the retina; and to this mode of operation is given the name of RECLINATION. The operation of extraction seems to have derived no small improvement from the method of Sir William Adams, who, after detaching the cataract, first passes it through the opening of the pupil into the interior chamber by means of his needle, and then extracts it by an opening on the outer side of the cornea, instead of by one in its interior part. GEN. I. Cataract. extraction by Adams: Method of absorption most ad viseable: and why. The preci pitation of Maître Jan. Solvent power of active: vitreous The simplest and least irritating of these operations, however, is that by absorption, as it is now commonly called, as it was named precipitation by Maître-jan*, on his first noticing the disappearance of portions of the opake lens; but which in effect is neither absorption nor precipitation, but SOLUTION, or dissolution, as Mr. Pott correctly described it. But it should be known to the operator that while the solvent power of the aqueous the aqueous humour is wonderfully active, that of the vitreous is weak humour highly and inconsiderable: and hence the solvent or absorbent plan, first practised by Buchhorn, and since in our own that of the country by Sir William Adams, consists in dividing the humour cataract, after its separation, into small fragments, and weak. passing them with the needle by which they are thus Principle of divided, through the pupil into the anterior chamber, as practised which constitutes the seat of the aqueous humour, apparently in perfect coincidence with the method first practised by Gleize, and since recommended by Richtert. The sometimes fragments thus deposited are usually dissolved in a few very rapid.. weeks; and where the cataract is fluid they have often ly dissolved been dissolved and absorbed in a few seconds; and some- off. times even before the needle has been withdrawn. The division is here made through the cornea, previously illined with belladonna to dilate the pupil, and it is to this method of operating that M. Buchhorn gave the name of CERATONYXIS ‡. The first inventor, however, of the Ceratonyxis. plan in its simplest state was Conradi of Nordheim. * Traité des Maladies de l'Oeil. Edit. sec. Troyes, 1711. + Chirurgische Bibliothek. Band. x. Buchhorn de Keratonyxide. Halae, 1806, this method by Adams. Cataract and carried GEN. I. SPEC. X. Origin of the specific term. a P. Syni zesis sim plex. Simple closed pupil. @ P. Synizesis com SPECIES X. PAROPSIS SYNIZESIS. Closed Pupil. · DIMNESS OR ABOLITION OF SIGHT FROM CONTRACTION "consido THE term SYNIZESIS is derived from ouvia, coeo, coalesco"; and was used among the Greek grammarians, before it obtained an introduction into the medical vocabulary, to signify the coalescence of two or more syllables into one. This species exhibits two varieties: Simple closure of the pupil. Closure of the pupil com plicated with cataract, or opake cornea. The pupil becomes closed or obliterated from a gradual contraction and, at length, coalition of the muscular fibres of the iris; from inflammation of the surrounding membranes; or from protrusion of the iris. In all these cases it is a SIMPLE OBLITERATION OF THE PUPIL. It is COMPLICATED when the obliteration is combined with an opacity of the cornea, or with a cataract. When the disease Complicated is an effect of inflammation, it forms the ATRESIA IRIDIS closed pupil. of Dr. Schmidt of Vienna, who further subdivides it into complete, incomplete, and partial, according as the vision is totally destroyed, impaired, or confined to a part of the pupil *. plicata. Atresia iridis of Schmidt. Form of the The natural form of the human pupil is circular, this pupil chang- being the natural form of the fine fringe of the iris by ed by the disease. * Ueber Nachstaar und Iritis Nachstaar operationen. 4to. Wien. 1801. which it is surrounded. But in a very few instances the fringe, or rays, of the iris has evinced a different figure, and the pupil, in consequence, has been found oblong, or heart-shaped. The first has occurred most frequently: and according to Albinus has sometimes preceded loss of vision t. Block gives an instance in which the disease was congenital and hereditary ‡. GEN. I. SPEC. X. & P. Synizesis comComplicated. plicata. closed pupil. found con Has been, genital and hereditary. Dr. Pupil five con fold. If the iris contract irregularly, sometimes only a few of its fibres spread across the pupil, while others are retracted: and hence we have examples of double or more than Double double pupils, though of smaller dimensions than the na- pupils how produced. tural circle. Solinus gives an instance of two pupils hereby produced §, and Janin of not less than five || Plenck, who very unnecessarily multiplies diseases, fines the term synizesis to a total contraction of the pupil; and