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Home Medical and Vet Remedies, as Recommended by 19th and 20th century Doctors and Vets! |
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Home Medical and Vet Remedies, as Recommended by 19th and 20th century Doctors and Vets! |
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Gonorrhæal Inflammation of the Eyes.One who has seen many patients suffering from gonorrhoea, and has observed how ignorant they are of the danger to the eye involved by the disease, and how careless they are with reference to the protection of the eyes, cannot wonder that so many eyes are seriously injured and even destroyed by this disease. The patient who is suffering from gonorrhoea cannot be too careful to avoid all possibility of contact of the urethral discharge with the eye. The hands should be carefully washed every time that they come into contact with the genital organs or with the dressing used on these parts. Particular care should be taken with regard to the use of towels. The towel which is used for drying the hands should be kept separate from those used for the face. All cloths and other dressing used about the genital organs should be burned when soiled. Symptoms.-The evidences of inflammation in the eye begin about one or two days after matter has been introduced. The patient feels a sense of burning and itching in the lids, which causes him to rub the eye. This feeling increases in severity, and is soon accompanied by a watery discharge from between the lids. The edges of the lids become red and swollen, and the entire surface of the globe acquires a deep red color. Within twenty-four hours the lids may have become so swollen as to close the eye completely When they are separated there will be found an accumulation of discharge, which now consists of yellow matter. Within a day or two the eyes run profusely, the matter flowing over the lids onto the cheeks. The edge of the lid and the adjacent skin of the cheek become red and sore. The eye is the seat of most intense pain, which suffices to prevent the patient from sleeping. The danger to be apprehended is the extension of the inflammation to the deeper structure of the eye, causing ulceration of the cornea. In severe cases the entire cornea - the transparent front of the eye-becomes white and mortified, and may even dropoff in the course of the affection. Yet sight may be seriously impaired or lost without such extensive disease of the cornea, since if the cornea be ulcerated even over a small surface, there will remain a white opaque spot after the inflammation has subsided ; and if this spot happen to be located just in front of the pupil, vision will be thereby interfered with. Treatment*-It is extremely important that the treatment of gonorrhæal inflammation of the eyes be begun promptly and energetically, for there is no other affection which attacks the eye of the adult in which the most serious injury can be inflicted in so short a time. In many cases the eye is irreparably lost within twenty-four or even twelve hours after the discharge begins. One of the most important items to be observed is the protection of the other eye from contagion, for the matter produced in the inflamed eye is extremely contagious, quite as much so, indeed, as that which flows from the urethra ; and the proximity of the eyes renders transfer of the matter from the diseased to the sound eye very easy. Several plans have been proposed for protecting the sound eye. One consists in sealing the lids together with several layers of collodion, re-enforced by narrow strips of adhesive plaster. An ingenious device for protecting the sound eye without interfering with the use of it, is thus described by Mr. Buller : M It consists of a square piece of mackintosh, into the center of which a watch-glass is fastened, and of three strips of adhesive plaster. The mackintosh is trimmed to fit the nose and forehead of the patient, and should extend across one side of the forehead about half an inch above the eyebrow, and downward nearly to the tip of the nose, the nasal portion reaching a little beyond the middle line. " A strip of adhesive plaster about an inch in width, and long enough to reach from just in front of one ear to a corresponding point on the opposite side, is applied along the upper border of the mackintosh. The second strip may vary in width according to the height of the nose, and must be snipped in three or four places in order that it may be adapted to the uneven surface upon which it rests, the lower part only slightly overlapping the edge of the shield. For additional security, a third, the somewhat shorter strip, is placed along the ridge of the nose. The eye in thus completely protected by a waterproof shield, the upper and inner sides of which are firmly adherent to the skin of the forehead and nose, whilst the lower and outer borders are free, so that the eye is exposed to the air almost as freely as when an ordinary shade is worn. Moreover, the surfaces of the watch-glass being parallel, vision is not interfered with and the patient is able to attend to the affected eye. " As the strips of adhesive plaster become softened in the course of a few days, by the warmth and secretion of the skin, they require to be renewed. This may be done as often as is necessary without any difficulty or danger of infecting the healthy eye." Treatment.