Mercurius nit.-One of Dr. Liebold’s favorite remedies in phlyctenular ophthalmia. In severe cases as well as mild, chronic as well as acute, superficial as well as deep ulcers, all have yielded to its influences; in some cases there has been much photophobia, in others none at all, in some severe pain, in others none. It may be used as an external application at the same time; the first potency; ten grains to two drachms of water (or even stronger), dropped into the eye two, three or more times a day.
Mercurius praec. rub.-In trachoma with pannus it is a valuable remedy, especially in old chronic cases, when the cornea is covered with pannus of a high degree with considerable redness, discharge and photophobia.
Mercurius prot.-More commonly called for in membranous conjunctivitis than any of the other preparations of Mercury, and may be indicated in all stages of the disease. The membrane on the conjunctiva and cornea is ulcerated. Cornea more vascular, pains, photophobia and other symptoms of a higher degree than Kali bichr. The nocturnal aggravation and characteristic appearance of the tongue and throat are present. In phyctenular inflammation where there is quite extensive superficial ulceration of the cornea. In conjunctivitis trachomatosa, especially if pannus is present, the eye is quite red and painful, with photophobia and acrid discharges. Tongue coated yellow at the base.
Mercurius sol.-Most common preparation indicated in catarrhal conjunctivitis. The redness and dread of light are usually well marked, especially in the evening, by artificial light. The lachrymation is profuse burning and excoriating and the muco-purulent discharges thin and acrid, making the lids and cheek red and sore. This remedy is very often used in scrofulous ophthalmia and the indications correspond very closely in all points to those found under the head of Mercurius.
Natrum mur.-The eye symptoms are not particularly characteristic; there may be itching, burning and feeling of sand in the eyes, worse in the morning and forenoon; the pains are not severe, except, perhaps, the sharp pain over the eye upon looking down. The lachrymation is acrid and excoriating, making the lids red and sore; the discharges from the eye are also thin, watery and acrid. The photophobia is usually marked and the lids are spasmodically closed. The skin of the face, around the eyes, is often glossy and shining, while throbbing headaches and other concomitant symptoms are generally present. This remedy has proven of special value in follicular conjunctivitis.
Nitric acid.-Is especially advised for gonorrhoeal ophthalmia. Lids much swollen, red, hard and painful, conjunctiva hyperaemic, chemosis, cornea ulcerated, great photophobia and lachrymation, copious discharge of yellow pus which flows down the cheek, pressing and burning pain in the eye, worse at night. The cheeks are also usually much swollen and painful. A very weak solution may be used locally at the same time it is given internally.
Nux vomica-May be useful in phlyctenular ophthalmia and trachoma, especially if the cornea is involved, as the most characteristic indications are excessive photophobia and morning aggravation of all symptoms. The lachrymation is usually profuse and the pains vary in character, usually sharp, darting or burning in and around the eye and are always worse in the morning. The pains are sometimes relieved by bathing the eyes in cold water. Gastric symptoms of Nux are often present.
Phytolacca.-Should be valuable in diphtheritic conjunctivitis with firm, hard swelling of the lids.
Psorinum.-Is often useful in chronic cases of recurrent scrofulous ophthalmia.
Pulsatilla.-Is one of our most valuable remedies in phlyctenular, catarrhal and purulent conjunctivitis. In phlyctenular particularly when the pustules are confined to the conjunctiva and in purulent when the discharge is bland and profuse. Many cases of ophthalmia neonatorum have been cured by this drug alone, though it is particularly called for as an intercurrent remedy during the treatment by Argent. nit., for often when the improvement under the latter remedy is at a stand still a few doses of Pulsatilla will materially hasten the progress of the cure. In trachoma when the granulations are very fine (papillary trachoma).
It is particularly indicated in persons, especially amenorrhoeic females, of a mild temperament and a fair complexion, and is also very suitable in this class of ailments occurring in the negro. The dread of light is moderate or absent and the redness varies. The lachrymation is not acrid, but more abundant in the open air, while the other discharges are generally profuse, thick, white or yellow and bland. The pains are most often of a pressing, stinging character, usually worse in the evening, when in the wind and after reading, but relieved by the cool, open air. The lids may be swollen, are not excoriated, but very subject to styes. The eyes feel worse on getting warm from exercise or in a heated room and generally in the evening, but are ameliorated in the open air and by cold applications. Gastric symptoms, amenorrhoea, and other concomitant conditions will influence our choice.
