I may begin by saying that the great mass of oculists utterly ridicule the idea of curing cataract with medicines; they nearly all forget that no number of negative facts can do away with one single positive fact. Moreover, they appear to ignore the very important point that they are incompetent to judge of the subject. Why? Because they (as a rule) never try to cure cataract with medicines. If they were to do this in a careful, PERSEVERING, scientific way, for a sufficient length of time, with a sufficient variety and number of cases, then they could give an opinion on the subject that would be worth having. But this they have not done. I give them all honor for their surgical knowledge and operative skill, but I cannot see what they can possibly know about the curability of cataract with medicines, since they do not try to cure it medicinally. That they should just give- solatii causa- a tonic, or a bitter, or a little mercury (or much of it for the matter of that!) or iodine, cannot reasonably be called a fair trial.
The fact is, a dexterous operator cannot, in the nature of things, be ever a fair judge, inasmuch as his fingers itch too much for the knife, so that he has not the requisite patience in order to to give medicines a full and fair trial.
But to my task.
1. Carlsbad.-It is an admitted fact that certain cataract patients, who have gone to Carlsbad and used the waters have returned cured of their cataract. This is well known in the Vienna school, and not denied. Yet I never heard of a single Vienna oculist sending a patient with cataract to Carlsbad with a view to its cure; I believe it never strikes them, so accustomed are they to hear that cataract can only be cured with the knife.
2. Tetzer says (p. 268): `It is very remarkable, but cataract does sometimes get well without operation.”
3. Curtis (A Treatise on the Physiology and Diseases of the Eye, containing a New mode of curing Cataract without an Operation; London, 1833), who was aurist to George IV., was very decidedly in favor of the medicinal treatment of cataract.
Amongst the causes of cataract he reckons exposure to great heat, as cataract seems common to forgemen, glass-blowers, and blacksmiths; strong liquors; sour wines; rice diet; and sudden application of cold to the extremities.
Speaking of cystic cataract, which is usually consequent on concussion he says: “Cases of this kind, more frequently than any others, get well without an operation.
Then, speaking of traumatism (p. 115), he says: ” A spontaneous cure of cataract takes place in those cases where an injury, which has caused the cataract, has also so ruptured the lens and its capsule that its solution and absorption take place by the agency of the aqueous humor. In other more rare cases, where the lens has become detached from its connections in consequence of disorganization of the vitreous humor, and fallen from the axis of vision, a spontaneous cure has also happened. M. Boyer mentions an interesting case of a gentleman who, after twenty-five years blindness, his eye having been considered unfit for an operation, suddenly had his sight restored when walking along the street; the detachment of the lens above described having taken place at its upper half, by which it waved to and fro in the eye.”
He continues (p. 116):…”The late Mr. Ware communicated an account of the dissipation of cataract to the Medical Society of London in 1789 and 1790; and in his Chirurgical Observations he states that, since the preceding communications were read to the Society, he had occasion to attend a considerable number of cases of in which an opacity of the crystalline humor was produced by violence done to the eye; and in most of these the opacity was dissipated and the sight restored, during the external application of ether.”
His treatment consists in the use of alteratives, aperients, and then, “after the chronic inflammation is subdued, the `cataract’ is to be touched every morning with a solution of potassa cum calce, beginning with a weak solution, and increasing it gradually.” He probably means to touch the “eye” to stimulate it. He also made use of antiphlogistics and counter-irritants.
He then says:……”Some practitioners recommend that when a cataract is newly formed, we should wait until it is fit to be operated upon. On the contrary, I think we should use every means in our power to dissipate it as speedily as possible after it has made its appearance” Some of this author’s cases were evidently not cataract.
4. Jonathan Wathen (A Dissertation on the Theory and Cure of the Cataract; London, 1785) has no faith in the cure of cataract other than by operation, but quotes (p. 30) some few cases of spontaneous cure. He also adds that he has reason to believe that some cases of incipient cataract have been arrested by the external application of electricity and ether, and at the same time taking the ether internally.
5. C.G. Guthrie, formerly Assistant Surgeon to the Royal Westminister Ophthalmic Hospital, in his work (On Cataract, etc.; London, 1845), says (p. 53):.. “It is a fact, however, that cures (of cataract) have been completed by the operations of nature.” etc. Then again:…”The possibility of the recovery of the transparency of the lens after it has become partially opaque must be admitted.”