makes its partial contraction a distinct affection, which he calls myósis: and the second or complicated Complicated closed pupil. variety, another distinct affection which he denominates Myosis of synechia. But this is to perplex rather than to simplify Plenck. the subject. Synechia, what. of the first variety. Medicines in this disease are of little avail. In the Medical first variety an external application of the tincture of treatment belladonna, or a solution of stramonium, which is said to answer the same purpose, has occasionally effected a cure by destroying the contractile action; and dilute solutions of brandy, camphor, or sulphate of zinc, by their tonic or stimulant power. When the disease does not yield to this mode of treatment, or consists of the complicated variety, it belongs manifestly to the art of surgery, and its removal must be sought for in books on that subject: among the best of which may be mentioned, Mr. Guthrie's Lectures on the Eye lately published, and Professor Beer's Essay on Staphyloma, and artificial pupil, The second appertains to surgery. * Eph. Nat. Cur. Dec. 111. Ann. vII. VIII. Obs. 21. + Anat. Acad. Lib. vi. cap. 3. Medicinische Bermerkungen, p. 1. § Vide Marcel. Donat. Lib. vi. cap. ii. p. 619. Annual Report of the Liverpool Institution for Diseases of the Eye. GEN. I. SPEC. X. plicata. published in 1804 *, and his Doctrine of the Diseases of B P. Syni- the Eye published in 1817+. According to the nature zesis com- of the coalition, Beer employs three varieties of operation, Complicated incision, excision, and separation, which he distinguishes closed pupil. by the names of COROTOMIA, CORECTOMIA, and CORODIACorotomia, LYSIS. The first is the simplest, and that most usually had corodialysis. recourse to. In the second, an incision being made with a corectomia, The last, Reisinger's method. cataract knife, close to the edge of the cornea, and not larger than the third part of its circumference, the iris, if it protrude, is laid hold of by the hook; or if no protrusion take place, the hook introduced through the incision, is made to lay hold of the pupillary edge of the iris, which drags it through the wound when a sufficient portion of it is removed by a pair of scissors. In the third method, which is that formerly proposed by Dr. Reisinger, the operation is performed by a double hook or hook forceps t. SPECIES XI. PAROPSIS AMAUROSIS. Drop Serene. DIMNESS OR ABOLITION OF SIGHT WITH AN UNALTER- GEN. I. SPEC. XI. The gutta serena of the Arabians. THIS is the GUTTA SERENA of the Arabic writers, whence the term "Drop Serene" of our own tongue; terms we * Amicht der Staphylomatoien Metamorphosen des Anges, und der Künstlichen Pupillen bildung. Lehre von der Augenkrankheiter, &c. ut suprà. See also D. Weller's Treatise Ueber künstliche Pupillen, und eine besondere Methode, diese fertigen; published in Langenbeck's Neue Bibliothek. B. II. St. 4. See also Dr. Schlagintweit Ueber den gagenwärtigen Zustand der künstlichen Pupillenbildung, &c. München 1818. have already explained under PAROPSIS CATARRacta. Milton is well known to allude to this affection in his beautiful address to light, as he does also to the cataract by him called suffusion, as the Latins call it suffusio: but it is singular that, in the course of this allusion, he seems doubtful as to which of the two diseases he ought to ascribe his own blindness: Thee I revisit safe And feel thy sovereign vital lamp; but thou So thick a DROP SERENE has quench'd their orbs, 66 The term AMAUROSIS is derived from the Greek ἀμαυρὸς, obscurus, caliginosus, opacus". The most common cause is a paralysis of the retina, usually in conjunction with a paralysis and dilatation of the iris. Occasionally, however, the iris is rigidly contracted; its debility being accompanied with great irritability; and hence, offering two varieties; to which a third may be added, from the disease assuming, at times, an intermittent type. a Atonica. Atonic amaurosis. B Spasmodica. Spasmodic amaurosis. y Intermittens. Intermittent amaurosis. With permanent atony, and With a permanent contrac- With periodical cessations and returns. It would be easy to admit other varieties if we were to attend to all that has been written on the subject, and adopt all the opinions that have been delivered; for we are told of cases in which the pupil has not been permanently immoveable, but has contracted on exposure to an intense light; and of others in which the pupil instead of being black has evinced a pale or nebulous appear GEN. I. SPEC. XI. Paropsis Amaurosis. Confounded by Milton ract or suf with cata fusion. Origin of the specific term. Ordinary cause. Other monoticed by difications some writers; Par. Lost, III. 21. + Caldani ad Haller. v. Richter, Nov. Comm. Soc. Goett. Tom. iv. 77. Hey, Medic. Observ. and Inquir. Vol. 5. p. 1. |