seen, and he could only see the -shadow of an object.</p> - -<p>On the 23rd of January the left eye had got -tolerably clear and free from all specks, but still -subject to water when exposed to the wind.</p> - -<p>The right eye is now becoming transparent, -and vision in it is improving. He states that it -will soon be the best eye.</p> - -<hr class="tb" /> - -<p><span class="pagenum"><a name="Page_20" id="Page_20">[Pg 20]</a></span></p> - - - - -<h4>CASE 2.</h4> - -<p class="center"><i>Opacity of the Cornea from Inflammation.</i></p> - - -<p><span class="smcap">Ann Fitzgibbons</span>, aged 13, daughter of Thos. -Fitzgibbons, 11, Stratton Mews, is a day scholar -at the Blind School, Queen Square.</p> - -<p>Her father states that in infancy she lost the -left eye, owing to an attack of inflammation. -The right eye four years since became similarly -affected. She has been a patient at two Ophthalmic -Institutions, where she attended for -several months without any benefit. She was -brought to me by her father on the 1st of -October, 1842, who stated that for the last four -years she had been obliged to be led, and could -only discern the shadow and outline of objects, -but could not distinguish them.</p> - -<p>On examining the left eye, I found it shut, -and all the humours lost. The right eye was -much diminished in size, and the cornea was -very opaque, excepting at the upper part, where -a small portion of light was admitted. The<span class="pagenum"><a name="Page_21" id="Page_21">[Pg 21]</a></span> -bottle containing the acid was held to the left -eye as well as to the right, to ascertain what -effect would be produced. To my surprise, in -the period of a month the chambers of the eye -became partially filled with aqueous humours, to -the extent of at least half the size of a healthy -eye; the pupil was small, but the patient could -not see in the slightest degree. The right eye -has become almost transparent, and she can -now see with it sufficiently well to be able to go -anywhere. Indeed, her sight has become almost -perfect. The change is so great that many are -disposed to question the identity of the girl, and -the father is frequently asked whether the girl -is really his own daughter, whose eyes were so -disorganized.</p> - - - -<hr class="tb" /> -<h4>CASE 3.</h4> - - -<p class="center"><i>Inflammation, ending in Opacity of the Cornea in -the right eye and Staphyloma in the left.</i></p> - - -<p><span class="smcap">William Grindley</span>, aged 37, boot-maker, -formerly of 16, Whitecomb Street, Pall Mall,<span class="pagenum"><a name="Page_22" id="Page_22">[Pg 22]</a></span> -East, now of St. James's Workhouse, states that -he was attacked with acute inflammation in both -eyes in 1839. He at first had the advice of -private practitioners, and subsequently went to -two different Ophthalmic Hospitals. He remained -in one eleven months, in the other fifteen. -It appears from his own account that his sufferings -were very great, for he asserts his eyes and -eye-lids were swollen very much. The treatment -consisted in bleeding, cupping on the temples, -lancing frequently the eye and eye-lids; -caustic was applied to the eyes, and seatons to -the nape of the neck; leeches. The patient had -two caustic issues in the temples; he was salivated, -and had administered to him various -potent drugs.</p> - -<p>On the 9th of August he was sent to me from -the Board of St. James's Workhouse, when he -could scarcely discern light from darkness. He -said that he had been led about for the last -three years. The left eye was afflicted with -staphyloma, and was perfectly opaque. The<span class="pagenum"><a name="Page_23" id="Page_23">[Pg 23]</a></span> -cornea of the right eye was covered with a dense -opacity, so much so that no appearance of iris -or pupil could be discerned through it. The -right was not so unnaturally prominent as was -the left eye. The vapour in this case was daily -applied, and the progress of cure was so rapid, -that in the course of a month he was able to -come to me from St. James's without his accustomed -guide. At Christmas he obtained permission -from the Board to be absent for a few -days for the purpose of visiting his wife and -children. It was his wish to see the faces of -those near and dear to him; for in his former -visits he could only hear them talk, for not one -glimpse of their countenances was he able to -obtain. The cornea of the right eye is rapidly -becoming transparent. The convexity of the -left eye is still considerable, but the opacity is -so far removed as to give evidence that a continuation -of the medicine will render it again -perfect, although it must take a considerable -time to effect so desirable an object.</p> - -<hr class="tb" /> - -<p><span class="pagenum"><a name="Page_24" id="Page_24">[Pg 24]</a></span></p> - - - - -<h4>CASE 4.</h4> - -<p class="center"><i>Two cases of —— Ophthalmia, ending in -Opacity of the Cornea.</i></p> - - -<p><span class="smcap">Sarah Hopping</span>, aged 15, daughter of Thomas -Hopping, boot-maker, 20, King Street, Drury -Lane, and of the Blind School, Queen's Square, -about nine years ago had a violent attack of inflammation -in both eyes. She was taken to an -infirmary, and remained there for many months, -where she became perfectly blind. She was -afterwards taken to two Ophthalmic Hospitals as -an out-patient—one for six months, another -three. The treatment generally was lancing -the inner eye-lids, and applying caustic to both -the eyes and temples, leeching and blistering -both the neck and temples often. The left eye -was altogether opaque, and did not show the -least appearance of either iris or pupil when -looking at it in a strong light. The right eye -appeared quite lost, for there was only in the -socket a small red tumour, about the size of a pea.</p> - -<p><span class="pagenum"><a name="Page_25" id="Page_25">[Pg 25]</a></span></p> - -<p>The vapour was applied, and at the present -time the opacity is so far gone that she can -see to walk alone; but there yet remains much -to be removed.</p> - -<p>Her sister Elizabeth, aged 12, was similarly -affected, but the disease had not attained to the -same height. She is now almost well.</p> - - - -<hr class="tb" /> -<h4>CASE 5.</h4> - -<p class="center"><i>Case of Ophthalmia, terminating in an Opacity -of the Cornea.</i></p> - - -<p><span class="smcap">John Gadd</span>, aged 31, of 16, Little Britain, -bookbinder, states that he has been blind and -unable to guide himself for upwards of twelve -months, but for some months previously he felt -himself gradually losing the sight of his right -eye. He went to an Ophthalmic Institution, and -in two or three days he was seized with a violent -attack of ophthalmia, which he attributed to the -applications used for his recovery. He did not<span class="pagenum"><a name="Page_26" id="Page_26">[Pg 26]</a></span> -know the nature of the ointment inserted in his -eyes, but was told it was black ointment. In -ten days he visited another Ophthalmic Institution, -where he remained for two months. In -this institution a liquid was dropped into his -eye, leeches were applied every night for a -week, issues were inserted in the temples, carbonate -of iron was administered for six weeks, -and counter-irritants were applied to the neck.</p> - -<p>From this time he became quite blind. He -then went to another Ophthalmic Institution, -where he was cupped in the temples; the eyes -were scarified, aperient medicines were given, -and lotions used. The inflammation still continued, -and he was unable to lift his head, or -allow the bandages to be taken off his forehead, -without experiencing the most excruciating pain.</p> - -<p>In this state he was brought to me on the 9th -of September, 1840, when I ordered for each -eye two drops of the oil of almonds (after being -warmed) to be put into the eyes. The relief -that he experienced was so great, that he said<span class="pagenum"><a name="Page_27" id="Page_27">[Pg 27]</a></span> -he felt as if he were in another world. In eight -days the pain had greatly diminished. He was -enabled to open his eye-lids, but could discern -no object whatever. I then ordered castor oil -to be dropped into each eye, for the purpose of -removing the opacity. He left me at the end -of December, at which time he could see very -imperfectly; but returned to me in January, -1843, when the opacity of the cornea still continued. -He has had, almost daily, the prussic -acid vapour applied to his eye. He is at the -present time so well that he can read the -smallest diamond print.</p> - - - -<hr class="chap" /> -<div class="chapter"><h3 class="invisible"><a id="Staphyloma"></a>Staphyloma</h3></div> - -<h4>CASE 6.</h4> - -<p class="center"><i>Opacity of the Cornea and Staphyloma.</i></p> - - -<p><span class="smcap">Georginia Larkins</span>, aged 10, at No. 25, Grafton -Street, Newport Market, and at the Blind -School, Queen Square. Her aunt states that -this patient has been blind since she was six<span class="pagenum"><a name="Page_28" id="Page_28">[Pg 28]</a></span> -days old, in consequence of an attack of inflammation, -which gave rise to a great discharge -from the eyes. In her infancy fluids of various -kinds were injected underneath the eye-lids, and -when four months old she was taken for three -years regularly to an Ophthalmic Hospital, where -she was told that the right eye was destroyed. -The left eye had caustic applied to it for a -length of time thrice a week. Ointment was -then applied underneath the eye-lids until the -eye became so very large that she was at last -told that it was a hopeless case, and that no -more could be done for her. Her next visit -was to an eminent oculist, who said he would -not undertake the treatment of such a case. -She then went to another Ophthalmic Institution, -where she remained for about two years -without deriving any improvement in her sight; -but she was relieved from much pain.</p> - -<p>I saw her first on the 6th of April, 1840, -when the appearance of the left eye seemed to -be at least twice the size of a natural eye. It<span class="pagenum"><a name="Page_29" id="Page_29">[Pg 29]</a></span> -was of a dark-blue colour, standing out beyond -the lids; and where the pupil ought to have -been, there was a blue circular ring of lighter -hue than the rest of the eye, and in the centre -of this ring was a white body about the size of -a pea.</p> - -<p>The right eye was quite a contrast, for it -appeared perfectly white, without the slightest -appearance of iris or pupil. The eyes were continually -rolling about in their sockets. Looking -at the little creature, I said, "What do you -expect me to do in such a fearful case?" -Without waiting for a reply, I said, "I will -endeavour to diminish the size of the eye, but -unquestionably no hope can be held out that I -can restore the use of sight."