In two cases of traumatic detachment of the retina, Dr. hunt has observed the retina become re-attached under the influence of Arnica30.
ARSENICUM.
Objective.- Eyelids swollen and oedematous, first the upper and then lower (this swelling is mostly non-inflammatory and painless); the oedematous lids are firmly and spasmodically closed and look as if distended with air. Blepharo-adenitis; edges of lids very red. Continual trembling of the upper eyelids; with lachrymation. Cornea degenerated. Conjunctiva inflamed; extreme redness of the inner surface of the eyelids. Lachrymation and discharges from the eye excoriate the lids and cheek. Anxious expression of the face.
Subjective.- Sub-orbital pain on the left side with prickings as with needles, sometimes quite severe. Pain in the margin of the eyelids on moving them, as if they were dry and rubbed against the eyeballs. Burning on margins of lid. In the evening a feeling as of sand in the eyes, obliging him to rub them. Burning in the eye; eyes hot, with burning, sore pain in the balls, and a feeling a if they had no room in the orbit. Pulsative throbbing in the eyes and with every pulsation a stitch; after midnight. Photophobia. Ciliary neuralgia with fine burning pains.
Clinical.- Only by concomitant symptoms can we distinguish between Arsenicum and Apis for non-inflammatory oedematous swelling of the lids, as both are indicated in this condition.
Blepharitis following erysipelas ten years previous, with scaly condition of edges of the lids and dry, smooth, scaly skin, was cured by this remedy.- J.H. BUFFUM.
Its value in croupous conjunctivitis following ophthalmia neonatorum was illustrated in a child three weeks old. The discharge was moderately tenacious, stringy and yellow-white in color. The lids were slightly oedematous. The right cornea was clear, but the palpebrae (especially lower lid) was covered with shreds of exudation, loosely attached but easily removed, leaving a bleeding surface and hypertrophied papillae. On the lower half of the left cornea was a large ulcer which had perforated and the remain der of the cornea was opaque. The conjunctiva of the lower lid was covered with a dense, white, semi-transport, fibrinous exudation which could not be removed without much force. A similar membrane was present on the upper lid, but not as dense nor as firmly attached. After Argentum nitr., Bromine and Chlorine water had failed to improve, Arsen.30 was given on account of the restlessness after midnight and desire to nurse often and little. A solution of alcohol (3i ad 3ij) was used locally at the same time. The membrane rapidly disappeared and the ulcer healed, leaving a slight purulent discharge which Argentum nitr. controlled.
Arsenicum may be called for in chronic trachoma, in which the internal surfaces of the lids are inflamed, painful, dry and rub against the ball, especially if there are intense burning pains and excoriating lachrymation.
In scrofulous ophthalmia this remedy has been frequently employed with success, especially in ulcers of the cornea, with soreness of the internal surface of the lids which are swollen and spasmodically closed, so that opening them causes intense burning, sticking pains, worse at night, excessive photophobia and acrid lachrymation; tears gush out on opening the eyes; eyes can be opened well in the cool, open air, but not in the house, even in a dark room; eyes feel as if they had no room in the orbit, with general ulceration of the cornea recurring first in one eye and then the other, especially in young people who are anaemic (in one case when the eyes were better the feet were swollen); ulcer on outer side of cornea with elevated edges, pain like the pricking of needles, excoriation of the external canthus, burning and sticking pains.
Vascular elevations on the cornea resulting from ulceration, aggravated by opening and closing the eyes, with violent, burning pains every afternoon, have been benefited.
Parenchymatous keratitis may require the use of this remedy, as, for example, the following case occurring in my clinic and treated by Dr. Charles C. Boyle: Mrs.J., aet.30. had suffered from an inflammation of the eyes for eleven weeks. Both cornea were very hazy, densely infiltrated and vision nearly lost, especially in the right eye. There was deep ciliary injection and commencing vascularity of the cornea; much photophobia and lachrymation burning pain in the eye and over the brow, worse about four A.M.; shooting pain in the ball, over the head and down the cheek; sensation like pains and needles sticking in the eyes, worse at night. Pupil dilated slowly under Atropine. No specific history. For one week Cinnab.3 and Aurum mur., with Atropine externally, were prescribed with only an aggravation of the symptoms. Arsen.3. was then given with almost immediate amelioration of pain and rapid diminution of the inflammatory symptoms. One week later the 30th was prescribed. In about four weeks the haziness of the cornea had so nearly disappeared that with correcting glasses vision was 20/30.
