It is a very happy provision that the local application of Atropine to a healthy eye almost always spends its whole drug power upon the peripheral nerve-fibres of the iris and ciliary muscle and that very seldom do any constitutional symptoms arise. In twenty years’ experience we have seen no single bad effect from the use of strong a(four grains to the ounce) solution of Atropine for dilating the pupil in order to examine the fundus. Its use should always be avoided in all stages of glaucoma, as cases are reported of most violent inflammation following its use in that disease (though Belladonna does not seem to be at all Homoeopathic to glaucoma, as the action of Atropine is probably mechanical).
If an attack of iritis could be promptly recognized and met at the very beginning, before the exudative stage is reached (that is, within twenty-four hours), there might be no need of atropine; but if exudation has taken place and the inflammation is violent, to four hours; it will not materially interfere with the action of remedies. It is, however, in all cases, the safest plan, for, if adhesions take place, an iridectomy will usually be required. In severe case, in which the congestion of the capillaries is enormous and the iris, being so full of blood, cannot dilate, aconite may be employed in frequent doses to reduce the hyperaemia. In rare cases of this kind even cupping of the temples may be justifiable as a temporary expedient to enable us to obtain a dilated pupil. this being accomplished, remedial measures may be resumed and continued.
Its use is recommended for the relief of ciliary neuralgia.
Objective-Redness and swelling of the lids. Redness of the sclerotic; constant lachrymation; photophobia; morning agglutination; eye very red and angry looking.
Subjective-Burning, stitching, drawing and itching in the inner canthus of the eyes and in the lids; sensation upon using the eyes, as of violent heat in them; pressure in the eyes and constant feeling of sand in them; pressive pain in the right ball from above downward, also from without inward, worse on touch; pain in the eye from blowing the nose. Bones around eyes feel bruised.
Vision-Hemiopia, the upper half of the field of vision seems covered by a black body, the lower half visible. He cannot distinguish anything clearly, because he sees everything double and one object is seen mixed with the other, with violent tension in the eyes. Vision indistinct as though a veil.
Clinical-In considering the clinical application of Aurum in ophthalmic diseases, no distinction will be made between metallic gold and the muriate, for experience has not yet demonstrated that there is any practical difference between these two preparations.
In blepharitis it is rarely useful, though it may be called for, especially in syphilitic patients after the abuse of mercury, if the lids are red, swollen and ulcerated.
for trachoma with or without pannus (especially with), there is probably no remedy oftener indicated than Aurum. Its characteristics are not well marked, but its usefulness has been confirmed in a variety of cases; there is commonly much photophobia, lachrymation and pain, burning or dull in character, compelling one to close the lids, usually worse in the morning and ameliorated by the application of cold water; although one or more of these symptoms may be absent without necessarily contra- indicating this remedy.
For ulcerations and pannus like thickening of the outer layer, Aurum is of great service, especially in case of scrofulous ophthalmia with ulcerations and vascularity of the cornea, with great irritability of the patient; great sensitiveness of the eyes to touch; swollen cervical glands; pains from without inward, worse on touch (reverse of Asafoetida)
No remedy has given greater satisfaction in the treatment of interstitial keratitis than Aurum muriaticum and may cases of the sluggish form of inflammation have yielded promptly to its use. Is sphere of action does not seem to be closely circumscribed, for rapid improvement has followed its use in case of a scrofulous origin, as well as in those which can be traced to hereditary syphilis. The cornea is more or less opaque and may be very vascular or not. The degree of ciliary injection, photophobia and pain is variable. Its verification in cases dependent upon hereditary syphilis is of frequent occurrence. In old, obstinate redness, photophobia and lachrymation.
In low forms of episcleritis in which the cornea is becoming infiltrated from the sclera, with moderate redness, pain and photophobia, benefit has been derived from Aurum.
