The character of the pains will furnish out chief indications; thus we have pain in the eyeball as if it were crushed or wrenched, or pain as if pressed asunder; again we often find the pain of a sharp, shooting character extending through the eye back into the brain, or this sharp pain may be seated above the eye extending into and around it or over the corresponding side of the head. Sometimes the pain will commence behind the ears and shoot forward to the eye, but, as already remarked, it is generally of this sharp, piercing character. Motion usually aggravated, and rest relieves, the severity of the pains. The pains are occasionally periodic in character and may be worse at night.
These pains, to which Prunus is adapted, are especially found in disorders of the internal structures of the eye; therefore it has been given in many of these cases with marked benefit. Particularly in sclerotico-choroiditis posterior, have good results been obtained in stopping the progress of the disease.
Other cases of choroiditis, either with or without retinal complication, have been quickly relieved and the vision restored so far as possible in the degenerated condition of the tissues.
The opacities and haziness of the vitreous occurring during the course of choroidal troubles have been known to disappear under Prunus. when given in accordance with the usual indications.
PSORINUM.
Ophthalmia, with pressing pains, as if sand were in the eyes. Soreness of the eyes and burning; she has to close them constantly. The eyes become gummy. Lachrymation. Lids spasmodically closed. Eyelids swollen and inflamed.
Burning, pressing pains in the eyes. Stitches in the eyes. Itching of the lids, especially in the canthi. Photophobia.
Vision blurred. Fiery sparks before the eyes.
Clinical.- This remedy occupies an important position in the treatment of many ophthalmic disorders dependent upon scrofula.
Cases of ciliary blepharitis, especially if of a chronic recurrent nature, are often amenable to this drug; they are usually old chronic cases with no marked local symptoms to govern us in the selection of the remedy. Inflammation of the lids, of a more acute character, as when the internal surface has become much congested and combined with great photophobia so that the child cannot open the eyes, but lies constantly on the face, has been cured.
In old recurrent cases of pustular inflammation of the cornea and conjunctiva most benefit seems to have been gained. The chronic nature, recurrent form and scrofulous basis are our chief indications.
A case of serous choroiditis occurring in a young lady about twenty-one was greatly improved under its use. There was some ciliary congestion and great haziness of the vitreous, so that the optic nerve was only discerned with great difficulty, and then was found decidedly hyperaemic, as was the whole fundus. Some headache was present, especially in the morning; also a profuse sweating of the palms of the hands all the time.
PULSATILLA.
Objective.- The margin of the lower lid is inflamed and swollen, with lachrymation, in the morning. Style on the lid, with inflammation of the white of the eye, now in one, now in the other canthus, with drawing, tensive pains in the eyes on moving the muscles of the face and with ulcerated nostrils. The eyelids are agglutinated in the morning. Lachrymation in the cold, open air. The eyes are full of water; they lachrymate; blear eyed. A red (inflamed) spot on the white of the eye, near the cornea.
Subjective.- Dryness of the lids. A biting pain and a sensation of soreness in the inner canthus. Pressive pain in the inner canthus. Violent sticking in the eyelids and canthi in the evening. Itching (biting) and burning in the lids in the evening. Dryness of the eye and a sensation in the morning as if a foreign body were pressing in it. Pressure as from sand in the eye when reading. Pressive pain in the eyes as if there were heat in them. A pressive, burning pain in the eyes. Burning and itching in the eyes, that provokes rubbing and scratching.
Vision.- Dimness before the eyes and lachrymation in the open air. Dimness of vision, like a fog before the eyes. Obscuration of vision, with inclination to vomit and paleness of the face. Dizzy obscuration of vision after sitting, on rising and beginning to walk about. Transient obscuration of vision. It seems dark before the eyes in the morning on rising from bed. During the menses it became black before the eyes and she felt worse on going into a warm room.
Clinical.- This remedy is very frequently indicated in a great variety of diseased of the eye, but in its selection we are governed in a great measure by the temperament and general symptoms of the patient. Those eye troubles, especially the superficial, found in the negro race, as well as those occurring in the mild, tearful female, seem to be particularly amenable to Pulsatilla.
