When violent pains in the eyes take place, consider from what diathesis
the eye happens to be pained in the inflammations; for they are either
occasioned by the pungency of an acrid defluxion, or from the coats being
over filled and stretched, or from the distension of thick humours or of
flatulent spirits. When the pains proceed from pungency, they are to be
cured by evacuating with purgatives, and by injecting into the eye the
white of an egg. When the inflammation is concocted, if the body be free
of impurities, the most befitting remedies are baths. Inflammations from
plethora are to be cured by the detraction of blood, purging the belly,
and applying friction to the inferior extremities. Those from distension
are to be cured by first evacuating the whole body, then by occasioning
a revulsion downwards of the humours, and afterwards by using topical
applications of a discutient nature. The eyes must be fomented, and the
decoction of fenugreek poured into them. When the vessels of the eye are
distended with thick blood, while there is no plethoric diathesis in
the general system, the patient must drink wine which has the power of
heating, evacuating, and removing obstructions.
_On disorder of the eye, and particularly of ophthalmy._ Disorder of
the eye is a wateriness and heat of it, with preternatural redness, not
occasioned by any cause within the body, but by some external one, such
as the sun, smoke, dust, or the wind; wherefore it is soon dispelled when
the cause is removed. And ophthalmy is a marked disorder, which may be
occasioned not only by an external cause, but also without any obvious
one, and remains until the third, fourth, or fifth day. It is best cured
by avoiding every external exciting cause, by spare diet, drinking water,
walking, and by opening the belly.
_On inflammation._ When inflammation remains in the eyes after evacuation
of the general system, we may use ointments for dispelling the rheum,
and soothing the irritation, such as the collyrium of Nilus made from
roses, the chiac, or the collyrium from nard. When the tunica adnata
is inflamed, we may use the collyria called monhemera, injecting them
into the eye with the white of an egg. Next day, if the inflammation
be not aggravated, we may anoint them with the collyrium of nard, and
use a fomentation of the decoction of melilot and fenugreek. When the
humour which occasions the ophthalmy is thick, we may use medicines which
are neither obstruents nor incrassants, but which, on the contrary,
will dissipate, dilute, and evacuate the humours, such as the chiac
collyrium. But, if the humours are impacted in the head, we may fix a
cupping instrument to the hind head, or scarify, or apply leeches to
the forehead, near the eye affected. We must use cataplasms of pure
bread soaked in water, with a little rose-oil, or polenta boiled in the
decoction of poppy-heads also with rose-oil. We may also use a more
efficacious cataplasm from saffron, melilot, the fleshy parts of dates,
the tender leaves of coriander, eggs, and roasted wheat and crumbs of
bread dipped in a decoction with a small quantity of rose oil, in a
decoction of pounded poppy heads. We mix also the seed of the poppy as an
anodyne. If compelled by the severity of the pain, we must add a little
opium; but, unless the pain be very violent, we must abstain from all
narcotics. If the inflammation be moderate, apply aloes by itself, or rub
it in with water or the white of an egg. In order that the remedy may be
ready for use, take of saffron, dr. vj; of aloes, dr. xvj; of gum, dr.
ix; mix with rain water, and make a collyrium. And the saffron collyria,
as they are called, are proper for the commencement of ophthalmies. In
those cases in which there is an œdematous and white swelling about
the eyebrows and tunica adnata, without injury of the coats, the best
applications are those called liquid collyria, prepared from saffron,
copperas, and honey. And this one is excellent:
_A liquid anodyne collyrium._ Of the melanteria used by tanners, of Attic
honey, of the juice of fenugreek, equal parts. Boil to the thickness
of honey, and touch the two angles of the eye with it, by means of the
rounded extremity of a specillum or probe.
_For a copious defluxion._ For a flow of humours, in the commencement
abstinence from food is proper, and the drinking of water, and most
especially abstinence from venery; the belly should be opened, and the
face washed with a watery oxycrate, if the rheum be of a hot nature; but
if otherwise, the forehead and eyebrows may be anointed with copperas
and honey. Some dissolve the copperas in water, and bathe with it. In
defluxions without inflammation, or with inflammation, but so that
the affection is seated above the skull, we must use agglutinative
applications to the forehead, either simple ones, such as green vine
leaves, or the juice of the bramble, or of purslain, or of quinces with
some fine polenta, or with gall levigated in wine, or with fine polenta
or hemlock, or flea-wort with water, or nightshade, or snails with their
shells pulverized, and applied from temple to temple, and, in a word,
with things of an astringent and cooling nature, or with the following
compound applications: Wheat flour, and myrrh or frankincense, with the
white of an egg, may be rubbed in; or Samian earth, with myrrh and manna,
in like manner, with the white of an egg; but in colder defluxions, of
native sulphur, of bitumen, of pitch, of colophonian rosin, of each,
dr. ij; also the trochisk of Musa, that called aster, and the like, are
suitable repellents. And the theriac, dissolved in an astringent wine,
and rubbed on the forehead, stops cold defluxions, and may be drunk with
great advantage. Over the eye apply wool, or a small rag wet in the
white of an egg; and new-made cheese, in like manner, when applied to
the eye, restrains acrid defluxions in particular; also the astringent
collyria, as they are called, when rubbed in or injected into the eye
in a watery state, do the same thing. But if the humour be deep-seated,
and below the skull, and if fixed there for a length of time, after the
general evacuations use errhines and masticatories, shaving the head, and
applying rubefacients to it. But to these must be joined the surgical
operations for the head, namely, Angiology, Arteriotomy, Hypospathismus,
and Periscyphismus, with burning at the vertex down to the bone. But
cupping instruments, with scarifications applied to the hind-head, will
produce a revulsion of the defluxion. The symptoms of defluxions external
to the skull are distension of the vessels of the forehead and temples,
forming, as it were, a band to the head, and the complaint being remedied
by agglutinative applications of a desiccant nature. When these symptoms
are not present, and the defluxion proves of long duration, and sometimes
is exasperated by sternutatories, the humour is to be supposed seated
below the skull.
_On chemosis._ The disease is called chemosis when both the eyelids are
everted in consequence of a violent inflammation, so that the eyes are
scarcely covered by them, and the white of the eye is elevated above the
black, is red, and occupies a large portion of the black. We must cure it
by phlebotomy, purging, the white collyrium of roses, and the spodiac,
with milk, or the white of an egg, and we may anoint the eyelids,
temples, and forehead with the same, and have recourse to paregoric
fomentations and cataplasms. When the inflammation begins to remit, we
may rub in the more acrid applications, such as the green one from roses.
_On hyposphagma and emphysema._ Hyposphagma is a rupture of the veins
of the tunica adnata, occasioned most frequently by a blow. Bathe the
eyes with the blood of the wood-pigeon, or of the common pigeon, or the
warm milk of a woman in which a little frankincense has been triturated,
and inject brine, more particularly that from Cappadocian salts, and
use a fomentation from the decoction of hyssop. Swellings about the
eyes from blows are remedied by repeated fomentations with oxycrate, or
a sponge out of oxycrate may be applied to them, or a liniment may be
used, consisting of equal parts of burnt lapis specularis, and pigeon’s
dung, triturated with wine or vinegar. Or a cataplasm may be applied of
new cheese, or of the rind of radishes, or of dried grapes without the
stones. Each of these is to be mixed with oxycrate or honied water. The
same remedies apply also to emphysema.