</p> - -<p>I at first put, daily, a drop of castor oil into -each eye, occasionally substituting for the castor -oil the oil of almonds. This treatment in about -two months diminished much the size of both -eyes, and the opacity of the right eye greatly -decreased; so much so that a little edge of the<span class="pagenum"><a name="Page_30" id="Page_30">[Pg 30]</a></span> -pupil became visible, and the child began to see, -and in four months she could walk alone. -Shortly afterwards the pupil could be distinctly -seen, and there appeared a white speck upon -the anterior capsule of the lens. She ceased to -be a patient of mine in December, 1840, but -returned in January, 1842, when the prussic -acid was daily applied to both eyes. The left -eye is diminished about one-half in size, and light -is becoming perceptible. The right has assumed -a healthy appearance; the cornea is transparent, -and there is still a spot upon the capsule, about -the size of the eighth part of the pupil. This -does not appear to impede the vision. She can -now read, with the eye, the raised letters with -great quickness. She was formerly taught to -read the letters with her fingers; she is also -learning to read common print.</p> - -<p>When the child came to me I had not had -sufficient experience of the effects of the prussic -acid vapour, and I hesitated in using a remedy -of such acknowledged potency until I had, with<span class="pagenum"><a name="Page_31" id="Page_31">[Pg 31]</a></span> -great care, thoroughly investigated its properties. -This I have been engaged in doing for -several years, and I am now able to state, that -in no case in which I have used it has it been -attended with any injurious effects either to the -eye or general health.</p> - - - -<hr class="tb" /> -<h4>CASE 7.</h4> - -<p class="center"><i>Staphyloma of both Eyes.</i></p> - - -<p><span class="smcap">Mary Ann Goodman</span>, aged 22, of St. Giles's -Workhouse, and a scholar at the Blind School, -Queen Square, fourteen years ago was attacked -with violent inflammation of both eyes. To -remove this she was subjected to very active -antiphlogistic treatment. The inflammatory -symptoms subsided, after which she was regularly -led for five years to an Ophthalmic Institution, -at which place the right eye was operated -upon five times; in addition to which she was -cupped three times and bled from the arm twice;<span class="pagenum"><a name="Page_32" id="Page_32">[Pg 32]</a></span> -caustic was applied frequently to the inside of -the eye-lids; she was also blistered behind the -ear and nape of the neck. The patient was -unable to walk about without assistance; if she -attempted to do so, she was knocked and jostled -about.</p> - -<p>On the 4th of March her friends brought her -to me, to ascertain whether I could do anything -for her. I could not hold out to her any great -hope of recovery; for both eyes were affected -with staphyloma, and perfectly opaque and -studded with blue spots, and standing prominently -out beyond the lids, and having no -appearance of iris or pupil in either eye.</p> - -<p>In the space of a fortnight the eye assumed a -very different appearance; each eye became -greatly diminished in size. As the opacity -cleared off, a large triangular pupil made its -appearance at the bottom of the iris in the -right eye, enabling her to see with the eye with -which, for fourteen years, she had not been -able to discern light from darkness.</p> - -<p><span class="pagenum"><a name="Page_33" id="Page_33">[Pg 33]</a></span></p> - -<p>The progress of cure in the left eye is fully -equal to that of the right; so that now she is -able to walk about in the crowded streets with -safety, and is intrusted to lead about two or -three other persons in the Blind School. She -can distinguish colours, and is able to perceive -large letters.</p> - -<p>In such a state of disorganization as this poor -girl's eyes were in, it is unreasonable to anticipate -that she can make much greater progress.</p> - - - -<hr class="chap" /> -<div class="chapter"><h3 class="invisible"><a id="Inverted_Eye-lashes"></a>Inverted Eye-lashes</h3></div> -<h4>CASE 8.</h4> - -<p class="center"><i>Inverted Eye-lashes, with Opacity of the Cornea.</i></p> - - -<p><span class="smcap">Diana Primrose</span>, aged 32, of No. 2, Benborough -Street, St. Giles's, says she had a violent -attack, eight years back, of ophthalmia in -both eyes, accompanied with great swelling and -constant discharge of matter from the eye-lids, -arising from the eye-lashes of both eyes being -turned in.</p> - -<p><span class="pagenum"><a name="Page_34" id="Page_34">[Pg 34]</a></span></p> - -<p>She was an out-patient to one of the Ophthalmic -Hospitals for two years, but, instead of getting -better, she became worse. She then applied -to another Ophthalmic Institution, where -she was subjected to treatment for four months, -but no improvement took place. Three years -ago her sufferings prompted her to visit a third -institution, when one of the surgeons cut off the -upper eyelid of the left eye, which gave rise to -great pain and inflammation, but the opacity was -not diminished nor the vision improved. She -was obliged, during the eight years, to have her -eye-lashes constantly pulled out.</p> - -<p>She visited me on the 28th of October, 1842, -when the eye-lashes of the right eye, both above -and below, were still turned in, and rubbing -against the cornea. The eye-lids were exceedingly -red; the cornea of both eyes was nearly -opaque, and only a small portion of the pupil -could be observed through the opacity. Her -vision was so imperfect that she could do little -more than find her way about. She was often<span class="pagenum"><a name="Page_35" id="Page_35">[Pg 35]</a></span> -confined to the house for a week at a time, -through inflammation.</p> - -<p>The vapour was only applied for the space of -a week, after which she could see much better. -The opacity was greatly diminished, and the eye-lashes -began to resume their proper position. -She continues to use the prussic acid vapour -three or four times a week, and at the present -time she is able to follow her occupations with -comfort, and the eye is resuming all the appearance -of health. She never has had occasion to -pull one eye-lash out since I first saw her. She -is now very comfortable, and can see tolerably -well.</p> - -<p>This is the first case of the kind that I have -treated with prussic acid.</p> - - - -<hr class="chap" /> -<div class="chapter"><h3 class="invisible"><a id="Conical_Eye"></a>Conical Eye</h3></div> -<h4>CASE 9.</h4> - -<p class="center"><i>Conical Eye.</i></p> - - -<p><span class="smcap">William Stevens</span>, aged 25, at No. 20, Gracechurch -Street, states that he had been for several<span class="pagenum"><a name="Page_36" id="Page_36">[Pg 36]</a></span> -months at two different Ophthalmic Institutions, -where many modes of treatment were adopted to -improve his vision; but he was at length told -they could do him no good, as the disease under -which he laboured was conical eyes.</p> - -<p>When I examined him, in May, 1840, I found -the right eye so prominent that it had the appearance -as if a large transparent bead had -grown from the cornea. With this eye he could -see a short distance. The conical state was not -only greater in the left eye, but there was an -opacity on the apex of the cornea. He could -see nothing with it, if the right eye were shut, -unless the objects of vision came in contact with -his face. He continued to visit me, professionally, -two or three times a week, for four months, -and had a drop or two of castor oil put into both -eyes each time. This treatment greatly diminished -the prominency of the right eye, and -lengthened the vision; but the left eye was only -slightly benefited by it, although all opacity had -been removed, and it had diminished in size.</p> - -<p><span class="pagenum"><a name="Page_37" id="Page_37">[Pg 37]</a></span></p> - -<p>In December last he again called upon me -and wished to know if more could not be done -for him? He said he had continued to follow -his business with the use of concave glasses, but -saw with great difficulty.</p> - -<p>The vapour was employed thrice a week -for about three weeks, when his vision was restored -to its natural length. I saw him on the -21st of January, and he said he was perfectly -well, and could follow his business with great -pleasure to himself.</p> - - - -<hr class="chap" /> -<div class="chapter"><h3 class="invisible"><a id="Cataract"></a>Cataract</h3></div> -<h4>CASE 10.</h4> - -<p class="center"><i>Amaurosis of the Left Eye, and Cataract of -the Right.</i></p> - - -<p><span class="smcap">George Trousdale</span>, aged 37, horse-keeper, 37, -William Street, Hampstead Road, says, that -when he was 8 years of age, a shoemaker's awl -was accidentally pushed through the right eyelid -into the eye, which gave rise to an attack of -severe inflammation in both eyes. When the<span class="pagenum"><a name="Page_38" id="Page_38">[Pg 38]</a></span> -inflammation subsided he found the vision of the -right eye entirely gone. The left eye became -dim in May last, and his sight was much disturbed -by floating clouds passing before the eye. -When he looked steadily at an object the vision -almost vanished. He experienced great pain in -the forehead and temple on the same side.</p> - -<p>He applied to an infirmary, where he remained -as an out-patient for six weeks. He was salivated, -cupped, and leeched. He was then told -that the right eye was of no use, and they feared -the vision of the left also was destroyed.</p> - -<p>He then went to an Ophthalmic Institution, -where he remained as an out-patient for seven -weeks. He was again salivated; a liquid was -dropped into his eye regularly, and he was blistered, -but no good resulted.</p> - -<p>He then went to a private oculist, under -whose care he remained for six weeks. He -again was salivated; but still the sight became -more obscured, and the pains in his forehead -and temple more acute.</p> - -<p><span class="pagenum"><a name="Page_39" id="Page_39">[Pg 39]</a></span></p> - -<p>I saw him first in October; he was then suffering -from severe pain in the forehead and temple. -The left eye was so blind that he could -not distinguish, even when placed close beside -it, a large bookcase. He said he could scarcely -guide himself in the street. The pupil was almost -immoveable. There was a white cataract -in the right eye, and a total want of vision.