Some diseases of the eyelids, etc. / by W.S. Collins.

  • Collins, William Job, 1859-1946.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Some diseases of the eyelids, etc. / by W.S. Collins. 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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    in cortex, but a diffuse nuclear opacity is observed. Some red reflex is obtainable; the vitreous and fundus, so far as examination is possible, appear normal. V. = hand reflex. T. — ?. This case appears to me instructive in many ways, and by no means the least for the light it throws upon the hackneyed question of trophic troubles consecutive on nervous lesions. The points I would lay especial stress upon are these : a. The non-invasion of the mesial line by absolute anassthesia. We have evidence in other parts to show that the mesial areas of the body are supplied by filaments from both sides. An observation corollary to this is found in the respect that is paid to the macular region in cases of hemiopia. (3. The fact that although there is every reason to believe that the sensorial innervation of the ear by the auriculo-temporal was withdrawn, there was no evidence either of localised anaesthesia nor of lessened acuteness of sensation in the area to which it is usually distributed. y. As regards the trophic nerve question it appears to me this case furnishes us with evidence of the highest importance. There can be little doubt, from the entirety with which trigeminal sensation is abolished without the smallest implication of the motor root, and from the severe referred pain complained of in anaesthetic parts, that we have here a considerable lesion of the sensory portion of the fifth some- where between its nuclear origin in the pons on the one hand, and the eventual trifurcation of the Casserian ganglion on the other. It is equally certain that it is a pathological change, not a mechanical solution of continuity, we have to deal with. Yet here, with a profound and absorbing lesion of the fifth at its very fount, with absolute anass- thesia, there is not the slightest implication of the exposed and insensitive cornea, as the doctrines of Snellen and Biittner would lead as to expect, but in the lens, innocent of innervation, unexposed to the annoyance of foreign