_On prurient emphysema and psorophthalmia._ Emphysema is an œdematous
swelling of the eyelids; but psorophthalmia is a scabious eruption of
the eyelids attended with pruritus, arising from a saltish and nitrous
humour. They are remedied by oxycrate, the decoction of lentils, and a
fomentation of roses. The following is a liquid collyrium: Of copper,
dr. vj; of calcined misy, and myrrh, of each, dr. iij; of saffron, dr.
iss; of pepper, dr. j; of Chian wine, and Cretan sweet wine, of each
1½ cyathus; boil to the thickness of honey. This is the collyrium of
Erasistratus called panchrestos, which applies to cynanche, ulcers in the
mouth, and on the privy parts, and to the earache. They are to be rubbed
with oil into the patient’s eyebrows when he is going to sleep. Acid,
saltish, and acrid things are to be abstained from.
_On sclerophthalmia and xerophthalmia._ Sclerophthalmia is a hardness of
the eye with difficulty of motion, pain, and redness, without wateriness.
For this the eyes are to be fomented frequently with sponges out of hot
water; and at bedtime the white of an egg with rose-oil, or the fat of
geese, may be applied to the eyelids. Let them avoid everything of a
cooling and hardening nature; let the head be covered and anointed, and
the belly kept open. Xerophthalmia is a pruriginous affection of the eyes
without rheum. It is to be cured by baths, unguents, and a wholesome
diet. Applications of an acrid nature are suitable to both, as they
promote a flow of tears, by which the hardness will be softened, and the
dryness rendered more humid. Such are the panchrestos of Erasistratus,
and those called dicenteton and stratioticum.
_On ectropion, or eversion of the eyelids._ This complaint is an eversion
of the eyelid, occasioned either by a scar or fungous flesh. When it
is occasioned by fungous flesh, and is of long duration, roast scraped
verdigris, pulverise it and apply, or use burned lead washed with sulphur
vivum, or apply both in equal parts, namely, the verdigris and the lead.
Ectropion from a cicatrix, if at all remediable, must be cured by a
surgical operation.
_On ægilops and anchilops._ Ægilops is an aposteme between the great
canthus of the eye and the nose, which breaking and being neglected, ends
in a fistula that extends to the bone. Before the aposteme breaks out
into an ulcer, it is called anchilops. A very good application is horned
poppy and saffron, applied with the juice of perdicias (_pellitory of
the wall?_) They must be frequently changed, and till then it will not
turn to pus.—_Another_: Alica, boiled in vinegar and properly triturated,
not only cures the disease at the commencement, but, after suppuration,
it bursts the abscess and penetrates to the bone. By using it, you may
cure not only ægilops but anchilops.—_Another_: Garden rue, levigated and
boiled with protostactos and applied, answers excellently for ægilops,
penetrates to the bone, proving stimulating at first, but afterwards not
so; and, what is wonderful, it does not leave an ugly scar.—_Another_:
Pulverize snails with their shells and apply them; and sometimes aloes or
myrrh may be added before the ægilops is converted to pus; and after the
abscess bursts it dries up the pus.
_On trachoma._ Trachoma is a roughness of the inner surface of the
eyelid, an intense degree of which has the appearance of clefts, and
is called sycosis. When it becomes chronic and callous, it is called
tylosis. We must use collyria for it, namely, the one from wine, and
that prepared from the two stones; or the eyelid may be rubbed with the
bloodstone itself (hæmatites,) much washed in water. But the collyrium
called harmation, with a little of the cycnarius, or the saffron
collyrium, answer well with these, and with cases of psorophthalmia
without ulceration, when rubbed upon the everted eyelid. But if the
callus be hard and do not yield to these things, we must turn the eyelid
out and rub it down with pumice-stone, or the shell of the cuttle-fish,
or fig-leaves, or by the surgical instrument called blepharoxyston.
_On chalazion._ Chalazion is a concretion of an indolent humour in the
eyelid, for which pound ammoniac with vinegar, and anoint along with
galbanum. It likewise has a good effect when joined with cerate and
turpentine.
_On hordeolum, or stye._ Hordeolum is a small oblong aposteme on the
tarsus of the eyelid. We may foment it with white wax; or throwing away
the head of a fly, we may rub the part with the rest of its body; or wash
with the decoction of barley.
_For lice in the eyebrows._ Having first cleared away the pediculi, wash
the part with tepid sea-water, and use the under-mentioned application
to the tarsus: Of fissile alum, two parts; of stavesacre, one part;
triturate, and use.
_On madarosis, or milphosis._ This affection is a falling off of the
hairs of the eyelids. Wherefore, after attending to the general health,
use the detergent ointments called calliblephara. Of Cannel-coal, of
Celtic saffron, of ladanum, equal parts; pulverize, and use.—_Another_:
Of antimony, calcined and cleaned, dr. j; of lead, burned and cleaned,
dr. iv; of saffron, dr. iv; of Indian nard, dr. iij; pulverize, and
use.—_Another_: Of the burnt bones of dates, dr. iij; of Celtic nard, dr.
ij; pulverize, and use. This also cures scabious eyes.
_That of Neopolites for milphosis and chronic affections of the eyelids._
Of antimony, of cadmia, of chalcitis, of foreign misy, of each, equal
parts; beat together coarsely, mix with honey; when roasted, triturate,
and use.
_On ptillosis._ Ptillosis is a callous thickening of the eyelids, of
a red colour, and often accompanied with a falling out of the hair.
In addition to those already mentioned, the following is an excellent
application: Rub with mice dung burnt, and triturated in honey.
_For a falling off of the hairs of the eyebrows._ Anointing the
fingers with oil, or geese fat, rub them upon lead, and anoint with
this.—_Another_, which also darkens the hairs: Triturate blunt Pontic
walnuts with the fat of goats or of bears.—_Another_, which also applies
to alopecia of the chin: Of henbane, dr. ij; of mice dung, dr. j; of
maiden-hair, dr. j; of the ointment of iris, four spoonfuls. Pound well
together, mix the ointment, and, having first fomented, anoint. If you
previously shave the part, it will be the more efficacious.
_For trichiasis of the eyelids._ Having first torn out the hairs which
irritate the eye, anoint the part immediately with the blood of a frog by
itself, or with the ashes of white chameleon, or the blood of bugs; or
the juice of the fumitory, which grows among barley, mixing it with gum,
or the ashes of pickled limpets with cedar rosin (_gum vernix?_), or the
ashes of the lotos; or liquid alum, called _phorimum_; or the blood of a
tick taken from a dog. It is very efficacious.
_Agglutinative medicines._ The following substances agglutinate the
hairs when bent inwards: Bitumen, mastich, colophonian rosin, glue, the
glutinous part of snails.
_On encanthis and rhyas._ Encanthis is an excrescence of the natural
flesh at the great canthus, but rhyas is a wasting of it. You may treat
encanthis with the remedies mentioned for ectropion, and similar caustic,
or septic applications; but the whole substance must not be consumed,
lest rhyas be produced, for it must only be reduced to its natural size.
Rhyas, when the whole flesh is consumed, either by an awkward surgical
operation or medicines, is incurable. But if part of it only be lost, you
may restore it by moderately astringent and incarnating applications,
such as that from saffron, horned poppy, and aloes; and the saffron
collyria, and henbane boiled in wine and applied, and a small quantity of
alum with wine.