-A patient suffering from gonorrhceal inflammation of the eye is usually in a depressed and debilitated condition, as the result of the sufferings which he has endured from the gonorrhoea. The inflammation of the eye aggravates considerably this condition. It becomes necessary, therefore, to administer remedies which shall sustain and strengthen the patient. For this purpose we may administer the compound syrup of hypophosphites, a teaspoonful of which may be given three times a day. The diet should also be generous in both quantity and quality ; yet the gonorrhoea forbids the use of liquors unless these be dry wines. It will be well to administer quinine regularly in the following prescription : Sulphate of quinine, - One drachm. Tincture of the chloride of iron, - Six drachms. Peppermint water, - Three ounces. Mix, and take a teaspoonful in water before meals. The patient will probably suffer intense pain from the inflammation in the eye ; this can be in part relieved by the application of water dressings to the eye, as will be presently described. Yet in most cases it becomes necessary to administer opium in some form. The most convenient and desirable way will be in the following prescription : Sulphate of morphia, - Two grains. Sulphate of atropia, - - One-eighth of a grain. Water, - Two ounces. A teaspoonful of this solution may be taken three or four times a day, if necessary, to subdue the pain ; two teaspoonfuls may be taken at once at bedtime. If there be much fever and thirst, with a coated tongue, the following mixture may be given : Bicarbonate of potash, - - Twenty grains. Aromatic spirits of ammonia, - Half a drachm. Water, - - - One ounce. This may be taken in a wineglassful of water. Locally, the most important item of treatment for the patient and his friends to attend to is per'fect cleanliness of the eye, that is, its freedom from the discharge which will otherwise accumulate. To accomplish this the eye must be carefully washed every half hour, or as often as matter accumulates between the lids. In washing the eye, the lids should be separated and a stream of water should be directed from a small syringe, so as to remove any matter which may have collected under the lids. In the intervals between these cleansings of the eye, the patient should apply a soft cloth, such as an old handkerchief, which may be folded to make three thicknesses, and should be kept wet with ice water. This should be moistened afresh frequently, in order to keep the parts cold. A most important application is a solution of the nitrate of silver. The strength of this solution, according to the severity of the case, from ten to forty grains to the ounce of water. This should be applied to the lids in the following way : The lids are separated, and their edges turned upward and downward respectively, so as to expose as much surface as possible of the inflamed conjunctiva. A soft camel's-hair brush is dipped in the solution of nitrate of silver, and swept gently over the exposed surface. The brush is then rinsed in water and again passed lightly over the lids, so as to remove the excess of the silver solution. This application should be made just after the eye has been washed. In general, it will be sufficient to apply the silver solution once in the day. In severe cases it may be necessary to repeat the application twice in the same day. No one but a surgeon should undertake the application of nitrate of silver to the eye, since it is possible to inflict serious damage by the improper use of so powerful an agent. If it be impossible to secure the services of a professional man, or if many hours must elapse before his arrival, it will be well for the patient to use the following solution, which can be made in a few minutes in almost every household : Take as much powdered alum as can be conveniently taken up on the point of a penknife, and dissolve it in a tablespoonful of water. Six or eight drops of this may be dropped into the eye between the lids every half hour or hour, after washing the eye with simple water. Or the following lotion may be obtained at the drug store : Sulphate of zinc, - Four grains. Tincture of opium, - - - - Half an ounce. Glycerine, ----- Half an ounce. Water, ------ One ounce. A few drops of this may be dropped into the eye every hour at least. Yet the patient must never lose sight of the fact that the hope of saving the eye depends upon the care in keeping it clean, rather than the use of medicines or eyewater. It is hardly necessary to say that the discharge from the eye is as contagious for other individuals as for the other eye of the same person, and that the greatest care should be used to avoid the possibility of contagion. All cloths, brushes, etc., which have been employed in the treatment of the case, should be burned when no longer required. Towels and body linen which may have been soiled by the discharge, should also be kept from possibility of contact with other people. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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