Also, speaking of his father (p. 51), he says:….. “Mr. Guthrie admits, however (our author is arguing against the curability of cataract by any then known medicinal means) that he has seen, in the course of his long experience in diseases of the eye, some very few cases in which incipient cataracts or commencing opacities disappeared in one eye after operating on the other, and in two cases after suppuration of the eyeball of the other eye from accidental causes.” Finally (p. 52), “In some few instances the extraction of the cataract from one eye seemed to have caused the removal of the commencing opacity in the other; but in all these instances the opacity was never central, but was commencing from the circumference.”
It seems to me that the very unwilling admissions on the part of Mr. Guthrie, Sr. and Jr., are extremely important as demonstrating the possibility of a resolution of cataract by nature herself And if unaided nature can sometimes do it, why not nature aided with appropriate remedies?
The thought occurs to me, also, that the suppurative process may have afforded nature a means of ejecting some materies moroi, and this done, the remaining eye recovered in consequence. This idea is borne out in many of the cases treated homoeopathically.
6. I will next quote from A Treatise on the Diseases of the Eye and their Remedies, etc., by George Chandler, Surgeon: London, 1780.
On p. 164 is mentioned the case reported by Fabricius Hildanus, “of a cataract arising in one night’s time from an incessant weeping for some days before.”
This does not seem impossible, when we consider the etiology of some pathogenetic cataracts.
On p. 165 he says: Dr, Buchan affirms that he has himself resolved a recent cataract, by giving the patient frequent purges with calomel (we note the dictum of Boerhaave, cataractas mercurius solvit), keeping a poultice of fresh hemlock constantly upon the eye, and a perpetual blister upon the neck.
Platner strongly recommends the juice of live millepedes. Sauvages extols the white henbane as a specific in this case. These are his words: “Usus extracti hyoscyami albi quotidianus, a triente grano incipiendo, etsensim augendo, quamdiu, nulla est oesophagi nariumve siccitas, est egregium et ferme unicum remedium quod cataractam resolvat, ut pluribus observationibus compertum habeo. Presbyter ea affectus in oculo dextro, post octo dies quibus hoc medicamine usus est, quo intervallo, and tria granna pervenit, jam minutos librorum characteres legere valet, qui prius non nisi maximos perspiciebat; chrystallinus, prius albus, jam subcaeruleus evasit et subpellucidus, suffusio myodes qua laborabat evanuit, fames autem et somnus, prius languentes, vigent maxime. Ab hoc medicamine alumi vidimus a D. Coulas etiam curatum, cujus chrystallinus omnino diaphanus evasit.”
We shall come to Hemlock again.
7. I go now to Lecons sur la cataracte professees a l’hopital Saint Louis, par Em. Foucher. Paris, 1868, and read:
“Gentlemen: What are we to think of the medicinal treatment of cataract?”
In olden times they used to believe in the possibility of curing cataract by purely medicinal means.
Goudret, in a memoir that he published in support of the treatment of cataract with revulsives, cites a certain number of cures These cases of cure refer, no doubt, (How do you know, M. Foucher?), to false or accidental cataracts in their incipiency. These opacities being almost from an inflammatory cause, may be dissipated, as Mirault, of Angers, has demonstrated, by extinguishing with antiphlogistics and revulsives the inflammation that engenders them.
Having made this admission to the partisans of the medicinal curability of cataract, we may say that the tentatives still made by them every day to again render the crystalline transparent (How do you know, M. Foucher?) are fruitless.
Within the last few years M. Sperino, of Turin, tried puncturing the vitreous body, but soon abandoned it.
8. Can we stop an incipient cataract in its onward march?
M. Cusco, in his researches on the nutrition of the crystalline demonstrated the intimate connection existing between the vitality of the lens and that of the choroid by showing that, “when the latter became morbidly affected the crystalline was modified in its nutrition and turned opaque. To arrest the progress and even the formation of cataract by curing the choroiditis was the practical deduction drawn from the ingenious discovery of M. Cusco. But, unhappily, we posses no efficacious therapeutic means against choroiditis.”