_On ulcers._ Of the ulcers in the eyes there is but one genus, but many
particular species. For that in the cornea, when hollow, narrow, and
clean, is called bothrion. That which is broader than the bothrion, but
less deep, is called cœloma. Argemon is the name given to that which
arises on the circle of the iris, but affects the surrounding parts, so
that the part which is on the external side of the iris is red, but that
on the internal white. Epicauma is a foul and impure ulcer with eschars,
which, when cleaned away, often give vent to the humours of the eye.
There are many other varieties of ulcers, all of which we shall treat
of in general terms. If, therefore, the ulcer happen to be attended
with inflammation, the cure must be accomplished by such things as are
calculated to soothe and digest the inflammation, regard being had to the
peculiar nature of the ulcer. Such are the collyria, called _libanium_,
_cycnos_, and _palaria_, _aster_, and the like; and those from starch,
Samian earth, and ceruse. But the most sedative collyrium which we are
acquainted with is that of Nilamon; and yet we must not persevere long
with it, because it is very narcotic. The best of all applications is
the collyrium from decoctions not possessed of a narcotic quality. But
if the ulcer be attended with a rheum, we must mix some of the collyria
for it, such as that from the _hydra_, the _chiac_, the yellow _cycnos_,
and such as possess repellent properties without being stimulant. When
the ulcers are foul, we must use honied water moderately diluted, and
the decoction of fenugreek, by themselves, and along with the collyria
for that purpose; when they are acrid, we may use that of Severianus
with the diachylon from fenugreek; when not acrid, those from myrrh and
nard. When the ulcers are cleaned, they may be cicatrized by means of the
collyrium called _cleon_, in addition to which it will render the scar of
the same colour.
_On procidentia._ Procidentia is a projection of the coat called uva
(_iris?_), formed by an ulceration or rupture of the cornea. When,
therefore, it is small, so as to resemble the head of a fly, it is called
myocephalon. When it increases more, so as to resemble a grape-stone, it
is called staphyloma; when it advances far forward, so as to protrude
between the eyelids, it is called melon; and if it has become callous,
it is called clavus. If, therefore, the projection is small, like the
head of a fly, we must use repellent and astringent applications, such
as the chian, that called _fuscum_, the _nard_, and the _theodotian_,
and those from olive leaves, and from horn. And we must bind upon them
without pressure a piece of sponge which has been soaked in oxycrate,
or astringent wine, or the decoction of roses, or the compress called
splenium may be used. The best application for procidentia, and all
ulcers of the eye, is the collyrium called _olympiac_ or _olympus_, with
the juice of olive, or of knot-grass, or of poley. The same things are
applicable to clavus and staphyloma, before they whiten; for after they
become white and callous, they are incurable.
_On hypopyon._ Hypopyon occurs occasionally in the cornea, being
sometimes deeply seated, and sometimes more superficially, the matter
assuming the shape of a nail, and hence the affection has got the name
of onyx. The indication of cure is either to dispel the pus by remedies
possessing this property in a moderate degree, such as honied-water, and
the juice of fenugreek, and the collyria formed from it, the libyanum,
and those from frankincense; or to make it burst, and cleanse the ulcer
by means of the more potent remedies, such as those called _diasmyrna_
and the _hygidian_. For cases of hypopyon without ulceration one may use
the following liquid collyrium: Of copperas, and of saffron, of each,
dr. viij; of myrrh, dr. iv; of honey, lb. j. The phlyctæna, which is an
elevation of the cornea, by a certain humour corroding its fibres, yields
to the same treatment as hypopyon.
_The liquid collyria of Bassus for hypopyon._ Of saffron, of aloes, and
of myrrh, of each, oz. j; of wine, oz. iij; of the finest honey, oz.
vj. The saffron is to be levigated with a small quantity of the wine,
then with the aloes and myrrh; and when it thickens, add the honey, and
having mixed together, lay up in a glass vessel, and use twice a day, or,
if the case be urgent, three times. It at the same time cleanses the eye
and proves incarnating and cicatrizing.
_On cicatrices and leucomata._ Superficial scars on the eye are called
by some cicatrices, and by others nebulæ; but the more deeply seated are
called leucomata. The proper remedies for them are those of a detergent
and cleansing nature. Wherefore, nebulæ may be cleansed by the juice of
anemone, and that of the small centaury, with honey; but the more chronic
are reduced by cedar gum, or by copper alone levigated with water for a
collyrium, and by the cleansing collyria, such as that from hartshorn,
and those called _rhinarian_, _hecatombe_, and the like. Leucomata may be
cleared away by nitre carefully levigated with some old oil, and properly
smeared upon them, and by the shell of the cuttle-fish (_sepia_) burnt
and pounded finely with honey. Among the collyria, the following one
proves an excellent and mild detergent: Of mamira, of ammoniac perfume,
of Troglodytic myrrh, of crocodile’s dung, equal parts; make a collyrium,
and use. Levigate the dung of the land crocodile with water, and
anoint, having formed it into a collyrium. You may also succeed well by
dissolving Cappadocian salts in water, and then dissolving the collyria
for leucoma in it, and injecting it.
_Dyes for cicatrices._ Of galls and acacia, of each dr. iv; of copperas,
dr. ij; use. The following is a collyrium: Of the flowers of the
pomegranate, of copperas, of acacia, of gum, of each dr. iv; of antimony
and galls, of each dr. ij; triturate with water. When the flowers of the
pomegranate are not at hand, you may use the internal membrane between
the seeds.
_On pterygium._ Pterygium is a nervous (membranous?) excrescence of the
tunica adnata, arising at the angle of the eye, and advancing to the
corona. When it increases greatly, it covers the pupil itself. Wherefore,
large and chronic pterygia can only be extirpated by a surgical
operation. But the smaller and more recent ones may be worn down by the
abstergent applications, such as those used for trachoma and leucoma.
Among the simple remedies are burnt copper, and copperas with the gall
of swine, which answer well. The following is a more potent remedy: Of
copperas, p. i, of gum, p. ss.; triturate with wine, and anoint, or form
into collyria. Some mix the gall of a goat with honey, and anoint with it.
_For pterygium, hypopyon, and dimness of vision._ (From Oribasius.) Of
the magnet-stone, of scraped verdigris (xyston), of reddle, of ammoniac
perfume, of each dr. iv; of saffron, dr. ij; of Attic honey half a
spoonful. It also answers for leucoma.
_For carbuncle and carcinoma._ Carcinoma is an affection of the cornea,
attended with pain, distension, redness of the tunics, and pungent agony,
extending to the temples, more particularly if shaken. They loathe
their food, and have the pain increased by acrid things. The affection
is incurable, but may be alleviated by a milk-diet, farinaceous and
otherwise wholesome food, devoid of all acrimony; and the injection of
soothing collyria, such as the Spodiac, Severianum, and the like. We must
previously attend that the general system be in a proper temperament.
Carbuncle also is a malignant ulcer of the sloughy kind, forming
sometimes in the ball of the eye, sometimes in the eyelid, as in the
other parts of the body. In cases of carbuncle of the ball of the eye,
we must first evacuate with a clyster, and then purge moderately with
boiled milk, afterwards foment with a sponge, and apply a cataplasm of
the flour of tares, or of wheat boiled in honied water, or sometimes we
may add pounded iris, and wash the eye with milk. If the ulcer spread,
we may apply a cataplasm of lentils with honey or boiled quinces: if
it continue spreading, we may use the boiled leaves of the olive, the
rind of the pomegranate boiled in wine and pounded with honey. When the
ulceration stops, and the eschar falls off by the application of the
medicine about to be described, and the ulcers have become clean, we may
apply a cataplasm of the roasted yelks of eggs, triturated with saffron
and honey, until the ulcer is healed. The medicine is this: Of spodium,
dr. iv; of myrrh not much toasted, dr. iij, and oboli iij; triturate in
Aminæan wine until it become dry, mix old Cretan sweet wine, and having
triturated, lay up the liquid in an earthen vessel, and anoint with it.
