In one case of slight roughness of the integument of the lids, with intense itching, which had been present for a year or more, quick and permanent relief was obtained from Graphites.
It is of service in preventing there recurrence of successive crops of styes. It is also valuable in eczema of the lids if the eruption is moist and fissured, while the margins of the lids are covered with scales or crusts.
In catarrhal ophthalmia Graphites has been employed with benefit, and in scrofulous ophthalmia characterized by ulcers and pustules it is second to no other drug in impurities. it has curd deep ulcers of the cornea, even with hypopyon, but it is more particularly adapted to superficial ulcerations, especially if resulting from useless; often with considerable vascularity of the cornea. The pustules which have been removed under the influence of Graphites have been of various kinds and accompanied by various symptoms; they may be either on the cornea or conjunctiva, but especially on the former; the attacks may be acute or chronic, but it is particularly called for in the chronic recurrent form.
The photophobia is usually intense and the lachrymation profuse, though in some cases nearly or entirely absent; it is generally worse by daylight than gaslight and in the morning, so that often the child cannot open the eyes before 9 or 10 A.M. The redness of the eye is generally marked and the discharges of a muco-purulent character, constant, thin and excoriating. The pains vary and are not important, being sometimes sticking, burning, aching or itching in character. The lids are red, sore and agglutinated in the morning or else covered with dry scurfs and the external canthi are cracked and bleed easily upon opening the eye. A thin, acrid discharge from the nose often accompanies the ophthalmias of Graphites.
Graphites is somewhat similar to Hepar and Sulphur in scrofulous inflammation of the eyes. Under Graphites, however, the discharges from the eyes and nose are thinner and more excoriating, and there is a greater tendency toward cracking of the external canthi. The latter symptom is also sometimes observed under Hepar, but is not as marked, and the discharge is not as excoriating, though the lids are more swollen, eyes redder and ulceration deeper. The Sulphur patient is more restless and feverish at night, and complaints of occasional sharp sticking pains in the eye, though the face and body may be covered with eruptions, they differ in character from those of Graphites.
HAMAMELIS VIRGINICA.
Eyes inflamed and burning. Intense soreness as from a foreign body. Swelling of eyelids. Feeling as if the eyes would be forced out.
Clinical-A spontaneous eversion of the upper lid during the course of a severe conjunctivitis was relieved by the application of dilute ” Pond’s Extract.”-W. S. SEARLE.
This remedy has been employed with decided success in inflammation of the conjunctiva or cornea, even in ulceration of the later, if caused by a burn or an injury.
The action or Hamamelis in injuries of the eyeball is very similar to that of Arnica and calendula, although it seems to be of more service than either of the above in hastening the absorption of intra-ocular haemorrhage.
Traumatic iritis with haemorrhage into the iris, traumatic iritis with great pain at night, and haemorrhage into the interior of the eye, have been speedily relieved by this drug.
HEPAR SULPHUR
Objective-Redness, inflammation and swelling of the upper lid, with pressive pain. The lids are closed in the morning on waking, so that she cannot open them for a long time. Inflammation and swelling of the eye. with redness of the white. Intense photophobia and profuse lachrymation.
Subjective-Smarting pain in the eternal canthus, with accumulation of hardened mucus. Pain in the eyes from the day light. Feeling as if the eyes were being pulled back into the head by strings. The eyes are very painful in bright daylight if he attempts to move them. Pressure in the eyes especially on moving them, with redness. Eyes sore, agglutinated at night. Secretion of hardened mucus. Pressive pain in the eyeballs and a feeling as if beaten when touched. Boring pains in the upper bones of the orbit. Eyeballs sore to touch.
Vision.- Obscuration of vision while reading. The eyes become dim and he cannot see well in the evening by candle-light. Feeling of blindness before the eyes on rising and standing up after sitting bent over. Field of vision reduced one-half. Complaints of a continual movement of bright circles before the eyes objects look too large.