Then according to M. Foucher, cataract is due to inflammation of the choroid, and if we had any sure means of curing choroiditis we should at once arrest the onward march of every such cataract. So we not only cannot cure cataract, but we also cannot cure an inflamed choroid, and so we are altogether helpless! Or shall we, perhaps, “perform an operation for the extraction of the choroid?” Granted, that a regular panophthalmitis, in a dyscratic individual, is a terrible thing to deal with, still I cannot admit that we do not know how to quell an ordinary choroiditis. It is an odd choroiditis that will not yield to rigid diet. scientific homoeopathy, and hydropathy. The hydropaths tell many an instructive tale of “incurable” cases of ophthalmitis that had gone on their weary months, aye years, with Nitras Argenti and Hydrargyrum cum-stupiditate.
9. My readers will remember that Conium Maculatum occurs very frequently in the prescriptions of the narrators of the homoeopathic cures of cataract, which I have given in a former part of this little work. If they possess Stork’s monographs on Cicuta (Antonii Stork, Medici Viennensis et in Nosocomio civico Pazmariano Physici ordinarii, LIBELLUS, quo demonstratur: Cicutam non solum usu interno tutissime exhiberi, sed et esse simul remedium valde utile in multis morbis, qui hucusque curatu impossibiles dicebantur, Vindobonae, 1760), they will see it was so used in pre-homoeopathic days, and that notwithstanding its “impossibility.” Stork knew no impossible in therapeutics on the ipse dixit of the superlatively sapient, who ween their own endeavours to be the full extent of the possible. Stork cured bonafide cases of cancer and cataract with Conium; of that there can be no reasonable doubt. If you doubt, my skeptic reader, peruse his books; they are about in old book-stalls. I will only give his cataract cases. The italics are mine.
Casus Decimus Octavus.
In viro quinquagenario, ex cataracta in ambobus oculis caeco, et in meo nosocomio ex acuta convalescente, pilulae hae (that is, of Conium) tantum effecerunt, ut intra duos menses non modo solus ambulare, sed et objecta, et colores potuerit distinguere. (p. 92, Cap. ii.)
Casus Decimus Nouns.
Virgini, 22 ann., ex incipiente in utroque oculo cataracta, visus adeo debilis factus est, ut jam citra summam adtensionem vix amplius ola incidere potuerit.
Ex usu autem harum pilularum intra binos et dimidium menses cataractae penitus dispulsae sunt, et visus adeo bonus rediit, ut jam fila per subtilissimarum acuum foramina ducat, et neat accuratissime.
Dominus Leber hanc Virginem and Illustrissimum VAN SWIETEN adduxit, ut Ipse historiam audiret, et videret effectum.
I am especially glad Stork sent the girl to Van Swieten, as we thus have the case verified by the highest medical authority then existing in Europe.
In the Corollaria to the First Monograph, Cap. iii., Corollar. 14 et 15, p, 105, are these epitomes. 14) Visum, cataracta nondum inveterata. demtum, quandoque restituit. 15) Incipientes cataractas aut solvit, aut earum progressum saltem impedit.
10 In the following year, 1761, Antonius Stork published his LIBELLUS SECUNDUS, quo confirmatur: Cicutam, etc.
We note from the title that from being only the Hospital Ordinarius, he is now Imperial Court Physician in Vienna.
On p. 154 we read: Casus Vigesimus Septimus: Operarius, qui ab anni fere spatio cataractam in oculo sinistro habuit solo usu cicutae et decocto bardanae spatio trium et dimidn mensium curatus est.
Omni decimo quarto die datum fuit purgans.
Per sex septimanas quotidie drachmam unam et dimidiam extracti cicutae assumpsit.
Ultimo autem mensa drachmas duas.
Use cicutae hicce homo non tantum visum recuperavit integerrimum; verum et longe robustior factus est, et liberabatur simul a suis doloribus rheumatics quibus per totum corpus jam and octo annis and omnem temporis mutationem excruciabatur.
Possibly this additional information, relating to the collateral cure of this patient’s rheumatic pains in the whole body, that he had had eight years at every change of weather, may sometimes be useful in the homoeopathic differential drug diagnosis for the treatment of cataract. We cannot afford to do without the aids ex usus in morbis, especially on this comparatively new ground. In the Supplementum to the foregoing we read further:
Corollarium Sextum. (p.39.)
Cicuta subinde fundit cataractas, aut eorum progressum impedit.
Et hac ratione visum conservat, aut auget, aut perditum restituit.
Stork’s remarkable success with Conium in cancer, scrofula, and some of the worst forms of cutaneous affections is not a little note worthy.
