374 



months. The disease presents two stages: in the first, there exist 

 only amaurotic symptoms alone; in the second, to these are added 

 symptoms of inflammation. In many cases there are amaurotic 

 symptoms at or even before convalescence from fever, and yet the 

 inflammatory stage has not supervened for weeks or even months. 

 In other cases, dimness of vision has not commenced for several days, 

 weeks, or even months after the febrile attack, and has then been 

 immediately followed by symptoms of inflammation. The amaurotic 

 invariably precede the inflammatory symptoms — the latter uniformly 

 subside before the former. There is not a texture of the eye the 

 structure of which does not suifer materially in the course of the 

 disease. 



In 1828 Mr. Jacob, of Dublin, published in the fifth volume of the 

 Irish Med. Transactions a paper on "internal inflammation of the 

 eye following typhus fever;" — his description very nearly corre- 

 sponds with that given by Mr. Wallace. In the London 3IedicaI 

 G-azette for Nov. 24, 1843, Mr. Mackenzie, of Glasgow, has given 

 an able account of " an affection of the eye following epidemic re- 

 mittent fever." He very appropriately names the disease " ophthal- 

 mia postfebrum," or "ophthalmitis postfebrilis." The following are 

 some of the principal facts he gives. That the disease is evidently 

 a consequence of the fever — that it is generally traceable to some 

 exciting cause, and especially cold. It first commences in the retina, 

 producing great imperfection of vision ; — this is soon succeeded by 

 inflammation of the iris, sclerotica, and other textures of the eye. 

 Of thirty-six cases twenty-seven occurred in females, and only nine 

 in males; — the youngest patient was eighteen months, the oldest 

 fifty-six years of age — nearly one half were between the ages of ten 

 and twenty. The right eye was affected in eighteen, the left in ten, 

 and both eyes either together or consecutively in eight cases. The 

 disease came on at from three to sixteen weeks from the commence- 

 ment of the fever. In several it came on about two weeks after re- 

 covery from the relapse. Recovery from disease of the eye was 

 tedious; in the majority of cases two months of careful and uninter- 

 rupted treatment has been necessary for a cure. Recovery is more 

 rapid in young than old subjects. 



In regard to the fever which preceded the ophthalmic affection as 

 it prevailed in Dublin in 1826-27, the following are some of the 

 principal facts as selected from Mr. O'Brien's account, published in 

 the fifth volume of the Irish Med. Transactions. After giving a 

 description of the ordinary typhus, he states that the other species 



