The Calabar bean as a new agent in ophthalmic medicine / by D. Argyll Robertson.

  • Robertson, Douglas Moray Cooper Lamb Argyll, 1837-1909.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: The Calabar bean as a new agent in ophthalmic medicine / by D. Argyll Robertson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    we find in experiment third, after tlie second application of the Calabar bean, that the extent of distinct vision is limited to 3 inches, viz., from 6 to 9 inches from the eye, but an hour after distinct vision extends to any distance beyond 5 inches. It has also been observed that the accommodation of the eye is not usually affected in cases where contraction of the pupil is due to lesion of the sym- pathetic (exemplified in a case narrated by Dr von Willebrand in the Arcliiv fur Ophthalmologie, vol. i., where contraction of the pupil depended on the pressure of enlarged glands on the cervical sympathetic, and where no affection of the accommodation was present). ■ As regards the cases in which this substance may be applied in practice, it is applicable in all instances where atropine is used to render the examination of the eye more perfect or more simple. This includes two classes of cases, those in which dilatation of the pupil is either necessary or desirable to aid ophthalmoscopic exami- nation, and those in which paralysis of the ciliary muscle is neces- sary, in order to ascertain the state of the accommodation of the eye. In cases of retinitis, with photophobia, I think it might be advan- tageously employed to diminish by contraction of the pupil the access of light to the retina, and this more especially in those cases of this disease where the pupil has been dilated for the purpose of ophthalmic examination. The cases, however, in which I should expect this remedy to produce the most beneficial effects are those in which paralysis of the ciliary muscle occurs as a consequence of long-continued debili- tating disease. Cases of this kind are occasionally reported as following attacks of typhus or other fevers. The dimness of vision that forms a frequent sequela of diphtheria appears also to be due to this cause, judging from the symptoms detailed by Dr Begbie in an admirable paper on diphtheria, recently published in this Journal; therefore, in these cases, good effects may be expected from the use of the Calabar bean. In cases of ulceration at the margin of the cornea, leading to per- foration, or even when prolapsus of the iris has just occurred, as well as in cases where the iris has a tendency to protrude through a corneal wound, the contraction of the pupil induced by this agent might prove serviceable by drawing the iris away from the circum- ference. I have shortly pointed out the cases in which I consider this remedy may prove useful, but have as yet had but little opportunity to test it practically; I think, however, there can be little doubt that in the Calabar bean we possess an agent that will soon rank as one of the most valuable in the ophthalmic pharmacopoeia. PRINTED BY OLIVER AND BOYD, TWEEDDALE COURT, EDINBURGH.