In both Susannah Earle and John Law’s cases, the eye was distended by
the accumulation of the aqueous humour, separated in great quantity
by the repeated straining of the blood-vessels in the whooping cough,
which might gradually relax and enlarge the aqueous ducts of Susannah
Earle’s eye; and possibly by the rupture of those ducts, and of some
blood-vessels, at the time John Law exerted himself violently in
beating dung about the close: for in either case the _impetus_ of the
blood must have been so violent, as to produce those effects. However,
from the _hydrophthalmia_ succeeding the operation on John Law, the
fungous excrescence, and continual serous discharge during several
months from the wound, it plainly appears, that an abundance of aqueous
humour was discharged at first by the distention or laceration of the
aqueous ducts, and latterly for want of a contraction of those vessels,
and of the lymphatics, which were no longer of use.
Both these cases shew the necessity of inquiring particularly into
the causes of diseases of the eyes, as well as of other parts of the
body; for by barely attending to the symptoms, the disease will not
be removed, tho’ the symptoms be alleviated. Bleeding, and moderate
evacuations, would certainly have, at first, decreased the tension and
pain, and assuaged the inflammation; but both topical applications, and
internal medicines, were properly to be adapted, and a suitable diet
regulated.
Not to mention the absurd and impertinent abuse of empirics, what
benefit could accrue, in both these cases, from unctuous, laxative,
or emollient applications, from drastic and mercurial purges? Tho’
such applications might be well intended, to take off the tension
and inflammation; yet, as the distension of the blood-vessels only
increased gradually, as the globe of the eye was enlarged; so whatever
application relaxed the coats of the eye, must infallibly stretch out
the vessels yet farther, and cause a greater pain and inflammation;
which drastic and mercurial purges would also increase.
The only method then to be pursued in such bad cases would be at first
to endeavour to remove the fullness of the blood, and make use of such
topical remedies as would contract without irritation. If the cause
remains, as the whooping cough in Susannah Earle’s case, no amendment
of the eye can be expected, while the patient’s blood-vessels are
continually strained by frequent coughing. This illness therefore
should be attended to, and removed as soon as possible.
But should the eye be so enlarged, as to protrude itself out of the
orbit, there seems no other way to lessen the bulk of the eye, than
by making a puncture with a proper instrument, to let out the aqueous
humour; and then apply such agglutinant and contracting _collyria_, as
may reduce the distended coats and vessels to their former size. This
operation should be performed before the humours are vitiated, the
sight lost, the vessels in a state of suppuration, and the coats of the
eye too far extended; for at that time nothing less than extirpation
can be of use.
Professor Nuck, in his _Tractatus de Ductibus Oculorum Aquosis_, p.
120, _& seq._ relates the success he had in curing a young man by five
repeated punctures, and a strict observance in a proper use of all the
non-naturals.