In all these cases there is usually present excessive photophobia and redness, though sometimes these may be nearly absent. The pains are generally of a throbbing, aching character, worse at night; the pain often extends up into the head, which is sore to touch. In nearly every case we have the thick yellow coating at the base of the tongue and swelling of the glands in parts of the body, which are so prominent under this drug.
Benefit has been derived from this preparation of Mercury in syphilitic iritis, although it is not as frequently required as Mercurius corr.
In intra-ocular trouble Dr. Woodyatt has observed very favorable results from the use of iodide of mercury, as in opacities of the vitreous and in irido-choroiditis.
Cases of paralysis of the oculo-motor nerve of syphilitic origin have been cured by this preparation of mercury as is markedly shown in the following case: A young man appeared for treatment with complete paralysis of all the fibres of the third pair of nerves of the right eye. It was probably of syphilitic origin, as fifteen months previously he had a chancre which was followed by pain in the bones, worse at night, sore throat, etc. Kali iod., in material doses for three weeks and Rhus tox.1 for one week, together with electricity all the time, failed to improve. After three days’ use of Mercurius iod. flav.30 and electricity, the power began to return to the muscles so that he could raise the upper lid somewhat, and in less than a month he was fully restored.
MERCURIUS IODATUS RUBER.
Clinical.-The action of this form of mercury is very similar to that of the yellow iodide and by some is used instead of the latter.
Its usefulness has been especially verified in trachoma and pannus, though the points of difference between the two iodides in this affection are not known.
MERCURIUS NITROSUS.
Clinical.-The nitrate of mercury has been successfully employed, both externally and internally, in various forms of blepharitis with no particular indications.
As a caustic is syphilitic ulceration of the lids, there is none better.
This preparation of mercury is more often indicated than any other in pustules and ulcers of the cornea, particularly the former. It has been especially used by Dr. Liebold with remarkable success in a large number of cases, without regard to symptoms. Severe cases as well as mild, chronic cases as well as acute, and superficial as well as deep (even with hypopyon) have yielded to its influence; also in some cases there has been much photophobia, in others none at all; in some, severe pain, especially at night, while in others it has been absent, and thus we might go through a variety of other symptoms, differing as much as the above, in which this drug has been curative. It has usually been employed both externally and internally at the same time and in the lower potencies; about the first potency ten grains to two drachms of water (or even stronger) as an external application, to be used in the eye two, three or more times a day, and the second or third potency to be taken internally. It may, however, be given internally alone with success.
MERCURIUS PRAECIPITATUS FLAVUS.
Clinical.-Dr. W.P. Fowler writes of this remedy as follows: “The yellow oxide of mercury is a remedy from which I have obtained very favorable results in marginal blepharitis. It has proved most beneficial where the edges of the lids were red, covered with fine crusts and slightly thickened. Where there is ulceration of the lids of an indolent nature, it is also efficacious. I have prescribed this remedy in the 6th trit. and applied it locally, prepared according to the formula.
Rx. Hydrarg. oxyd. flav.,……………….. gr. viii Vaseline…………………………… 3i
“Every night a little of the ointment should be applied with a camel’s hair brush to the roots of the lashes. Before making the application, the margins of the lids should be thoroughly washed with warm water, all the crusts removed and the lids then carefully dried. Unless this precaution be taken, little, if any, benefit with follow.” Dr. C. M. Thomas also says, ” I find the yellow oxide of mercury (1 gr. to 3i cosmoline) far more effectual than Graphites or Mercurius nitr., in blepharitis.” The latter prescription of Mercurius praec. flav. I have also found especially beneficial in ciliary blepharitis.
MERCURIUS PRAECIPITATUS RUBER.
Clinical.-The red precipitate of mercury, so often used by the old school, has been too little employed by us, as we have no symptomalogy, but are guided in its selection simply by clinical indications.
In scrofulous ophthalmia it has proved beneficial. There is commonly bright red swelling of the conjunctiva; the lids may be everted and granular; the cornea is superficially ulcerated and covered with vessels; the discharges from the eye are copious and purulent, forming crusts upon the lids which are firmly agglutinated in the morning; the photophobia is usually great; the symptoms are aggravated by working over a fire.
