CHAPTER II.
In October, 1835, a paper of mine appeared in theLondon Medical and Surgical Journal, stating the beneficial action of a concentrated tincture of capsicum for diseases of the eye, by rubbing it for a few minutes daily over the forehead and temples with a sponge.
Soon after this I was induced to try what effect essential oils, possessing powerful stimulating properties, might possess in removing amaurosis and diseases generally of the eye. The formulæ which I use are—
EMBRO. CARYOPH. CO.℞—Ol. Caryoph.— LavandāāƷiv.— Cinnamom.Ʒss.Sp. Vin. Rect.℥iij.M. Ft. Embro.
EMBRO. PIMENT. CO.℞—Ol. Piment.— Rosmar.āā℥ss.— Cinnamom.Ʒss.Sp. Vin. R.℥iij.M. Ft. Embro.
Finding great utility to arise from the use of the cloves and pimento, it appeared by no means undesirable or hopeless to administer them internally for the same complaints. In order to shield the pungency of these oils I united them with calcined magnesia, which, by its very strong affinity with these essential oils, forms a body nearly solid, and thereby removes all pungency, warmth, and even smell; for, in this state, it requires to be held in the mouth for a considerable time before it produces any warmth or pungency. They are thus rendered easily taken, in sufficient quantity, without heat or uneasiness.
Some children are the subjects of many diseases of the eye, producing blindness from opacities, &c. I ordered the same to be made into a powder, in which form it can be taken easilyin any vehicle, without exciting disagreeable warmth. The formulæ are—
PIL. CARYOPH. C.℞—Ol. Caryoph.Magnes. Cal.āāƷi.Ol. Cinnamom.qtt. vi.M. Ft. Pil. xxiv.
PIL. PIMENT. CO.℞—Ol. Piment.Magnes. Cal.āāƷi.Ol. Cinnamom.qtt. vi.M. Ft. Pil. xxiv.
The dose of these pills is one or two thrice a day.
Expedition is required in the making of these pills, otherwise it becomes a solid mass, and unable to be formed into pills.
I have found an alcoholic extract of cloves and pimento, made into pills with magnesia, equally efficacious.
PULV. CARYOPH. C.℞—Ol. Caryoph.Magnes. Calc.āā℥i.Ol. Cinnamom.Ʒi.M. Ft. Pulv.
PULV. PIMENT. CO.℞—Ol. Piment.Magnes. Calc.āā℥iOl. Cinnamom.ƷiM. Ft. Pulv.
The dose of these powders is from four to eight grains thrice a day.
In the making of these powders, the oil and the magnesia ought to be well mixed and allowed to remain for half-an-hour, then reduce the mass to fine powder, and keep it in glass bottles with stoppers.
These medicines, by their local application, increase the circulation, and give a greater supply of blood to the deficient organs, and thereby produce natural tone and power. They are equally useful in removing chronic diseases, where thickening and opacity have taken place, by rousing into activity the absorbent and nervous influence by their stimulating power. Among many others possessing the same power, is a concentrated tincture of pepper nigrum, ginger, &c.
The internal administration has been found much more serviceable in chronic diseases of the eye, such as opacities, &c., than in amaurosis.
The manner of using the embrocations is, by rubbing the forehead and temples with a sponge saturated with the liquid. This plan alone, kept up daily, is beneficial; but the efficacy is more than doubled if another sponge, with warm or cold water, is rubbed upon the forehead for a minute afterwards. By this the energy of the medicines in inducing a free circulation is greatly augmented, and greater warmth is rapidly developed. The rationale, in my opinion, is, that the large quantity of carbon in some of the essential oils, and its solubility in alcohol, permits it, by the friction, to pass through the cuticle and unite with the oxygen. As the oils are very insoluble in water, and as the alcohol has a strong affinity for the water, the carbon is more readily disengaged, and forms a union with the oxygen in the vessels, and thereby produces heat and great activity of circulation. I haveno doubt that that is the reason why many bodies are so pungent, when put into the mouth. I have only given two cases—viz., John Plunkett and William Dale—as illustrative of the action of the essential oils.