</p> - -<p>He has had the vapour of the prussic acid -applied to both eyes almost daily since October. -He can now, with the left eye, read ordinary-size -print, and is free from all pain. Nearly -the upper half of the cataract of the right eye is -absorbed, and he is beginning to see with it. -This case shows the power of the acid in not -only producing absorption, but in the removal of -amaurosis at the same time. Unless the capsule -of the lens had been lacerated by the awl, I do -not think that the acid could have had any power -in causing absorption in a case of cataract -which had existed for the long period of twenty-eight -years. He is still under treatment.</p> - -<hr class="tb" /> - -<p><span class="pagenum"><a name="Page_40" id="Page_40">[Pg 40]</a></span></p> - - - - -<h4>CASE 11.</h4> - -<p class="center"><i>Cataract.</i></p> - - -<p><span class="smcap">Mr. Monro</span>, aged 28, at No. 16, Featherstone -Buildings, twelve years ago, had violent inflammation, -occasioned by the lash of a whip striking -the left eye, from which time he has been unable -to see more than the shadow of an object. He -says that many have advised him to submit to -an operation for cataract, but others have recommended -him not to do so as long as one eye -remained sound.</p> - -<p>On the 16th of May, when he applied to me, -I tried, as an experiment, the vapour of the -prussic acid, which was employed for about three -months. At the end of that time he could see -different objects, and discern countenances, -when the other eye was closed.</p> - -<p>Afterwards he went into the country, where -he remained without using any medicine. On -his return to town, on the 18th of January, 1843 -he called upon me, when I found the eye was<span class="pagenum"><a name="Page_41" id="Page_41">[Pg 41]</a></span> -not improved in appearance. He is now again -under my care, and has had the vapour applied -five times. It appears to produce a very decided -effect upon the vision. In three or four -parts the cataract appears as if it had been operated -upon with a couching needle.</p> - -<p>This is a case of great interest, and it is impossible -for any unprejudiced person to doubt -the great absorbent powers of prussic acid in -many diseases of the eye; but I am certain it -will not be a general remedy for lenticular cataract -(unless employed in its incipient state) without -operation, unless aided by rupturing the -capsule of the lens by the needle first. Many -are the cases where we want such a solvent -power after operations.</p> - - - -<hr class="chap" /> -<div class="chapter"><h3 class="invisible"><a id="Amaurosis"></a>Amaurosis</h3></div> -<h4>CASE 12.</h4> - -<p class="center"><i>Amaurosis.</i></p> - - -<p><span class="smcap">Ann Weeks</span>, of No. 19, Little Queen Street, -aged 14, daughter of Thomas Weeks, carman,<span class="pagenum"><a name="Page_42" id="Page_42">[Pg 42]</a></span> -52, Great Wilde Street, has been blind in her -right eye since she was two years old. The -left eye is unaffected. When two years of age -she was taken to an Ophthalmic Hospital, where -various modes of treatment were adopted for the -recovery of the eye, until the month of March, -1842, when she went to another Ophthalmic Hospital, -where she attended for six months, but received -no benefit.</p> - -<p>On the 16th of June the Rev. Peter Hall, of -Long Acre Chapel, brought her to me; and -when examined in a strong light, with her face -towards the window, we could not perceive the -slightest action of the pupil. Mr. Hall and I -tried her with a sheet of white paper, moving it -before her eyes several times, but she was perfectly -unconscious of it. After the eye was exposed -to the vapour of prussic acid for a short -time the pupil acted slightly when exposed to -light; and she was able, not only to see the -paper, but to take hold of it with her hand, and -could walk round the table when the left eye<span class="pagenum"><a name="Page_43" id="Page_43">[Pg 43]</a></span> -was shut. She continued the vapour four or five -times weekly for the space of six weeks.</p> - -<p>When she left me the eye was so far recovered -as to answer all ordinary purposes of vision, although -not quite equal to the other.</p> - -<p>I have examined her to-day (Jan. 20, 1843), -and find the improvement continues.</p> - - - -<hr class="tb" /> -<h4>CASE 13.</h4> - -<p class="center"><i>Amaurosis.</i></p> - - -<p><span class="smcap">Frances Read</span>, aged 14, daughter of —— Read, -71, Fetter Lane, and one of the scholars at the -Blind School, Queen Square. Her mother said -that she took her daughter to an Ophthalmic Institution -until she was tired. No good was effected. -The parents of this case were unable to say -when the blindness first developed itself. She -has always been able to see a little with the right -eye.</p> - -<p>I was first consulted in this case in July, 1842, -when the right eye appeared to have some<span class="pagenum"><a name="Page_44" id="Page_44">[Pg 44]</a></span> -vision. The pupil acted under a strong light, -but very sluggishly. She could observe objects -very indistinctly with the left eye.</p> - -<p>The prussic acid was employed almost daily, -for three months, to both eyes. The right eye -recovered so that she can now thread her needle. -She is also learning to read.</p> - -<p>Upon the pupil of the left eye the prussic acid -does not appear to have the least effect.</p> - -<p>As a general rule, I have found that when -prussic acid does not dilate the eye, in amaurosis, -much good is not to be expected from its -use. In such cases I am inclined to believe that -the disease is caused by pressure upon the optic -nerve.</p> - -<p>It is my intention to persevere in the application -of the vapour to the left eye, with the -view of ascertaining whether the sight may not -be restored. I do not despair of success.</p> - -<hr class="tb" /> - -<p><span class="pagenum"><a name="Page_45" id="Page_45">[Pg 45]</a></span></p> - - - - -<h4>CASE 14.</h4> - -<p class="center"><i>Congenital Amaurosis.</i></p> - - -<p><span class="smcap">George Pritchard</span>, aged 7 years, son of Edward -Pritchard, cab-driver, Black Bull Yard, -Gray's Inn Lane, and one of the scholars at the -Blind School, Queen Square.</p> - -<p>This patient has been totally blind from birth. -His case has been examined by almost all the -eminent oculists of London, and has been taken -to several hospitals; but all the medical men, -without one exception, stated that they would -not prescribe for him, as they could do nothing -for him.</p> - -<p>He was brought to me in May, 1840, at -which time the eye appeared more than half -sunk in each orbit, and the pupil, when exposed -to the action of strong light, was fixed and immoveable. -In fact, he had not the slightest perception -of light.</p> - -<p>Two drops of castor oil were put into his eye -daily, for the space of three months, before the<span class="pagenum"><a name="Page_46" id="Page_46">[Pg 46]</a></span> -pupil manifested a disposition to act. At each -successive month there was a visible change in -the size of the eye. When he left me, in Dec., -1840, he was not able to discern more than light -from darkness.</p> - -<p>He has visited me since the month of April, -1842, and has had, once or twice a week, the -vapour of the prussic acid applied to his eye. -He is now so improved that he is beginning to -distinguish one object from another, and the eye -is assuming a healthy appearance. From the -progress that this boy has made the last two -months, I think it probable that the medicine -may ultimately effect much greater good.</p> - -<hr class="chap" /> -<p><span class="pagenum"><a name="Page_47" id="Page_47">[Pg 47]</a></span></p> - -<div class="chapter"><h3 class="invisible"><a id="W_H_Newnham"></a>W. H. Newnham</h3></div> -<p>The following letter was forwarded to me by -H. Newnham, Esq., for the purpose of publication:—</p> - - -<p class="right"> -<small>"January 24th, 1843</small>. -</p> - -<p>"<span class="smcap">My dear Sir</span>,—Having, by the vapour of -prussic acid, been nearly cured by yourself of -an opacity of the cornea, which, for twenty years -past, had rendered the sight of my left eye of -little worth more than to distinguish light from -darkness; and firmly believing that, when I shall -be able to replace myself under your care, my -sight will be perfectly restored; and having -also, during my attendance at your house, witnessed -the beneficial effects of this remedy on -many other persons, the subjects of cataract, -amaurosis, staphyloma, &c., I earnestly beg you -will accept this testimony of my high opinion of -its efficacy in these cases.</p> - -<p class="center"> -"I am yours gratefully,</p> -<p class="pi20"> -"<span class="smcap">William H. Newnham</span>, Surgeon, &c.</p> - -<p class="pi30"><small>"Late of Alton, Hants."</small></p> - -<p><small>"To A. Turnbull Esq., 48, Russell Square."</small></p> -<hr class="chap" /> -<p><span class="pagenum"><a name="Page_48" id="Page_48">[Pg 48]</a></span></p> -<div class="chapter"><h3 class="invisible"><a id="Professor_Forbes"></a>Professor Forbes</h3></div> -<p>Extract from a letter of Professor Forbes, of -King's College, Aberdeen, Jan. 23rd, 1843:—</p> - -<p>"I seized the first hour which I could command -after receiving your note to call on Milne, -that I might see in what state he was, as I had -not heard of him for some time. I was also -desirous of having the particulars of his case -accurately from himself.</p> - -<p>"John Milne was a cooper, and in that capacity -had gone with the whale-ships to Davis's -Straits and Greenland for sixteen years.</p> - -<p>"In July, 1836, he was seized with a violent -inflammation in one of his eyes, which soon -extended to the other. After two years he -became so blind that he could not walk with -safety in the streets, and after meeting with a -severe accident from his want of sight, he gave -up attempting to walk out alone.</p> - -<p>"He continued for more than two years in -this state, always becoming worse and worse in -his sight. His eye-balls were covered with -ulcers; he suffered extreme pain, except when<span class="pagenum"><a name="Page_49" id="Page_49">[Pg 49]</a></span> -lying in bed with the room quite darkened; and -was at various times confined for six weeks without -being able to bear the admission of light into -his room. During the whole of this long period -he was under medical treatment by different -surgeons without deriving any benefit, but, on -the contrary, his case seemed to become daily -more hopeless. The only relief, indeed, which -he experienced was, he says, from the division -of the blood-vessels, from time to time, with -which the eye-ball was covered.