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DOMESTIC MEDICINE

CHAP. XXVII.

OF THE OPTHALMIA, OR, INFLAMMATION OF THE EYES.

THIS disease may be occasioned by external injuries; as blows, burns, bruises, and the like. It may likewise proceed from dust, quicklime, or other substances, getting into the eyes. It is often caused by the stoppage of customary evacuations; as the healing of old sores, drying up of issues, the suppressing of gentle morning sweats, or of sweating of the feet; &c. Long exposure to the night-air, especially in cold northerly winds, or whatever suddenly checks the perspiration, especially after the body has been much heated, is very apt to cause an inflammation of the eyes. Viewing snow or other white bodies for a long time, or looking stedfastly at the sun, a clear fire, or any bright object, will likewise occasion this malady. A sudden transition from darkness to very bright light will often have the same effect.

NOTHING more certainly occasions an inflammation of the eyes than night-watching, especially reading or writing by candle-light. Drinking spirituous liquors, and excess of venery, are likewise very hurtful to the eyes. The acrid fumes of metals, and of several kinds of fuel, are also pernicious. Sometimes an inflammation of the eyes proceeds from a venereal taint, and often from a scrophulous or gouty habit. It may likewise be occasioned by hairs in the eye-lids turning inwards, and hurting the eyes. Sometimes the disease is epidemic, especially after wet seasons, and I have frequently known it prove infectious, particularly to those who lived in the same house with the patient. It may be occasioned by moist air, or living in low, damp houses, especially in persons who are not accustomed to such situations. In children it often proceeds from imprudently drying up of scabbed heads, a running behind the ears, or any other discharge of that kind. Inflammations of the eyes often succeed the small-pox or measles, especially in children of a scrophulous habit.

SYMPTOMS - An inflammation of the eyes is attended with acute pain, heat, redness, and swelling. The patient is not able to bear the light, and sometimes he feels a pricking pain, as if his eyes were pierced with a thorn. Sometimes he imagines his eyes are full of motes, or thinks he sees flies dancing before him. The eyes are filled with a scalding rheum, which rushes forth in great quantities, whenever the patient attempts to look up. The pulse is generally quick and hard, with some degree of fever. When the disease is violent, the neighbouring parts swell, and there is a throbbing or pulsation in the temporal arteries, &c.

A SLIGHT inflammation of the eyes, especially from an external cause, is easily cured; but when the disease is violent, and continues long, it often leaves specks upon the eyes, or dimness of sight, and some times total blindness.

IF the patient be seized with a looseness, it has a good effect; and when the inflammation passes from one eye to another, as it were by infection, it is no unfavourable symptom. But when the disease is accompanied with a violent pain of the head, and continues long, the patient is in danger of losing his sight.

REGIMEN. - The diet, unless in scrophulous cases, can hardly be too spare, especially at the beginning. The patient must abstain from every thing of a heating nature. His food should consist chiefly of mild vegetables, weak broths, and gruels. His drink may be barley-water, balm-tea, common whey, and such like.

THE patients chamber must be darkened, or his eyes shaded by a cover, so as to exclude the light, but not to press upon the eyes. He should not look at a candle, the fire, or any luminous object; and ought to avoid all smoke, as the fumes of tobacco, or any thing that may cause coughing, sneezing, or vomiting. He should be kept quiet, avoiding all violent efforts, either of body or mind, and encouraging sleep as much as possible.

MEDICINE. - This is one of those diseases wherein great hurt is often done by external applications. Almost every person pretends to be possessed of a remedy for the cure of sore eyes. These remedies generally consist of eye-waters, and ointments, with other external applications, which do mischief twenty times for once they do good. People ought therefore to be very cautious how they use such things, as even the pressure upon the eyes often increases the malady.

BLEEDING, in a violent inflammation of the eyes, is always necessary. This should be performed as near the part affected as possible. An adult may lose ten or twelve ounces of blood from the jugular vein, and the operation may be repeated according to the urgency of the symptoms. If it should not be convenient to bleed in the neck, the same quantity may be let from the arm, or any other part of the body.

LEECHES are often applied to the temples, or under the eyes, with good effect. The wounds must be suffered to bleed for some hours, and if the bleeding stop soon, it may be promoted by the application cloths dipt in warm water. In obstinate cases, It will be necessary to repeat this operation several times.

