Keratitis parenchymatosa dependent upon hereditary syphilis very frequently calls for Mercurius, which has proved extremely valuable in this affection. It may also be of service in interstitial inflammation of the cornea, if traceable to acquired syphilis, as was verified in a case recently under treatment.
Kerato-iritis, both with and without hypopyon, has been cured with Mercurius; it is indicated by the pains and nightly aggravation. In one case in which benefit was derived the pain was very severe at night, the eye feeling as if it were a ball of fire, the lachrymation was hot and hypopyon was present.-T. F. A.
In the treatment of episcleritis it should be considered with Thuja.
Mercury has always been and probably always will be the principal remedy for iritis. The solubis has been employed with great success in many cases, though it is not as commonly useful as the corrosivus. It is especially called for in the syphilitic variety and when gummata are present in the iris, though its sphere of usefulness is not confined to this form, as it may be indicated in the rheumatic or any other form of iritis, and in mild cases as well as severe, when hypopyon is present, and when it is absent. The usual symptoms of iritis, contraction, discoloration and immobility of the iris, ciliary injection, haziness of the aqueous, etc., are of course found, but the characteristic indications are to be looked for in the pains, which are usually of a tearing, boring character, chiefly around the eye, in the forehead and temples, which are often sore to touch; with this there may be throbbing, shooting and sticking pains in the eye; all of which are always worse at night.
In retinitis or in choroiditis, particularly if dependent upon syphilis, this remedy has been employed with benefit. In these cases the retina is often very sensitive to the glare of a fire. It is the great remedy for diseases of the optic nerve and retina occurring in workers in foundries.
MEZEREUM.
Obstinate jerking of the muscle of the left upper lid. Lachrymation, with biting in the eyes. Eyes hot, inflamed, on rising in the morning; the conjunctiva of the ball very much injected, dirty red, especially in the vicinity of the external canthus; most in the left eye; with pressive pain and a sensation of dryness. Much pressure in the eyes, with a sensation of dryness, as if the conjunctiva of the lids were much inflamed. Smarting in the eyes, compelling to rub them. Pressive pain above the left eye. Itching, biting on the margin of the lids and skin near the nose.
Clinical.-In eczematous affections of the lids, face and head, characterized by thick, hard scabs from under which pus exudes on pressure, Mezereum is especially useful. It has been given with benefit in blepharitis, pustular conjunctivitis and abscess of the cornea, chiefly when these symptoms have been present.
Ciliary neuralgia, especially after operations upon the eye, has been relieved by this drug.
MURIATICUM ACIDUM.
Clinical.-The following symptom, found in a case of muscular asthenopia, was speedily relieved by Muriatic acid; sharp burning pain extending from the left to the right eye in the morning, ameliorated by washing. Vertigo worse on moving the eyes.
NAPHTHALIN.
In the Berliner Klinische Wochenschrift, No. 44, 1887, there is reported changes occurring in the eyes of animals who were fed naphthalin. When the drug was given in large doses, from thirty to forty grains, the results come on rapidly, with sometimes detachment of the retina; in smaller doses the process was much slower. The fundus was filled with numerous small brilliant points, which seemed to be formed as a large, white plaque, usually below the optic disc, and which in extending covered over the choroidal vessels. The same brilliant spots were seen in the optic papilla. The most important changes were seen in the lens, which showed a turbidity extending from the posterior surface and the borders, increasing so rapidly that within two days the whole posterior surface was dim. There were also opaque radiating striae coming from the borders of the lens. The author believed the haziness to be due to an exudation between the capsule and the lens and also between the lens fibres.
From the experiments upon animals Naphthalin has been frequently tried to arrest the progress of cataract, but so far as known at present with little or no success.
NATRUM CARBONICUM.
He could hardly open the lids; they involuntarily closed. Small ulcers about the cornea, with stinging pains in the eye, so that he was obliged to shade it from every ray of light. Needle- like stitches in both eyes after dinner. Heaviness of the upper lid.
