SPECIES VII. OPHTHALMIA ENTROPIUM. Inverted Eye-lid. TARSUS DRAWN INWARDS, CILIARY HAIRS BENT AGAINST TEGUMENTS. GEN. VIII. SPEC. VII. Synonyms. THIS disease has been distinguished by various names, as ptosis, phalangosis, and trichiasis, but is now chiefly known by that selected on the present occasion. The Description. evil it produces is the reverse of that just described, and consists in an internal traction of the tarsus above or below, in consequence of which a perpetual irritation is produced in the conjunctiva, by the friction of the hairs of the eye-lid thus thrown out of their natural line of growth. The inflammation is in time communicated to the cornea, which becomes opake, and is frequently ulcerated. When the disease has acquired a chronic state, the integuments appear redder than usual, the eyelid is thickened, the conjunctiva is contracted at its commissures, and the tarsus assumes an unnatural curvature. Various plans have been devised for the cure of this Treatment defect from the time of Celsus, or rather of Hippocrates. various according to Of these the chief have consisted in a careful attention plans. to remove, and if possible prevent the future growth of hairs, either by pulling them out, or destroying their roots by sulphuric acid; a removal of a fold of the skin, and producing an artificial retraction by drawing the extremities of the wound together by sutures or strips of adhesive plaster, as recommended by Scarpa; and lastly, an entire removal of the edge of the eye-lid, including the cilia, as proposed by Jaer, and since performed with little variation by Mr. Saunders. GEN. VIII. Of these methods the first, which is the simplest, SPEC. VII. rarely if ever, as Beer has justly observed, produces a Ophthalmia Entropium. permanent cure; while the rest either do not succeed or are peculiarly unsightly in the issue. Inverted eye-lid. Objections. Guthrie's method. To remedy these evils Mr. Guthrie has lately introduced an operation which, though in some respects more complicated than the preceding, seems completely to succeed, and with little or no disfigurement. Its principle consists in taking off all contraction, by slitting up the eye-lid at each angle, and then producing a sufficient degree of permanent retraction, by taking away a small slip of the affected tarsus as near the edge as may be, and afterwards uniting the edges of the wound, as already noticed, by ligatures *. Lectures on the Operative Surgery of the Eye, &c. p. 33. 8vo. Lond. 1823. Quadrì, Annotazione pratiche sulle Malattiè degli Occhi. Napoli, 1819.-Travers, Synopsis of the Diseases of the Eye. 1810.-Beer, Lehre, &c. ut suprà. GENUS IX. CATARRHUS. Catarrh. INFLAMMATION OF THE MUCOUS MEMBRANE OF THE Origin of the generic term. GEN. IX. senses ap CATARRH is a Greek compound, and imports "defluxion", from xarà, denoting, as stated in the table of significations to the affixes and suffixes of medical terms in the Nosology, "augmented action", and pew, "to flow". Catarrhus, however, like ophthalmia, has been used in various senses and latitudes by different authors. Schneider Different and Hoffman show a disposition to extend it to inflam- plied to it. mation of the mucous glands in general; and Parr, enticed by such an example, has made it a genus for including not only what is commonly understood by catarrh, but the cough of old age (which he admits is without pyrexy), croup, dysentery, phthisis, cystirrhoea, leucorrhoea, gonorrhoea, and one or two others. This is the widest acceptation of the word. The narrowest is that of the old pathologists, who thus distinguished between three separate terms which are now regarded by many writers as synonymous: Si fluit ad pectus, dicatur rheuma CATARRHUS; Ad fauces, BRONCHUS; ad nares, esto CORYZA. This couplet is, perhaps, founded upon Galen's account of these affections; but it does not follow up the Greek distinction into all its ramifications; for the Greek physicians, as Galen himself tells us, had also a further supply of names for the defluxion when it fixed itself chiefly in other parts of the neighbourhood; as ACINUS, when VOL. II, M M How distinguished by the Greeks. Catarrhus. Catarrh. How deno minated by Celsus; GEN IX. the uvula was the seat of affection; ANTIADE, when the the tonsils; and PARISTHMIA, when the attack was common to the fauces. For all these Celsus employs the Latin term GRAVEDO, between which, however, and CORYZA he observes that there is a manifest difference. his subdivi- It is this difference which I have endeavoured to support in the present system; in which coryza, treated of under our second class, as an affection of the vocal avenues, is made to import nasal defluxion without pyrexy. Celsus takes no notice of the term catarrh; for in his day catarrh was changed by the later Greek writers into sions. Distinctions CATASTAGMUS. Sauvages has only deviated from the rule contained of Sauvages: in the above Latin couplet by omitting bronchus and employing catarrhus in its stead, and rheuma in the stead of catarrhus; so that with him RHEUMA imports a cold, or febrile defluxion of the chest; CATARRHUS, the same affection of the fauces, and adjoining organs; and CORYZA, the same malady of the head or nostrils. compared with the arrangement of Cullen. in the pre sent system. Cullen has regarded rheuma, coryza, bronchus, and catarrhus as synonymous terms, scarcely indicating varieties of the same disease. The arrangement of Dr. Cullen, moreover, did not allow him to place bex, tussis or cough, any where else; and being obliged to yield to the force of necessity, he has made cough also a synonym of catarrh, and has treated of it under this genus. It is Signification here the present system differs from Dr. Cullen, as it does likewise in separating coryza from the list of phlogotic affections. Cough is not necessarily a pyrectic or inflammatory disease, though it may be occasionally a symptom of such disease. Cough therefore, under the Greek term BEX, we have already considered, as well as CORYZA, under the second or PNEUMATIC class; where they will probably be allowed by most nosologists to occupy more correct and natural posts than in the present place. Catarrh, thus explained, embraces the two following species: 1. COMMUNIS. 2. EPIDEMICUS. COLD IN THE HEAD OR CHEST. Catarrhus. Under neither of these species can catarrh be regarded GEN. IX. as a dangerous or very serious disorder, unless neg- Catarrh. lected or treated improperly; or unless it occurs with great severity in persons of delicate lungs or possessing a consumptive diathesis; in all which cases its result may be very mischievous, and lead on to pneumonitis, bronchlemmitis, phthisis, or dropsy of the chest, though in itself, and separate from such concomitants, by no means alarming. SPECIES I. CATARRHUS COMMUNIS. Cold in the Head or Chest. FEVER SLIGHT; MUCOUS DISCHARGE CONSIDERABLE. GEN. IX. SPEC I. Synonyms. THIS is the pose of old English writers, a term precisely synonymous with the gravedo of Celsus, which is also employed in the earlier medical works of our own country. To pose is still used in the sense of to stupify, and the real meaning of posie is a "narcotic charm", and hence a nosegay of tranquillizing odour inducing repose or sleep. The common symptoms of this species are a Description. sense of fulness in the head, and of weight over the eyes, which are inflamed and lachrymose. The nostrils are obstructed, and pour forth a thick acrimonious ichor, which excoriates the skin as it descends, accompanied with frequent sneezing. The voice is hoarse, the fauces sore, and the lungs loaded, often producing a troublesome cough. Its usual cause is suppressed perspiration from cold; Causes. whence Dr, Cullen conceives that cold is the constant and only cause, and would in every case be detected to be such, were men acquainted with, and attentive to, the circumstances which determine cold to act upon the body. |