</p> - -<p>"In these circumstances he was brought to -you by a surgeon who had attended him, and -began, under your direction, the application of -the prussic acid vapour. This gave him immediate -relief, and in six weeks the whole ulcers -had disappeared, light was no longer troublesome -to him, and he saw quite well to go about -his business and to read.</p> - -<p>"This was his state in autumn, 1841, at -which time I first saw him, and he continues -equally well down to the present date. A slight<span class="pagenum"><a name="Page_50" id="Page_50">[Pg 50]</a></span> -opacity in the cornea of both eyes still remains, -and he cannot expose himself to the blaze of a -very bright day or to violent winds for a length -of time without experiencing a return of uneasiness. -He is, however, quite positive, that had -he continued under your care for a sufficient -period, he would have quite recovered; and he -has been planning a voyage to London to have -your additional advice. I discovered, however, -from him, that he has never got <em>the prussic acid -of sufficient strength</em> since you left this; for it has -never had the power of bringing on the state of -the eye which the strong acid did, and which he -found to be attended with so good effects. I -have taken means to get the acid prepared for -him of the right strength, and hope that its -application will be as efficacious as he so confidently -expects.</p> - -<p>"N.B.—The patient Milne was brought to -me by George Rainy, Esq., Surgeon to the -Aberdeen Ophthalmic Institution."</p> -<hr class="chap" /> -<p><span class="pagenum"><a name="Page_51" id="Page_51">[Pg 51]</a></span></p> - -<div class="chapter"><h3 class="invisible"><a id="Case_of_Staphyloma"></a>Case of Staphyloma</h3></div> -<p>Extracted from the <cite>Lancet</cite> of December 31st, -1842:—</p> - -<p>"<span class="smcap">Prussic Acid Vapour.</span>—Mr. J. C. Atkinson, -of Romney Terrace, Westminster, in a -letter to the Editor, dated December 26th, after -a few prefatory remarks, writes on this subject -as follows:—A patient, aged 28, who had rather -a severe attack of variola last May, became, -after the recovery, subjected to staphyloma, one -of the sequelæ of that formidable complaint. -In this he was treated according to the approved -methods, both at two public institutions and by -private practitioners, for some months, without -any apparent advantage, when I was applied to; -I instantly determined on a trial of the prussic -acid vapour, having read in your able journal -an account of this new remedy some time before. -After fourteen applications the opaqueness and -prominence abated considerably, and the eye is -now very serviceable, and nearly as useful as the -sound one, no inflammation or appearance of -irritation being observable. The plan adopted<span class="pagenum"><a name="Page_52" id="Page_52">[Pg 52]</a></span> -by me was most simple: the affected eye, open, -was placed over a two-ounce phial, containing -about half an ounce of the acid, while the -patient's hand, properly directed, was to retain -it in the position that was thought necessary. -The time occupied in this operation was from -five minutes to a quarter of an hour. The eye -became in a short time inflamed, the conjunctiva -exhibiting the appearance of deep injection, -which gradually disappeared in a few hours, -but which was not accompanied by any pain. -No paralysis of any of the appendages of the -eye has resulted from the application. Such is -the outline of the case. I feel assured that this -remedy will prove a powerful auxiliary in the -hands of a surgeon-oculist."</p> -<hr class="chap" /> -<p><span class="pagenum"><a name="Page_53" id="Page_53">[Pg 53]</a></span></p> - -<div class="chapter"><h3 class="invisible"><a id="Dr_Maclean"></a><a id="Dr_Macleans_Cases"></a>Dr. Maclean's Cases</h3></div> -<p>Extract from the <cite>Lancet</cite>, of January 7th, -1842. Cases in which the vapour of prussic -acid was employed for the cure of Ophthalmic -disease, by Donald J. Maclean, M.D., Lic. Roy. -Col. Surg. in Edinburgh.</p> - -<p>"I have been induced, for my own satisfaction, -(in consequence of some observations made by -Sir George Sinclair, who had witnessed its -effects on patients under Dr. Turnbull's care), -to give a very extended trial to the prussic acid -in cases of ophthalmic disease which might be -considered suitable for its application, and desire -that the results of some of the cases should be -submitted to the consideration of those of our -profession who may take an interest in the subject -I have, therefore, made out a report of -the following cases. In our present state of -knowledge it is impossible to explain the <i lang="la">modus -operandi</i> of the prussic acid; it will be sufficient, -meantime, to observe accurately, and merely -give the results of treatment. In what kind of -cases it will be found most suitable can only be<span class="pagenum"><a name="Page_54" id="Page_54">[Pg 54]</a></span> -determined by further inquiry and experience. -If, however, the results prove permanent, the -prussic acid must occupy a very high place -amongst our remedial agents; and, possessing -stimulant properties of a peculiar character, it -may prove useful under many circumstances -where diseases of the eye are not readily amenable -to ordinary treatment.</p> - - - -<hr class="tb" /> -<h4>"CASE 1.</h4> - - -<p>"<span class="smcap">J. Mackay Reay</span>, aged 11 years. Diffused -opacity of the cornea, the result of a -protracted attack of scrofulous ophthalmia. The -vapour of strong prussic acid was applied, -daily, for thirteen days, by exposure of the eye -to it, during which period the cornea gradually -got transparent. On the fourteenth day no remains -of former opacity existed, and the vision -of that eye was perfectly restored.</p> - -<hr class="tb" /> - -<p><span class="pagenum"><a name="Page_55" id="Page_55">[Pg 55]</a></span></p> - - - - -<h4>"CASE 2.</h4> - - -<p>"<span class="smcap">Margaret Mackay</span>, Thurso, aged 12 -years. Severe rheumatic ophthalmia, of three -weeks' duration. She complains of deep-seated -aching pain in the eye-ball, greatly aggravated -in the evening and through the night; no apparent -disorder of the general health. The ordinary -remedies were used, viz., leeching, blisters, -calomel, and colchicum: they appeared to give -no relief. The prussic acid was applied, daily, -for about ten days; the relief following each application -was extraordinary; the pain was trifling -for the rest of the day. At the expiration of -twelve days the intolerance of light, the injected -state of the vessels on the sclerotica, and the -other symptoms, entirely disappeared; and since -September the little patient has continued quite -free from any symptom of her former ailment.</p> - -<hr class="tb" /> - -<p><span class="pagenum"><a name="Page_56" id="Page_56">[Pg 56]</a></span></p> - - - - -<h4>"CASE 3.</h4> - - -<p>"A girl, named <span class="smcap">Munro</span>, from Mount -Pleasant. Albugo of corneæ in both eyes, the -result of an attack of acute conjunctival ophthalmia, -which she had about two years ago, -whilst residing in Dundee, where various means -were tried for her relief. Vision was almost completely -destroyed; she could not distinguish the -outlines, form, or colours, of objects presented to -her. At her own urgent request, but without -holding out any prospect of her being benefited -by it, the prussic acid was applied, daily, for -about six weeks.</p> - -<p>"11th day.—She states that she can see some -objects. The corneæ appear more transparent. -At the end of another week she was able (in the -presence of Sir George Sinclair) to state the -names of some objects, and to recognise, with -accuracy, the colours of a variety of flowers which -were presented to her in order to test the degree -of progress that had been made. She can now<span class="pagenum"><a name="Page_57" id="Page_57">[Pg 57]</a></span> -walk out and home to her own residence (a distance -of a mile and a half from Thurso) without -assistance. The improvement continues to be -progressive, and the corneæ are now comparatively -translucent.</p> - - - -<hr class="tb" /> -<h4>"CASE 4.</h4> - - -<p>"<span class="smcap">Sinclair Sutherland</span>, a labourer, aged -26 years. Staphyloma of one eye, and occlusion -of pupil in the other, from effused lymph. -In the centre of this there was a small opening -which would admit the point of a fine needle. -The prussic acid was applied, daily, for about -three months. Felt great relief in the staphylomatous -eye since its application; the prominence -of cornea diminished at least one-half, and -though formerly opaque, from repeated attacks -of inflammation and ulceration, it is, at this date, -quite translucent. The effusion of lymph in the -other pupil has been disappearing gradually,<span class="pagenum"><a name="Page_58" id="Page_58">[Pg 58]</a></span> -and the pupil is now about four lines in diameter. -The patient is quite sensible of the -improvement taking place, and can now name -various objects presented to him.</p> - - - -<hr class="tb" /> -<h4>"CASE 5.</h4> - - -<p>"<span class="smcap">Mr. Alexander Macdonald</span>, jun., merchant, -Thurso, has suffered for the last six -months from an affection of the retina, characterised -by the following symptoms, viz., obscurity -of vision, excessive intolerance of light, and deep-seated -pain in the orbit. The external appearance -of the eye is quite healthy, and the motions -of the iris are natural; ascribable, he says, to -too great application to business, and night reading: -and, in many respects, the symptoms resemble -those of inflammation of the retina. The -ordinary treatment of this affection was resorted -to with some benefit, and the eye kept constantly -shaded; but the deep-seated pain con<span class="pagenum"><a name="Page_59" id="Page_59">[Pg 59]</a></span>tinued, -and the patient was getting uneasy. The -prussic acid was applied, daily, for about six -weeks. The relief obtained was great, and at -the expiration of one month all the former distressing -symptoms had totally disappeared; but -I thought it advisable to continue the remedy -for some time longer. The patient can bear a -strong light with impunity, and exert his eyes -on any object, however minute, without uneasiness, -and is now quite well.</p> - - - -<hr class="tb" /> -<h4>"CASE 6.</h4> - - -<p>"<span class="smcap">Mrs. M'Kenzie</span>. Capsular cataract of -one eye, of three or four years' duration. By -way of experiment, the prussic acid was applied -for about five weeks, daily. Absorption of the -diseased structure was slowly taking place all -this time; it has now entirely disappeared, and -vision of this eye is quite restored. The result -in this case was very satisfactory.</p> - -<hr class="tb" /> - -<p><span class="pagenum"><a name="Page_60" id="Page_60">[Pg 60]</a></span></p> - - - - -<h4>"CASE 7.