Hydrocephalic amaurosis / by Jabez Hogg. Amaurosis and strabismus from ascaris lumbricoides.

  • Hogg, Jabez, 1817-1899.
Date:
[1888]
Catalogue details

Licence: Public Domain Mark

Credit: Hydrocephalic amaurosis / by Jabez Hogg. Amaurosis and strabismus from ascaris lumbricoides. 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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    to a child otherwise in the enjoyment of fairly good health. The history of the case is as follows E. L., the first born of a young mother inheriting rheumatic gout through two or three generations, from a slight attack of which she became a sufferer before convalescence. Before the child was three months old it was generally remarked that it “ had an unusually large head, and that its eyes wandered vacantly.” During the next month or two there could be no doubt whatever that the head had increased in size. The alarm of the mother was however mostly confined to vision, her little one she observed “ in no way seemed to return her caresses as did other peoples’ children of the same age.” The eyes were clear, the irides being of a bright blue colour, so that there was no visible difference to an ordinary observer. The family medical attendant was of opinion that the child could not see, and this he thought might be due to the pressure of fluid. It was at this time, and when the child was six months old, that I was con- sulted in the case. Its body appeared to me not at all well nourished; feeding by bottle having taken the place of the breast. The head was certainly very large; on the nurse changing its position the little fellow uttered a pitiful cry. The shape of the head was irregular, it bulged out anteriorly and a little more to the left-side than to the right. The anterior fontanel was more open than usual, and on pressure a distinct fluctuation was felt. The veins crossing the forehead were prominent ; the eyes having a smaller appearance from the projection of the forehead ; there was convergent strabismus of the left eye in particular. Under very considerable disad- vantages I attempted an ophthalmoscopic examination but unsuccessfully : at a later date, however, and by good management I succeeded in determining that the discs had a “ choked ” appearance. My prognosis was not only a guarded one but a very unfavourable one. I saw little or no hope of either the restoration of the sight or of the intellect of the child, which at this time was but feebly developed. I prescribed the syrup of the iodide of iron and cod-liver oil, and as the milk was not properly digested, produced some irritation of the bowels, I recommended a trial of finely minced raw beef-steak. A couple of months passed away before I again saw the child, when a very manifest improvement had taken place.