For carbuncles of the eyelids, having cut an acid pomegranate, boil it
whole in vinegar, and, when softened, pound and put it into a linen
cloth, and use. Change twice or thrice during the day, and once during
the night.
_On mydriasis._ When the pupil does not appear changed in colour, but
much wider than natural, and when it sometimes wholly impairs the
vision, and sometimes nearly so, and when every object appears smaller,
the affection is called mydriasis. The cause of it is some redundant
humour. We must cure it by bleeding from the arm, or purging; but, if
not, by dividing the veins in the angles of the eye, and then applying a
cupping instrument to the back part of the head, and bathing the face and
eyes with sea-water, or, if it be not at hand, with brine or oxycrate. We
must also use the remedies which are applicable to phyletænæ or blisters.
_On phthisis and atrophy._ Phthisis is an affection of the pupil,
which is contracted, and appears duller and more rugose than usual,
but objects seem larger than natural. The cause of it is condensation,
mostly occasioned by dryness. Phthisis differs from atrophy in this, that
phthisis renders the pupil contracted, whereas in atrophy the whole eye
is smaller and more depressed. We may cure them by exercise, and rubbing
carefully the head, the face, and the eyes; by bathing the face with
water, and anointing the head with some healing ointment; and smearing
the eyes with an attenuant and acrid composition, such as the following:
Of ammoniac, dr. j; of crocomagma, dr. iv; of saffron, dr. ij; of
verdigris, dr. j. Triturate in water, form and use.
_For nyctalopia._ In the disease called nyctalopia, the patient sees
during the day, but at sunset his vision becomes dimmer, and when night
comes on he does not see at all. We must effect the cure by bleeding
from the arm and the angle of the eye, then purging or evacuating by a
clyster, and afterwards ordering masticatories or sternutatories. Before
food, we give hyssop to drink, or rue; but, if the disease do not yield,
we must again administer the purgative medicine formed from scammony,
and castor, anoint with clarified honey, and make the patient shut his
eyelids, so as to retain the liquid application. Or of burnt alum, p. ij;
of fossile salt, p. j; triturate with honey and anoint.—_Another_: Having
roasted the liver of a goat, collect the ichor during the roasting and
anoint, but give the liver itself to eat; or boil, and direct the vapours
to be received with open eyes.
_For glaucoma and suffusion._ (From Ruffus.) The ancients considered
glaucoma and suffusion as the same disease; but by their successors
glaucoma has been accounted an affection of the crystalline humour,
which is changed by a watery substance to a cerulean colour; but
suffusion is reckoned a defluxion of humours concreted between the cornea
and the crystalline lens. Glaucoma is in every case incurable. Suffusion
may indeed be cured, but not always. We may try to cure suffusion before
the disease is completely formed, by taking blood from the arm, by
purging and acrid clysters, such as those made from the decoction of
centaury, or of the bitter cucumber, and by keeping the bowels for some
time in a loose state. Cupping instruments with scarifications may be
applied to the hind-head; the patient must drink water during the whole
regimen, take attenuant food, and, in process of time, masticatories may
be used for a few days with advantage. When the vision is depraved, as,
for example, gnats appearing before the eyes, which case proceeds from a
cacochymy or from bilious vapours ascending to the head, we may give for
a time the bitter medicine from aloes, or purge with it. To the eyes we
must make applications at first simple, such as honey and oil, with the
juice of fennel, and afterwards compound, such as this: Of sagapene, dr.
ij; of Cyrenaic juice, of white hellebore, of each, dr. vj; triturate
with eight heminæ of honey. We, says Oribasius, use the following
medicine: Of the juice of wild carrots, of germander, of cresses, of
each, equal parts; triturate. The following collyria are beneficial,
namely, that from the juice of the fennel, that called _proteus_, the
_thalasseros_ and that from opobalsam. The collyria prepared from them
are useful, and the decoction of fennel in the commencement answers well
as a fomentation, and that from juices, opobalsam, honey, old oil, and
the like.
_On amaurosis and dimness of sight._ Amaurosis is, for the most part, a
complete impediment of the sight without any apparent affection about the
eye; and dimness of sight is an imperfection of vision arising without
any sensible cause. The same mode of cure as that described for suffusion
applies generally in this case; but, in particular, blood may be
abstracted from the corners of the eye, leeches applied to the temples,
and friction of the extremities. In process of time we must have recourse
to sternutatories, emetics with an empty stomach, and the application of
ointments, at first with equal parts of honey and oil, and afterwards
with the under-mentioned composition: Of saffron, two oboli; of the gall
of the hyæna, dr. j; of common pepper, eighty-five grains; of fennel
juice, dr. xvj; of ammoniac perfume, dr. j. Triturate the dry substances
with the juice, add four spoonfuls of honey, prepare and lay up in a
copper vessel for use. Before using, let him foment the eyes by immersing
them in hot sea-water.
_On strabismus, or squinting._ Congenital squinting is cured by the
application of a mask, so that the children are compelled to look
straight forwards; for strabismus is a spasmodic affection of the muscles
which move the ball of the eye. And the lamp should be placed fairly
opposite, and not so as to shine obliquely. When the eye is turned to
the nose, purple flocks of wool should be fastened to the outer angle of
the eye, so that by looking steadily at them, the persons affected may
correct the state of the eyes.
_On ecpiesmus._ The eyes are sometimes forced out, so as to remain
prominent. When this happens from strangulation, we must let blood
from the arm; but if otherwise, we must purge with black hellebore or
scammony. When the eyes become prominent from the pain of labour, the
complaint is often removed by the cleansing after parturition; hence we
ought to promote it; and, in men, after phlebotomy, if it do not abate,
we may affix a cupping instrument to the back part of the head, and apply
wool smeared with honey, or flocks of it with water, and bind a compress
gently above it. Cold salt water poured upon the face is likewise
suitable to them, and also the juice of endive and knot-grass, rubbed in
with the juice of poppy, and whatever else can repress and contract.
_On synchysis, or confusion._ Confusion of the sight occasioned by a blow
may be cured by bleeding from the arm, and by filling the whole eye with
the blood of a newly-slaughtered animal, of a turtle in particular, but,
if not, of a pigeon, and then applying soft wool which has been immersed
in an egg beaten up with wine and rose-oil, and binding it on the place.
The same thing is to be done next day; and on the third, it is to be
fomented, washed with milk, and suitable cataplasms applied; after which
it is to be anointed with the remedies for old affections, such as Chiac.
_For myopia._ Those persons are called myopes, or near-sighted, who, from
their births, see near objects, but not those at a distance. Such a state
is wholly incurable, being occasioned by a weakness of the optic spirit.
Old men are affected in the opposite manner to these, for they do not
perceive near objects, but see those at a distance.
* * * * *
COMMENTARY. See Hippocrates (Aphoris., de Visu, et alibi); Galen (de Loc.
