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nearly gone, but the redness continued. His vision was quite distinct, but the eye was irritable. In three days, by the application of an opiate, the inflammation was completely removed, his vision perfectly restored, and he returned home complaining merely of a little tenderness. Since which he has remained well.

A case of inflammation of the eye, occasioned by a burn, exactly similar to the case just related, though the symptoms were not so severe, was completely relieved by the evacuation of the aqueous humour, which suddenly mitigated the pain, and removed all the inflammatory symptoms.

§ 12. Of the Changes produced in Opacities of the Cornea from the Discharge of the Aqueous Humour.

It has already been observed that a diminution might take place in the transparency of the cornea, from an alteration in the quantity of the contents of the eyeball, and it has also been noticed, that in the dead eye the cornea assumes a milky colour when pressure is applied upon the eyeball, or when the veins are injected with clear water.

That some opacities of the cornea are produced from an increase in the quantity of the contents of the eyeball, and not from the deposition of an albuminous fluid in the texture of the cornea, as takes place in common speck, seems to be proved from the immediate effects which have resulted, in some in. stances, from the discharge of the aqueous humour. In these cases the opacity of the cornea seemed entirely to arise from over-distension; for the instant the aqueous humour was discharged, the cornea regained its natural transparency, as imitated in the experiments on the dead eye. In other cases it was evident, that the opacity of the cornea depended on two distinct causes; the one, as in the former cases, arising from overdistension, whilst the other proceeded from that change in the structure of the cornea which produces common speck. Cases of the first class are distinguished by a cloudines or

turbid state of the whole anterior chamber; whereas in common speck the obscurity is more defined, being limited to a certain portion of the cornea.

These two different kinds of opacity were strikingly illustrated, in some instances, where both took place in one eye at the same time, there being a general dimness throughout the whole anterior chamber, besides some defined spots in particular parts of the cornea. In these cases, the instant the aqueous humour was discharged, all the general obscurity disap peared, and nothing remained but the more opake spots, which became more distinctly circumscribed.

From what has been already said, little difficulty will arise in selecting those cases of opacity of the cornea, which the evacuation of the aqueous humour is calculated to remedy. From the cases, the particulars of which are detailed, the beneficial effects of the operation are sufficiently obvious, and would lead us to expect very important results from future. experience.

CASE XII.

In a girl, twelve years of age, the whole of the white of the right eyeball had become of a bright red colour, from a number of blood-vessels, whose trunks could all be separately distinguished running in straight lines towards the cornea, and some of their small branches passed over its edge, and were distributed into its substance. There was a circularshaped speck, of a considerable size, near the centre of the cornea; and throughout the rest of the cornea, particularly around the speck, there was a good deal of muddiness. The upper eyelid was slightly swelled, with some varicose veins on its external surface; whilst the vessels of the internal membrane were increased in number and in size. She had a good deal of pain in the eyeball, but it was particularly severe in the side of the head and temple above the affected eye. Though the vision was destroyed, yet she complained when the eye

was exposed to a bright light. The disease had continued three weeks. It began with the sensation of a mote in the eye, attended with pain; the following morning it was very red, and every symptom had increased daily.

Treatment. The aqueous humour was discharged, which caused a good deal of smarting, but in a few minutes it subsided. A great change took place in the transparency of the cornea, all the general cloudiness instantly going away, and the speck left much more distinctly circumscribed. During the course of the day the pain of the head and eye went off, and she slept well during the night, whereas formerly her nights were very restless and disturbed by startings. On the day subsequent to the operation, she had not the least pain in the head or eye; the eye was not very sensible to light, and the number of blood-vessels was very much diminished. She could now readily distinguish all her fingers, and observe large objects at a considerable distance.

CASE XIII.

The eyeball of a woman, thirty-eight years of age, was very much inflamed, and some spots of a purulent looking fluid were seen in the anterior chamber; whilst, at the same time, there was a considerable degree of opacity throughout the cornea. She complained of an intense pain of the eyeball, and in the forehead and temples. The disease was of three weeks standing.

Treatment. The aqueous humour was discharged, the parts were afterwards fomented, and she took a brisk purge. On the following day the pain of the head was much easier, and the blood-vessels were less numerous.-She rapidly got well.

CASE XIV.

A lady, thirty-two years of age, had complained, during eleven weeks, of an inflammation in her right eye, attended

with pain occasionally in the forehead, and inability to look at objects. There was a very opake speck of the cornea opposite the pupil, with a degree of turbidness around it, so that nearly the whole pupil was hid; the white of the eye was slightly red, and the eyelids were of a purple colour towards the edges; the eye watery. Scarifications, opiates, and stimulants, gave no relief.

Treatment. The aqueous humour was discharged, and instantly the whole speck, except a small central portion, disappeared, and she could distinctly see with this eye imme diately afterwards. All the inflammatory symptoms subsided in a few days by fomentations.

CASE XV.

The whole of the white of the eye of a healthy middle-aged man was crowded with vessels of a large size, and of a bright red colour: these vessels all terminated at the margin of the cornea, ran in a straight direction towards it, and did not ramify until they approached it, and there they divided into numerous branches. The transparency of the anterior chamber was diminished, and all objects appeared dim. The eyelids were a little swelled, and the blood-vessels on their internal surface, though not much increased in number, were enlarged and turgid. He had a violent pain in the forehead, which was not constant, but came on in such severe paroxysms that he could scarcely support their violence. The inflammation had come on four days before without any evident cause.

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Treatment. When the aqueous humour was discharged, the anterior chamber acquired its natural transparency, and he could more clearly distinguish objects. A remarkable change took place in the blood-vessels of the white of the eye; the number of them was so much diminished, and also their size, that the eye at once lost all the appearances of inflammation.

VOL. V.

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No. 17.

Besides ordering a purge, and applying fomentations to the eye, it was thought proper to bleed this patient, from the violence of the inflammation and its accompanying fever. Under that treatment he got well rapidly.

Two Cases of Ulcers in the Cornea, where the Aqueous Humour was advantageously discharged.

CASE XVI.

In a young lady the anterior chamber of one eye appeared very turbid, and there was an ulcer on the central part of the cornea, and a cluster of blood-vessels passing towards it; the whole eyeball was much inflamed, having the peculiar redness of the pustulous ophthalmia.* She complained of an agonizing pain in the forehead, which sometimes went off during the day, but was always severe in the night. The inflammation had lasted fifteen days, the pain in the head only eight days; little sleep, pulse quick, and the tongue white.

Treatment.-Discharged the aqueous humour by puncturing the cornea at the place where the vessels passed. The pain in the head never afterwards returned; and all the other symptoms rapidly subsided by the use of fomentations, and the vinous tincture of opium.

CASE XVII.

A healthy looking young man had an ulcer of the cornea, accompanied with a good deal of inflammation and pain in the eyeball, in consequence of the suppuration of a pustule. The ulceration and inflammation subsided rapidly by the use of the vinous tincture of opium.

A few days after the eye had recovered this attack, he was suddenly seized with acute pain in it, which soon extended

* See Essay on the Morbid Anatomy of the Eye.

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