11. In Krebel’s Volksmedicin und Volksmittel verschiedener Volkerstamme Russlands, Leipzig, 1858, p. 159, it is noted that, in certain parts of Russia, burnt sugar, *(We have seen that sugar causes cataract.) vitriol, and pounded glass are reputed remedies for cataract. The Russians strew the powder of the kernels of a certain kind of cherry (die Cornelius- Kirsche) into the eyes for the purpose of curing cataract.
Also in Russia they make use of the gall of the sturgeon and the gall and the blood of the patridge. Also an injection of a solution of soap.
They likewise make use of the Succus Chelidonii Majoris dropped into the eye. We have seen that Buchmann cites two cures of cataract with Chelidonium; Dr. Berridge’s case has also been quoted, and likewise my own case.
12. Plenk in his Lehre von den Augenkrankheiten, Vienna, 1788, p. 197, says: Drugs are not often capable of curing cataract, but people have lauded the internal use of the extract of Aconite, of the black Pulsatilla of the white Hyoscyamus with Mercurius Dulcis, the juice of Millepedes and Theden’s tincture of Antimony. Thus 1 (Plenk) gave a man, who had a cataract of the left eye for three months, eight drops of this tincture night and morning, with such a good result, that already on the fourth day he could again distinguish large objects.
Cataracts due to a certain acridity seem more amenable to treatment, so I recommend you to try Mercury in venereal cataract, the bark with Conium in the scrofulous, and in the arthritic the extract of Aconite with Antimony.
13. I now pass on the excellent work entitled, On the Cure of Cataract, etc., by Hugh Neill, Surgeon to the Liverpool Eye and Ear Infirmary, London, 1848 where may be read (p.22) these words: “Cases, no doubt, have occurred, but they are assuredly rare, in which cataract has been cured by the use of drugs. Recourse may be had to such means at the beginning, where the object is-to remove constitutional irritation, to restore the secretions, and to improve the tone of the digestive organs. Local applications. too, are of concurrent use.”
14. Victor Stoeber also observes, that in such cases Antimonials, and affecting the system with Mercury, is the practice of some; “and in addition to Aconite, Arnica, Belladonna, and above all, Pulsatilla, the last being administered in doses varying from five to twenty-five grains of the extract.” (In Neill)
Then Neill adds condemnatory remarks, and concludes very characteristically in these words: “And as to Pulsatilla, whether experimented with in infinitesimal or less scrupulous doses, I equally recommend being left to an undisturbed place in the Quixotic Pharmacopoeia of Homoeopathy.”
Now, above, the same writer says: “Cases, no doubt, have occurred, but they are assuredly rare, in which cataract has been cured by the use of drugs.” Hence it transcends my comprehension why the drug treatment of cataract should be condemned on the same page. Oh! prejudice, thy optic opacity is indeed a thousand fold worse than the hardest cataract, and oh! how senile withal. To purge such a visual ray would require more euphrasy and rue than could be found on the whole globe.
15. I might thus continue to multiply instances from ophthalmological literature, but it would serve no useful end; so let me conclude with the Treatise upon a New, Expeditious and Safe Method of Treating Cerebro-Sensorial Affections, particularly Amaurosis and Cataract, by which the Cataract is removed Without Operation. By Louis Francois Goudret, London and Paris, 1840.
Goudret gives some twenty cases of amelioration or cure of cataract without operation. They are for the most part undoubted cases of true cataract, and clearly demonstrate that cataract can be cured by derivatives, revulsives, and counter-irritants, and therefore without operation.
His treatment is rough, painful, and slightly disfiguring, but it cures without operation, and better. It consists essentially in cupping and the application of his ammoniacal pomade and some general treatment with diet.
In cases in which homoeopathy had failed either wholly or in part, we might have recourse to it; and in those cases in which homoeopathy had at first been beneficial, and then the cataract seemed at a standstill, I should not shrink from a trial of dry cupping and the gentle use of his pomade. Then would recur to the more radical and scientific homoeopathic treatment. And to give an occasional stir-up to a very hard cataract, Goudret’s treatment might be useful.
Having thus wandered a little in, and called from the literature of cataract, and considered also the mature and seat of the opacity and the histogenesis of the lens and of its capsule, it now only remains for me to give a little more of my own experience, which is neither special nor large, and then some general notions on its treatment, as they are present to my mind.