Unilateral albuminuric retinitis : with report of a case / by Walter L. Lyle.

  • Pyle, Walter L. (Walter Lytle), 1871-1921.
Date:
[1898]
Catalogue details

Licence: Public Domain Mark

Credit: Unilateral albuminuric retinitis : with report of a case / by Walter L. Lyle. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    The history of the case under my care is as follows: The patient is a well-built man of 49, with a good family- history. In his early manhood he was especially vigorous; and there is no specific or alcoholic history. In 1893 he was annoyed by neuralgic pains in the back and loins, and general prostration, and presented himself at the office of a well- known local physician for treatment. An analysis of his urine revealed a specific gravity of 1020, marked acidity, granular casts, and an albuminous ring half as thick as a penny. He was ordered salol, salines, and special diet. Through some slight disagreement as to treatment the patient left his first physician and consulted a homeopath at Atlantic City, N. J., in the spring of 1893. At this time he was considerably worse, and he began to feel his neck gradu- ally becoming stitt. In view of his advanced renal disease, and liis poor physical condition, the second physician ordered him to take the mud-baths at Langenschwalbach, Germany, whither he went in September, 1893. From then on to the last of October, his German attendant made repeated analyses of the urine, invariably reporting the presence of albumin and casts. The mud-baths closing in October, the man spent the remainder of the winter in Southern Europe without medical advice. After leaving the baths, the patient went to Frankfort, and while there experienced what was evidently the first ocular manifestation of his nephritis. While sitting on the hotel- porch one morning late in October, 1893, he noticed that a curious sign across the Schiller])latz to his left, ordinarily in his field of vision, was absent. He then discovered that the extreme left of his field was nearly or completely dark. For 10 days this state of affiiirs annoyed him, but as he was not embarrassed in his working-vision, and being tired of physi- cians, he did not consult an oculist, and the matter passed out of his mind. He did not realize that his left eye was worthless until I saw him in January, 1898, nearly 5 years later. By December, 1893, the patient's neck was completely an- kylosed, lateral movement was abolished, and only a slight up-and-down movement has since been possible. In April, 1894, he returned to this country, and early in 1895 he con- sulted a third physician, who reported the presence of albu- min in the urine. The man remained under treatment until the end of 1895. He then stopped all medication and dietetic precautions. In January, 1898, he was attacked with an acute inflammation of the right eye, and returned to his first physician, by whom I was called in consultation. I found a typical case of iritis, with the iris immobile and bound down by posterior synechia^. After several instillations of atropin and cocain I managed to obtain full mydriasis. Small black remnants of the synechiae were plainly visible on the anterior