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Violent Symptoms from the Bite of a Rat

1840 American Journal of the Medical Sciences  
one of the Resident Physicians to the Philadelphia Hospital, Blockley. Having observed in your Journal of August last a case illustrative of the " value of the catoptric examination of the eye as a means of diag¬ nosis," I have thought that a case confirmatory of the same fact might be interesting to you. The following case, which occurred under my obser¬ vation, is therefore presented to you for your disposal. J. M., a stone-cutter, while engaged at his trade in trimming a stone, 18 years ago,
more » ... tone, 18 years ago, was struck in the left eye by a piece of the stone, or of the instrument which he was using, which caused severe pain, redness and swelling. These were removed in a month by bleeding, leeches and pur¬ gatives, but he has since been deprived of useful vision with that eye. The eye presents the following appearances:-Cornea, conjunctiva, sclerotica, natural; colour of iris same as that of the right; pupil black, clear, somewhat larger than the right; slightly irregular, apparently no ad¬ hesions; iris tremulous and somewhat contractile. Says that he can dis¬ tinguish day from night, and bodies when moved in front of the eye, and can see best from the nasal side of the eye. On examination with a lighted candle, I cotdd only distinguish the first upright image from the cornea. I examined the eye several times, and could never see more than the one image. As this corresponded with the appearance of the eye in your case, 1 presumed that the lens had been dis¬ placed by the blow which he had received eighteen years ago. I then procured a pair of spectacles with double convex lens, and ad¬ justing them to the eye, and closing the right one, he was much surprised at being able to distinguish objects. After wearing them for a few mo¬ ments he could readily distinguish a key, knife, cent, quarter or half dol¬ lar. I then directed him to wear them for a few hours, when he was able to distinguish persons and large letters. Although this case is not so satisfactory as yours, yet it is useful as showing the value of the catoptric examination as a means of diagnosis, and points out a ready mode of relief.
doi:10.1097/00000441-184005000-00076 fatcat:2xygktwfj5c4bpdkx3dqrgbhiq