It will be seen in the following extract from Tyrrell on the Eye, "Functional amaurosis arises from a deficient supply of red blood." He says—
"In these cases there always exists, I believe, a want of general power and vigour of circulation at first; but in some instances of long-continued affection of this kind, the local circulation never regains its proper force and fulness; and the supply of blood is inadequate to support the functions of the part, although the general system recovers its natural tone and power."
I think this statement very correct, and therefore the embrocations producing so much additional circulation, point out at once the essential oils, along with the water, as its proper remedy. I here quote Magendie, who corroborates theplan which I adopt—viz., the medicines being most useful when applied to the forehead and temples in amaurosis:—
"Lectures on the Physiology of the Nervous System, delivered in 1836, in the College of France, by Majendie."—Lancet, April 29th, 1837, page 186.
"The integrity of both the optic and the fifth nerves, then, is indispensably necessary for the exercise of vision, which is lost whenever either of these nerves is separately destroyed."
Lancet, May 20th, 1837, page 279.
"Nervous pains of long duration and the greatest intensity have been quickly removed by topical applications to the temporal region."
Lancet, page 280.
"Amaurosis cannot be considered as a simple affection of the optic nerve; at least, in the actual state of the science, it is generally impossible to say that the fifth nerve has no connexion with the loss of sight, and in many cases theconnexity is evident. Hence a rule which I invariably follow of addressing my remedies, in the first instance, to some of the branches of the frontal nerve; and I have frequently had the satisfaction of observing some of these cases of incomplete amaurosis improve sensibly under the influence of therapeutic agents applied to the fifth pair. I would go even further and say, whenever you have a case of incipient amaurosis, commence by acting on this nerve, for it is at once the most expeditious and efficient method. I cannot, however, quit this point without assuring you that no physician is capable of treating diseases of the eye unless fully in possession of the facts I have just had the honour of explaining to you. These facts are daily becoming more numerous and more convincing, and already a considerable number of our younger practitioners, who devote themselves to the study of diseases of the eye, are fully aware of the immense influence of the fifth pair of nerves over the exercise of vision."
Lancet, page 281.
"To resume, then, what I have said concerning the sense of vision and our several experiments, allow me once more to impress you with the idea that sight can never be exercised in a complete and perfect manner without a certain influence of the fifth pair of nerves; destroy that influence, and you destroy vision. This is all we know upon the matter; for up to the present moment we have been unable to determine how far this influence extends, or in what manner it is communicated."
Case of Amaurosis.
John Plunkett, Mermaid Gardens, Hackney, formerly an attorney's clerk, visited me in May, 1837, and stated that he had been blind and obliged to be led about by his children for the last four years. For five years previously his sight had been gradually diminishing. Hefurther stated that he was much troubled with floating images before his right eye, as well as with clouds resembling animals, strange goblins, and sometimes with flashes of lightning, vivid red, changing into light blue. One great peculiarity of this miserable man's case was, that when he threw back his head there appeared a stream of blood flowing from the top of the right eye to the centre, where it formed into a circular pool about the size of a split pea, but ultimately it became as large as a shilling. It often remained a considerable time, and then diminished gradually in red streaks. This was a matter of great alarm to him. He had been at several Ophthalmic Institutions for nine years previously to his visiting me. He has had electricity, tartarate of antimony, blisters, issues, stramonium, mercury (until it produced dysentery), and almost every kind of treatment that could be suggested, tried, but to no purpose.
When I saw him the pupil was immoveable, and the eye dull in the anterior, and veryobscure. The left eye was destroyed. He could not discern, in a bright light, the shadow of white paper when it was moved between him and the light.
The compound embrocation of oil of cloves was used by rubbing it upon the forehead and temples daily, and in the space of twelve days he was able to discern objects and could touch them. In two months he could put his finger through a ring when held by another person. He continued occasionally under my care for about a year, during which time the embrocation was regularly used. He could walk alone, and the eye was generally useful, but he was not able to read with it. He could see objects at the distance of thirty feet.
