In cases of muscular insufficiencies where we are trying to restore power to the weakened muscle by the systematic exercise with prisms, it is our universal rule to apply electricity for a minute or two after each treatment and to this use of electricity we attribute much credit in the restoration of the muscle power. It certainly leaves a very grateful sensation to the eye when gently used and often the patient states that eyes feel rested and stronger after its use. It has been and is claimed by some that electricity gives beneficial results in various diseases of the lens, choroid, retina, optic nerve, etc., but with these the writer has had no experience and finds no sufficiently accurate evidence to warrant a favorable opinion of its use.
The static electricity has been used of late in muscular troubles with even more benefit than galvanism. It seems to relieve the asthenopic symptoms in a remarkable manner.
ESERINE.
No proving of Eserine, an alkaloid of Calabar bean, has been made, but it is very extensively employed in ophthalmic practice. In the Medical Analectic, October, 1887, we find recorded a poisoning from a solution of gr.j to 3j. About one-half hour after the instillation of one drop of this solution in the eye severe clonic spasms of the eyelids set in; a quarter of an hour later spasmodic stiffness of the lips, especially the upper, set in, and soon the same sensation under the jaw on the left side. Within an hour there was a feeling of tremor or spasm in the arms or thighs and at the same time a sensation of pressure on the eye-balls and of weight and pressure within the head. Mental confusion and memory impaired; slept uneasily, waking often; pupils contracted to a pin point and conjunctiva injected. The action of Eserine upon the ciliary muscle is to stimulate its contraction and diminish the range of accommodation. It is, therefore, homoeopathic in spasm of the accommodation. It has also proven of value clinically in ulcerations of the cornea.
Laqueur, Archiv. fur Ophthalmologie, xxiii., 3. of Strassburg, first recommended the instillations of Eserine in the treatment of glaucoma. Since then it has been used by most oculists with varying success. There is no doubt that in some cases it may relieve the intra-ocular tension temporarily, if not permanently, and should, therefore, always be given a few hours’ trial, at least in every case of glaucoma. Its action is chiefly, if not wholly, mechanical. By acting upon the muscular tissue of the vessels it causes a contraction in their calibre, or, as is more probable, by drawing away the iris from the angle of the anterior chamber the filtration passages are opened and so excretion accelerated.
Eserine has been recommended by prominent specialists of the old school for a variety of ocular diseases, as conjunctivitis puru-lenta; keratitis, especially suppurative; kerato-conus; asthenopia, muscular and accommodative. Harlan plus Medorrhinum Rec., June 23, 1888. reports eighteen cases of corneal ulcers after injury, all of which were cured with Eserine. It is being recommended now in much weaker solutions than formerly, 1/1000 or even 2/4000 being considered strong enough by some. Personally we have seen perfect contraction after cataract extraction without iridectomy from a 1/10000 solution.
EUPATORIUM PERFOLIATUM.
Soreness of the eyeballs. Redness of margins of lids. Great aversion to light.
Clinical.-As an intercurrent remedy in various affections in which excessive soreness of the eyeballs has been a prominent symptom, this drug has been very useful.
EUPHRASIA.
Objective.__ Redness and swelling of the margins of the lids, with at times an itching burning in them and increased watery discharge. Margins of lids red, with dry sensation. The lids are swollen and red. Injection of conjunctival vessels. Lachrymation profuse; tears acrid and burning. Excessive photophobia.
Subjective.__ Burning and pressure in the eyes, with much lachrymation. Burning, biting in the eyes, obliging frequent winking. Itching of the eyes on going out, obliging frequent winking and wiping of the eyes, with increased lachrymation in the afternoon. Burning in the margins of the lids, with distressing sensation of dryness. The lids are sensitive and swollen. Feeling as though the cornea was covered with much mucus; it obscures his vision and obliges him to frequently close and press the lids together. Vision somewhat dim, as through a veil, in the evening. Eyes sensitive to candle-light.
Clinical.__ The indiscriminate use of Euphrasia in all cases of ophthalmia, as prescribed by many practitioners, is not to be imitated, for although it is a remedy of great importance, especially in superficial diseases of the eye, still its sphere of action is well defined.
