530 
O P II T H 
fe&ion. By fuch means, the irritability of the patient 
was increafed, and of courfe the enfuing inflammation, 
and all its bad effe£ts, were aggravated. Befides, the long 
formal preparation tended to increafe the alarm which 
the patient generally felt before the operation was under¬ 
taken ; while perfifting in the exhibition of aperient falls 
checked the fecretion from the fkin, weakened the fto- 
mach and bowels, and difpofed the patient to gaftric com¬ 
plaints, which were fure to have an unfavourable effef't 
upon the confequences of the operation. Repeated expe¬ 
rience proves, lays Richter, that operations on the eyes 
are performed with molt fuccefs upon patients who are 
ftrong, hardy, healthy, and'little irritable, and who have 
not fubmitted to any of the above preparatory treatment. 
The only things which can be of ui'e before the operation, 
confift in endeavouring to quiet the patient’s apprehen¬ 
sions, by reprefenting what is about to be done as fafe, 
and by no means very painful ; in not keeping the pa¬ 
tient a long while in fearful expeftation of the opera¬ 
tion ; in letting him take exercife in the open air; in 
giving him antimouials in order to promote perfpiration, 
by which means the riik of inflammation will be ma¬ 
terially leffened ; and laftly, in adminiftering an opiate 
half an hour before the operation, if the patient feems reft- 
lefs. 
Whenever the patient can eafily bear a moderate de¬ 
gree of light, all coverings Should be removed from the 
eyes, except a Shade of green* or black Silk. A brighter 
light Should be gradually admitted every day into his 
chamber : fo that he may become habituated as loon as pof- 
Sible to the open day-light. Nothing, fays the judicious 
Scarpa, has a greater tendency to keep up and increafe the 
morbid irritability of the eyes, than keeping them unne- 
ceflarily long in a dark Situation, or covered with com- 
preSTes and bandages. 
Of the purulent, cr Egyptian, Ophthalmy. — This fpecies 
of ophthalmy has received the laft of the above appella¬ 
tions, in confequence of its having been fuppofed to re- 
femblethat kind of inflammation of the eyes, which de- 
ftroyed the light of a confiderable number of our foldiers 
in Egypt, in the year 1801 ; or rather in confequence of 
the opinion, that it is a peculiar ophthalmy, which was 
firft brought from that country into England by the 
troops which returned front the celebrated Egyptian ex¬ 
pedition. Mr. Ware, however, does not approve of call¬ 
ing this ophthalmy Egyptian, becaufe, fays he, an oph« 
thalmy, precifely fimilar in its fymptoms- and progrefs, 
lias appeared long ago in this and other countries ; and 
in Egypt, as well as England, leveral varieties of oph¬ 
thalmy prevail. This gentleman prefers naming the epi¬ 
demic inflammation of the eyes purulent, fince one of its 
chief fymptoms, and that which diftinguilhes it from 
every other, is the profufe difcharge of a purulent-co¬ 
loured fluid. This cafe is very different from an oph¬ 
thalmy, which, at various times, has been epidemic in this 
and other countries, without any purulent difcharge from 
the eyes, which is feldom dangerous to fight, and in a few 
days generally yields to internal antiphlogiftic means, 
and mildly-aftringent applications. 
Few furgeons have feen more of this diftreffing difeafe 
than Mr. George Peach, furgeon, to the 9th regiment of 
light dragoons, and formerly furgeon to the 2d battalion 
of the 52d regiment of foot, a corps in which the Egyp¬ 
tian ophthalmy prevailed in a l’urprifing degree. Accor¬ 
ding to this gentleman, the patient complains, in the 
firft ftage of the difeafe, of being fuddenly feized with a 
rolling of land in his eye ; the veffels on the albuginea 
become quickly turgid with blood, and the lower pal- 
.pebrae very vafcular. The cafes treated in this recent 
ftate generally yield. But, if very aftive meafures do not 
arreft the progrefs of the difeafe, thefecond ftage appears, 
when fhepalpebras fuperiores become much enlarged ; the 
eye-lids can only be opened with extreme difficulty, and 
then either a fcalding fluid is difcbarged and excoriates 
the face, or a flux of thick yellow matter takes place. In 
A L M I A. 
