Imatges de pàgina
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creased excretion in the parts above mentioned. Thus, to give only one inftance; fo large a quantity of tears may be furnished, in confequence of the morbid relaxation and preternatural dilatation of the excretory ducts of the cornea and conjunctiva, as to deceive a practitioner who is ignorant of this circumstance, and induce him to believe that there was an obftruction in the ductus ad nafum; which nevertheless might be in the most perfect state, though not capable of carrying off this unusual quanP tity.

The Author next relates feveral experiments, the intention - of which is, not only to prove the existence of these excretory ducts in the conjunctiva and cornea; but likewife to fhew, that the liquor which paffes through them is furnished by the aqueous humour, which he accordingly confiders as the most abundant fource of the tears. He further endeavours to prove, that the aqueous humour itself is produced, or regenerated, by a kind of tranfudation from the vitreous humour; and produces experiments to fhew, that this laft body confifts of a capfulary tunic, inclofing a cellular fubftance, the cells of which have a communication with each other, and are full of a diaphanous aqueous fluid, which is conveyed into each cell through a great number of lymphatic veffels, which pafs from the choroides and retina.

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To fhew the fimilarity of the aqueous and vitreous humours, chemically examined, the Author, after letting out the aqueous humour from the eye of a fubject lately dead, places the globe, a little inclined, upon a small grate, which stands on a glass .tumbler. A diaphanous fluid, like the aqueous humour, will drop from it gradually; and in lefs than fix hours the eye will become flat. On examining it, the tunics of the vitreous humour will be found without fluid. On taking equal parts of this vitreous fluid, and of the aqueous humour, and evaporating them over a flow fire, in feparate veffels, till they are reduced to one third; they will each be found to have acquired the fame degree of viscosity as a weak folution of gum arabic; and fome chryftals will be found in each, when cold. Continuing the process, each will produce an equal quantity of alcaline falt; which will be found to weigh about a tenth part of the quantity employed in the experiment.

According to an experiment of the Author's, the quantity of tears produced by each eye, in the fpace of twenty-four hours, is commonly two ounces and upwards. He applies close to the circumference of one of the eyes a fmall drinking-glafs; where it is fuffered to remain half an hour. A light vapour is foon perceived, which condenfes into drops over the whole extent of the infide furface of the glafs. Thefe drops, we are told, amount to the weight of twenty or twenty-five grains. Being procured by perfpiration, they contain nothing of a faline or

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viscous nature. This experiment is neceffarily inaccurate, from the very nature of it; independent of any confideration of the quantity of tears abforbed, during the fame time, by the puncta lacrymalia. The Author gives us a calculation on this laft fubject, which, we own, we do not understand.

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After treating of the abforbent part of the lacrymal system, the Author gives us his formula medicamentorum; which we can by no means approve; as, in the greater part of them, the effective ingredients, when there are any in the Recipe, are overwhelmed by a rabble of non-effectives. Thus his refolving cataplafm confifts of a medley of no less than fourteen feeds, meals, flowers, and roots. An ounce of purging falts is not prefcribed, without a little hoft of roots, leaves, and feeds, in its train. The Author, too, adopts the unintelligible jargon of the last century, when, in characterising a certain decoction of balm and betony, and two other equally unmeaning ingredients, and which-though no good reason can be given why-is ycleped Cephalic; he gravely tells us, that it fortifies the nerves, and refreshes the animal fpirits.' Nor can we conceive, why he gives to a certain compofition, confifting of waters, fpirits, oils, and balfam, the ftrange title of Fluidus electri vim habens, and afterwards calls it an Electrical fluid.'

Curative

The last part of the work contains the Author's Methods'-for the Fiftula lacrymalis; for the disorders of the eye-lids; for the external and internal diforders of the globe of the eye; and for the complicated diforders of the eye, and its attributes. We fhall not attend him through this part of his work. Those who particularly profefs this branch of furgery, especially the operative part of it, may probably, when they have made themselves mafters of the Author's phrafeology, meet with fome hints that will be useful to them. In confequence of his uncouth idiom, we have not been always certain that we have fully caught his meaning, even in thofe parts of his work which we have chofen as the fubjects of the preceding analyfis.