</h4> - - -<p>"<span class="smcap">Mrs. M'Beath</span>. Suffered for many years -past from a disease combining the characters -of conjunctival and sclerotic ophthalmia. -The prussic acid was applied, daily, for about -three weeks, and at the expiration of that time -the redness and angry appearance of the eye -disappeared; the organ looked clear and healthy, -and no pain whatever was felt. The patient can -bear a bright light without uneasiness, and is -now free from any symptom of her former ailment.</p> - -<p>"<small>Thurso, Caithness, Dec. 20, 1842.</small>"</p> -<hr class="chap" /> -<p><span class="pagenum"><a name="Page_61" id="Page_61">[Pg 61]</a></span></p> - -<div class="chapter"><h3 class="invisible"><a id="DISEASED_CORNEA"></a>DISEASED CORNEA</h3></div> -<p>Extracted from the <cite>London Medical Gazette</cite>, -of January 13th, 1843:—</p> - -<p class="center">PRUSSIC ACID IN DISEASED CORNEA.</p> - - -<p class="pi20"> -"<i>To the Editor of the Medical Gazette.</i></p> -<p class="right"> -<small>"Perth, December 31st, 1842.</small> -</p> - -<p>"<span class="smcap">Sir</span>,—If you deem the following case of diseased -cornea, &c., worthy of a place in the -<cite>Medical Gazette</cite>, I shall feel myself obliged, -while I have the honour to be, &c. &c.,</p> - -<p class="right"> -"<span class="smcap">G. K. H. Paterson</span>, </p> -<p class="pi60">"Surgeon."</p> - -<p>"<span class="smcap">Case.</span>—M. J., æt. 29, of a strumous diathesis, -has been repeatedly attacked with inflammation -in both eyes alternately, accompanied with more -or less intolerance of light, and pain of head, -ever since she had small-pox, about her ninth -year: to relieve this her friends sought various -means, but without any avail, and on entering -her eighteenth year she became blind. The<span class="pagenum"><a name="Page_62" id="Page_62">[Pg 62]</a></span> -catamenia had never appeared before she was -twenty; and from that period onwards, till about -four years ago, menstruation had always been -scanty, and attended with the usual symptoms -of dysmenorrhœa.</p> - -<p>"On the 28th September, 1842, her eyes presented -the following state:—The right cornea -transparent, with an unusual quantity apparently -of aqueous humour on the anterior chamber, so -as to give it externally a somewhat conical -aspect; iris of a dark red colour, and its pupillary -edge contracted to the size of a pin-hole, -and in close contact with the capsule of the -lens. No vision in this eye remaining. That -of the left cornea was all but opaque, from -coagulated lymph between its layers, with the -exception of a small lucid segment, at the upper -and outer margin of its circumference; behind -which, on the eye being turned downward and -inward, the pupil could be seen contracted also, -and of an oblong shape, along with a great -increase of aqueous humour in the anterior<span class="pagenum"><a name="Page_63" id="Page_63">[Pg 63]</a></span> -chamber, and the cornea, to external appearance, -much more bulged forward than that of -the right. With this eye she could only distinguish -an object when it was rolled downward -and toward the inner canthus, on being passed -between her and the light.</p> - -<p>"This ill-fated woman being altogether an -object of charity, her friends solicited me to -take up her case, of which I was not at all sanguine. -However, having previously perused, -with much pleasure, a brief extract by Dr. -Turnbull, on the fumes of prussic acid as a valuable -remedy in certain diseases of the eye, I was -led to make trial of a few applications of it in -the above case, according to his method; and I -must candidly confess, that ere long I was completely -astonished on observing the rapid effect -it produced on the opaque cornea before mentioned; -more so, as the longer I cautiously and -perseveringly used it, the greater in proportion -did the inspissated lymph become absorbed, and -the layers of the cornea, over a wide space,<span class="pagenum"><a name="Page_64" id="Page_64">[Pg 64]</a></span> -begin to assume their natural transparency, as -also in dilating the pupil to a considerable -extent; so much, indeed, that before one month -under its use, she could observe objects in a very -different light, and ere another had elapsed, she -could find her way out of doors by herself, and -come to my residence for any medicine she -required; since which she has gone on gradually -to progress favourably, without any more applications, -and the vision is now sufficient to enable -her to go about free from the dread she had -before, or the use of a guide.</p> - -<p>"During the use of this potent remedy, it struck -me very forcibly that the extract of belladonna -might assist the case considerably (more especially -when one had reasons for suspecting adhesions -to exist), in keeping up a greater effect -on the pupil than that arising from the use of -the acid, which every one will admit at once, -who has seen its powers depicted upon the human -eye, to be only temporary, and, I believe, -still less so in disease of the cornea and iris than<span class="pagenum"><a name="Page_65" id="Page_65">[Pg 65]</a></span> -in any other incident to such an organ. With -such an object in view, and after once applying -the extract, smeared round the eye, at bed-time, -I soon found it to be also of considerable service, -along with the daily use of the fumes of the acid, -which were both, afterwards, employed assiduously -in this manner, for the rest of the treatment.</p> - -<p>"But in drawing my remarks to a close at this -time, I cannot refrain from saying less, in regard -to the utility which is likely to arise from this -medicine, when properly applied, than that, in -such a similar case as I have stated, I would not -for a moment hesitate again in giving it and the -extract of belladonna a fair trial, so convinced -am I now, after employing it pretty freely by -itself, in different affections of the same organ -(in all of which more or less improvement of -vision was manifested), of its potency to remove -many of those formidable diseases of the eye, -more especially that of the cornea, which are so -often the opprobium of our art. However, be<span class="pagenum"><a name="Page_66" id="Page_66">[Pg 66]</a></span>fore -I have done, it is but justice to ascribe this -noble discovery to Dr. Turnbull, whose indefatigable -research has not failed to find out -others, no less wonderful in their effects, as they -are useful to mankind; and for such he cannot -but claim to himself the best thanks of the profession -at large."</p> - -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_67" id="Page_67">[Pg 67]</a></span></p> - - - - -<div class="chapter"><h2><a name="CHAPTER_II" id="CHAPTER_II">CHAPTER II.</a></h2></div> - -<h3><a id="ON_THE_ACTION_OF_ESSENTIAL_OILS"></a>ON THE ACTION OF ESSENTIAL OILS, &C.</h3> - - -<p>In October, 1835, a paper of mine appeared -in the <cite>London Medical and Surgical Journal</cite>, -stating the beneficial action of a concentrated -tincture of capsicum for diseases of the eye, by -rubbing it for a few minutes daily over the forehead -and temples with a sponge.</p> - -<p>Soon after this I was induced to try what -effect essential oils, possessing powerful stimulating -properties, might possess in removing -amaurosis and diseases generally of the eye. -The formulæ which I use are—</p> - - -<div class="center"> -<table border="0" cellpadding="4" cellspacing="0" summary=""> - -<tr><td align="center" colspan="2">EMBRO. CARYOPH. CO.</td></tr> -<tr><td align="left"> ℞—Ol. Caryoph.</td></tr> -<tr><td align="left"> — Lavand</td><td align="left"><i>āā</i> Ʒiv.</td></tr> -<tr><td align="left"> — Cinnamom. </td><td align="left">Ʒss.</td></tr> -<tr><td align="left"> Sp. Vin. Rect.</td><td align="left">℥iij.</td></tr> -<tr><td align="center" colspan="2">M. Ft. Embro.</td></tr> -</table></div> -<p><span class="pagenum"><a name="Page_68" id="Page_68">[Pg 68]</a></span></p> - -<div class="center"> -<table border="0" cellpadding="4" cellspacing="0" summary=""> -<tr><td align="center" colspan="2">EMBRO. PIMENT. CO.</td></tr> -<tr><td align="left"> ℞—Ol. Piment.</td></tr> -<tr><td align="left"> — Rosmar.</td><td align="left"><i>āā</i> ℥ss.</td></tr> -<tr><td align="left"> — Cinnamom. </td><td align="left">Ʒss.</td></tr> -<tr><td align="left"> Sp. Vin. R.</td><td align="left">℥iij.</td></tr> -<tr><td align="center" colspan="2">M. Ft. Embro.</td></tr> -</table></div> - - -<p>Finding great utility to arise from the use of -the cloves and pimento, it appeared by no means -undesirable or hopeless to administer them internally -for the same complaints. In order to -shield the pungency of these oils I united them -with calcined magnesia, which, by its very strong -affinity with these essential oils, forms a body -nearly solid, and thereby removes all pungency, -warmth, and even smell; for, in this state, it -requires to be held in the mouth for a considerable -time before it produces any warmth or pungency. -They are thus rendered easily taken, in -sufficient quantity, without heat or uneasiness.</p> - -<p>Some children are the subjects of many diseases -of the eye, producing blindness from opacities, -&c. I ordered the same to be made into -a powder, in which form it can be taken easily<span class="pagenum"><a name="Page_69" id="Page_69">[Pg 69]</a></span> -in any vehicle, without exciting disagreeable -warmth. The formulæ are—</p> - -<div class="center"> -<table border="0" cellpadding="4" cellspacing="0" summary=""> -<tr><td align="center" colspan="2">PIL. CARYOPH. C.</td></tr> -<tr><td align="left"> ℞—Ol. Caryoph.</td></tr> -<tr><td align="left"> Magnes. Cal.</td><td align="left"><i>āā</i> Ʒi.</td></tr> -<tr><td align="left"> Ol. Cinnamom. </td><td align="left">qtt. vi.</td></tr> -<tr><td align="center" colspan="2">M. Ft. Pil. xxiv.</td></tr> -</table></div> - - -<div class="center"> -<table border="0" cellpadding="4" cellspacing="0" summary=""> -<tr><td align="center" colspan="2">PIL. PIMENT. CO.</td></tr> -<tr><td align="left"> ℞—Ol. Piment.</td></tr> -<tr><td align="left"> Magnes. Cal.</td><td align="left"><i>āā</i> Ʒi.</td></tr> -<tr><td align="left"> Ol. Cinnamom. </td><td align="left">qtt. vi.</td></tr> -<tr><td align="center" colspan="2">M. Ft. Pil. xxiv.</td></tr> -</table></div> - - -<p>The dose of these pills is one or two thrice a -day.</p> - -<p>Expedition is required in the making of these -pills, otherwise it becomes a solid mass, and -unable to be formed into pills.</p> - -<p>I have found an alcoholic extract of cloves -and pimento, made into pills with magnesia, -equally efficacious.</p> - - -<div class="center"> -<table border="0" cellpadding="4" cellspacing="0" summary=""> -<tr><td align="center" colspan="2">PULV. CARYOPH. C.