377 



blance between the several epidemics, though occurring at different 

 times, and in places widely separated, viz : The suddenness of the 

 attack, the energy with which the disease was developed, its compa- 

 ratively short duration, great liability to relapse, its contagiousness, 

 and the fact that no special morbid lesions were discovered after 

 death. 



Having given this brief sketch of the history of the ophthalmia, 

 and of the fever which succeeded it, I will at once enter upon a de- 

 scription of the symptoms as they presented themselves in the cases 

 that came under my own observation. The first symptom that attract- 

 ed the attention of the patient was the appearance of musc?e volitantes. 

 These may exist alone for several days, but are generally soon fol- 

 lowed by dimness of vision and slight uneasiness in the eye. The 

 occurrence of muscac as a primary symptom, seems to me fully to 

 justify the opinion advanced by Mr. Wallace, that the disease begins 

 in the choroid coat, and then extends itself to the other textures of 

 the eye. At a period varying from a few days to several weeks after 

 the appearance of the muscse, the eye becomes injected. There is 

 now great intolerance of light and lachrymation. When the disease 

 is fully developed, the eye presents the following appearances: — A 

 pink zone, formed by the injection of the capillaries of the sclero- 

 tica, is seen surrounding the margin of the cornea. This zone is 

 occasionally more or less concealed by vascularity of the conjunc- 

 tiva. The iris is found to have lost all its brilliancy, and to be mueh 

 changed in colour. The pupil is sometimes dilated, sometimes con- 

 tracted, sluggish, generally irregular, but rarely adherent to the cap- 

 sule of the lens. The iritic circle, (a white ring at the circumference 

 of the cornea,) either partial or complete, is generally observed. 

 The cornea appears dull and hazy, owing to the disease extending to 

 the lining membrane of the aqueous humour. That this membrane 

 is affected is farther shown by the occasional presence of lymph in 

 the anterior chamber. In no case have I seen bridles of lymph across 

 the pupil, or tubercles of lymph on the surface of the iris, as is so 

 frequently observed in syphilitic iritis. In one patient in whom both 

 eyes were affected, and in whom the disease had existed for seven 

 months before admission, the entire pupil of the left and the loAver 

 half of the right eye were adherent to the anterior capsule. Vision, 

 which in the early stage of the disease is but slightly disturbed, soon 

 becomes seriously impaired, in most instances the patient having a 

 bare perception of light. The pain, too, which at first is slight, and 

 in some few cases is absent, soon becomes severe, particularly the 

 lb 