Its action upon the lachrymal sac is very decided. No remedy is more frequently needed in the early stages of acute phlegmonous dacryocystitis than Pulsatilla. It will sometimes abort the inflammation and prevent the formation of pus, even when the swelling at the inner angle of the eye is extensive, sensitive to touch and involves both lids. It may be useful throughout the whole course of the disease. For blenorrhoeal inflammation of the lachrymal sac it is also valuable, especially if the discharge is profuse, yellow, while, thick and bland and occurring in a Pulsatilla temperament. It has appeared to be particularly called for in affection of the lachrymal sac found in children.
For blepharitis, both acute and chronic, it is a valuable remedy, especially if there is inflammation of the glands of the lids both meibomian and sebaceous; also in cases of blepharitis in which there is a great tendency to the formation of styes or abscesses on the margin of the lids. It is called for in blepharitis resulting from indulgence in high living or fat food and if accompanied by acne of the face. The swelling and redness of the lids vary in different instances, as does also the discharge, though more frequently we find profuse secretions, which cause agglutination of the lids in the morning. the sensations experienced are usually of an itching, burning character, and are aggravated in the evening, in a warm room, or in a cold draught of air, bur ameliorated in the cool open air.
If prescribed early in the treatment of styes (hordeola) it will, in the majority of cases, cause them to abort without the formation of pus. It is especially adapted to the attack per se, but may be of service in preventing the recurrence of successive crops.
In tarsal tumors, especially of recent origin, subject to inflammation or when accompanied by a catarrhal condition of the eye, help has been derived from its use.
Spasmodic action of the lids, with lachrymation and photophobia, has been relieved.
Pulsatilla has been successfully employed in a great variety of conjunctival and corneal affections. It is often the remedy for simple catarrhal conjunctivitis, especially the acute form (though also useful in the chronic) either resulting from a cold, from bathing, an attack of measles, or other cause; if there is present a variable amount of redness, even in some cases of chemosis, burning, itching or sticking pain in the eye; usually worse in the evening, when out in the wind, and after reading, but relieved in the cool open air. The lachrymation may be profuse by day, with purulent discharge at night, though generally a moderately profuse muco-purulent discharge of a whitish color and bland character, which agglutinates the lids in the morning, is to be found. Catarrhal conditions of the conjunctiva dependent upon gastric disturbances may also require this remedy.
In purulent ophthalmia benefit will frequently be derived from this drug if the discharges is profuse and bland and the concomitant symptoms also indicate its selection. The form of purulent ophthalmia found in new-born children (ophthalmia neonatorum) has been greatly benefited; even in some instances well-marked cases have been cured without the use of any other drug. It seems, however, especially useful in this trouble as an intercurrent remedy during the treatment by Argentum nitricum, for often when the improvement is at a standstill a few doses of Pulsatilla will materially hasten the progress of the cure.
It has been employed with some success in trachoma, usually uncomplicated with pannus. The granulations are generally very fine; eye sometimes dry or may be bathed in an excessive secretion of bland mucus. There may also be soreness of the ball to touch and itching or pain in the eye, worse in the evening and better in the cool air or by cold applications. It is especially adapted to cases occurring in anaemic amenorrhoeic females.
Another large class of superficial ophthalmic disorders in which Pulsatilla is particularly useful is to be found in scrofulous ophthalmia, phlyctenular conjunctivitis or keratitis. Here it has proved one of our sheet anchors in the treatment. especially if the pustules are on the conjunctiva. The dread of light is usually moderate in degree, though it may be absent. The lachrymation is not acrid, but more abundant in the open air, while the other discharges may be very moderate or profuse, thick, white or yellow and bland. The pains are more often of a pressing, stinging character, though they vary greatly. The lids may be swollen, but are not excoriated, though subject to styes. The eyes feel worse on getting warm from exercise, or in a warm room and generally in the evening, but are relieved in the open air and by cold applications. The concomitant symptoms of ear disorders, thirstlessness, gastric derangement and amenorrhoea must be taken into consideration.
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.