Favorable results have followed its use in iritis and kerato-iritis, particularly the syphilitic variety, and after the abuse of mercury. there is usually much pain around the eye which seems to be deep in the bone and to extend from without inward; aggravated by touch. On one case recently under my care in which the improvement and cure was remarkably rapid under Aurum mur., 3 there was great swelling of the iris, extensive posterior synechiae, large gumma of the iris, haziness of aqueous, with deposits on posterior surface of the cornea, tending to extension into the parenchyma, together with much pain and soreness around the eye; worse at night.
It is almost a specific for exudative chorio-retinitis with exudations in the vitreous-T.F.A.
Hemiopia, in which the right half of objects is invisible, has been helped, though not cured. But the form of hemiopia to which Aurum is especially adapted is when the patient can see nothing above the median line, as the following case will illustrate. Some years ago a gentleman, who had taken large quantities of iodide of potash, complained that the vision of the left eye had been failing for a year and a half; he could not see the upper half of a room or any large object, though the lower half was clear; no pains in the eye; objects seemed smaller and more distant; had some black spots before vision; was always worse as the the day progressed and better in the mornings; twitching in the upper lid. On inquiry it was found that he had syphilis ten years ago, but had not been recently troubled with secondary symptoms, except that a large bursa-like swelling on the wrist had persisted a long time. vision was 5/200. Upon ophthalmoscopic examination there was found chorio-retinitis (chronic) with an accumulation o fluid beneath the retina, which settled to the lower portion of the eye and caused a large detachment of the retina. Vitreous hazy from infiltration. Right eye normal;refraction normal. Knowledge of the pathological conditions here gave no clue to the remedy, and we were obliged, this time at least, to rely upon the symptomatology (as one should always be ready to do). The remarkable symptom of not seeing anything in the upper half of the field of vision is of course the most prominent. Taking the history of the case into account and the previous dosing with iodide of potassium Aurum 200 was given, under which he steadily improved, the haziness of the vitreous almost entirely disappeared; the inflammation of the retina subsided and in one year the vision rose to and remained at 1/100, beyond which it would not go, for the retina was partly disorganized and could not be repaired with retinal tissue-T.F.A. Since then several cases of retinal disease have been successfully treated with Aurum, though in some cases no improvement followed and the remedy only served to arrest further progress of the malady (compare Gelsem.). Aurum cases will usually be found to follow overdosing by potash or mercury and perfect vision can never be expected from the nature of the tissue changes.
Its reported benefit in paralysis of the muscles from syphilitic periostitis seems reasonable, though I have not yet had occasion to verify its action.
BADIAGA.
Bluish purple margins of lids. Headache, extending to the eyeballs. Pains in the eyeballs, extending into the temples, aggravated by turning them in either direction. Slight aching pains in the posterior portion of both eyeballs and in the temples (with headache from 2 P.M. till 7 A.M.) The left eyeball quite sore, even upon closing it tightly.
Clinical-This variety of sponge has been useful in some cases of exophthalmic goitre and should always be thought of in its disease.
Has proven of value in some cases of scrofulous ophthalmia with enlarged cervical glands.
BARYTA CARBONICA.
Redness of the conjunctiva, with swollen lids and dryness of the eyes. Itching of the eyes. Sensation as of a gauze before the eyes in the morning and after a meal. Light dazzles the eyes, with fiery spots before the eyes in the dark. Photophobia.
Clinical-Dr. Dudgeon advises its use in scrofulous inflammations of the eye characterized by phlyctenules and ulcers on the cornea, especially when associated with glandular swellings.
Has been of service in checking the advancement of cataract.
BARYTA IODATA.
Clinical-Up to the present time no. proving has been made of this substance, so that its sphere of action is hypothecated from its composition; clinically, it has proved a great addition to our armamentarium. It was first introduced to notice as an ophthalmic remedy by Dr. Liebold, who says that it is especially adapted to disease occurring in scrofulous subjects, in which there is great swelling of the glands, particularly of the lymphatics, “which feel like a string of beans everywhere between the muscles down to the spinal column; they can be felt of all sizes and all degrees of induration; some may be suppurating, while others have healed with an ugly scar.” It has been used very successfully in chronic recurrences of phlyctenular Keratitis and conjunctivitis found in the above subjects.
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.