Choroid

“ In tumors of this kind affecting the choroid plexus the chain of symptoms is essentially the same as given under cholesteatoma and the prognosis is nearly equally grave. It need only be said that in recent cases in which there is as yet little permanent tissue, measures may sometimes be hopefully adopted, to secure the reabsorption of liquid constituents, and even perchance to remove some obvious cause of passive congestion upon which the effusion depends. ”

“ At about the 80th hour its cells commence to receive a deposit of pigment, and eventually form the so-called pigmentary epithelium of the choroid; from them no part of the true retina (or no other part of the retina, if the pigment-layer in question be supposed to belong more truly to the retina than to the choroid) is derived.
On the fourth day, the inner (anterior) wall of the optic cup (fig. 289, R) has a perfectly uniform structure, being composed of elongated somewhat spindle-shaped cells, with distinct nuclei. ”

“ The transparency of the cornea is due to the fact that all these structures have the same refractive index.
The middle or vascular coat of the eye consists of the choroid, the ciliary processes and the iris. The choroid (fig. 1, ch) does not come quite as far forward as the corneo-scleral junction: it is composed of numerous blood-vessels and pigment cells bound together by connective tissue and, superficially, is lined by a delicate layer of pigmented connective tissue called the lamina suprachoroidea in contact with the already-mentioned perichoroidal lymph space. ”

“ This nucleus is entirely surrounded by a membrane, which the author likens to that which surrounds the fetus, and to which he gives the name of choroid membrane. From the surface of the nucleus a gelatinous juice transpires, which, thickening in layers, forms the enamel and the rest of the tooth. The choroid membrane is abundantly furnished with nerves, and with blood and lymph vessels. Into the interior of the teeth penetrate vascular and nervous branches which serve to maintain its vitality. In fetal jaws one finds, besides the germs of the deciduous teeth, also those of the permanent ones. ”

“ Into this put the point of the scissors and very carefully pick up the choroid and the retina with the point of the scissors and cut [31] them. (Fig. 5.) If the choroid alone has been picked up and separated, the retina will show milky white or yellowish white underneath. The retina must then also be separated. Care must be taken not to go deeper than the retina or the hyaloid may be damaged. Continue the cutting of the choroid and the retina for a distance of about 20 mm. ”

“ It will be well to state here that during this dissection the specimen should not be lifted from the table. Keep the eye resting on the table all the time, and never lift it by holding it suspended from the optic nerve. [67] Loosening the choroid from the sclerotic up to this point is a very easy matter; ordinary precaution is all that is necessary to prevent puncturing the choroid with the scalpel, just be sure to remember to keep the point of the scalpel close to the sclerotic. ”

“ The choroid plexus is congested and swollen with infiltration. The brain tissue adjacent is firmly adherent and there is a hyperplasia of its connective tissue constituting a veritable sclerosis. At some points, however, the compressed nervous tissue has undergone degeneration and softening. As might be expected from the pressure of the liquid, anæmia of the brain tissue is a marked feature of the morbid condition. ”

“ Dentigerous cysts, containing a formation identical to that of a tooth, growing from the temporal bone, sometimes are found lying loose within the cranium.
Tumors of the choroid plexus, known as brain sand, are frequently met with on post-mortem examinations, but seldom give rise to any [Pg 225] appreciable symptoms during life. They are found in horses at all ages, and are slow of development. They are found in one or both of the lateral ventricles, enveloped in the folds of the choroid plexus. ”

“ First, the choroid coat of the eye, on which the semitransparent retina is expanded, is of different colour in different animals; in those which feed on grass it is green; from hence there would appear some connexion between the colour of the choroid coat and of that constantly painted on the retina by the green grass. ”

“ There is atrophy in spots of the capillary layer of the choroid, and the larger vessels of the deeper layer are exposed between the interstices of the pigment masses. There is no definite choroidal rupture. The lesion encroaches upon and implicates the macular region.
The injury is a concussion one, not necessarily resulting from contact, and certainly not due to a perforation. The loss of movement and faulty position are the result of injury to the muscles, and not to nerve implication. ”

“ The vitreous humour is derived (except in Cyclostomata) from a vascular ingrowth, which differs considerably in different types, through the choroid slit. Its real nature is very much disputed. According to Kessler’s view, it is of the nature of a fluid transudation, but the occasional presence in it of ordinary embryonic mesoblast cells, in addition to more numerous blood-corpuscles, gives it a claim to be regarded as intercellular substance. The number of cells in it is however at best extremely small and in many cases there is no trace of them. ”

“ Some of the symptoms may not be strongly pronounced, one or two may be absent, but the general picture will suggest no other disease. According to Seitz, tubercle of the choroid is rare in tubercular meningitis of the adult. It is usually associated with tuberculosis of other organs, the pia being free. ”

“ Although inflammations of the iris, choroid, and retina—the inner, vascular, and nervous coats of the eye—occur to a certain extent independently of each other, yet one usually supervenes upon the other, and, as the symptoms are thus made to coincide, it will be best for our present purposes to treat the three as one disease. ”

“ A blackish round or oval stain has been described by M. Larcher on the sclerotic coat on the outer side, which he calls l‘imbibition cadavérique du fond de l‘œil. It is probably due to thinning of the sclerotic from evaporation, enabling the choroid to be seen through it. The spot precedes rigidity and is a forerunner of putrefaction.
3. The most powerful stimulus applied to the body does not cause any reaction. The muscles may, however, be made to contract shortly after death by the stimulus of a slight blow, or by galvanism.
4. The surface of the body becomes of an ashy-white colour. ”