this ftate it is frequently in our power to flop the progrefs 
of the evil ; but, if the molt decided and aftive practice 
be not. adopted, the difeafe reaches the third ftage, in 
which every thing is feldom of little avail in relieving the 
mod diftreffing fymptoms. The cornea now too often 
becomes ulcerated, and the eye ruptured. On the firft 
appearance of the difeafe, Mr. Peach had recourfe to ve- 
nefedtion, and the antiphlogiftic treatment. Being un- 
luccefsful, he tried bark and ftimulants ; but, being ftill 
more unfuccefsful with this mode of treatment, he re¬ 
verted to the antiphlogiftic plan in its fulleft extent, and 
with the greateft fuccefs ; and he found, that he did not 
formerly fucceed, becaufe he did not carry this mode far 
enough. It is in the commencement of the difeafe that 
a very large quantity of blood Ihouid be taken away: in 
that ftage, large venefedtion, even ad deliquium animi, is 
almoft an infallible remedy. It is not fufficient to take 
away twenty or thirty ounces of blood. Mr. Peach has 
often taken away lixty, at the fame time enjoining perfect 
reft, the avoidance of all animal food, and putting in 
practice every other part of the antiphlogiftic treatment. 
The complaint is naturally difpofed to relapfe; and, as 
often as the difeafe, or even the flighted: pain or uneafi- 
nefs in the eye, ret urns, fo often did this gentleman return 
to the lancet. Such pradlice, Mr. Peach confeffes, is likely 
to excite aftonifhment; but the fulleft trial of it has dc- 
monftrated to him its utility. IiT many of the cafes 
which occurred to him, the progrefs of the inflammation 
was fo rapid, that it probably would have totally deftroy- 
ed the eye, if only the ordinary mode of treating oph¬ 
thalmy had been refopted to. He advifes particular atten¬ 
tion to be paid to the firft fenfa.tion of land in the eye : 
he never defers venefedtion when this is complained of.; 
and the patient, in general, finds fo much advantage du¬ 
ring the operation, that he fays “ the fand is removed.” 
Mr. Peach has occafionally found advantage arife from 
dropping the undiluted aqua litharg. acetat. into the eye, 
though great pain was the immediate effedl of its applica¬ 
tion. On the whole, however, he concludes, that drop¬ 
ping fubftances into the eye is not ferviceable; and fays, 
that, fince this pradlice was relinquiflied, the eye-lids have 
not been fo often inverted. The bowels mull be kept 
open. Benefit has often been derived from (having the 
head, and keeping it continually wet with water or vi¬ 
negar. Blifters are alfo fometimes indicated; but the 
great reliance is to be put in the ftridteft antiphlogiftic re¬ 
gimen, and copious venefedtion. 
With regard to the caufes of the epidemic purulent 
ophthalmy, Mr. Ware feems to think, that the complaint 
is moftly communicated by contadl. Some of the vvorlt 
cafes of the purulent ophthalmy of children have hap¬ 
pened in thole, whofe mothers were fubjedl to an acrimo¬ 
nious difcharge from the vagina at the time of parturi¬ 
tion. Some of the worft forms of the purulent ophthal¬ 
my in adults have occurred in thole, who, either fliortly 
before the attack of the ophthalmy, or at that very time, 
laboured either under a gonorrhoea, or a gleet. Mr. Ware 
does not mean to impute every purulent ophthalmy to 
fuch a caufe ; but, in the majority of adults whom he has 
feen affedted, if the diforder had not been produced by 
the application of morbid matter from a difeafed eye, it 
could be traced to a connexion between the ophthalmy 
and dileafe of the urethra. Other caufes, Mr. Ware ac¬ 
knowledges, may contribute to aggravate, and perhaps 
produce, the diforder; and the purulent ophthalmy in 
Egypt has been attributed to a great number. The com¬ 
bined influence of heat and light, of a burning dull con¬ 
tinually railed by the wind, and of the heavy dews of 
the night, may powerfully tend to excite inflammations 
of the eyes. Yet fomething more mu ft operate in caufing 
the malignant ophthalmy now under confideration 5 for 
the fame caufes operate with equal violence in fome other 
countries beiides Egypt, and yet do not produce the fame 
effedt; and in this country, (continues Mr. Ware,) the 
diforder prevailed, during the laft funimer, to as great a 
degree. 