OPENING and diluting medicines are by no means to be neglected. The patient may take a small dose of Glauber's salts, and cream of tartar, every second or third day, or a decoction of tamarinds with senna. If these be not agreeable, gentle doses of rhubarb and nitre, a little of the lentitive electuary, or any other mild purgative, will answer the same end. The patient at the same time must drink freely of water-gruel, tea, whey, or any other diluting liquor. He ought likewise to take, at bed-time, a large draught of very weak wine-whey, in order to promote perspiration. His feet and legs must frequently be bathed in luke-warm water, and his head shaved twice or thrice a-week, and afterwards washed in cold water. This has often a remarkable good effect.

IF the inflammation does not yield to these evacuations, blistering-plasters must be applied to the temples, behind the ears, or upon the neck, and kept open for some time by the mild blistering ointment. I have seldom known these, if long enough kept open, fail to remove the most obstinate inflammation of the eyes; but, for this purpose, it is often necessary to continue the discharge for several weeks.

WHEN the disease has been of a long standing, I have seen very extraordinary effects from a seton in the neck, or betwixt the shoulders, especially the latter. It should be put upwards and downwards, or in the direction of the spine, and in the middle between the shoulder-blades. It may be dressed twice a-day with yellow basilicon. I have known patients, who had been blind for a considerable time, recover sight by means of a seton placed as above. When the seton is put across the neck, it soon wears out, and is both more painful and troublesome than between the shoulders; besides, it leaves a disagreeable mark, and does not discharge so freely.

WHEN the heat and pain of the eyes are very great, a poultice of bread and milk softened with sweet oil or fresh butter, may be applied to them, at least all night; and they may be bathed with lukewarm milk and water in the morning.

IF the patient cannot sleep, which is sometimes the case, he may take twenty or thirty drops of laudanum, or two spoonfuls of the syrup of poppies, over night, more or less according to his age, or the violence of the symptoms.

AFTER the inflammation is gone off, if the eyes still remain weak and tender, they may be bathed every night and morning with cold water and a little brandy, six parts of the former to one of the latter. A method should be contrived by which the eye can be quite immersed in the brandy and water, where it should be kept for some time. I have generally found this, or cold water and vinegar, as good a strengthener of the eyes as any of the most celebrated collyriums.

WHEN an inflammation of the eyes proceeds from a scrophulous habit, it generally proves very obstinate. In this case the patient's diet must not be too low, and he may be allowed to drink small negus, or now and then a glass of wine. The most proper medicine is the Peruvian bark, which may either be given in substance, or prepared in the following manner:

TAKE an ounce of bark in powder, with two drachms of Winter's's bark, and boil them in an English quart of water to a pint; when it has boiled nearly long enough, add half an ounce of liquorice-root sliced. Let the liquor be strained. Two, three, or four table-spoonfuls, according to the age of the patient, may be taken three or four times a-day. It is impossible to say how long this medicine should be continued, as the cure is sooner performed in some than in others; but in general it requires a considerable time to produce any lasting effects.

Dr. CHEYNE says, 'That AEthiops mineral never fails in obstinate inflammations of the eyes, even scrophulous ones, if given in a sufficient dose, and duly persisted in.' There is no doubt but this and other preparations of mercury may be of singular service in ophthalmias of long continuance, but they ought always to be administered with the greatest caution, or by persons of skill in physic.

IT will be proper frequently to look into the eyes, to see if any hairs be turned inwards, or pressing upon them. These ought to be removed by plucking them out with a pair of small pincers. Any foreign body lodged in the eye may be expeditously removed by passing a small hair pencil between the eye-lid and the ball of the eye. In some places, the peasants do this very effectually, by using their tongue in the same manner.

THOSE who are liable to frequent returns of this disease, ought constantly to have an issue in one or both arms. Bleeding or purging in the spring and autumn, will be very beneficial to such persons. They ought likewise to live with the greatest regularity, avoiding strong liquor, and every thing of a heating quality. Above all, let them avoid the night air and late studies. As most people are fond of using eye-waters and ointments in this and other diseases of the eyes, we have inserted some of the most approved forms of these medicines in the appendix. See Appendix, Eye-water and Eye-salve.

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