</td></tr> -<tr><td align="left"> ℞—Ol. Caryoph.</td></tr> -<tr><td align="left"> Magnes. Calc.</td><td align="left"><i>āā</i> ℥i.</td></tr> -<tr><td align="left"> Ol. Cinnamom. </td><td align="left">Ʒi.</td></tr> -<tr><td align="center" colspan="2">M. Ft. Pulv.</td></tr> -</table></div> -<p><span class="pagenum"><a name="Page_70" id="Page_70">[Pg 70]</a></span></p> - -<div class="center"> -<table border="0" cellpadding="4" cellspacing="0" summary=""> -<tr><td align="center" colspan="2">PULV. PIMENT. CO.</td></tr> -<tr><td align="left"> ℞—Ol. Piment.</td></tr> -<tr><td align="left"> Magnes. Calc.</td><td align="left"><i>āā</i> ℥i</td></tr> -<tr><td align="left"> Ol. Cinnamom. </td><td align="left">Ʒi</td></tr> -<tr><td align="center" colspan="2">M. Ft. Pulv.</td></tr> -</table></div> - - -<p>The dose of these powders is from four to eight -grains thrice a day.</p> - -<p>In the making of these powders, the oil and -the magnesia ought to be well mixed and -allowed to remain for half-an-hour, then reduce -the mass to fine powder, and keep it in glass -bottles with stoppers.</p> - -<p>These medicines, by their local application, -increase the circulation, and give a greater -supply of blood to the deficient organs, and -thereby produce natural tone and power. They -are equally useful in removing chronic diseases, -where thickening and opacity have taken place, -by rousing into activity the absorbent and nervous -influence by their stimulating power. -Among many others possessing the same power, -is a concentrated tincture of pepper nigrum, -ginger, &c.</p> - -<p><span class="pagenum"><a name="Page_71" id="Page_71">[Pg 71]</a></span></p> - -<p>The internal administration has been found -much more serviceable in chronic diseases of the -eye, such as opacities, &c., than in amaurosis.</p> - -<p>The manner of using the embrocations is, by -rubbing the forehead and temples with a sponge -saturated with the liquid. This plan alone, -kept up daily, is beneficial; but the efficacy is -more than doubled if another sponge, with warm -or cold water, is rubbed upon the forehead for a -minute afterwards. By this the energy of the -medicines in inducing a free circulation is greatly -augmented, and greater warmth is rapidly developed. -The rationale, in my opinion, is, that -the large quantity of carbon in some of the -essential oils, and its solubility in alcohol, permits -it, by the friction, to pass through the -cuticle and unite with the oxygen. As the oils -are very insoluble in water, and as the alcohol -has a strong affinity for the water, the carbon is -more readily disengaged, and forms a union with -the oxygen in the vessels, and thereby produces -heat and great activity of circulation. I have<span class="pagenum"><a name="Page_72" id="Page_72">[Pg 72]</a></span> -no doubt that that is the reason why many -bodies are so pungent, when put into the -mouth. I have only given two cases—viz., -John Plunkett and William Dale—as illustrative -of the action of the essential oils.</p> - -<p>It will be seen in the following extract from -Tyrrell on the Eye, "Functional amaurosis -arises from a deficient supply of red blood." -He says—</p> - -<p>"In these cases there always exists, I believe, -a want of general power and vigour of circulation -at first; but in some instances of long-continued -affection of this kind, the local circulation -never regains its proper force and fulness; and -the supply of blood is inadequate to support the -functions of the part, although the general system -recovers its natural tone and power."</p> - -<p>I think this statement very correct, and therefore -the embrocations producing so much additional -circulation, point out at once the essential -oils, along with the water, as its proper remedy. -I here quote Magendie, who corroborates the<span class="pagenum"><a name="Page_73" id="Page_73">[Pg 73]</a></span> -plan which I adopt—viz., the medicines being -most useful when applied to the forehead and -temples in amaurosis:—</p> - - -<h3><a id="EXTRACTS"></a>EXTRACTS.</h3> - -<p>"Lectures on the Physiology of the Nervous -System, delivered in 1836, in the College of -France, by Majendie."—<cite>Lancet, April 29th, -1837, page 186.</cite></p> - -<p>"The integrity of both the optic and the fifth -nerves, then, is indispensably necessary for the -exercise of vision, which is lost whenever either -of these nerves is separately destroyed."</p> - -<p class="center"><cite>Lancet, May 20th, 1837, page 279.</cite></p> - -<p>"Nervous pains of long duration and the -greatest intensity have been quickly removed -by topical applications to the temporal region."</p> - -<p class="center"><cite>Lancet, page 280.</cite></p> - -<p>"Amaurosis cannot be considered as a simple -affection of the optic nerve; at least, in the -actual state of the science, it is generally impossible -to say that the fifth nerve has no connexion -with the loss of sight, and in many cases the<span class="pagenum"><a name="Page_74" id="Page_74">[Pg 74]</a></span> -connexity is evident. Hence a rule which I -invariably follow of addressing my remedies, in -the first instance, to some of the branches of the -frontal nerve; and I have frequently had the -satisfaction of observing some of these cases of -incomplete amaurosis improve sensibly under -the influence of therapeutic agents applied to -the fifth pair. I would go even further and -say, whenever you have a case of incipient -amaurosis, commence by acting on this nerve, -for it is at once the most expeditious and efficient -method. I cannot, however, quit this -point without assuring you that no physician is -capable of treating diseases of the eye unless -fully in possession of the facts I have just had -the honour of explaining to you. These facts -are daily becoming more numerous and more -convincing, and already a considerable number -of our younger practitioners, who devote themselves -to the study of diseases of the eye, are -fully aware of the immense influence of the fifth -pair of nerves over the exercise of vision."</p> - -<p><span class="pagenum"><a name="Page_75" id="Page_75">[Pg 75]</a></span></p> - -<p class="center"><cite>Lancet, page 281.</cite></p> - -<p>"To resume, then, what I have said concerning -the sense of vision and our several experiments, -allow me once more to impress you with -the idea that sight can never be exercised in a -complete and perfect manner without a certain -influence of the fifth pair of nerves; destroy that -influence, and you destroy vision. This is all -we know upon the matter; for up to the present -moment we have been unable to determine how -far this influence extends, or in what manner it -is communicated."</p> - -<hr class="tb" /> - -<p class="center"><i>Case of Amaurosis.</i></p> - -<p><span class="smcap">John Plunkett</span>, Mermaid Gardens, Hackney, -formerly an attorney's clerk, visited me in -May, 1837, and stated that he had been blind -and obliged to be led about by his children for -the last four years. For five years previously -his sight had been gradually diminishing. He<span class="pagenum"><a name="Page_76" id="Page_76">[Pg 76]</a></span> -further stated that he was much troubled with -floating images before his right eye, as well as -with clouds resembling animals, strange goblins, -and sometimes with flashes of lightning, vivid -red, changing into light blue. One great peculiarity -of this miserable man's case was, that -when he threw back his head there appeared a -stream of blood flowing from the top of the -right eye to the centre, where it formed into a -circular pool about the size of a split pea, but -ultimately it became as large as a shilling. It -often remained a considerable time, and then -diminished gradually in red streaks. This was -a matter of great alarm to him. He had been -at several Ophthalmic Institutions for nine years -previously to his visiting me. He has had electricity, -tartarate of antimony, blisters, issues, -stramonium, mercury (until it produced dysentery), -and almost every kind of treatment that -could be suggested, tried, but to no purpose.</p> - -<p>When I saw him the pupil was immoveable, -and the eye dull in the anterior, and very<span class="pagenum"><a name="Page_77" id="Page_77">[Pg 77]</a></span> -obscure. The left eye was destroyed. He -could not discern, in a bright light, the shadow -of white paper when it was moved between him -and the light.</p> - -<p>The compound embrocation of oil of cloves -was used by rubbing it upon the forehead and -temples daily, and in the space of twelve days -he was able to discern objects and could touch -them. In two months he could put his finger -through a ring when held by another person. -He continued occasionally under my care for -about a year, during which time the embrocation -was regularly used. He could walk alone, -and the eye was generally useful, but he was -not able to read with it. He could see objects -at the distance of thirty feet.</p> - -<p>The last month he has visited me once or -twice a week, for the purpose of having the -prussic acid vapour applied to his eye, to ascertain -if the sight could be restored sufficiently to -enable him to follow his occupation as a clerk. -In this case an advantage has been gained. The<span class="pagenum"><a name="Page_78" id="Page_78">[Pg 78]</a></span> -patient is now able to read a little, which, previously -to the use of the prussic acid vapour, he -was unable to do.</p> - -<hr class="tb" /> -<p class="center"><i>Amaurosis.</i></p> - -<p><span class="smcap">William Dale</span>, boot-maker, of 14, Clarence -Gardens, Regent's Park, visited me in July, -1837. He stated, that with his right eye, for -the last year, he could only discern light from -darkness; and that for several months before -he was much troubled by clouds and spots floating -before his eyes. The evening gaslight produced -a continued flashing of light from his eye. -The light looked as if surrounded by all the colours -of the rainbow.</p> - -<p>He first went to an Ophthalmic Hospital, -where he was blistered on the temple and salivated. -Nux vomica produced such an effect -upon him that all his limbs were involuntarily -twitched, so as to alarm them exceedingly. He<span class="pagenum"><a name="Page_79" id="Page_79">[Pg 79]</a></span> -then left, and went to another institution -for three months; and at length was told that -the optic nerve was injured, so as to render a -restoration of vision impossible. The left eye, -when looked into, had a dark green, muddy hue, -and the pupil was exceedingly dilated and immoveable. -He was unable to distinguish an -object placed before his eyes; yet he states -that he could distinguish light from darkness.