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Wound of Cornea. Discharge of Aqueous HumourEntire Loss of SightRecovery.

I have deemed the following case worthy of publication as a remarkable recovery if not cure. I have to report it from memory, as my original records are lost or mislaid.

Mrs. G. sent for me, September 22nd, 1854. Several weeks before, she had received an injury of the cornea of one eye, which immediately destroyed the sight by letting out the aqueous humor. The circumstances were as follows: —

Her husband was a good for nothing drunken fellow, and was accustomed to use her pretty roughly. One evening, he laid on a lounge opposite the door, she looked in through a glass in the upper part of the door, at this, he took up a brass ring, which had been part of a solar lamp, and threw it at her; the ring passed through the glass and struck her in the eye. She felt a gush of something which she supposed to be blood, but soon ascertained it to be colorless. The sight was immediately and entirely destroyed, and she continued to suffer much pain in the eye. As I had treated her with success the previous year for diarrhea, she sent for me shortly after the injury, but I having removed my residence, the messenger did not find me at that time.

Within a few days after the injury, she went into the Hospital of the Sisters of Charity, then in East Thirteenth Street. She remained there five weeks, having certainly the benefit of the best surgical talent of the city. I saw her a few days after she came from the Hospital, viz.: — on September 22nd, 1854. To the best of my recollection, her condition was as follows: —

The affected eye (left I think) appeared decidedly smaller than the other; the wound across the cornea remained open; it had never closed; occasionally a watery discharge would come from it. Ever since the injury, she had suffered much pain in the eye, more particularly at night. It is my impression that I gave Bell.“, but as my records of the case are lost, I cannot say certainly nor can I detail the treatment which followed, nor the particulars as I should like to do. I can only state that my account books show that I visited her from the 22nd of September to the 10th of October, making only eight visits in all. From memory, I can state that the pain in the eye was relieved within a few days, and, further, much to my surprise and gratification the wound in cornea healed, and aqueous humour, which was previously discharged through the wound as fast as secreted, now was retained and the eye became gradually larger until it attained the full normal size. This change was accompanied by the entire recovery of the light. No medical means were used excepting the internal administration of attenuated medicines. And whether we consider the case as a fortunate recovery or as a successful cure, it is interesting as it would enable us to give some encouragement to a patient similarly affected.

It seemed like something more than a coincidence, that in a few days after commencing homoeopathic treatment she was relieved of the pain in the eye, and within a few weeks the wound of cornea closed and the sight was restored. She stated to me, that the surgeons of the Hospital had not encouraged her to think that she would recover her sight. I last saw this patient about two years after the above events occurred, her eye remained well and could not be distinguished in appearance from the other.

FISTULA LACHRYMALIS. — J. C, came to the Central Homoeopathic Dispensary, Nov. 13th 1855. Fistulous ulcer from the lachrymal sac, from the opening of which upon the cheek, is discharged pus and tears. Has had this affection for four months. Inflammation around fistula. Calc. c.30

November 20th. — No inflammation about fistula, it is almost closed; slight discharge of whitish matter. Sacch. lac.

27th. — Return of trouble, probably in consequence of getting her feet damp. Discharge of pus and tears from fistula; bitter taste in mouth in morning. Puls.30

December 20th. Continues about the same. Sepia.30

January 15th, 1856. Was better until yesterday, Sep.30

21st. She says her eye is better than at any previous time since first attack. Sep.30

February 12th. No trouble about the eye, excepting lachrymation on exposure to cold. Fistula entirely closed. Sacch. lact.

March 13th. Eye quite well.

Whilst this patient was under treatment, a prominent allopathic surgeon, after personal examination of the case, pronounced it incurable except by an operation. I have heard from this patient several times since the last date; the eye remained well.

FISTULA LACHRYMALIS. — On the evening of September 19th, 1859. I was requested to visit Mrs. B., residing in East Twelfth Street. I found the right side of her face red, swollen and painful. The inflammation had commenced several days before at the inner canthus of eye, and had gradually extended until the whole side of face was affected. Bell.12 was prescribed, a dose every hour.

On the 20th, an abscess broke in the inner canthus, constituting a fistula lachrymalis. Hep.5, every two hours, was given.

21st. No discharge of pus since yesterday afternoon; opening of abscess seems to have closed; no pain; still some swelling of inner canthus; has a fistula lachrymalis of the other eye, which commenced nine or ten years since, with symptoms like the present sickness. A tube was inserted eight or nine years ago, and has been used since. Hep. every three hours.

24th. The right eye is about well; scarcely any redness remaining. Hep.6 four times a day.

30th. The right eye is well. Dr. Joslin, Sen., and myself concluded to advise the permanent removal of the tube from the left eye. The tears sometimes flow through puncta lachrymalia. The tube has pained her much for some time past, and there has been a discharge of pus around it. Hep.8 three times a-day.

