On granular disease of the conjunctiva and contagious ophthalmia / by Edward Nettleship.

  • Nettleship, Edward, 1845-1913.
Date:
[1874-1875]
Catalogue details

Licence: Public Domain Mark

Credit: On granular disease of the conjunctiva and contagious ophthalmia / by Edward Nettleship. 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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    I prefer the solutions of silver as standard applications, reserving the lapis divinus for those who get worse or do not improve under any form of silver. It is a curious fact, which I have several times observed, that children who are made worse by either of these substances are generally benefited in a marked degree by the other I have been less struck with the necessity of changing the treatment than some other observers, the only decided impression I have on this point being that after no more improvement can be gained by silver, however varied in frequency or degree, the lapis divinus does sometimes carry the case considerably further. _ There is no objection to the 10-gram solution of silver being applied by a careful and skilful nurse who has been taught how to use it. This may be quite safely done with a large number of the cases, provided that the medical officer sees them himself at intervals of a few days so as to watch their progress. This is another practical reason in favour of this solution over the lapis divinus with which in effect it is perhaps most comparable and the use ot which could not be left indiscriminately to a nurse. I have made many careful trials of the solid powdered acetate of lead/ both according to the method of Buys, and the modified plan of Gouzee which consists of applying the salt m a slight y moistened state instead of in dry powder. I applied acetate of lead m more than fifty cases, repeating it two or three times in several ol these The general result was that, when used on Buys' plan the ordinary (acid) acetate (sugar of lead) had in most cases no effect at all on the granulations beyond whitening them for many months It slightly increased the discharge when this had been present before while in a few cases it did decided harm by leading after some months to ulceration of the coruea, due no doubt to the apices of the granulations being rendered harder and rougher by its presence than C wcSd have been if left alone. When applied on Gouzee s method I found that it did harm in a much larger proper ion of Tses especially by causing ulceration of the conjunctiva followed by the oPrmatioyn of cicatricial bands which often imprisoned smal lumps of the salt beneath them ; these rough, projecting nodules and scars often after several weeks or months set up or predispose to relanses of conjunctivitis, and in several cases ulceration of the cornea was produced by them. In one child s ight organic entro- uion odurred, which was, however, easily remedied by removing a CzoS fold of skin. I think, therefore that the use of pTwaS i It should be mentioned that most of my cases were treated with the ordi- all, and bud no effect on the six cases m which 1 used it.