Eyes dim; he was constantly obliged to wipe them. Black, floating spots before vision while writing. Blinding lightnings before the eyes on waking.
NATRUM MURIATICUM.
Objective.-Redness of the margins of the lids; in the morning the eyes were agglutinated with scabs. A catarrhal affection of the margins of the lids developed; they become red with burning, especially in the evening while reading; secreted mucus and were agglutinated in the morning on waking and covered with thick scabs. Spasmodic closure of the lids. Irritability of the margins of the lids and their conjunctiva. Lachrymation in the open air. Acrid lachrymation, which makes the canthi red and sore. Redness of the white of the eyes, with lachrymation. Redness and inflammation of the white of the eye, with a feeling as if the balls were too large and compressed. Inflammation of the eyes and lachrymation in every slight wind. Giving out of the eyes. The eyes give out on reading or writing; with a pressure in the right eye, extending into the head, disappearing on walking about the room.
Subjective.-Slight pressive pain above the eyebrows. Sensitive dry sensation in the eyes, as after weeping a long time, while riding in a carriage. Pain as from a foreign body in the eye. Burning in the eyes, with increased secretion of mucus; the lids are agglutinated in the morning, with great sensitiveness to lamplight. Violent burning in the eyes in the evening. Pressure in the eyes on looking intently at anything. Sticking in the right eye. Sensitiveness of the eyes. Smarting pain in the eyes. Sensation as if sand were in the eyes in the morning. Itching in the eyes. Itching in the inner canthi and lachrymation.
Vision.-Eyes dim and weak. Vision not as clear as usual; the eyes seem misty all day. Objects seem covered with a thin veil. On looking at anything, especially on sewing, sudden darkness before the eyes; she could see nothing till she directed the eyes to another object, at 6 P.M., with sleepiness. Unsteadiness of vision; objects become confused on looking at them. Letters and stitches run together, so that she cannot distinguish anything for five minutes. Small fiery points before the eyes wherever she looks.
Clinical.-Natrum mur. has been successfully employed in a variety of ophthalmic affections, both superficial and deep. It is better adapted to chronic diseases than to those which are more acute in their course.
Well authenticated cases of morbus Basedowii are reported to have been permanently relieved by this remedy. It is, therefore, mentioned in this place, though my own experience has not verified the indication.
Stricture of the lachrymal duct, fistula and blenorrhoea of the lachrymal sac, in which the diagnosis cannot be questioned, have been benefited by this remedy.
It is very useful in certain forms of blepharitis in which the thick, inflamed lids smart and burn, with a sensation of sand in the eye and acrid lachrymation which excoriates the lids and cheek, especially if caused from caustics.
Dr. F. H. Boynton first called attention to Natrum mur. as valuable remedy for follicular conjunctivitis. It is useful in this from of inflammation of the conjunctiva, in which the follicular formations are chronic and chiefly confined to the oculo-palpebral folds. It has also been of service in these cases when complicated with true trachoma.
Old cases of granular lids, with or without pannus, may require this remedy, especially if they have previously been “much treated’ with caustics and are accompanied by acrid, excoriating lachrymation.
In pustules and ulcers of the cornea much benefit is frequently derived from the administration of Natrum mur., especially in chronic recurrent cases, though the symptoms which led to its selection are not particularly characteristic. There may be itching and burning in the eyes or a feeling as from sand in them, usually worse in the morning and forenoon. The pain vary in character, though are not severe, with the exception of a sharp pain over the eyes on looking down. the lachrymation is acrid and excoriating, making the lids red and sore; the discharges from the eye are also thin, watery and excoriating (Mercurius, Arsen.). The photophobia is usually well marked and the lids are spasmodically closed. The skin of the face around the eye is often glossy and shining, while the lips may be sore and the corners of the mouth cracked.
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.