8th. Sharp pain in inner corner of eye, which was the seat of the recent inflammation. Has not yet removed the tube. Seven powders of Puls. 30 one each night.

November 11th. Took tube from the eye, just after the last date. Has experienced no difficulty; tears have flowed through the natural passage. The opening where tube was inserted is almost closed, a very minute opening remains, which neither affects convenience or personal appearance. May, 1860. Eye continues well.

GONORRHOEAL OPHTHALMIA. Almost complete Loss of SightRecovery

Mr. X. applied to me to be cured of Gonorrhoea which he had recently contracted. I prescribed Cann. ind.0 under which the discharge at first abated, but on the fourth day increased. I then gave him Cann. sat.0, and at the same time advised him to lay up for a few days to expedite the cure. On the seventh day of my attendance, the discharge was less; a slight redness of eyelids was observed, but as it was quite slight I paid little attention to it. At this time I gave him Sacch. lac. Two days after, discharge less and even less inflammation about the eye. Gave Cann. sat. 2

Being by my advice at home all day, he amused himself by reading, and that evening (the ninth of my attendance) his eye became much worse. When I saw him the next day, there was considerable swelling of eyelids and of ocular conjunctiva, producing decided chemosis. Cornea clear, very little pain and scarcely any photophobia, but profuse discharge of pus and tears, the passage of which through the lachrymal duct, produced excoriation of nostril of the affected side. The symptoms increased in severity for two days, during which period Puls.6 and Bry.7 were prescribed. The chemosis became so great as to much diminish the apparent size of cornea; a sensation of pressure and fulness was experienced in the eye, but no acute pain; profuse purulent and lachrymal discharge. On the morning of the eleventh day of my attendance, I gave him Merc. viv.3, a powder every hour, and was much gratified in the evening to find a slight diminution of the chemosis; had considerable smarting and burning in the eye. On the next day, the improvement was decided; less pain and chemosis. Continued to give Merc., viv.3 until the thirteenth day; there was then much less swelling of conjunctiva, but this day he had rather severe cuttings in the eye and the discharge of pus increased, on which account I gave him Euphrasia 1/50 solution.

The next day, the discharge and pain were less, but photophobia increased. Phos 30 was prescribed, under which he improved until the sixteenth day, had then increased photophobia. Gave him 2 Sulph. 30 at intervals of three hours. On the seventeenth day, had much less inflammation about the eye, but the sight was impaired to a greater extent than ever; could just distinguish light from darkness, but could not distinguish any objects. This loss of sight came on rather suddenly, two days before, could see pretty Well, although there was a haziness before sight. A slight opacity of cornea could be seen, though not sufficient to account for the blindness; light was painful. Hep.6 was then given, and the next day Nit. ac3 On the nineteenth day, Merc. Viv3 was resumed. On the twenty-first day, a slight improvement in sight was observed, he could distinguish his fingers when held before the eye.

On the twenty-second day, could distinguish black from white, and the day after the form of objects. On the twenty-fifth day, his cornea appeared quite clear; said he could see my eye and many other objects. The chemosis was gradually diminishing. About the twenty-seventh day, the discharge from urethra increased, it had almost disappeared previously. Merc. viv.3 was continued until the twenty-eight day; had then rather severe pains in right side of head. Bell.12 was prescribed, but Merc.3 resumed the next day and continued at longer intervals for the next month. During this period he improved in every respect. About this time, he had an attack of dysentery, very probably occasioned by the long continued use of Merc.viv.3, Nux promptly relieved the attack. At this time, his sight was quite good for short distances, but it was several weeks later before he acquired perfect vision. The cure was finally complete. A dose or two of Sulph30 was about all he took subsequently to the above treatment.

Fracture of the Patella. A Case successfully treated on a somewhat novel plan.

On the evening of January 23rd, 1858, I was called to see an old colored man, who was said to have put his knee out of joint. I found the patient with his leg across a chair suffering much pain, more especially when any attempt was made to flex the leg. He told me that he had charge of the drill rooms in the upper part of the building he was then in, and while bringing down stairs a scuttle of ashes he slipped, and on making an effort to save himself, he felt as though he was struck a violent blow on the right knee, and as though something gave way at the same time; he immediately lost the power of moving the leg.

I found the patella drawn up from its proper position, and was of the impression that he had ruptured the ligamentum patellae, but Dr. R. G. Perkins, whom I requested to see the case with me, correctly diagnosticated it as a fracture of the patella. By far the larger portion of the bone was included in the upper fragment; on drawing this downward until it met the lower portion, crepitus was distinctly felt. The fracture was oblique from below upward, and from before backward. After the parts of the patella were brought in co-aptation and the hold upon them withdrawn, the upper portion was drawn up a quarter of an inch. He was carefully removed to his own home, and Arnica tincture, ten drops to a pint of water, applied on cloths to the knee. Arn.20, a powder, every three hours was given internally.

