Clinical.- Very little successful use of Phosphorus has been made in external affections of the eye. Its greatest sphere of action is to be found in diseases of the fundus, especially when the optic nerve and retina are involved.
In both disseminate and serous choroiditis benefit has been derived from the use of Phosphorus In these cases there will usually be found photopsies or chromopsies; in one case of choroiditis disseminata the latter were red in color.
There seems to be no question that Phosphorus is a valuable remedy in clearing up the vision and relieving many subjective symptoms in old cases of glaucoma after an iridectomy has been made, as illustrated by the following case: In a case of glaucoma after an iridectomy the patient suffered from a feeling as if something were pulled tight over the eye, with spangles (white) around the gas and a boring in the eye extending into the head. Phosphorus relieved the pulling sensation and headache and cleared up the vision.- T.F.A.
In both hyperoemia and inflammation of the retina, favorable, results have been obtained from this remedy. In one case it relieved very quickly a congestion of the retina in which the balls were sore on motion, no photophobia, pains extending form the eyes to the top of the head.- T.F.A.
It may be called for in various forms of retinitis. It is especially indicated in retinitis nyctalopica. From its pathogenesis we are also led to believe that it will prove a valuable addition to our list of remedies for retinitis albuminurica and some experience seems to corroborate this view. The degenerated condition of the blood-vessels found in retinitis apoplectica not infrequently requires the use of Phosphorus It not only seems to aid in restoring the proper tone to the vessels, but also appears to hasten the absorption of the haemorrhages. (Compare with Crot. and Lachesis.) The haemorrhages may be confined to the different layers of the retina or (as has occasionally been the case) may have extended into the vitreous. The inflammatory symptoms are not usually prominent, the impairment of vision and haemorrhages into the retina constituting the chief symptoms. A haemorrhagic diathesis will often accompany the eye indications (especially haemoptysis).
The symptom of cherry red color before the vision, found in optic neuritis and other diseases of the fundus, has been frequently relieved by this remedy.
Benefit has been observed form its use in stopping the progress of cataract, as in the case of an old lady. with incipient and progressive hard cataract, in whose lens were hard, white, convergent striae with diffuse haziness; she complained that on reading the letters seemed as if printed in red ink, although the paper looked white and natural. V., 5/50. Under Phosphorus the haziness disappears, no more striae appeared and in six months the vision improved to 13/70.- T.F.A.
Rapidly increasing myopia has been checked in its progress by this drug.- T.F.A.
In weakness of the internal recti muscles it has been found indicated, as in a case of asthenopia muscularis, in which there was pain and stiffness of the eyeballs on moving them and at times a feeling of heat in the eyes as after looking at a fire (Nat. mur.).-T.F.A.
PHYSOSTIGMA.
SUBJECTIVE.- Twitching of lids. Drawing, twisting sensation in the eyes. Sharp, shooting and drawing sensation in the right eye. Eyes are sore and give pain when moved from side to side. Intolerable pain over both orbits. Eyes smart; lids feel sore. Felt film over the eyes and blur; objects mixed; after which dull pain over the eyes and between the eyes. Eyes feel weak. Pain in the eyeballs. Contraction of the pupils. Spasm of accommodation, which may be irregular, producing astigmatism. Muscae volitantes. The accommodation recovers before the pupil.
Clinical.- Calabar bean being one of our most prominent myotics and antagonistic in its action to atropine, has been often employed to overcome the ill effects of atropine when used for purposes of examination, etc. Its action, however, is so short that frequent instillations are necessary to thoroughly counteract the action of the mydriatic and its effects are often unpleasant.
It has been used as a mechanical aid in tearing adhesions of the iris, especially to the cornea. In cases of deep ulceration of the cornea when at the periphery it is used to contract the pupil, so that if perforation occurs the pupillary edge of the iris will not be drawn into the opening.
It has also been of services, used locally, in paralysis of the accommodation and dilatation of the pupils consequent upon less of power of the oculo-motor nerve.
