Tobacco amblyopia in a woman, with anomalous scotomas / by G. E. de Schweinitz.

  • De Schweinitz, G. E. (George Edmund), 1858-1938.
Date:
[1897]
Catalogue details

Licence: Public Domain Mark

Credit: Tobacco amblyopia in a woman, with anomalous scotomas / by G. E. de Schweinitz. 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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    TOBACCO AMBLYOPIA IN A WOMAN, WITH ANOMALOUS SCOTOMAS. Ry G. E. de SCHWEINITZ, M D. Professor of Ophthalmology in the Jefferson Medical College, Philadelphia. ILLUSTRATED. The following case is reported chiefly because of the somewhat unusual shape of the scotoma which was the distinguishing character- istic of the affection, and also because the clinical history indicates that the relation of alcohol to the development of the central ambly- opia is practicalh^ eliminated as an etiological factor. A married woman, aged 60, in good circumstances, of large frame and healthy nolor, presented herself on the 25th of November, 1896, with the following state- ment: vSince June, 1896, vision has been slowh' failing, and since July she has been ' unable to read. This loss of vision had been unaccompanied by pain or any exter- nal manifestation of ocular trouble. Her history, obtained partly by questioning and partly from a letter written by her physican, Dr. J. Cardeen Cooper, is as follows, I quote his exact words: The patient has always disobeyed the laws of health and has always been subject to excessive tax upon her nervous system: great mental anxiety, loss of sleep, late hours and irregular meals. Four years ago she suffered from enlargement of the liver, disturbed portal circulation and chronic bronchitis. This illness was followed by general neurasthenia and much indigestion. At this period of her history the urine contained, from time to time, traces of albumin and sugar. Under treatment these symptoms entirely subsided and specimens of urine recently examined were normal. The patient is rheumatic in the vague sense in which this term is used, but has not been subject to inflammatory rheumatism. There is no history of severe illness other than the one detailed in Dr. Cooper's letter. When 45 years of age, or 15 years before she sought advice, the patient began to smoke, at first only a few cigars a day, but for some years she has averaged at least six cigars during the twenty four hours, many of them being smoked late at night and during hours when she should have been asleep. It is probable that the use of the tobacco has been even greater than these words imply, as her daughter freely testified that she doubted if her mother had an^^ idea how many cigars she smoked. The patient began to smoke to relieve, as she supposed it would, high tension of the nervous system brought on by insomnia, worry and domestic difficulties. She does not use spirits in any form, is not an excessive tea drinker and takes no drug of any kind except digitalis, which has been prescribed in medicinal doses on account of a weak heart.