Rhus tox.-Useful in pustular inflammation after it has progressed to superficial ulceration of the cornea. Occasionally in catarrhal conjunctivitis and frequently in purulent ophthalmia. Of value in relieving the intensity of the symptoms found in conjunctivitis granulosa with pannus. Especially useful in relieving the profuse secretion of tears. The lids are red, oedematous and spasmodically closed so that we are compelled to use force to open them, when a profuse gush of tears takes place. The photophobia is intense and the conjunctiva very red, even chemosed. There is usually a copious, thick, yellow purulent discharge. The child is usually cachectic and restless; head hot. The skin of the face is often covered with a Rhus eruption, and a rheumatic diathesis would especially suggest this remedy. The symptoms are usually worse at night, after midnight and in damp weather, the patients are restless at night and disturbed by bad dreams.
Rhus rad. has been employed with excellent results in scrofulous ophthalmia when the above symptoms were present.
Sanguinaria.-Benefit has been derived from its use in catarrhal conditions of the conjunctiva, with burning in the edges of the lids, worse in the afternoon. Haemorrhages in the conjunctiva with tendency to trachoma; moderate discharge and pain.
Sepia.- Acute catarrhal conjunctivitis, with drawing sensation in the external canthi and smarting in the eyes, ameliorated by bathing in cold water and aggravated morning and evening. Conjunctivitis with muco-purulent discharge from the eyes in the morning and great dryness in the evening. This remedy has proven a most valuable one in those cases of recurrent conjunctivitis, known as vernal catarrh and in follicular or trachomatous conjunctivitis, which is only observed in or always made worse by hot weather. Especially of value in pustular inflammation in women, either occurring with or dependent upon uterine troubles, particularly when the cornea is affected. The pains are usually of a drawing, aching, piercing character, aggravated by rubbing, pressing the lids together or pressing upon the eye. The conjunctiva may be swollen, with agglutination of the eyes morning and evening; considerable purulent discharge; edges of the lids raw and sore; feeling as if the lids were too tight and did not cover the ball; eruption on face, etc. All the symptoms are worse in the morning and evening and better in the middle of the day.
Sulphur.-This is the remedy, par excellence, in phlyctenular ophthalmia and is a valuable remedy in both acute and chronic catarrhal conjunctivitis. Its sphere of action is very wide and adapts it to a great variety of cases especially chronic, and occurring in scrofulous children covered with eruptions. The pains vary, though are usually of a sharp, lancinating character, as if a needle or splinter were piercing the eye; we may have a sharp shooting pain going through the eye back into head from 1 to 3 a.m., which disturbs the sleep. Various other sensations may be present, as pressing, tensive, cutting or burning pains, a feeling of sand in the eyes, etc. The photophobia and lachrymation are usually well marked, but may be absent. The redness may vary greatly, but is usually considerable. The secretions also vary both in quantity and quality, but often, acrid and corroding and sometimes tenacious. Morning agglutination of the lids is commonly present. The lids are often swollen, burn and smart, as if bathed in some acrid fluid, or an itching sensation. They are frequently covered with an eruption, as well as the surrounding integument of the head and face. The patients are usually feverish and restless at night. All the symptoms are, as a rule, aggravated by bathing the eyes, so that the child cannot bear to have any water touch them; also usually worse in the open air.
Professor of Ophthalmology in the College of the New York Ophthalmic Hospital; Surgeon to the New York Ophthalmic Hospital. Visiting Oculist to the Laura Franklin Free Hospital for Children; Ex-President American Homoeopathic Ophthalmological, Otological and Laryngological Society. First Vice-President American Institute of Homoeopathy : President Homoeopathic Medical Society of the State of New York ; Editor Homoeopathic Eye. Ear and Throat Journal : Associate Editor. Department of Ophthalmology, North American Journal of Homoeopathy, etc.