</p> - -<p>When he applied to me I had the compound -embrocation of pimento applied occasionally to -the forehead and temples, by means of a friction -sponge. During the first month he was able to -discern objects and colours. The pupil acted -under the impression of light almost equal to the -good eye. It was not until this application had -been used for a year that the patient was enabled -to read with the eye.</p> - -<p>I saw the patient this day (the 25th of Jan. -1843). The eye, upon examination, appeared -to be in a healthy state. The sight was not so -good as when he left me, and after he left off the<span class="pagenum"><a name="Page_80" id="Page_80">[Pg 80]</a></span> -applications, but this he attributes to the circumstance -of his general health not being good, -owing to his having suffered from intermittent -fever.</p> - -<hr class="chap" /> - -<p>In January, 1834, I published the first edition -of my work upon Veratria, and gave an account -of two cases of amaurosis, combined with tic-douloureaux, -cured by the external application of -veratria. I there suggested that it was probable -that amaurosis, uncombined with tic-douloureaux, -might be removed by applications of a stimulating -nature to the branches of the fifth pair of -nerves. No notice of this suggestion having -been taken by medical men, I determined to put -the plan into execution, and employed a surgeon -to carry it into effect in St. Giles's Workhouse, -where blind cases were given me for that purpose. -I here extract the case of Eleanor M'Cartney, -for the purpose of showing the power of -capsicum when rubbed upon the forehead and<span class="pagenum"><a name="Page_81" id="Page_81">[Pg 81]</a></span> -temples. I select this case of amaurosis for -several reasons; she was the first patient on -whom I tried the efficacy of capsicum. She had -had, seven years previously, a stroke of palsy, -which removed all power of the right side. The -only power recovered was that of the right arm. -The hearing was perfectly gone; and she had -not had the least perception of sight for seven -years. It is now nearly eight years since her -recovery; and, at the present date (27th of Jan. -1843), she can read perfectly well; and has never -had another application since the three first days. -It will also satisfy the minds of many that a recovery -by stimulating applications of this description, -is not of a temporary nature.</p> - -<p>I here quote the case as given in my work on -"Painful and Nervous Diseases," page 131.</p> - -<p>"<span class="smcap">Eleanor M'Cartney</span>, aged 40, an inmate -of St Giles's Workhouse, was attacked, seven -years ago, with palsy of the right side, when perception -of light and sound, in the right eye and -ear, was extinguished. There was a constant<span class="pagenum"><a name="Page_82" id="Page_82">[Pg 82]</a></span> -and profuse flow of tears, and the pupil was immoveable.</p> - -<p>"The treatment commenced on the 19th of -October, 1835, and was continued for three days -only. On the first day after the commencement -of the treatment there was a great abatement of -the flow of tears, and she could perceive light -and light-coloured objects. On the second day -she could see a watch, and direct her hand to it, -and distinguish the palm from the back of the -hand. On the third day she could distinguish -objects with great facility. There was no further -application of the remedy after the third -day. On the fifth day she could read a duodecimo -prayer-book with ease. On the seventh -day the flow of tears ceased, the pupil moved -readily, and her sight and hearing were perfect. -She is still an inmate of the workhouse, and may -be seen on application to the matron, Mrs. -Bailey."</p> - -<hr class="chap" /> -<p><span class="pagenum"><a name="Page_83" id="Page_83">[Pg 83]</a></span></p> -<div class="chapter"><h3 class="invisible"> <a id="A_Cruikshank"></a>A. Cruikshank</h3></div> -<p>The next case which I select from the same -work is that of <span class="smcap">Alexander Cruikshanks</span>, Esq., -of Strathcathro Castle, Forfarshire. When -this case came under my care he was undergoing -the necessary preparation for an operation for -cataract. The peculiar difference in the removal -of cataract without operation is, that the -person afterwards needs no cataract glasses, as -will be seen from the extracts of two of Mr. -Cruikshank's letters to the author. It is now -seven years since his recovery, and he is at the -present date perfectly well.</p> - -<p>"March 8th, 1836.—My right eye was affected -with dimness, or defect of vision, so long -ago as the year 1810, and commenced by the -deceptious effect of seeing two objects distinctly -where there really was but one. This deception -of double vision gradually disappeared as the -vision of the eye became imperfect. The other -eye was not affected until about four or five years -ago. The affection of this, like the other, commenced -and continued, with the double vision,<span class="pagenum"><a name="Page_84" id="Page_84">[Pg 84]</a></span> -until Dr. Turnbull's remedy was continued six -weeks, when it totally disappeared. The right -eye, by this time, was restored to such a healthy -state, that I could read 'Blackwood's Magazine,' -or the leading article of a newspaper, without -glasses, and the smallest print with them. By -the way, it may be proper to mention that it was -not till July last, 1835, that I ascertained, beyond -question, the nature of the complaint with -which I was affected. In that month I applied -to an eminent oculist, who, after two examinations, -informed me the complaint was cataract."</p> - -<hr class="small" /> - -<p>"May the 10th, 1836.—I am favoured with -your letter of the 3rd instant, intimating that -you had heard it reported that the benefit I had -derived from your treatment of my eyes had disappeared. -The only person with whom I have had -any communication on the subject is my friend, -Mr.——, whom I informed that the remedy -was applied to my forehead and temples, by -friction only, without your having prescribed or<span class="pagenum"><a name="Page_85" id="Page_85">[Pg 85]</a></span> -administered one grain of medicine, or having -confined me to the house, or directed the slightest -change in my former habits of living, either -as to drink or diet; and that my sight was good -enough to read, write, fish, shoot, and to see a -pin on the floor at the most distant corner of an -ordinary-sized room. What more can, or ought, -a man of 67 years of age wish for in this respect? -But if any are sceptical as to your mode -of treatment, let them produce a testimony like -this of a superior method.</p> - -<p class="pi20"> -"My dear Sir,</p> -<p class="pi30"> -"Yours very faithfully,</p> -<p class="pi30"> -"<span class="smcap">Alexander Cruikshanks</span>."</p> -<p> -<small>"A. Turnbull, Esq., M.D."</small> -</p> - -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_86" id="Page_86">[Pg 86]</a></span></p> -<div class="chapter"><h3 class="invisible"><a id="Dr_Kents_Letter"></a>Dr. Kent's Letter.</h3></div> -<p>The only other case which I intend to quote, -in order to show that the recoveries are lasting -when the essential oils have been employed, is -the case of Dr. Kent. This gentleman continues -perfectly well. It is now nearly seven years -since his recovery. He had, alternate days, rubbed -upon his forehead and temples, with the -friction sponge, the compound clove and pimento -embrocation, quoted from page 136, on "Painful -and Nervous Diseases."</p> - -<div class="figcenter"> -<img src="images/i002.jpg" alt="" /> -<div class="caption">Friction Sponge</div> -</div> - -<p>The following case was communicated to me, -by letter, from the patient, <span class="smcap">Dr. Kent</span>, who was -for several years a physician in extensive practice -at Walsall, in Staffordshire, now residing in -Harley Street, Cavendish Square.</p> - -<p class="right"> -"39, Duke Street, St. James's,<br /> -"April 19th, 1836. </p> - -<p>"<span class="smcap">My dear Sir</span>,—Thinking that an outline of -the principal features in my case might be perused -with advantage by many who take an interest -in the success of your efforts, I have sub<span class="pagenum"><a name="Page_87" id="Page_87">[Pg 87]</a></span>joined -it in as concise a form as justice to the -subject would admit. Upon my return from a -very cold ride in a violent storm of snow and -sleet, on the evening of the 29th of January, 1836, -I discovered that the sight of my right eye was -gone. In a few hours violent inflammation supervened, -and continued several weeks, in spite -of the most vigorous and energetic treatment, its -principal seat being the optic nerve, and subsequently -the iris. The inflammation was at -length overcome, but vision was not restored; -and the irritability in both eyes was so great as -to render it absolutely necessary not only to -avoid all attempts to use them, but also to exclude -them from the light. The sight of the -right eye was entirely, and, as I feared, irrecoverably -gone; its pupil contracted almost to -the size of a pin's point, and immoveable. I removed -to the country, by the advice of the professional -friends who had attended me, in the -hope that, as my general health improved, the -irritability would subside, although they gave me<span class="pagenum"><a name="Page_88" id="Page_88">[Pg 88]</a></span> -no reason to expect that the organ, originally -diseased, would ever again prove of much use to -me. In this opinion a medical gentleman of -high celebrity, in Oxford, coincided; but he -strongly recommended me to consult some of the -most eminent oculists in the Metropolis. A -much esteemed friend having mentioned your -success in the treatment of many obstinate and -almost inveterate cases, I placed myself under -your care on the 2nd of April, and had the satisfaction -to find, that after the lapse of three or -four days, a very considerable alteration was observable -in the appearance of the right eye, and -that my perception of light, and afterwards of -objects, became more distinct. The improvement -has been regularly progressing, and I am -now (the 19th of April) able to read with ease -with that eye which, only three weeks ago, could -scarce distinguish light from darkness. I may -also add, that the irritability which so long annoyed -me, ceased almost immediately after your<span class="pagenum"><a name="Page_89" id="Page_89">[Pg 89]</a></span> -first application, and I have not since been -troubled with it.</p> - -<p class="pi30"> -"I am, my dear Sir,</p> -<p class="right"> -"Yours, very sincerely, and much indebted,<br /> -<br /> -"<span class="smcap">Benjamin Archer Kent, M.D.</span>" </p> -<p> -<small>"A. Turnbull, Esq., M.D., &c. &c."</small></p> - - -<p class="center">THE END.