Several cases of kerato-iritis with burning pains over the orbit, worse at night and with profuse acrid lachrymation, have been cured.
Benefit has been derived from its use in the syphilitic iritis and also idiopathic iritis, characterized by burning pains in the eye, worse at night, especially after midnight, with great restlessness and much thirst.
Arsen, cured a progressive choroiditis disseminata which alternated with bronchial catarrh; when the eyes were better the chest was worse, and vice versa. there was heat in the eyes and burning in the chest, with dyspnoea and a whole train of Arsenic chest symptoms-T.F.A.
The favorable results obtained from use of Arsen. in retinitis albuminurica are sometimes very gratifying, as shown in the following case; Miss M.P., eat.20; retinitis albuminurica fully developed in both eyes. L. V. counts fingers at two feet. R. V. 20/70. Right ventricle hypertrophied; appetite variable; bowels regular great thirst for small amounts; occipital headache of a pricking character; tongue large, dry and yellowish; menses too often and venous; breath oppressed and pulse irregular. Cured in two months by Arsenicum 3d and 30th, and Sulphur 30. Last report: No albumin: R. V.20/20: L. V. 10/50- W. S. SEARLE.
Both arsenicum and Rhus are often indicated in scrofulous cases, but the paroxysmal character of the pains, the extreme prostration often present, the burning, sticking pains and the excoriating discharges will distinguish Arsenic. The brilliant red inner margins of the lids and the dryness of the inner surfaces are very marked indications for its use in trachoma. The nervous irritability associated with the symptoms of Arsenic is a very pronounced anaemic hyperaesthesia.
Arsenic cases are generally relieved by warm application. They are very frequently periodic in their occurrence commencing every fall, and often alternating from one eye to the other.
ARUM TRIPHYLLUM.
Clinical-A brilliant cure or catarrh of the lachrymal sac, with desire to bore into the side of the nose, was made by this drug-C. A. BACON.
ASAFOETIDA.
Severe boring pains above the brows. Tearing pain in the forehead; dull pressure at the external border of the left orbit. Troublesome dryness of the eyes. Periodic burning in the eyes and pressing together of the lids, as if overcome with sleep. Burning pain in the ball from within outward. Throbbing pain at night relieved by pressure.
Clinical-Asaf is very useful in ciliary neuralgia, and from its power of relieving the intense boring, burning pain in the brows, especially at night, has arisen its very beneficial action in certain forms of deep-seated inflammation of the eyeball attended by those ciliary pains and turbidity of the humors, as in iritis, kerato-choroiditis and retinitis, especially if if syphilitic origin. the pains are usually throbbing, boring or burning in character, either in the eye, over or around it; they are often intermittent, extend from within outward and are ameliorated by rest and pressure reverse
Aurum).
Asaf, has relieved a sharp pain extending through the eye into the head upon touching.
ASARUM.
Clinical-Asthenopia, accompanied by congestive headaches, has been cured. The eyes were worse morning and evening, when outdoors in the heat and sunlight; were better in the middle of the day and from bathing them in cold water-T.F.A.
ATROPINUM.
About 9 P.M. eyelids felt heavy and difficult to keep open. Sharp pain under the right eye, with slight pain in the temples. Neuralgic pains commencing under the left orbit and running back to the ear, lasting perhaps ten minutes at a time and then disappearing for fifteen or twenty; these have been noticed for several hours. Hard, tense eczematous swelling and redness of the lids.
Clinical-Its wholesale and empyrical application for therapeutical purposes is unsafe, since we have few accurate data upon which to base a prescription of Atropine to cure (it should never be used when Belladonna is indicated, since Atropine does not comprise Belladonna).
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.