The results of many cases have proved its value in blepharitis. When indicated, the lids will be found red, swollen and covered with a thick, yellow, acrid discharge, together with profuse acrid burning lachrymation, which makes the lids and cheek sore and excoriated; firm agglutination of the lids in the morning is also present and fluent coryza often accompanies the eye symptoms.
The cases of catarrhal and strumous inflammation of the cornea and conjunctiva, which speedily respond to this drug, are to be counted by sores, for it is in these that Euphrasia is especially efficacious. It is useful in both the chronic and acute form of inflammation, but especially in the latter, as follows: Catarrhal inflammation from exposure to cold; catarrhal inflammation of the eyes and nose in the first stage of measles; papillary trachoma with or without pannus; pustules on the cornea and conjunctiva; superficial ulceration of the cornea (sometimes accompanied with pannus), though is rarely indicated in the deep form, except, perhaps, as a palliative in the first stage. In all the above cases we usually find much photophobia, though it may be nearly absent. The lachrymation is profuse, acrid and burning, as is also the thick, yellow, muco-purulent discharge, which is usually present excoriating the lids, making them red, inflamed and sore, as well as giving the cheek an appearance as if varnished. The conjunctiva may be quite red, with chemosis. The pains are not characteristic though usually smarting, sticking or burning, from the nature of the discharges. Fluent coryza often accompanies the above symptoms.
Purulent ophthalmia has been benefited, particularly that form found in new-born children (ophthalmia neonatorum). The condition of the lids and nature of the discharges already given, which indicate its choice, will be found more often in the later stages than at the beginning of the disease.
The following case indicates that it may be useful in paralysis of the muscles: A man, aet. 52, appeared for treatment, with total paralysis of the oculo-motor nerve, even to those filaments which supply the iris and ciliary muscle, which came on rapidly after exposure in the cold and wet. Electricity was applied every day or two for about five weeks, and either Rhus or Causticum given internally at the same time, with no benefit. At the end of this time, on account of some slight catarrhal symptoms, Euphrasia 30 was given and the electricity continued. After taking two doses of Euphrasia the upper lid could be slightly raised, the pupil began to contract and the eye to turn inward; within four weeks a complete cure was effected.
Euphrasia is very similar to Mercurius in the character of its discharges, only that in Mercurius they are thin and excoriating, while under Euphrasia they are thick and excoriating. Arsenicum also has acrid secretions, but they are usually thin, not as as profuse as in the above remedies and are accompanied by much burning pain and photophobia. Rhus, like Euphrasia, has profuse lachrymation, but it is not as excoriating. In paralysis of the muscles, caused by exposure to cold or wet, Euphrasia may be compared to Causticum and Rhus, the remedies upon which we chiefly rely in these affections, but it seems especially called for when a catarrhal condition of the eye is, at the same time, present.
FERRUM.
Sticking pain over the left eye, coming suddenly and lasting a short time only. Photophobia. Lids swollen and profuse discharge of pus when opened. Inflamed eyes with burning stinging pains.
Clinical.__ The iodide of iron has been used by Dr. Liebold with benefit in exophthalmic goitre. In one case, occurring in a woman after suppression of the menses and characterized by protrusion of the eyes, enlargement of the thyroid gland, palpitation of the heart and excessive nervousness, the menses soon reappeared, the nervousness diminished and all the symptoms improved after the administration of Ferrum iodatum. Another similar case, occurring in a colored woman, was relieved by the acetate of iron.
FERRUM PHOSPHORICUM.
First stage of abscess of the cornea, for the pain and redness. Inflammation of the eyes, with acute pain, without secretion of mucus or pus. Acute conjunctivitis and photophobia in measles. Pain in the eyeball aggravated by moving the eyes. Retinitis. Eyes inflamed, red, with burning sensation, sore and red looking. Sensation as if grains of sand were under eyelids. The Twelve Tissue Remedies, Boericke & Dewey, 1888.
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.