7 DISEASES CLASS I. 2. 2. 13; 



a grain of corrofive fublimate of mercury difTolved in brandy, or 

 taken in a pill, twice a day for fix weeks. Couching by depref- 

 fion, or by extraction. The former of thefe operations is much to 

 be preferred to the latter, though the latter is at this time fo 

 fashionable, that a furgeon is almoft compelled to ufe it, left he 

 ihould not be thought an expert operator. For deprefiing the 

 Cataract is attended with no pain, no danger, no confinement, 

 and may be as readily repeated, if the cryftailine fhouid rife again 

 to the centre of the eye. The extraction of the cataract is at- 

 tended with confiderable pain, with long confinement, generally 

 with fever, always with inflammation, and frequently with irre- 

 parable injury to the iris, and confequent danger to the whole 

 eye. Yet has this operation of extraction been trumpeted into 

 vmiverfal fafhion for no other reafon but becaufe it is difficult to 

 perform, and therefore keeps the bufinefs in the hands of a few 

 empirics, who receive larger rewards, regardlefs of the hazard, 

 which is encountered by the flattered patient. 



A friend of mine .returned yefterday from London after an 

 abfence of many weeks 5 he had a cataract in a proper flate for 

 the operation, and in fpite of my earned exhortation to the con- 

 trary, was prevailed upon to have it extracted rather than depreff- 

 ed. He was confined to his bed three weeks after the operation, 

 and is now returned with the iris adhering on one fide fo as to 

 make an oblong aperture ; and which is nearly, if not totally, 

 without contraction, and thus greatly impedes the little vifion, 

 which he poiTeffes. Whereas I faw fome patients couched by 

 depremon many years ago by a then celebrated empiric, Cheva- 

 lier Taylor, who were not confined above a day or two, that the 

 eye might gradually be accu domed to light, and who faw as well 

 as by extraction, perhaps better, without either pain, or inflam- 

 mation, or any hazard of lofing the eye. 



As the inflammation of the iris is probably owing to fdrcing 

 the cryftailine through the aperture of it in the operation of ex- 

 .tracting it, could it not be done more fafely by making the open- 

 ing behind the iris and ciliary procefs into the vitreous humour ? 

 but the operation would ftill be more painful, more dangerous> 

 and not more ufeful than that by deprefling it. 



If extraction of the cryftailine be ufed, Dr. Reimarus of Ham- 

 burgh advifes to drop into the eye previous to the operation, 

 fome extract of belladonna diflblved in water, which he has found 

 to produce a temporary paralyfis of the retina, and thence a total 

 inaction of the iris, fo that it remains perfectly expanded, and 

 is thence lefs liable to be injured by the operation, and the eye 

 perhaps lefs liable to inflammation. Might not this be of advan- 

 tage in fome ophthalmies ? 



14. InnutrltiQ 