Aff. iv, de Med. Sec. Loc. iv); Aëtius (vii); Alexander (ii); Oribasius
(Synops. viii); Actuarius (Meth. Med. iv, 11); Leo (iii); Psellus (Opus
Medicum); Palladius (Comment. in Hippocrat. Epidem.); Scribonius Largus;
Octavius Horatianus (i, 10); Nonnus (Epit. 45); Serapion (ii); Avicenna
(iii, 3, 1, 2); Mesue (de Ægrit. Ocul.); Avenzoar (i, 7); Haly Abbas
(Theor. ix, 13, Pract. v, 34); Alsaharavius (Pract. iv); Rhases (Divis.,
ad Mansor. ix, and Contin. ii); Canamusali (de Oculis, vi); Jesu Haly
(Tract. de Oculis.)
_On pain, disorder of the eye, ophthalmy, inflammation, and defluxion._
The ancients treat of these complaints separately; but, as they are so
nearly connected, we shall class them together. By disorder of the eye
(_taraxis_), they meant an inferior degree of ophthalmy, as is remarked
by Turnebus. (Bernard’s Nonnus, 45.) It is, therefore, the mild acute
ophthalmy of Scarpa. The remedies enumerated by Hippocrates for pains of
the eyes are thus given in the language of Celsus: “Sanguinis detractio,
medicamentum, balneum, vinum.” Drinking wine might appear to us at first
sight not a very likely mode of curing ophthalmies; and yet Galen, in
his Commentary on this Aphorism (vi, 31), has related a case in which
it effected a cure after every other remedy had failed. Even Scarpa
allows the correctness of the aphorism as a rule of practice, and states
that wine and the cold bath are proper when the disease is kept up by
excessive irritability. Alexander recommends wine and the tepid bath
when the inflammation arises from thick and pituitous blood. Philagrius,
as quoted by Theophilus in his ‘Scholia on Hippocrates,’ indicates
that the wine should be white, sweet, new, and if the patient’s head
be delicate, diluted with water. (See further, t. ii, 501, ed. Dietz.)
Mesue makes many interesting remarks upon the above-mentioned remedies of
Hippocrates. For further explanation of the rationale of this practice,
see Schelhammer (de Tumoribus), and Littré (Hippocrat. t. iv, 418.)
Another of Hippocrates’ aphorisms is, that a spontaneous diarrhœa is
a favorable occurrence in ophthalmy; upon which Galen remarks, that,
in imitation of nature’s method of removing the complaint, physicians
are in the practice of producing an artificial looseness by means of
cathartics and clysters. Lead is an ingredient in several of Alexander’s
collyria. For periodical ophthalmy, Hippocrates recommends purging the
head and bowels; and in certain cases bleeding, cupping, and restricted
diet. Celsus, Galen, and, in short, most of the ancient authorities make
mention of narcotics, such as opium and mandragora, but do not approve
of them as common remedies. Galen, however, instances ophthalmy as one
of the species of inflammation in which opium is admissible. (De Optima
Secta, 9.) Alexander, in like manner, cautions against the indiscriminate
use of opium to lull the pain. Some of his prescriptions for collyria,
however, contain opium. Galen recommends scarifications in chronic
defluxions of the eye. Aëtius lays down very proper rules respecting
purging, fomentations, venesection, and baths. He properly remarks
regarding the use of wine, that it is only applicable when the patient
is of a dry and cold intemperament. Celsus is a decided advocate for
fomentations with hot water in all cases of ophthalmy.
The Arabians treat ophthalmy upon the same principles as the Greeks,
without supplying much additional information. Mesue, like our author,
recommends bleeding by opening the temporal artery, which operation he
describes minutely. When the bleeding cannot be stopped otherwise, he
directs us to secure the vessel with a silk thread. He also makes mention
of leeching and the actual cautery. He is very minute in his directions
about his collyria. One of his anodyne collyria consists of the juice of
hyoscyamus, mandragora, and opium; and another contains camphor, saffron,
hyoscyamus, and the like. The use of narcotics, however, is forbid by
Jesu Haly. Rhases also rather disapproves of them. Avicenna makes mention
of bleeding by the temporal arteries, the angular vein of the nose, and
the frontal. When the usual remedies do not succeed, he approves of the
cautery; and, in certain cases, recommends strongly the use of stimulant
applications, such as æs ustum, copperas, and arsenic. Galen, in like
manner, makes mention of arsenic, and also of misy, sori, and chalcitis
(substances resembling our sulphate of copper) among his remedies for
diseases of the eye. Having ourselves had occasion to use arsenic in
certain malignant diseases of the eyelids, and not having found that it
produced any serious disorder in the ball of the eye, we would call the
attention of modern oculists to this medicine as one from which, when
properly managed, the best results may be expected. When the ophthalmy is
of a cold nature, Avicenna approves of treating it by an attenuant diet,
the bath, and white wine. In certain cases he directs us to pour cold
water on the head. Haly Abbas describes three varieties of ophthalmy. The
first arises from manifest causes, such as the sun, dust, and the like;
and is to be cured by bleeding, purging, and cooling lotions, containing
rose-oil, camphor, &c. In the second, the symptoms are more severe,
being attended with greater redness and pain. It also is to be cured by
bleeding, cupping, and emollient collyria. The third variety is chemosis.
Alsaharavius treats of the disease at great length. When it is connected
with a bilious cause, he directs us to purge, use the bath, apply vapours
to the eye, and soothing collyria. Serapion, like Haly, describes three
varieties of the disease by the names of _tarkinisis_, _noutelinie_,
and _kermufil_. Jesu Haly recommends general bleeding, purging, and
fomentations, with the decoctions of fenugreek and fennel, for ophthalmy.
It remains to be mentioned that Galen, Alexander Aphrodisiensis, and all
the Arabian authorities have placed ophthalmy in the list of contagious
diseases. See, in particular, Alex. Aph. (Prob. i, 35), and our brief
sketch of the history of ancient opinions on contagion in the Second
Book, Sect. XXXVI. The celebrated Fracastorius confidently maintains that
ophthalmy is contagious. (De Morb. Contag.) And we may further mention
that all the authorities of the middle ages speak of ophthalmy as being
contagious.
_On chemosis._ By chemosis, modern oculists (as, for example, Scarpa)
understand that state of ophthalmy when blood, owing to a rupture of one
or more vessels, is effused into the cellular membrane which connects
the conjunctiva to the anterior hemisphere of the eye. Our author’s
account is mostly taken from Oribasius, who, in his turn, borrows from
Demosthenes. Galen and Octavius Horatianus, without saying anything of
the general treatment, merely recommend us to apply upon a clean linen
cloth flies pounded with the yelk of an egg. Chemosis is Haly’s third
variety of ophthalmy, for which he recommends copious and repeated
bleeding, cupping, gentle laxatives, cataplasms containing poppies when
the pain is violent, and other soothing collyria. Alsaharavius, in like
manner, recommends depletion and emollient fomentations. Serapion, among
other things, mentions soothing fomentations. In chemosis, according
to Rhases, all the symptoms of ophthalmy are particularly strong and
violent; the eyelids being swelled and everted, and the white of the eye
appearing black. He recommends local and general bleeding, purging, and
astringent applications.
_On hyposphagma and emphysema._ Hyposphagma is not described by any
particular name in modern surgical works. Besides the local applications
mentioned by our author, Aëtius properly recommends general treatment,
we mean bleeding, purging, and the like. Avicenna also makes mention
of venesection and arteriotomy. Haly describes the disease by the name
of _tumor oculi_ as his first variety of _inflatio_. Alsaharavius uses
the same term. Serapion treats of it by the name of _sanguis divisus in
oculo_, recommending treatment similar to our author’s. See also Celsus
(vi, 6.)