“ There is limited evidence on adjuvant therapy and not a standard practice. There are no systemic curative treatments for the majority of patients with metastatic uveal melanoma. In older, unselected series, the prognosis is poor, with reported median survivals ranging from 2 to 12 months [2] [3] . In many cases, the predominant site of metastatic disease for patients with choroid melanoma is the liver, and this has led to the extensive evolution of treatments targeting hepatic disease. Spinal/vertebral metastasis secondary to choroidal melanoma is an infrequent clinical entity. ”

“ The choroid plexuses contain the small choroidal arteries; and the blood from these is returned by small veins, which join to form the veins of Galen. These veins pass along the centre of the velum, and, as is shown in fig. 1, open into the straight sinus. If the velum interpositum be now carefully raised from before backward, the optic thalami, third ventricle, pineal body and corpora quadrigemina are exposed.
The optic thalamus is a large, somewhat ovoid body situated behind the corpus striatum, and above the crus cerebri. ”

“ H31.10 Unspecified choroidal degeneration Choroidal sclerosis NOS H31.101 Choroidal degeneration, unspecified, right eye H31.102 Choroidal degeneration, unspecified, left eye H31.103 Choroidal degeneration, unspecified, bilateral H31.109 Choroidal degeneration, unspecified, unspecified eye H31.11 Age-related choroidal atrophy H31.111 Age-related choroidal atrophy, right eye H31.112 Age-related choroidal atrophy, left eye H31.113 Age-related choroidal atrophy, bilateral H31.119 Age-related choroidal atrophy, unspecified eye H31. ”

“ It is often rife in one district a long consecutive time. Facts like this must certainly be regarded as pointing to a condition of the blood as one, at least, of the causes of this terrible disorder. This condition of the blood may react upon the nerves, and maintain in them a particular morbid state. Chorea seems also to depend primarily on the state of the blood, and is indirectly curable by medicines which, like Iron and Quinine, improve its condition. In a weakly and strumous child it may be brought on by a sudden fright which would not affect one of a good constitution. ”

“ A large majority of the cases of chorea occur in females and at the period of life when the nervous system is subjected to unusual requirements. In these cases the "Favorite Prescription" effects a gradual restoration of nervous energy, and improvement in the tone of the nerve centres, and by its direct effect upon the circulation in the ovarian region, eliminates the most potent causes of debility. In young people, we usually advise a dose of three drops for each year of the age. ”

“ O’Shaughnessy’s report on the chemical pathology of malignant cholera, by which it appears that in that disease there is a very great deficiency both of the water and saline matter of the blood. On which deficiency, the thick, black, cold state of the vital fluid depends, which evidently produces most of the distressing symptoms of that very fearful complaint, and is, doubtless, often the cause of death. In this opinion I am abundantly borne out by the phenomena produced on repletion by venous injection. ”

“ In a disease such as variable chorea, which has features in common both with tic and with chorea properly so called, the problem of diagnosis is still more complicated, though excellent hints for its solution have been furnished by Brissaud. [178]
However frequently and warmly the theory of the origin of chorea in a neuropathic predisposition was advocated by Charcot, the fact of its usual evolution consecutive to some toxic or infective process is no less certain. ”

“ ST VITUS’S DANCE [1] or Chorea, a disorder of the nervous system occurring for the most part in children, and characterized mainly by involuntary jerking movements of, the muscles throughout almost the entire body (see Neuropathology) . Among the predisposing causes age is important, chorea being essentially an ailment of childhood and particularly during the period of the second dentition between the ages of nine and twelve. It, is not often seen in very young children nor after puberty; but there are many exceptions. It is twice as frequent with girls as with boys. ”

“ He believes the history of chorea to be this: “Owing to emotional disturbance, sometimes stopping of various vessels of the brain, or sometimes the presence of organic disease, there is an altered condition of the ganglionic cells throughout the nerve-centres. If the cause is removed and the altered condition of the nerve-cells goes only so far, it remains what we call a functional disease. If it goes so far that the cells show alteration, we have an organic disease of the nervous system.” ”

“ In those rare cases, called “cholera sicca,” in which no purging takes place, the intestines have been found distended with the excretion peculiar to the disease, 11whenever an examination of the body has taken place after death. In all the cases of cholera that I have attended, the loss of fluid from the stomach and bowels has been sufficient to account for the collapse, when the previous condition of the patient was taken into account, together with the suddenness of the loss, and the circumstance that the process of absorption appears to be suspended. ”

“ Chorea and epilepsy when with anaemia are benefited by iron. Combined iron and arsenic for chorea. Septicaemia, pyaemia and all forms of blood poisoning, as purpura, haemorrhagica, scarlatina, etc., with quinine. The tincture chloride is prescribed in blood poisoning. In red water of cattle, after bowels are freely opened. In convalescence from debilitating diseases it is a valuable tonic combined with other medicines as nux vomica, quinine, etc. Such diseases as influenza, chest diseases and chronic catarrh should be followed with iron and other tonics. ”

“ I may, however, mention, that the idea of having recourse to this remedy in cholera, occurred to Dr. Latta, from being convinced, (which I am also,) that the evacuations upwards and downwards are in reality the serum of the blood; that it is the duty of the physician to replace it, as speedily as possible, by injecting a fluid, as similar to the serum as can be formed artificially, directly into the veins, which has been done here with wonderful, and, so far as we can yet judge, excellent effect. ”

“ What is the usual age for Chlorosis to occur, and what are the symptoms?
Chlorosis more frequently attacks girls from fifteen to twenty years of age; although unmarried women, much older, occasionally have it. I say unmarried, for, as a rule, it is a complaint of the single.
The patient, first of all, complains of being languid, tired, and out of spirits: she is fatigued with the slightest exertion: she has usually palpitation of the heart (so as to make her fancy that she has a disease of that organ, which, in all probability, she has not) ; she has shortness of breath, and a short dry cough ”