Various

“ With these symptoms it may not require much time to make a correct diagnosis, but it may be some time ere the patient is entirely free from the trouble even if he does use good homeopathic treatment. Then it is the treatment which interests us most. The patient at the beginning will ask if you can cure him and how long it will require to do it. The physician necessarily must guard his prognosis, especially if it is a case of long standing. If there is much atrophy, which has extended over several years, a permanent cure is very doubtful. ”

“ II. of the Materia Medica Pura, the number of symptoms relating to the eye and its neighborhood is so large as to lead to the supposition that, if the theory of homeopathy be a correct one, this drug should prove of special value in the treatment of diseases of the visual organs. Never did an hypothesis receive better support when reduced to practice; and if the efficacy of the law of similia similibus curentur were compelled to rest upon a single test to demonstrate its truth, few better selections could be made than that of rhus tox. ”

“ Hubbell says: “In the diplopia test, the dissociation is effected by changing the visual axis of one eye by means of a prism. The displacement of one image cannot be done without associating with it, more or less, an impulse to some form of ocular effort.... In the obscuration test (Maddox rod) no such effort is invited, no change of innervation takes place.” But in the rod test the light seems nearer to the patient than in the prism test. This may account for much of the difference in results and amount to “an extraneous impulse to muscular contraction.” ”

“ The manner in which the general, topical, or mechanical and hygienic portion of the treatment is handled is to be strongly approved. The homeopathic indications are well written. Like almost all books by homeopathic authors, it shows the peculiar bent of the homeopathic physician’s mind is upon the therapeutics or cure of the patient rather than upon the fine development of the pathology, ætiology, etc., of the disease. ”

“ Tuberculous patients, in whom the tuberculous process in the larynx begins with a sensation of a lump in the throat, may be in very good health, but this particular impression is often the first symptom which they observe in a laryngitis, which finally becomes tuberculous. At the moment when the patient complains of this symptom it may happen that laryngoscopic examination fails to detect any lesion. It is useless to add that this form is especially met with in the female. It most nearly resembles that form that begins with a dysphagia that persists to the end ”

“ In ten out of the one hundred cases the patient recovered completely from the headache and general cerebral symptoms and regained perfect health, but the optic neuritis was followed by atrophy and complete blindness. In the face of this terrible termination we cannot help thinking that simple trephining of the skull and the removal of bone, without any interference with the brain, as suggested and practiced by Mr. Victor Horsley for the relief of optic neuritis and pressure symptoms, is a method of treatment worthy of more frequent trial when vision is failing markedly. ”

“ But when all these conditions have been excluded and when the symptoms are apparently due to a cerebral affection, there is one group of cases in which localizing brain symptoms are absent and in which the chief indications of disease are headache, double optic neuritis, and often vomiting. In most of these cases syphilis can be also excluded. A diagnosis of brain tumor is given, and the growth is thought to be situated in some region in which the localizing symptoms are at first indefinite—cerebellum, temporo-sphenoidal lobe, or prefrontal region. Such a diagnosis often proves to be correct. ”

“ Many a case of ozena has been brought on by the indiscriminate use of caustics on the mucous membrane of nose. Also injudicious cutting away of inferior and middle turbinated bones. Then again there is a predisposition to disease, especially in those people with a syphilitic and scrofulous diathesis. Excessive drinking of alcohol, excessive smoking of tobacco, working in poorly ventilated rooms or where there is a great deal of dust, and where there is an impoverished condition of blood from malaria or malnutrition, all have a tendency to set up this disease. ”

“ The detection of optic neuritis is of the greatest importance in the diagnosis of cerebral affections. Nevertheless, in certain cases of double optic neuritis with headache considerable caution is necessary before coming to a conclusion as to the exact nature of the disease. Though these two symptoms are present in the majority of cases of brain tumor and are so frequently due to this cause they are also met with in other diseases. In some cases of granular kidney, for example, the patient comes under treatment for headache and failure of vision ”

“ Correct the odor, the dryness, and the formation of scabs. If the case is not of too long standing, very likely you will be able to produce a healthy condition of the mucous membrane. If you are so fortunate as to produce a cure, the patient will always remember you for it, and you will or should feel proud of it yourself. Much will depend on occupation, age, and persistence with which the patient carries out treatment. ”

“ In some examples of its spinal form locomotor ataxia is undoubtedly an extremely chronic disease, with few and imperfectly developed symptoms; and it is thus not unnatural to expect that similar limitations may obtain in the ocular manifestations of the disease. That evidences of grave nervous disease may be limited to the pupil is well seen in Case XVIII., where a syphilitic patient was under observation for three years without the discovery of any abnormality other than paresis of each sphincter iridis. ”

“ They get that idea because they have a dry and coated tongue and a very bitter taste in mouth. After an examination is made you fail to find symptoms to corroborate the patient’s diagnosis, but will soon find the real cause. With the reflected light and nasal speculum it takes but a short time to satisfy your mind from conditions of nose that have all the symptoms of ozena. There is a discharge made up of mucus which is very thick, therefore not very easily expelled, and as a result finds its way into all the fossæ and crevices in the nose. ”

“ If the patient is a woman, who because of offensive breath is barred from society, she will become morbid and hypochondriacal in time. There is so much of the thick mucus hanging on the walls of the pharynx that the openings into the eustachian tubes are filled up and in a short time a certain degree of deafness appears—roaring in the head and other manifestations of ear trouble. As soon as the hearing is noticed to be abnormal the patient will be ready to consult some physician. ”