The emphysema appears to have been a sort of œdema seated below the
eyelid. Aëtius remarks that it occurs principally in old men. We have
often seen it in them. He recommends fomentations by means of a sponge,
rubbing the eyelid within with honey, pouring hot water on the head,
using baths, drinking wine, and even bleeding at the arm. This last
measure is omitted by our author, and must be unnecessary in general. It
is described by Haly Abbas as his second variety of _inflatio oculi_. He
says it is an œdematous swelling principally affecting old men in summer.
He recommends collyria of a sharp penetrating nature, and various other
applications.
_On psorophthalmia, sclerophthalmia, and xerophthalmia._ For these
affections Aëtius gives various prescriptions containing calamine, burnt
copper, chalcitis, and the like. Similar ones may be found in Galen (sec.
loc.) Galen, like our author, recommends fomentations, by means of a
sponge, with hot water or the decoction of poppies. One of Alexander’s
prescriptions for psorophthalmia contains arsenic. Celsus describes the
symptoms and treatment of xerophthalmia very minutely: “Neque tument,
neque fluunt oculi, sed rubent tantum, et cum dolore quodam graves
sunt, et noctu præ gravi pituita inhærescunt.” He gives the sum of
his treatment in this short sentence: “In hoc vitio multum ambulare,
multum exerceri, lavari sæpe, ibique desudare, multâque frictione uti
necessarium est.” He also prescribes gargles, food of a middle quality,
and various compound collyria, such as the rhinion which contained burnt
copper, myrrh, Phrygian stone, &c. This affection, the dry ophthalmy,
had been described by Hippocrates (Aph. iii, 12, 14.) Most probably, as
Sichel suggests, it was the same as the catarrhal ophthalmy. See Littré
(Hippocrat. t. iv, 418.) Celsus recommends this collyrium also for
the psorophthalmia, which he describes by the name of _scabri oculi_.
For this last-mentioned affection he recommends various stimulant
applications; and, when other remedies are not at hand, directs us to
apply bread pounded in wine. The psorophthalmia is the _prurigo oculi_ of
Haly Abbas, for which, among other things, he recommends a composition
containing pepper, sal ammoniac, saffron, spikenard, camphor, &c. He
describes sclerophthalmia by the name of _durities oculi_, and recommends
for it bleeding, gentle purgatives, emollient collyria, &c.
_On ectropion._ Aëtius, in like manner, recommends compositions
containing ærugo æris, misy, and chalcitis. None of the subsequent
authorities supply any additional information. Alsaharavius in particular
gives a very accurate account of the disease, which, when it arises from
a fungous excrescence growing from the inner side of the eyelid, he
directs us to burn with caustics; but, when it arises from a cicatrix, it
is to be cured only by a surgical operation. This will be found described
in the Sixth Book. In place of the caustics recommended by the ancients,
Scarpa directs the argentum nitratum to be applied.
_On ægilops and anchilops._ These are different stages of the disease
now known by the name of fistula lachrymalis. Galen states that at the
commencement it is to be cured by applications which are repellent
without being too stimulant. He gives a full account of the treatment
recommended by Archigenes. The first application mentioned by him is
a cataplasm consisting of tares and honey. Scarpa, by the way, speaks
favorably of the practice of Ægineta, Aëtius, and Avicenna. Avicenna
treats of the disease with great judgment. His first applications
appear to have been intended to produce resolution; and, if these fail,
suppuratives are to be applied. When the abscess bursts, the sore is to
be reduced to a healthy state by escharotic powders containing alum,
limatura æris, sal ammoniac, and the like. When these fail, a surgical
operation must be had recourse to. This is described in the Sixth Book.
Mesue also has treated of the disease at great length. Haly Abbas
describes the disease very correctly. He says, “Aliquando autem ejus
sanies ad nares defluit per foramen quod inter oculum est et nasum.” This
passage puts it beyond a doubt that the ancients were acquainted with
the lachrymal duct. The disease, he says, sometimes occasions caries of
the cartilages (_os unguis?_). When it is recent, he recommends bleeding
and laxatives; and when it gets into a fistulous state, he directs us to
use applications containing arsenic, sal ammoniac, cantharides, alum,
&c. Alsaharavius mentions that the abscess of the lachrymal sack may
either burst outwards or into the nose. It would appear, therefore, that
he also was acquainted with the natural structure of these parts. One of
the applications recommended by Rhases for fistula lachrymalis contains
arsenic, quicklime, and vitriol. Another is prepared from litharge,
arsenic, and oil. These applications are mentioned by the earlier of the
modern authorities on medicine. See Theodoricus (iii, 2.)
The protostactos mentioned by our author was a composition consisting of
potass and lime. (See Book Seventh, _in voce_, κονία.)
_On trachoma._ This affection does not appear to be noticed in our
late treatises on diseases of the eye, and yet in our own practice
we have met with some cases of it. Rowley mentions it as an asperity
of the internal superficies of the eyelid. Celsus describes it by
the name of _aspritudo_. In severe cases, he says, some scarify the
inside of the eyelid with a fig leaf, a rough probe, or a scalpel. But
in ordinary cases, he rather approves of using exercises, frequent
baths, fomentations with hot water, attenuant food, and escharotics,
such as copperas, misy, antimony, and the like. Galen and Aëtius give
prescriptions for various collyria. They consist principally of detergent
and caustic substances, such as sal ammoniac, squama æris, calamine, and
the like. It seems to be the disease which Haly Abbas treats of by the
name of lapidositas. (Pr. v, 51.)
_On chalazion._ We will treat more fully of the nature of this tumour in
our notes on Section XVI of the Sixth Book. It appears to be the species
of encysted tumour said by Scarpa to be well described by M. Aurelius
Severinus. (On Diseases of the Eye, 3.) Rowley describes it as a moveable
tumour in the margin of the eyelids. Aëtius recommends us to open the
tumour with a scalpel, and apply to it escharotics, such as burnt copper,
chalcitis, and red arsenic. By Haly Abbas it is called _grando_, and
the remedy mentioned by our author is recommended by him. Alsaharavius
describes it as a gross humour congealed in one of the eyelids. He
describes by the name of _alsaanac_ a fatty tumour of the eyelids which
we have sometimes met with and extracted. On the chalazion, see Celsus
(vii, 7), and Isidorus (Orig. iv, 8.)
_On hordeolum._ Most of the ancient authors treat of this trifling
complaint in much the same terms as our author. Scarpa evidently is
mistaken in making the hordeolum and chalazion to be the same complaint.
Haly Abbas describes it as being an oblong abscess resembling a grain of
barley on the extremity of the eyelid. He recommends general depletion,
and nearly the same remedies as our author; also a cataplasm of galbanum.
Alsaharavius treats of it in a similar manner. Rhases particularly
recommends melted wax as an application to it. He also speaks favorably
of the diachylon plaster.
_On lice in the eyebrows._ Stavesacre is a very ancient remedy for
pediculi on all parts of the body. Celsus lays down very minute
directions for the constitutional treatment, and recommends a local
application containing sandarach, or the red sulphuret of arsenic.
Avicenna makes mention of sulphurous baths. Haly Abbas recommends general
purging, various stimulant applications, and abstinence from figs. Our
author states, in Section LXXXI of the First Book, that figs engender
lice. Alsaharavius directs the eyebrows to be rubbed with sal ammoniac,
alum, salts, &c. Jesu Haly recommends purging with hiera, the frequent
use of the bath, and applications containing stavesacre, sulphur, alum,
nitre, sal ammoniac, vinegar of squills, and the like. Rhases recommends
a powder containing quicksilver.