Dr. Perkins called with me the next morning, and was associated with me in the whole remaining treatment of the case We found the patient feeling quite comfortable. Pulse 72; had some swelling about the knee, but very little pain excepting when the limb was moved. Strips of adhesive plaster were applied from the upper part of patella to the back of leg, and from lower portion to the posterior portion of thigh, and one strip across front of patella. One dose of Acon.20, and more was left to be taken if he had much fever or pain.

On the 25th, he was quite comfortable; less swelling of knee. Re-applied adhesive straps. No medicine was given.

26th. Has had slight shooting pains about joint; pulse 60. Put the lower extremities on a straight board with foot piece attached. 'Applied bandage over splint and leg; did not disturb the adhesive plaster. The portions of patella are nearly in apposition, No medicine.

27th. Had some pain in heel, caused, I think, by keeping the foot in one position; had also severe pricking pain in patella. He had loosened the bandage somewhat.

28th. Considerable sharp pain in knee last night; pulse 60. One dose of Acon.20

29th. Less pain in knee, otherwise comfortable.

30th. Considerable pain last evening in foot, extending upward to knee and afterward stitching pain in knee.

31st. Much less pain; has itching about joint.

February 1st. Doing well.

2nd. Doing well; re-applied adhesive straps and bandages.

6th. So far we had kept the patient in bed. His chief suffering had been from the inconvenience of having to remain in one position. He was quite restless and we had found it almost impossible to keep our apparatus adjusted, as he would move about some. Taking into consideration the age of our patient, and the serious troubles which might arise from keeping him too long in a recumbent position, as general impairment of health and possibly bed sores, we resolved upon a course of treatment which would enable him to be up, while his cure was going on. As the apparatus was perfectly simple, such as any one could easily make, and perfectly fulfilled all the indications of treatment, I think it worthy of a description. We took a piece of board, of the width of the limb and eighteen inches in length, cut a piece of strong ticking of same length and nearly wide enough to meet around the limb, this was tacked on to the board, the latter being well padded on upper surface. The limb rested upon this. Two smaller boards were prepared, one for the anterior surface of thigh and the other for anterior surface of the leg, both well padded. Tapes were attached at short intervals to the ticking, and tied in front over the anterior splints. Cotton was tucked in at various points to make the apparatus set well. In this way the limb was kept perfectly straight, and all motion at the knee joint prevented. The splint on thigh pressed upon the great extensor muscles of the leg, preventing either voluntary or involuntary movement. The splint upon leg was mainly to make the pressure on tibia more general and less irksome. To keep the portions of patella together, we relied entirely upon numerous adhesive straps. After this, we had little to do but watch, for if the tapes drew a little to hard for comfort, we gave him liberty to loosen one and tighten up those adjoining. He sat up during the day, and even walked about the room on crutches.

7th. Doing well. I tightened the tapes.

9th. The same. — 14th. The same.

17th. Took straps off; patella seems to be united; on right side a slight ridge can be felt; straps re-applied as before. Has today difficult micturation; urine passed in small quantities. One dose of Calc.30 was given.

23rd. Doing well.

March 2nd. Doing well. Goes up and down stairs.

8th. It is now six weeks and two days since he fractured his patella; up to this time we have kept the limb in an apparatus. We this morning took it off; patella well united. He can walk pretty well.

9th. Is able to walk much better than is usual after such an injury.

16th. Doing well. Has walked to the rooms, of which he has charge, and back, a distance of, in all, at least, two miles.

April 6th. Is attending to his business; can walk well, without cane; does not limp at all; knee appears natural; a slight depression can be perceived at seat of fracture.

The union, in this case, was undoubtedly by bone, and the cure perfect in every respect. The result exceeded our expectations, as the patient was old, at least sixty. I learned subsequently, that he was rather intemperate, which would naturally lessen his chances of a favorable result. But the most interesting feature of the case was, that he was enabled to go about after the second week of the treatment, and, for any reason I know off, might have gone about during the whole course if we had applied our apparatus earlier. Scarcely any medicine was given, as there was very little indication for it.


Source: The American Homoeopathic Review Vol. 02 No. 09, 1860, pages 397-405
Description: Clinical Contributions; Wound of Cornea — discharge of Aqueous Humour — entire Loss of Sight; Fistula Lachrymalis; Gonorrhoeal Ophthalmia — almost complete Loss of Sight; Fracture of the Patella.
Author: Joslin, B.F. Jr.
Year: 1860
Editing: errors only; interlinks; formatting
Attribution: Legatum Homeopathicum
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