LYCOPUS VIRGINICUS.
Clinical.-This remedy is noticed here on account of its reputed power in the treatment of exophthalmic goitre (morbus Basedowii). In my hands, however, it has failed to benefit in every case in which it has been given.
MERCURIALIS PERENNIS.
Objective.-Blinking of the eyes in the open air and sunlight. Twitching of the upper lids, especially of the left eye. Watery eyes. Pupils dilated.
Subjective.-On waking at night she was unable to open the lids immediately; they seemed paralyzed and could not be opened until she had rubbed them. Weakness of the upper lids, so that at times she could not completely raise them. Lids heavy and dry. Dryness of the eyes. Burning in the eyes. Pain in the eyes while reading and writing. Bruised, sore feeling of the eyes, with sensation as if they were too large for their sockets or as if they would be pushed out.
Vision foggy. Weakness and sensitiveness of the eyes to bright and artificial light. Blinking of the eyes while sewing or reading by the light. Letters run together while reading.
Clinical.-Hyperaemia of the conjunctiva after using the eyes with heaviness of the lids will often find its remedy in Mercurialis.
Our attention should be more frequently directed toward this drug in the treatment of asthenopia. It is especially indicated if the patient complains of a sensation of dryness in the eyes and heaviness on the lids. (Compare with Alumina). The sensation as of a mist before the eyes in the morning, and a burning pain in the left eye, worse in the evening and after using, occurring in cases of asthenopia, have also been relieved. Also the hyperaemia of the conjunctiva, already noted, should suggest this remedy in those cases.
MERCURIUS CORROSIVUS.
Redness of both ocular and palpebral conjunctiva. Inflammation of the eyes. Pupils insensible to light. Thin and acrid mucopurulent discharges.
Eyes painful. Burning in the eyes. Tearing as if in the bone above the left eye, near the root of the nose, and in other parts of the bone. Pain behind the eyeballs as if they would be forced out. Photophobia. Lachrymation profuse, burning and excoriating.
Clinical.-The corrosive sublimate is more often indicated in severe inflammatory conditions of the eye, especially superficial, than any other form of mercury.
In certain forms of blepharitis it is frequently very valuable, as an inflammatory swelling of indurated lids; inflammatory swelling of the cheeks and parts around the orbits, which are covered with pustules, or in scrofulous inflammation of the lids, which are red as in erysipelas. In these cases the lids are usually very red and excoriated by the acrid lachrymation, and the pains are very severe, particularly at night.
Chronic catarrhal conjunctivitis, tending toward trachoma, with redness and excoriation of the lids, and a dull feeling, with itching in the eyes in the evening, has been cured under this remedy.
Mercurius corr. is usually more useful in strumous ophthalmia than Mercurius sol. It is chiefly called for if phlyctenules, ulcers, or even deep abscesses are formed in the cornea, for then the severity of the symptoms would lead us to its selection, as this remedy is especially indicated in the erethistic form of inflammation. The eye is usually very red and the cornea vascular and ulcerated. The cornea may have become so weakened from the inflammation as not to be able to resist the normal intra-ocular pressure and so commencing staphyloma may be noticed. The photophobia is excessive and the lachrymation profuse, which, together with the ichorous discharges are acrid, excoriating the lids and cheek. The pains vary in character, though are generally very severe and not confined to the eye, but extend into the forehead and temples; always worse at night. The lids are much swollen, erysipelatous, oedematous or indurated; are red and excoriated from the acrid discharges and are spasmodically closed, rendering it almost impossible to open them and they often bleed easily upon attempting to do so. There are also usually present pustules on the cheek around the eye, soreness and excoriation of the nose, enlargement of the cervical glands, coated tongue, etc.
It has been employed with benefit in ophthalmia neonatorum in which the discharges were thin and excoriating, especially if the mother has gonorrhoea or syphilitic leucorrhoea.
Episcleritis, with much pain in and around the eye at night, requires Mercurius corr.
For kerato-iritis it is one of our chief remedies.