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Before we take our leave of this performance, we cannot help animadverting on a paffage, in which the Author, furely with too great confidence, denies the efficacy afcribed to electricity, in certain diseases of the eyes, in two late publications. One,' he fays, I would not have thought worth mentioning, had it not accounted for a gutta ferena cured by pofitive electricity.'To this I object, that a blindnets may have been cured by electricity, as well as fome other diforders; but that a gutta ferena has, is one of the greateft abfurdities, or a downright ignorance.'-We know not to what publication the Author alludes in this civil criticism: but in addition to Mr. Hey's and other fuccessful and well authenticated cafes that might be named, we fhall only refer him to the concluding part of the following

Article;

Article; where little doubt can be entertained that the cure of an incipient gutta ferena was effected by electricity: especially when it is confidered, that fenfation was restored to each eye, fingly, and fucceffively, on the fucceffive application of that remedy, on two days immediately following each other.

Speaking of the fecond writer, he fays, the other, a warm promoter of medical electricity, would have equally commanded my filence, had it not pretended to afcertain many phyfical and moral impoffibilities. A fiftula lacrymalis is of fuch a nature as not to be removed by any shock whatever, when exifting either in the lacrymal abforbent ways, or by a defect in these parts. I have, for the fupport of my affertions, the experiments lately made by M. Mauduyt, at the expence of the French government. See his Extract for 82 patients electrified. A Paris, chez Philippe-Denys Pierres, Printer.'

We have not feen this Extract; but if we had, we fhould ftill be at a lofs to know how thefe, or any other experiments, could prove that a fiftula lacrymalis has not, or could not have, been cured by electricity, under the adminiftration of others. In oppofition to this negative affertion of the Author, we have the pofitive teftimony of a late writer to produce; to whom we suppofe that he alludes. We mean Mr. Cavallo; an account of whofe performance is given in the prefent number. His teftimony is as follows:

"All the cafes of fiftula lacrymalis, as far as I am informed, that have been electrified by perfons of ability, for a fufficient time, have been intirely cured. The method generally practised has been that of drawing the fluid, with a wooden point; and to take very small sparks from the part. The operation may be continued for about three or four minutes every day. It is remarkable that, in these cases, after curing the fiftula lacrymalis, no other disease was occafioned by it, as blindness, inflammations, &c. by fuppreffing that discharge.'

We have attended to these criticisms of the Author, not merely to exhibit them as inftances of false reasoning, but from a confideration much more important. Obfervations of this kind, thus decifively pronounced, cannot poffibly do good to any one; but may prove injurious to many, by deterring either the members of the faculty, or the afflicted, from attempting to procure relief against a moft deplorable disease, by making trial of a new remedy, even allowing it to be a doubtful one: whereas electrical trials undoubtedly may be attended with fuccefs, and on the other hand there is no danger of their proving injurious; especially when conducted in the mild and judicious manner in which electricity has for some time past been applied.

ART.

ART. VI. Remarks on the Ophthalmy, Pforophthalmy, and Purulent Eye. With Methods of Cure confiderably different from thofe commonly ufed; and Cafes annexed, in Proof of their Utility. By James Ware, Surgeon. 8vo. 2 s. 6 d. Dilly. 1780.

TH

HIS little publication deferves the more particular notice, not only as it contains a judicious and well written account of the diforders mentioned in the title-page; but as it exhibits fome new methods of cure, the efficacy of which appears to be fatisfactorily afcertained, by various trials made of them by the Author, and by Mr. Wathen; to whom he acknowledges himself indebted for the practical improvements defcribed in this performance.