Clinical.- In dacryocystitis and orbital cellulitis Hepar is a remedy of importance especially if pus has formed and there is great sensitiveness to touch with throbbing pain. It may prevent the formation of pus or accelerate; it also seems use full in controlling the discharge after the canaliculus has been opened.
Hepar may be called for in chronic ciliary blepharitis if complicated with swelling of the meibomian glands, or ulcers and swellings on the margin of the lid, which are painful in the evening and upon touch though its chief sphere of action in palpebral diseases is in acute phlegmonous inflammation of the lids, which tend toward suppuration. The inflamed lids will be swollen, tense and shining as if erysipelas had invaded them, with throbbing, aching, stinging pain and sensitiveness to touch; the pains are aggravated by cold relieved by warmth.
Eczema of the lids in which thick honey-comb scabs are found both on and around the lids, with nocturnal agglutination etc. is especially amenable to Hepar.
Palpebral tumors frequently disappeared under its use.
It is sometimes useful in simple catarrhal conjunctivitis after the inflammatory stage has passed, and also in some cases of purulent conjunctivitis characterized by profuse discharge and excessive sensitiveness to air and touch. Pustules on the conjunctiva may require its use but not usually, unless the cornea has become involved.
For the severe forms of strumous ophthalmia in which the pustules and ulcers invade the cornea and are marked by great intensity of the symptoms, there is probably no remedy more frequently indicated than Hepar. Its value in ulcers and abscesses of the cornea, especially the deep sloughing form of ulcer complicated with hypopyon, is undoubted. It has proved curative in some torpid ulcers in which general symptoms have pointed to its use, but there is usually intense photophobia profuse lachrymation great redness of the cornea and conjunctiva, even chemosis, and much pain of a throbbing, aching, shooting character, which is relieved by warmth, so that one constantly wishes to keep the eye covered, and is worse on any draught of air (Sil) at night or in the evening; the lids are often swollen, spasmodically closed and very sensitive to touch, or may be red, swollen and bleed easily upon opening.
It has been successfully employed in acute aggravation of pannus which tend toward ulceration especially if occurring in mercurialized subjects.
In keratitis parenchymatosa it often serves to promote absorption after the disease had been checked by Mercurius, Aurum., calc or other remedies. It may however be of service in arresting the progress of the disease, as is well illustrated in the following case: Mary A.- 33 years of age. For months the left cornea had been so hazy that the iris could only be seen with difficulty and for two months the right cornea had gradually become involved from the periphery toward the centre. Both cornea were wholly opaque and vision lost. There was considerable pain in the eyes and head with iritis. The ciliary injection was great and the dread of light excessive; lachrymation marked. There was no history of syphilis but she suffered severely from rheumatic pains particularly in the shoulder. Various remedies, high and low had been given for two months with no avail Under Hepar 30 rapid improvement took place in a month she was discharged with fair vision and only moderate haziness of the cornea.
Kerato-iritis frequently requires the use of this remedy especially if characterized by ulceration of the cornea hypopyon, sensitiveness to air and touch.
For hastening the absorption of pus in the anterior chamber (hypopyon) there is no better remedy than Hepar. On this account it has been employed with benefit in iritis with hypopyon or associated with small abscesses in the iris (suppurative iritis). It has also appeared to exert a very beneficial influence in purulent capsulitis cataract either used alone or in alternation with Rhus.
Inflammation of the ciliary body in which the sensitiveness to touch is excessive sometimes yield to this drug.
From its usefulness in suppurative inflammation in general it has been administered with benefit in suppurative choroiditis or panophthalmitis.
Ulceration of the external parts of the eye, which bleed easily and are very sensitive to touch most positively indicate Hepar. These cases usually have excessive photophobia which is also very marked in Mercurius protoiod; while kali bichrom though indicated in extensive destruction of tissue and great sensitiveness of the eye to touch lacks entirely the photophobia so marked under Hepar.
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.