Its usefulness is not confined to its mechanical power, for when given internally upon physiological principles and according to the law of ” similia ” it is valuable.
Twitching of the lids should direct our attention to this drug, especially if combined with spasm of the ciliary muscle. In one case in which there was twitching around the eyes, patient could not read at all without much pain, frontal headache aggravated by any light, Physostigma gave quick relief.
Dr. W. H. Woodyatt, adopting the theory that myopia in a great majority of cases is due to spasm of the ciliary muscle or at least that its increase depends upon this cause, gave Physostigma 2d dec. in several cases with excellent results, often reducing the degree of myopia very perceptibly and even in some cases restoring the vision entirely. The symptoms of irritation, pain after using the eyes, muscae volitantes, flashes of light, etc., which might lead us to suspect spasm of the accommodation, were usually present and were soon relieved; while in other cases no symptoms of irritation were to be perceived; still the administration of Physostigma was followed by favorable results. The above observations have been frequently verified in practice, though hardly to the extent first reported by W. Its action in these conditions is very similar to Jaborandi, though I do not believe it be as commonly indicated as the latter in irritability of the ciliary muscle.
It has been useful in paresis of the accommodation after diphtheria and in muscular asthenopia.- J.H. BUFFUM.
PHYTOLACCA DECANDRA.
Eyelids agglutinated and oedematous. Reddish blue swelling of the eyelids, worse on the left side and in the morning. Eyes inflamed. Lachrymation.
Aching pains along the lower half of the right orbit. Pressure around the eyes in the afternoon as if the eyes were too large. Smarting and sandy feeling in the eyes. Lids feel as if granulated and the tarsal edges have a scalded, hot feeling, as if raw. Dull aching pains in eyes, worse from motion, light or exercise. Photophobia.
Clinical.- There is a comparatively rare from of orbital cellulitis in which Phytolacca is a remedy of great value. The inflammation is slow in its course and not attended by severe pain. The infiltration into the cellular tissue of the orbit is very pronounced; hard and unyielding to touch. The eyelids are reddish-blue, hard and swollen. The eyeball is pressed forward and its mobility impaired or lost entirely. There is chemosis and more or less dull aching pain, lachrymation and photophobia.
It has been employed with some success in ameliorating, if not curing, malignant ulcers of the lids, as lupus and epithelioma. In blepharitis Dr. Fowler has used this remedy when the lids are thick, incrusted, dark-red, tender to touch and somewhat ulcerated.
A very interesting case of suppurative choroiditis (panophthalmitis) in the right eye of a child, after a needle operation for cataract, occurred in Dr. Liebold’s clinic. The lids were enormously swollen, very hard and red, conjunctiva injected, chemosis, anterior chamber filled with pus and cornea tending toward suppuration; child pale, weak and restless. Phytolacca was prescribed, externally and internally. Rapid subsidence of all the inflammatory symptoms followed its use.
In orbital cellulitis and panophthalmitis Rhus tox. should be compared with Phytolacca. The former, however, more then corresponds to the symptomatology of these disease, as the symptoms are more intense, pain more severe and inflammation more active under Rhus than under Phytolacca. The lids are also oedematously swollen and lachrymation profuse in Rhus, while they are hard, bluish-red and swollen in Phytolacca.
PLANTAGO MAJOR.
Clinical.- Ciliary neuralgic from decayed teeth has been relieved by this drug. “In one case there was a dull, heavy ache in the left eye, with exquisite tenderness of the ball; left upper incisor decayed. Plantago relieved promptly.” – J.H.BUFFUM.
PRUNUS SPINOSA.
A sharp pain beginning in the right side of the forehead, shooting like lightning through the brain and coming out at the occiput. Pain in the right eyeball as if the inner portion of the eye would be torn out.
Clinical.- As a remedy for ciliary neuralgia, whether originating from some diseased condition of the eye or not, there are few, if any, drugs more often called for than Prunus.
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.