After giving a brief description of the eye and its appendages, the Author firft treats of the ophthalmy, or inflammation of the eyes; and after defcribing the nature and causes of that disorder, and pointing out the more general methods of cure, he proceeds to recommend a local application to the part, the use of which has been attended with remarkable fuccefs. This application is the Thebaic tincture of the London Dispensatory; composed of opium and warm aromatics, digefted in mountain wine. We fhall abridge the Author's account of the manner of ufing it, and of its effects.

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Two or three drops of this tincture are applied to the naked eye, by dropping them from a vial, once or twice a day, according as the fymptoms are more or less violent. A fharp pain is excited, followed by a copious flow of tears, which continue a few minutes, and gradually abate: after this, a great and remarkable degree of eafe generally fucceeds. The inflammation is often vifibly abated by one application; and many bad cafes have been completely cured by it in less than a fortnight; after every other kind of remedy had been used for weeks, and fometimes months, without any fuccefs.'-In fome cafes, however, a longer use of it is requifite; and a few inftances have occurred, in which no relief at all was obtained from its first application. In fuch cafes, the Author advifes to fufpend the use of it, till the exceffive irritation has been diminished by evacuations and other proper means: after which, it may again be applied, with hopes of fuccefs. The trial is faid to be attended with no other inconvenience than that of a pain, which does not continue long; and as foon as this goes off, the eye becomes perfectly eafy, and the diameters of the blood veffels are vifibly diminished.

It might be thought, that the curative intention, in this cafe, might be better anfwered by an aqueous folution of opium: but the Author, who has made feveral experiments to afcertain this point, has found reason to confine himself, for a long time paft, REV. Dec. 1780.

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to the use of the tincture alone: and from repeated experience recommends it, with the helps and cautions given in this pam phlet, as a most effectual application in every species and stage of the diforder, from the most mild and recent, to the most obftinate and inveterate.'-Nine cafes, felected out of a great number, are afterwards added, which feem fatisfactorily to evince the efficacy of this remedy.

The new method propofed by the Author for the cure of the pforophthalmy, or inflammation and ulceration of the edges of the eye lids, is the unguentum citrinum of the Edinburgh Difpenfatory, applied to the parts, either with the finger or a fmall brush of camel's hair. The utility of this application is exemplified by the relation of feveral cafes.

For the cure of the diforder called the Purulent eye, to which new-born children are fubject, the Author recommends the application of aftringents; on a conviction that the discharge is not real pus, but only mucus, increafed in quantity, and altered in colour, by fome irritating caufe. The remedy which he has found to be highly ufeful in this diforder is the aqua camphorata of Bates's Difpenfatory, greatly diluted with water, and injected with a fyringe..

At the close of this performance, the Author relates a fingular cafe of a gutta ferena, lately, and we may almoft add, extemporaneously, cured by electricity.

The patient, Sufannah Moody, about 17 years old, was feized with a pain in her teeth and jaw, on January 29, 1780, which after two days produced a confiderable fwelling in the face. Thefe fymptoms, however, foon difappeared; but were fpeedily fucceeded by an inability to open the eye-lids. An apothecary, who was confulted, was furprised to find, on opening the lids with his fingers, that the fight of both eyes was entirely loft. In this ftate the Author faw her, and found no inflammation in either eye; but the pupils of both were much enlarged, and the Iris had but a very small degree of contraction. The Thebaic tincture was applied, without effect; fhe was after(wards cupped on both temples, from which three ounces of blood were taken away; and then a bliftering plaifter was applied to each temple, and two others behind the ears. vifible change was produced by these means, either on the eye or eye-lids; for on feparating the latter, the patient had not the leaft degree of fight in either eye. We fhall give the remainder of this cafe in the Author's own words:

No

On February 7, with Mr. Wathen's confent, I electrified the left eye for a quarter of an hour: firft by carrying a ftream of the electric fire through the eye; and afterwards, by drawing fparks from all the parts which furrounded it. That evening the perceived no alteration; but the next morning fhe could open

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