</p> - - - -<p class="center"><small>CITY PRESS, LONG LANE: D. A. DOUDNEY.</small></p> -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_90" id="Page_90">[Pg 90]</a></span></p> - - - - -<p class="center space-above"> -FRICTION SPONGE.<br /> -<br /> -See Plate, page 66.<br /> -</p> -<hr class="chap" /> -<p><span class="pagenum"><a name="Page_91" id="Page_91">[Pg 91]</a></span></p> - -<div class="chapter"><p class="center"> -<i><small>Preparing for Publication</small></i>,<br /> -<br /> -<small>In One Vol</small>.<br /> -<br /> -<br /> -SUGGESTIONS<br /> -<br /> -<small>FOR AN</small><br /> -<br /> -IMPROVED TREATMENT OF THE<br /> -DISEASES OF THE HEART<br /> -AND LUNGS, &c.<br /> -<br /> -BY A. TURNBULL, M.D., <span class="smcap">Edin.</span></p></div> - -<p><span class="pagenum"><a name="Page_92" id="Page_92">[Pg 92]</a><br /><a name="Page_93" id="Page_93">[Pg 93]</a></span></p> - -<div class="chapter"> -<p class="center">WORKS BY THE SAME AUTHOR.</p></div> - -<hr class="small" /> - -<p class="center"><small>Price 6s. boards</small>.</p> - -<p>ON THE MEDICAL PROPERTIES OF -THE NATURAL ORDER RANUNCULACEÆ; -AND MORE PARTICULARLY ON THE -ALKALOIDS, VERATRIA, SABADILLINE, -DELPHINIA, AND ACONITINE.</p> - -<p>"In our last number we expressed a hope that the experience -of others might confirm that of the author, promising -at the same time that we should communicate the result of -our own trials. It is unnecessary to assure our readers that -on this, as on every other subject of professional inquiry, our -minds have not been biased either by prejudice or partiality. -Truth and justice are ever the only guides of our conduct.</p> - -<p>"We are satisfied that the medicine exerts a very peculiar -effect as a counter-irritant; it seems to differ from all others -in this respect, that its operation is confined solely to the -nerves of the part, the blood-vessels being scarcely affected.</p> - -<p>"It is therefore our decided opinion that Veratria is a useful -and very potent medicine in certain nervous affections, and -that it deserves to be, and no doubt will become, an established -member of the Materia Medica."—<cite>Editorial Remarks -on Veratria, Dr. Johnson's Medico-Chirurgical Review, July, -1834.</cite></p> - -<p>"I have often cured most successfully cases of Tic-Douloureux -of the face, by sprinkling small blisters, made in the -course of the affected nerves, with one or two grains of Veratria, -and repeating it every three or four days. I use the -same means, and with equal advantage, in cases of paralysis. -I need not add, that in these cases the application should be -made in the course of the facial nerve."—<cite>Majendie's Formulary, -8th edition, 1835.</cite></p> - -<p>"I have now made a very considerable trial of the Veratria -ointment as an external application in gout, and with such<span class="pagenum"><a name="Page_94" id="Page_94">[Pg 94]</a></span> -share of satisfaction in its effects, that I acknowledge myself -much indebted to the work of Dr. Turnbull for the possession -of a very useful remedy.</p> - -<p>"My conclusive opinion of the action of the Veratria ointment -in gout is, that we may consider it to be entirely a local -remedy. I have not detected any constitutional effects to be -produced by it in any case of gout in which I have prescribed -it. Probably the absorbents of a part affected with gout are -in a torpid state. It is no small praise of the application, -that it does not produce any inconvenient effects, and the -patient is pleased with its mode of operation."—<cite>Sir C. Scudamore's -Principles of the Treatment of Gout, 1835.</cite></p> - -<p>"Veratria has, since the last year, become so important a -medicine, having been recommended first by Dr. Turnbull; -and now fairly ranking among the most salutary ingredients in -Materia Medica, it must naturally be of great interest to the -pharmaceutical and medical world to obtain so valuable a substance -in its purity."—<cite>Silliman's American Journal, April, -1836.</cite></p> - -<hr class="small" /> -<p class="center"><small>Price 3s. 6d. boards</small>.</p> - -<p>ON THE PREPARATION AND MEDICINAL -EMPLOYMENT OF ACONITUM NAPELLUS -AND ITS ALCALOID ACONITINA.</p> - -<p>"Aconitine will cure a local pain where every description -of depletive and counter-irritant has failed."—<cite>London Medical -Gazette, Nov. 5, 1836.</cite></p> - -<p>"Dr. Turnbull's work will be read with great interest by -persons afflicted with neuralgia and other painful diseases. -The profession is certainly indebted to him for drawing the -attention of the public to an important, very potent, and much-neglected -class of substances."—<cite>London Medical Gazette, -April 1st, 1837.</cite></p> - -<p>"As a topical remedy, aconitine is most valuable for the -relief of neuralgic and rheumatic pains. In neuralgia no -remedy, I believe, will be found equal to it. One application -of the tincture produces some amelioration, and after a few -times use it frequently happens that the patient is cured. In -some cases the benefit seems almost magical.—<cite>Pereira's Elements -of Materia Medica, vol. II., page 1808.</cite></p> - -<p><span class="pagenum"><a name="Page_95" id="Page_95">[Pg 95]</a></span></p> - -<p>"Of the great efficacy of aconitina in neuralgic and rheumatic -affections, no one can entertain any doubt who has submitted -the remedy to trial."—<cite>Pereira's Elements of Materia -Medica, vol. II., page 1812.</cite></p> - -<p><i>Aconitine, discovered by Geiger and Hesse, in Aconitum -Napellus and A. Ferox.</i>—Our knowledge of this base is very -limited. There is reason to think, from the experiments of -Dr. Turnbull, either that the plant contains two bases, or that -the aconitine of Geiger and Hesse is an <em>altered product</em>.</p> - -<p>"Dr. Turnbull has succeeded in producing, but with difficulty -and in small quantity, an aconitine possessing in perfection -all the active properties of the plant. It produces <em>numbness</em> -of the <em>tongue</em> when applied to it, and is said to <em>contract -the pupil</em>, whereas Geiger's aconitine <em>dilates</em> it. In obtaining -the aconitine of Turnbull, much appears to depend on the -freshness of the plant; and the alkaloid itself is easily decomposed, -especially by alkalies.</p> - -<p>"As a remedy in neuralgia and similar painful and obscure -diseases, the aconitine of Turnbull possesses most valuable -powers. Could it be obtained at a reasonable price, it would -be extensively employed. At present, however, only one -manufacturer has been able to obtain it, and that in small -quantity. The aconitine of Geiger and Hesse does not appear -to possess the same action on the system.—<cite>Turner, Leibeg, -and Gregory's Elements of Chemistry, 1842, page 1167.</cite></p> - -<p><span class="pagenum"><a name="Page_96" id="Page_96">[Pg 96]</a></span></p> - - -<p class="center">CORRIGENDA.</p> - - -<p>In part of the impression the following errors occur:—</p> - -<p> -Page 37, line 14, <i>for</i> "28" <i>read</i> 8.<br /> -Page 38, line 15, <i>for</i> "months" <i>read</i> weeks.<br /> -</p> - -<div class="footnotes"><h3>FOOTNOTES:</h3> - -<div class="footnote"> - -<p><a name="Footnote_1" id="Footnote_1"></a><a href="#FNanchor_1"><span class="label">[1]</span></a> Morbid appearances produced by hydrocyanic acid in a case -related by Hufeland. -</p> -<p> -The inspection was made the day after death. The eyes -were still glistening like those of a person alive; but the -countenance was pale and composed like one asleep. The -arteries and left cavities of the heart were empty, and the -veins and right cavities distended.—<cite>Christison on Poisons, -page 708.</cite> -</p> -<p> -In most instances venous turgescence and emptiness of the arterial system is commonly remarked throughout the whole -body.—<cite>Christison on Poisons, page 710.</cite> -</p> -<p> -It appears that long after death the eye, as in Hufeland's -case, has a peculiar glistening and staring expression, so as to -render it difficult to believe that the individual is really dead; -and this appearance has been considered by Dr. Paris so remarkable, -as even alone to supply decisive evidence of poisoning -by hydrocyanic acid.—<cite>Christison on Poisons, page 711.</cite> -</p> -<p> -Numerous reports have now been made of those who have -died in consequence of this poison, and the most striking -effects to be observed are, the extraordinary state of the eye, -which has indeed been considered as the most characteristic -phenomenon, and at once to point out the cause of death: the -shining, glistening, sparkling lustre of the eye has been, on -most occasions, observed. No one has, so far as I am able to -learn, attempted to explain this most striking appearance; it -has, however, been said, that those who die from the effects of -charcoal often exhibit the same unearthly lustre.—<cite>Dr. Sigmond -on Poisoning with Prussic Acid.—The Lancet, August 26th, -1837, page 797.</cite></p></div> - -<div class="footnote"> - -<p><a name="Footnote_2" id="Footnote_2"></a><a href="#FNanchor_2"><span class="label">[2]</span></a> <cite>Lancet, Sept. 16th, 1837, page 883.</cite>—In whatever manner -it is prescribed or administered, either therapeutically or as a -poison, hydrocyanic acid operates directly on the nervous -centres.—<i>Professor A. T. Thompson.</i></p></div></div> - -<div class="transnote"> -<h3>Transcriber's Notes</h3> - -<p>Obvious typographical errors have been silently corrected, -other variations in spelling and punctuation remain as in the original.</p> - -<p>The original began with an unidentified illustration. This appears to be the Friction Sponge -referred to at the end of the book. The illustration has been placed on page 86 where its use is described -and a caption has been added.</p> - -<p>In the heading of CASE 4, "Two cases of —— Ophthalmia, ending in -Opacity of the Cornea." —— represents a word crossed out in all available copies of the book.</p> - -<p>The first of the corrigenda has been implemented, the second had already been corrected in the original.</p> -</div> - - - - - - - -<pre> - - - - - -End of the Project Gutenberg EBook of Treatment of the diseases of the eye, -by means of prussic acid vapour, and , by Alexander Turnbull - -*** END OF THIS PROJECT GUTENBERG EBOOK TREATMENT OF DISEASES OF EYE *** - -***** This file should be named 50254-h.htm or 50254-h.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/5/0/2/5/50254/ - -Produced by The Online Distributed Proofreading Team at -http://www.pgdp.net (This file was produced from images -generously made available by The Internet Archive) - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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