Benefit has been derived from its use in ophthalmia neonatorum.
In trachoma with pannus it is a valuable remedy. It is rarely of much service in the acute stage, for it is especially adapted to old chronic cases, in which the cornea is covered with pannus of high degree, with considerable redness, discharge and photophobia; granulations may be present, or may have been already removed by caustics.
MERCURIUS SOLUBIS.
Objective.-The upper lid is thick and red, like a stye. Great swelling, redness and constriction of the lids, which were very sensitive to touch. Eyelids agglutinated in the morning. He is unable to open the eyes well, as if the eyeballs were agglutinated (to the lids). Inflamed swelling in the region of the lachrymal bone. Inflammation of both eyes, with burning pain, worse in the open air. The eyes were forcibly drawn together, as if long deprived of sleep. Lachrymation.
Subject.-A sensation as of a cutting substance beneath the left upper lid. Heat, redness and pressure in eyes. Burning in the eyes. Burning and biting in the eyes, as from hoarse-radish.
Vision.-If she attempts to look at anything she cannot distinctly recognize it. and then the eyes are almost always involuntarily drawn together; the more she tries to restrain the contraction the less able is she to prevent it, she is obliged to lie down and close the eyes. A fog before one or both eyes. Dimness of vision. The eye cannot tolerate the firelight or daylight. Firelight blinds the eyes very much in the evening. Things like black insects constantly float before the vision.
Clinical.-Mercurius solubis has for many years been one of the most prominent remedies in ophthalmic practice, and even now it may be considered one of the polychrests.
Inflammation or Blenorrhoea of the Lachrymal Sac should suggest this remedy; if there is considerable swelling and pain at night, or if the discharge is thin and acrid in nature, providing the general condition of the patient at the same time calls for it. For fistula lachrymalis, with external ulceration resulting from syphilis, it has also proved useful.
In blepharitis there is no better remedy if the lids are red, thick and swollen (particularly the upper) and sensitive to heat, cold or touch. The lachrymation is profuse, burning and acrid, making the lids sore, red and painful, especially worse in open air or by the constant application of cold water. The symptoms are all worse at night in bed and by warmth in general, also from the glare of a fire, which is unusually painful. It is especially indicated in ciliary blepharitis caused by working over fires or forges, or by gaslight.
Ophthalmia neonatorum, marked by acrid discharge (usually thin) which makes the cheek sore and particularly if caused from syphilitic leucorrhoea in the mother, is more quickly relieved by this drug than any other.
In superficial inflammations of the cornea and conjunctiva, either ulcerative, phlyctenular or catarrhal, Mercurius has proved especially serviceable. We are led to its use by the following symptoms, which have been collected from a large number of cases: In inflammatory conditions dependent upon syphilis, either hereditary or acquired, it is one of the first remedies to be thought of. The ulcers of the cornea are usually quite vascular, though they may be surrounded by a grayish opacity and complicated with existence of pus between the layers of the cornea (onyx). The redness of the conjunctiva is variable, though more frequently of high degree; in some cases chemosis. The dread of light is generally very marked, in some cases so intense that the eyes can hardly be opened, even in a darkened room, and is more often aggravated by any artificial light, as gaslight or glare of a fire. The lachrymation is profuse, burning and excoriating and the muco-purulent discharges are very thin and acrid. The pains are generally severe and varying in character, but are more frequently tearing, burning, shooting or sticking, and are not confined to the eye, but extend up into the forehead and temples; and always worse at night, especially before midnight, from heat, damp weather or extreme cold, and are often ameliorated temporarily by cold water. The lids may be spasmodically closed, are thick, red, swollen, even erysipelatously, excoriated by the acrid discharges and are sensitive to heat, cold or contact; there is usually biting and burning in the lids, sometimes a feeling as if there were many fiery points in them; worse in the open air. The general aggravations in the evening by gaslight and at night after going to bed are of the first importance. At the same time the concomitant symptoms of soreness of the head, excoriation of the nose, eruptions on the face, condition of the tongue, offensive breath, night sweats without relief and pain in the bones, especially at night, would lead us in its selection.
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.