“ Jonnesco believes that the starting-point of the nervous derangement producing glaucoma is central: “When one removes the ganglion the point of origin of the influence will not be removed, but the communication between this center and the eyeball is destroyed.”
Regardless of the differing views of physiologists concerning the mechanism of the reduction of ocular tension, based on experiments made on the lower animals, there can be no difference of opinion concerning the effect of excision of the superior cervical ganglion in the human subject. ”

“ One must make reasonable use of such evidence as the brevity of life and the exigencies of practice permit. And the evidence here set forth affords at least a very strong presumption, to say the least of it, of the truth of the doctrines stated in the earlier paragraphs of this paper. Probably the particular proposition which is most likely to be contested is the one which places the Argyll-Robertson pupil equally with optic-nerve atrophy, and an ocular paralysis, as a possible first event in the eruption of the phenomena of locomotor ataxia. ”

“ Rarely the growth is asymmetrical, being situated only on one side of the nose. Pain in the nose and the presence of a sore in that organ are the symptoms complained of at the commencement of the disease; later headache is sometimes felt, and pain in the swelling during wet weather. As the growth becomes larger it seriously interferes with the sight by growing up in front of the eyes and even hiding them, but I have never seen it cause destruction of the eyeball. In many cases the patient has to bend his head downwards 223in order to be able to see over the tops of the swellings. ”

“ We have all used, for the removal of the excess of tissue, perhaps, with more or less success, the acids, the actual cautery, or some form of cutting instrument, but the patient, at least, will welcome a method that promises a good result with the least amount of pain at the time of treatment, and the least soreness afterward. ”

“ If no one case affords a complete history of all the stages of the disease the picture presented may none the less be fairly complete, provided the cases are sufficiently numerous, and they are seen at different points of development. ”

“ Too much time cannot be spent in a careful examination of the patient. Be certain the cause of trouble is ferreted out. The course of treatment will depend upon the cause of the disease. After thorough examination a course of treatment is planned. As I have said before, each case must be studied. There are no specifics for the disease.
In the local treatment the important object is cleanliness. The mucous membrane must be kept in a perfectly clean condition all the time. This is the main object of all local treatment. ”

“ There was a pricking feeling on winking, and the patient could not bear to have the upper lid touched in its outer half. She could only obtain ease by keeping the eyes closed and perfectly still, or wide open with the lids motionless. On examination no foreign body could be seen, and the lids were normal. In the lower outer quadrant of the cornea careful observation showed that the epithelium was ruffled and freely movable over a small area, and in part of the same area was a tiny circular, slightly opaque, raised patch of the corneal tissue. Nothing more could be made out. ”

“ Neither of the tonsils is inflamed nor hypertrophied; a few cervical lymphatics on the left side are slightly indurated, but slightly sensitive—if at all.
The swelling had probably existed longer than an abscess would be in forming, and there was neither pain nor fluctuation. Still an exploratory incision was made, but with the expected negative results.
Although the tumor was situated over the principal chain in lymphatics of the pharynx, it was not nodular, but smooth. Therefore the neoplasm was probably not of lymphatic origin, but an implication of the muscular tissue behind the pharynx. ”

“ It may be confined to either extremity, or the whole body may be the subject of hypertrophy. When, as is sometimes the case, the bony portion of the turbinate has become enlarged, the saw, and not electricity, will be the best means of cure.
But when the occlusion of the nares is caused by true increase of tissue we have, in galvanic electricity, a potent agent to safely and rapidly remove the obstruction.
To prepare a case for treatment, I always first thoroughly irrigate the nasal cavities with some antiseptic fluid, using the post-nasal syringe. ”

“ No cure can result unless good constitutional treatment is persisted in. When taking the case it is wise to inform the patient that he must expect treatment through several months, and even then the case must be examined once in a while or there may be a recurrence of the disease. ”

“ The symptom “while he turns the eye or it is pressed, the eyeball is painful, can hardly move it,” indicates its use in acute retrobulbar neuritis, which causes this symptom exactly and is well known to be frequently due to a rheumatic diathesis. The same symptom may call for its use in tenonitis, in which the stiffness, difficulty of and pain on moving the eye are specially prominent and which also has swelling and œdema of the upper lid, chemosis of the conjunctiva, and protrusion of the eyeball; all symptoms of rhus tox. ”

“ Panas and Duvigneaud have assumed rightfully that “If the nervous mechanism of intra-ocular secretion or, to speak without hypothesis, the action of the nervous system on intra-ocular tension can be known, the pathology of glaucoma will be cleared up, iridectomy will be explained, and perhaps a new and scientific basis for the treatment of glaucoma will be established.” Many observers have sought to solve the problem. Donders attributed the hypertension to a neuro-secretory cause and believed 261the trigeminus to be the agent of excessive secretion. ”

“ If eye, thyroid, and cardiac symptoms are to be relieved the entire chain must be excised.
In glaucoma removal of the superior ganglion alone is necessary. All of the sympathetic fibers of the eye, with the exception of those which pass directly from the cerebrum by way of the trigeminus, are connected with the superior ganglion.
In optic-nerve atrophy, if it should be proved that noninflammatory atrophy of the optic nerve can be improved by sympathectomy, removal of the superior ganglion alone will be necessary, for reasons already given. ”

“ It is certainly right to consider it as a symptom of the beginning of the disease.
“The speaking voice is often altered, dysphonia appears, and the patient who is attacked presents little alteration in his larynx; no ulceration, the cords accurately approximate, and they are very slightly congested; the laryngeal image does not reveal anything by which this profound alteration in the voice can be explained. There is no cough. There will come a time in the 251disease, however, which will cause us to see that this, too, is an initial form, and oblige us to give a prognosis exceedingly guarded. ”