In iritis, especially the syphilitic variety, it no doubt surpasses any other remedy in frequency of indication, and by some it is even considered a specific, providing atropine is used at the same time locally. The severity of the symptoms and the intensity of the pains at night over the eyes and through them, through the head and in the temples, are our chief indications. It is no less useful in the other forms of plastic iritis, as every-day experience full verifies.
Hypopyon occurring in the course of abscess of the cornea or iritis has been frequently absorbed under its use.
If the inflammatory process has extended to other portions of the uveal tract (cyclitis, choroiditis, irido-cyclitis or irido-choroiditis) this remedy still deserves special prominence.
In retinitis albuminurica, no remedy has been employed with better success in such a large number of cases; the inflammatory process is often seen to rapidly subside, and the exudations into the retina disappear under the influence of this remedy. The prescription is chiefly based upon the pathological changes, as the symptoms are so few in this disease.
In retinitis haemorrhagica Mercurius corr. is of great value in hastening the absorption of extravasated blood and in toning up the walls of the vessels so as to successfully resist further blood pressure.
In superficial inflammations of the eye, Mercurius closely resembles several remedies, as Graphites, Euphras., Arsen. and Sulph., but the severity of the symptoms and nightly aggravations are much more marked under Mercurius than either of the above. Under Graphites the discharge are also acrid and excoriating and the photophobia often intense, but the pains are not usually so severe as under Mercurius Besides we usually find the external canthi cracked and a moist eruption on the face and behind the ears when Graphites is indicated. The acrid discharges of Euphrasia are generally thick, while those of Mercurius are thin. The character of the pains and general cachexia will serve to distinguish it from Arsen. and Sulph.
MERCURIUS DULCIS.
Clinical.-Ciliary blepharitis associated with phlyctenular ophthalmia and accompanied by eruption on the face, soreness of the nose and swelling of the upper lip, is often amenable to Merc, dulc.
Calomel has been employed for many years by the old school in scrofulous ophthalmia, and even to this day it is considered by them as one of the most important remedies, though not a specific as was formerly supposed. Dusting the fine powder in the eye is the manner in which it is used by them.
We also, as homoeopaths, find it adapted to certain forms of strumous ophthalmia, though given in a different manner, in different doses under different principles. We use it only internally and for the general cachexia, as the following case will illustrate: A little girl, aet. 6, light complexion, pale skin, muscles soft and flabby, glands enlarged and general strumous diathesis. Upon examination a very deep ulcer of the left cornea was seen which had so nearly perforated that the membrane of Descemet had begun to bulge; small ulcers and pustules were present at the border of the cornea. In the right eye pustules and maculae of the cornea were also found. There was considerable redness and great photophobia. Various remedies, chiefly the anti-psorics, had been given with no benefit; Mercurius dulc.2, three doses daily, was administered; improvement soon began and went rapidly on to recovery, leaving only a macula behind.
Benefit has also been derived from the use of Mercurius dulc. in deeper forms of inflammation of the eye, as in irido-choroiditis, especially if dependent upon a scrofulous diathesis, and the general cachexia of the patient suggests the remedy.
MERCURIUS IODATUS FLAVUS.
Clinical.-Dacryocystitis blennorrhoea may call for this remedy, though it is not often indicated.
In some cases of blepharitis of syphilitic origin favorable results have been obtained from Mercurius prot., if the concomitant symptoms point to its use.
It has been of service in uncomplicated granular lids, but is more particularly adapted to trachoma with pannus. It may be indicated in all stages of pannus, but especially in acute aggravations after the first, or Aconite stage has passed. In these cases it often exerts a marked beneficial influence upon the trachoma itself. (Special indications have been given after ulceration of the cornea, page 248).
Mercurius iod. flav. has been useful in pustular inflammation of the cornea and conjunctiva, but its principal sphere of action is in ulceration of the cornea, especially in that form of ulceration which commences at the margin of the cornea and extends, involving only the superficial layers, either over the whole cornea or a portion of it, particularly the upper part, which appears as if chipped out with the finger nail, the so- called serpiginous form. Also in cases of ulceration occurring in the course of pannus and granular conjunctivitis it is excelled by no other remedy in frequency or indication.
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.