The last month he has visited me once or twice a week, for the purpose of having the prussic acid vapour applied to his eye, to ascertain if the sight could be restored sufficiently to enable him to follow his occupation as a clerk. In this case an advantage has been gained. Thepatient is now able to read a little, which, previously to the use of the prussic acid vapour, he was unable to do.
Amaurosis.
William Dale, boot-maker, of 14, Clarence Gardens, Regent's Park, visited me in July, 1837. He stated, that with his right eye, for the last year, he could only discern light from darkness; and that for several months before he was much troubled by clouds and spots floating before his eyes. The evening gaslight produced a continued flashing of light from his eye. The light looked as if surrounded by all the colours of the rainbow.
He first went to an Ophthalmic Hospital, where he was blistered on the temple and salivated. Nux vomica produced such an effect upon him that all his limbs were involuntarily twitched, so as to alarm them exceedingly. Hethen left, and went to another institution for three months; and at length was told that the optic nerve was injured, so as to render a restoration of vision impossible. The left eye, when looked into, had a dark green, muddy hue, and the pupil was exceedingly dilated and immoveable. He was unable to distinguish an object placed before his eyes; yet he states that he could distinguish light from darkness.
When he applied to me I had the compound embrocation of pimento applied occasionally to the forehead and temples, by means of a friction sponge. During the first month he was able to discern objects and colours. The pupil acted under the impression of light almost equal to the good eye. It was not until this application had been used for a year that the patient was enabled to read with the eye.
I saw the patient this day (the 25th of Jan. 1843). The eye, upon examination, appeared to be in a healthy state. The sight was not so good as when he left me, and after he left off theapplications, but this he attributes to the circumstance of his general health not being good, owing to his having suffered from intermittent fever.
In January, 1834, I published the first edition of my work upon Veratria, and gave an account of two cases of amaurosis, combined with tic-douloureaux, cured by the external application of veratria. I there suggested that it was probable that amaurosis, uncombined with tic-douloureaux, might be removed by applications of a stimulating nature to the branches of the fifth pair of nerves. No notice of this suggestion having been taken by medical men, I determined to put the plan into execution, and employed a surgeon to carry it into effect in St. Giles's Workhouse, where blind cases were given me for that purpose. I here extract the case of Eleanor M'Cartney, for the purpose of showing the power of capsicum when rubbed upon the forehead andtemples. I select this case of amaurosis for several reasons; she was the first patient on whom I tried the efficacy of capsicum. She had had, seven years previously, a stroke of palsy, which removed all power of the right side. The only power recovered was that of the right arm. The hearing was perfectly gone; and she had not had the least perception of sight for seven years. It is now nearly eight years since her recovery; and, at the present date (27th of Jan. 1843), she can read perfectly well; and has never had another application since the three first days. It will also satisfy the minds of many that a recovery by stimulating applications of this description, is not of a temporary nature.
I here quote the case as given in my work on "Painful and Nervous Diseases," page 131.
"Eleanor M'Cartney, aged 40, an inmate of St Giles's Workhouse, was attacked, seven years ago, with palsy of the right side, when perception of light and sound, in the right eye and ear, was extinguished. There was a constantand profuse flow of tears, and the pupil was immoveable.
"The treatment commenced on the 19th of October, 1835, and was continued for three days only. On the first day after the commencement of the treatment there was a great abatement of the flow of tears, and she could perceive light and light-coloured objects. On the second day she could see a watch, and direct her hand to it, and distinguish the palm from the back of the hand. On the third day she could distinguish objects with great facility. There was no further application of the remedy after the third day. On the fifth day she could read a duodecimo prayer-book with ease. On the seventh day the flow of tears ceased, the pupil moved readily, and her sight and hearing were perfect. She is still an inmate of the workhouse, and may be seen on application to the matron, Mrs. Bailey."