Wills’’ Hospital—Service of Dr. John Neill. Cases discharged
from. July 1$Z to October Is£, 1850.
Cured.	Relieved.	Incurable.
Amaurosis,	0	2	0
Closure of the pupil,	1	0	1
Amaurosis and cataract,	0	10
Catarrhal conjunctivitis,	2	0	0
Acute	“	3	0	0
Chronic	“	3	0	0
Granular	“	2	2	0
Cataract,	0	10
Amblyopia,	0	10
Scrofulous corneitis.	1	0	0
Injury of the eye,	1	10
Staphyloma sclerotic®,	1	0	0
Pustular ophthalmia,	2	0	0
Inflammation of the orbit,	1	0	0
Opthalmia tarsi,	3	0	0
Ulcer of the cornea,	4	0	0
Iritis,	1	0	0
Hypopion,	0	10
Entropium,	0	10
25	10	1
Wills’’ Hospital Dispensary—Cases treated.
Acute conjunctivitis,	10	Ulcer of the cornea,	5
Chronic	“	9	Granular lids.	7
Catarrhal	“	11	Amaurosis, (partial)	11
Scrofulous	13	Ophthalmia tarsi,	9
Pustular	7	Tumor of the lid,	2
Purulent <£	4 Adhesion of the lid to the globe, 1
Corneitis,	3	Inflammation of lach’l sac,	2
Iritis,	6	------
Retinitis,	1	Total 101
Conjunctivitis.—The chronic, catarrhal, and granular forms of
conjunctivitis, were treated chiefly by strong solutions of the nitrate
of silver, alternated occasionally as the more active symptoms sub-
sided with the sulphate of copper in substance, and the liquor
plumbi sub-acetatis. Under this plan the cases improved satis-
factorily.
Corneitis.—In the single case discharged cured, the disease oc-
curred in a scrofulous subject, and the treatment was modified ac-
cordingly. During the active stage of inflammation, the mild
chloride of mercury was cautiously used in connection with the sul-
phate of quinine. By this combined plan the disease was rapidly
subdued, and only a slight opacity remained as the result of the
corneitis. Great importance was attached by Dr. Neill to the ad-
ministration of tonics in connection with mercurials in the treatment
of strumous corneitis.
Photophobia.—The intolerance of light in cases of strumous
ophthalmia, was readily subdued in a large number of cases by the
external application of the tincture of iodine, painted freely over
the brows, temples, and upper portions of the cheek, with a camel’s
hair pencil.
Staphyloma Sclerotica.—Michael Faulker, a common laborer,
set. 37, a native of N. Y., having good general health, was admitted
to the hospital, July 30, 1850, with obscure disease of the right
eye. He applied for relief because of the sympathetic irritation
which the diseased eye kept up in the left, or sound one. He
came laboring under great anxiety of mind, as he had been told
by high surgical authority that the disease was malignant. After
carefully examining his diseased eye, Dr. Neill was satisfied that
the disease was not malignant, and he admitted him with the
intention of operating for his relief, by discharging the contents of
the globe and allowing it to collapse. At the time of his admission,
the globe was so much distended, that the lids would not close
over it; the cornea was opake and conoidal, and at the external
angle of the eye, the sclerotica was thinned and distended, so as to
form a slightly conical tumour, of a leaden or purplish hue. The
conjunctiva was in a condition of chronic inflammation. Some
years before, he had this eye injured in a stone quarry; inflamma-
tion of the eye followed, which in three months time subsided,
leaving the eye sightless. He had suffered often since then with
attacks of inflammation up to the time he applied for admission to
the hospital. Five years ago, the globe began to enlarge, and
continued gradually to increase, without causing him pain or any
other inconvenience, except the frequent inflammatory attacks
when exposed. July 12, Dr. Neill determined to operate ; the
patient was placed upon the operating table, and with a Beer’s
knife a section of the cornea was made, as in the operation for the
extraction of cataract; the aqueous humour, and the lens, which
was opake and partially dissolved, escaped. Behind the position
of the lens appeared a dense septum, this was torn away with the
curette, and immediately a large quantity of dark colored fluid,
seeming to consist of disorganized vitreous humour and blood,
flowed from the globe; this fluid continued to flow for half an hour,
during which time the patient was left upon the table, with the lids
closed over the globe. The blood was probably derived from the
rupture of the vessels of the choroid coat, when the great pressure
of the fluid which distended the globe was removed. For two
days after the operation, the patient seemed to do well, but on the
third, the eye became greatly distended, and exceedingly painful.
By the use of soothing applications and anodynes, the pain subsided
in a few days. During the third week the globe began to diminish
in size, and continued gradually to become smaller until August
31, when he was discharged entirely relieved; the globe had
resumed its natural shape and size, and the conjunctivitis was
completely removed. The history of this case seems to illustrate
emphatically the importance of a correct diagnosis in certain forms
of ophthalmic disease.
A. F. Mac Intvre, M. D.,
Resident Physician.
Wills’ Hospital, Philadelphia, October, 1850.