_On madarosis, or milphosis, and ptilosis._ Aëtius, Actuarius, and
Nonnus treat of these diseases in similar terms. The calliblephara are
fully described by Galen (sec. loc. iv.) Haly Abbas seems to allude to
these complaints in the following sentence: “Palpebrarum autem casus ex
humiditate fit acutâ aut alopetia, et quidam fit cum palpebrarum grossite
et duritie, ruboreque, et dolore.” His remedies are like our author’s.
The same may be said of Alsaharavius.
_On trichiasis._ Our author’s treatment is mostly imitated from Galen. We
shall treat more fully of the disease in the Sixth Book. Scarpa places
no confidence in the operation of plucking out the hair, and yet it is
favorably spoken of by most of the Greek and Arabian authorities, as,
for example, Aëtius, Avicenna, Alsaharavius, and Haly Abbas; and also by
Rowley, and other modern oculists. Haly, like our author, directs us to
touch the part from which the hair has been plucked with the blood of
a frog, or of a dog’s tick, or with the milk of a fig, or the gall of
a hedgehog. Alsaharavius makes mention of the same remedies, and also
of the mode of treating it by agglutinants. According to Actuarius, the
disease consists in certain of the ciliary hairs being turned inwards and
hurting the eyeball. (ii, 7.)
_On encanthis and rhyas._ Scarpa removes the encanthis by a surgical
operation; but, from our own experience of the effect of septic
medicines, such as arsenic, in similar complaints, we cannot doubt the
propriety of the ancient practice in certain cases. Galen’s applications
contain copperas, misy, sal ammoniac, and the like. Those of Aëtius
are nearly the same. He remarks that seamen are particularly liable to
the complaint. Haly Abbas recommends general evacuation and escharotic
applications.
_On ulcers._ In the description of the ulcers of the eye our author
follows Aëtius. He, however, evidently was much indebted to Galen (sec.
loc. iv.) The Arabians copy from Galen, describing like him seven
varieties of ulcer, which they treat upon general principles. See, in
particular, Haly Abbas (Pract. v, 41.) Opium is one of his medicinal
articles. Ceruse, starch, gum arabic, albumen, &c. also occur. See also
Jesu Haly (ii, 50,) and Rhases (Cont. ii.) Celsus recommends various
compound applications for ulcers of the eye, which he treats of very
minutely.
The collyria mentioned in this section will be found described in the
Seventh Book of this work.
_On procidentia._ Galen correctly describes procidentia as arising from
ulceration of the cornea and protrusion of the iris. (De Diff. Morb.
13.) Aëtius has treated of it with his usual accuracy. He recommends
various escharotic applications containing chalcitis, misy, and the like,
which, when properly managed, may probably have answered the purpose
equally well with the antimonium muriatum and argentum nitratum used by
Scarpa and other modern oculists. Avicenna treats of the complaint like
the Greeks. Some of his compositions contain antimony with ceruse, burnt
lead, and the like. Haly Abbas describes the disease minutely in nearly
the same terms, and recommends nearly the same remedies as our author,
namely, such as are of a repressing nature. He properly remarks that it
is one of the consequences of ulceration of the cornea. Alsaharavius
gives a similar account, and recommends general depletion.
_On hypopyon._ Aëtius gives much more judicious directions for the
treatment of this complaint than our author. He properly recommends
general bloodletting at the commencement, and afterwards local, by means
of leeches and cupping instruments; and then emollient, paregoric, and
discutient applications to the eye. Galen (Meth. Med.) makes mention of
an oculist in his time who effected wonderful cures in this complaint
by shaking the patient’s head. When this does not succeed, Galen
directs us to perforate the coats of the eye, and let out the matter.
(See Book Sixth.) Scarpa does not approve of this practice, unless the
collection of matter be considerable. However, Plempius and most of the
earlier modern authorities in surgery decidedly recommend it. Haly Abbas
recommends a discutient cataplasm containing opopanax, ammoniac, and
fenugreek. Alsaharavius properly directs bleeding and masticatories at
the commencement.
_On leucoma._ Aëtius directs his attention principally to the general
treatment, and properly cautions against the use of strongly stimulant
applications, as they only increase the evil. He allows afterwards
moderately detergent ones, containing verdigris, burnt copper, squama
æris, flos æris, sal ammoniac, and the like. His compositions are taken
for the most part from Galen’s works (de Med. sec. loc. iv.) Aëtius
disapproves of applications for changing the colour of the leucoma.
Alexander recommends the detergent applications mentioned by our author.
Nonnus copies from him. Haly Abbas describes it by the name of _albedo
oculi_, and recommends nearly the same remedies as our author. He
particularly praises green glass finely pulverized, which is still a
popular remedy in Scotland. Alsaharavius makes mention of the juice of
the lesser centaury as an useful application. Scarpa speaks favorably
of this remedy, and further recommends the Sapphirian collyrium, the
ingredients of which are similar to those which entered into the ancient
applications. It consists of a solution of scr. ij of sal ammoniac
and gr. iv of ærugo in oz. viij of aqua calcis, allowed to stand for
twenty-four hours, and then filtered. Rhases recommends an ointment
containing arsenic.
_On pterygium._ Aëtius correctly remarks that pterygium generally begins
from the inner canthus, rarely from the outer, and scarce ever from above
or below. He gives prescriptions for a variety of applications, which,
like our author’s, contain burnt copperas, magnesian stone, sal ammoniac,
and the like. Galen briefly commends the same. Nonnus, Serapion, and
the others approve of this practice. Modern oculists, however, trust to
nothing but the operation, which will be described in the Sixth Book.
Haly Abbas describes the disease very accurately by the name of _ungula_;
and recommends general bleeding, purging, restricted diet, and a variety
of collyria. Alsaharavius gives the same account of the ungula, and
when it becomes callous (nervosus), recommends an operation. Jesu Haly
recommends, before attempting a surgical operation, to make trial of
escharotic applications. Rhases also approves of this plan of treatment.
The most active ingredients in his prescriptions are sal ammoniac,
copperas, and arsenic. Some of his compositions are merely detergent.
_On carbuncle and cancer._ we are not aware that the parts about the eye
are particularly liable to anthrax, nor do we recollect to have ever
met with such a case; and yet, as Alexander and our author remark, the
disease may occur there as well as in other parts of the body. Rowley
describes carbuncle both of the eye and eyelids. Aëtius has given a
very circumstantial account of the symptoms and treatment of anthrax.
He forbids the early application of cataplasms, and seems to depend
most upon constitutional treatment, by clysters, purging, and bleeding.
Afterwards cooling and styptic fomentations are to be applied by means of
a sponge, along with other treatment similar to our author’s. Alexander’s
plan of treatment is nearly the same, and is laid down with excellent
judgment. That of Oribasius is similar.
To relieve the pains of cancer, Aëtius recommends soothing applications
and an anti-stimulant diet, consisting principally of milk. Avicenna,
Alsaharavius, and most of the ancient authorities join in praising
milk as the principal article of food in cancer of the eye. Avicenna’s
applications contain ceruse, opium, and the like. Haly Abbas recommends
general bleeding, if the patient’s strength permit, with emollient
lotions, and collyria: the diet to consist of birds, kids, and lambs.
According to Rhases, cancer of the eye is attended with excruciating
pains, redness, and distension of the veins, loss of appetite, and
inability to bear all applications.
_On mydriasis._ Aëtius treats mydriasis, or preternatural dilatation of
the pupil, like our author, by general and local bleeding, clysters, an
attenuant diet, and friction of the extremities. They no doubt considered
that the disease arises from congestion in the brain. Avicenna refers
the disease to cephalæa and injuries of the head. Scarpa quotes with
approbation the account given by Celsus of mydriasis, by which he thinks
was meant not only cases of dilated pupil but also of incipient amaurosis
occurring suddenly. Celsus approves of opening the bowels freely. Haly
Abbas describes the disease, but thinks it almost incurable. It sometimes
occurs, he says, from a blow, and sometimes from abscess within the uva.
Alsaharavius attributes the disease to congestion, and directs bleeding,
purging, and cooling applications. He calls it _dilatatio_. According to
Jesu Haly, it is produced by dryness of the uva, or abscess within that
tunic, or pressure on the brain. The first species is to be relieved
by diluents and relaxants, such as the warm bath. For the second he
recommends suitable cataplasms and purgative pills. The third is to be
treated by general and local bleeding, cupping, and fomentations with
water, vinegar, and salt. _Constriction of the pupil_ he directs us
to treat upon the same principles as our author. His account of it is
mostly taken from Aëtius. Leo describes, under the name of _symptosis_,
constriction of the pupil; under that of _paremptosis_, an affection of
the optic nerves; under that of _platycoria_, a preternatural dilatation
of the pupil, for which he recommends astringents; and under that
of _myocephalos_, procidentia of the lens, for which he recommends
astringents, and even copperas.
_On nyctalopia._ Aëtius recommends, according to the circumstances of
the case, general and local bleeding, drastic purgatives, errhines, and
the like. He, Celsus, Alexander, Rhases, Avicenna, Mesue, Jesu Haly,
Haly Abbas, and Alsaharavius, like our author, speak favorably of the
application from the roasted liver of a goat. Instead of it Hippocrates
recommends the liver of an ox. His treatment otherwise consists of
bleeding, purging with elaterium, and, in desperate cases, of trepanning
the head at the bregma and evacuating the water. (De Visu.) The general
treatment of the Arabians is like that of the Greeks. Thus Alsaharavius
recommends bleeding, purging with hiera, gargles, sternutatories, and the
like. This is also the practice of Jesu Haly.
The term nyctalopia is not used by all the ancient authorities in the
same sense. Thus Hippocrates applies it to that morbid state of vision in
which the patient is blind during the day but sees better in the evening.
Aëtius, Alexander, Paulus, and Actuarius, on the contrary, apply it to
that state in which the patient sees clearly during the day but becomes
blind in the evening.
_On glaucoma and suffusion._ Aëtius and Oribasius give nearly the same
account of these complaints as Paulus, and yet that of Aëtius seems
slightly different. He says that there are two kinds of glaucoma: that
the first, to which the name is properly applied, arises from a dryness
and concretion of the crystalline humour, which is changed to a sea-green
(glaucum) colour; but that the other arises from a suffusion, the humour
near the pupil having become congealed and dry. According to Leo, the
affection of glaucoma arises when the crystalline humour is congealed, as
it were, and having become white, obstructs vision: this occurs in old
age and is incurable. Haly Abbas was aware that the disease is sometimes
seated in the crystalline lens, but did not know that it always is so.
Hippocrates recommends masticatories and the actual cautery. Haly Abbas
and Alsaharavius approve of making trial of remedies similar to those
mentioned by our author, before attempting the operation. Rhases forbids
bleeding when the disease arises from the state of the eye itself.
Canamusali, who flourished about the year 1258, recommends a seton in
the nape of the neck for the cure of suffusion. (De Oculis, vi.) Rhases
considers the case incurable when the pupil has become insensible to the
stimulus of light.
_On amaurosis and dimness of vision._ Galen and Aëtius give a very
circumstantial account of the causes and treatment of amaurosis. They
state that the disease either comes on suddenly, in which case they refer
its origin to obstruction and paralysis of the optic nerve, or gradually,
when they believe it occasioned by a thickening of the coats of the optic
nerve, or a change of the spirits, or of the humours of the eye. They
enumerate various causes of it, such as injuries of the head, heat or
cold, indigestion, or the like. When the disease occurs suddenly, they
approve of general or local bleeding, such as cupping the back part of
the head, and active purging. In the other case general depletion is not
required, but the treatment is otherwise nearly the same, attention being
particularly paid to the state of the bowels. They forbid emetics after
food, but approve of errhines. They recommend in certain cases sinapisms
to the head.
The Arabians treat the disease upon the same principles. Haly Abbas
describes amaurosis among the affections of the optic nerves, and
recommends for it general bleeding, purging, and the saffron collyrium.
Alsaharavius remarks that it often arises from the state of the stomach,
which, in that case, will require the principal attention. Avenzoar
blames Galen for giving up as desperate cases of amaurosis which occur
suddenly. He recommends general and local bleeding, with repellent
applications to the head.
_On strabismus._ See Galen (de Causis Morborum); Oribasius (Synops. viii,
49.)
Avicenna properly remarks that squinting is occasioned by debility or
spasm of some of the muscles of the eye. He and Rhases recommend the
same treatment as our author. Avicenna also makes mention of a mask.
Haly Abbas, who appears to have been intimately acquainted with anatomy,
of which his work contains a valuable compendium, explains minutely the
cause of the disease, which he attributes to an unequal contraction of
the muscles of the eye. See also Alsaharavius and Jesu Haly. Jesu, like
our author, directs us to fasten a piece of black or red cloth on the
angle of the eye at the temples, when the eye inclines towards the nose.
He correctly explains that the complaint arises from spasms or paralysis
of some of the muscles of the eye.
_On ecpiesmus, or protrusion of the eyes._ This section is taken from
Oribasius. (Syn. viii, 50.)
Aëtius, Avicenna, and Rhases recommend the same treatment for this
complaint, which can only arise from suffocation, violent straining, or
swelling of the eye.
_On synchysis, or confusion of sight._ Aëtius and Oribasius treat of this
affection in nearly the same words.
Rowley defines _synchysis_ to be “a solution of the vitreous humour into
a fine attenuated aqueous fluid.” It does not appear to us that the
ancients understood it in this sense, or that they meant anything more by
it than a confusion or disorder of the eye occasioned by a blow.
_On myopia._ This section also is taken from Oribasius or Aëtius.
Alsaharavius treats of it by the name of _alhayn_. He says it sometimes
arises from external causes, such as exposure to snow and cold, in which
case he directs us to apply stimulant fumes to the eye and refrigerants
to the head. Although the ancients were aware of the magnifying powers
of _specula_ (as appears from Seneca, ‘Quæst. Natur.’), it is doubtful
if they ever thought of applying this knowledge to any useful purpose;
and hence none of the Greek, Latin, or Arabian medical authors make
any mention of spectacles or magnifying glasses as a remedy for this
complaint, or for weakness of sight. Dutens, however, maintains that they
were not unacquainted with telescopes. (p. ii, 10.) From a passage in
Iamblichus it has been supposed that they also used microscopes. (Vit.
Pyth. 26.)
One of the causes of myopia mentioned by Jesu Haly is enlargement of the
crystalline lens, which he recommends us to endeavour to lessen by means
of dissolvents. (De Oculis, iii, 6.)