ETIOLOGY AND TREATMENT OF AMAUROTIC DISEASES
227 exceed the adharing stage, and it is more tedious because suppuration must go on till the whole sack is consolidated by granulation. To produce the first method, it was proposed by the first Monro of Edinburgh, to make a puncture with a Trochar into the bag of water and let it out, then to inject by the same Trochar some wine to excite inflammation, and to let this wine out, then inflammation commences and the sides of the sack adheres; If it was certain that this effect would always be
... uced, and that every part of the surface of the sack and Testicle would adhere, then no more is necessary, but I am told, that these adhesions are not always perfect, which subjects the person to a relapse, and which has taken place, and it is probable that this was the reason of its being laid upside. Mr. Earl has again taken it up, and from his account, it would appear to succeed as well as we would wish, but I have been informed that it does not always succeed ; and that there are cases, where from experience it does not, which I can easily conceive. To produce adhesions of the sack by means of suppuration and granulation four methods have been recommended ; one, the most simple in the operation, was to make a small opening and let out the water, then into this opening put a tent, or a little lint ; ; this excited inflammation over the whole sack, and the whole sack suppurated, and I the whole was obliterated. To produce the same effect, one recommended a caustic to be apply'd, about the sise of a sixpence, and either to cut through the eschar or let it slough off. Another method was to pass through the sack a seaton, which was an old practice revived by Mr. Pott ; and the fourth was to open the sack from one end to the other, which is the most severe operation of the whole. Every one of these modes produced the same effect; and the same quantity of inflammation, suppuration &c succeeded ; the only difference was in the operation itself; but none of these four methods were at all times perfect, the disease recurred again M some of all of them. An accident hapen'd to a patient of mine at St Georges Hospital, which give me an oportunity of finding out the cause of those relaps's, which was, that the sack had not wholy inflamed and supurated ; therefore to effect an universal suppuration over the whole surface of the sack, I have taken care that no two parts of the sack shall come into contact till it has suppurated ; and to effect this, I put into the opening made into the sack (which is about two inchs long) some flower, which I spread all over the inside with my finger, and then a little lint on the cut edges of the wound, and a poultic over the whole. Then dlow suppuration to take place, and the whole heals. If this flour is well intro-duced through the whole sack, every part must suppurate, and every part must unite, which makes the complete cure. In whatever way the cure is effected, there is no danger. To Count Bruhl, Dover-street. ETIOLOGY AND TREATMENT OF AMAUROTIC DISEASES. It has been stated by Beer (Lehre von den Augenk., b. 2, p. 456), that imperfect amaurosis is seldom caused by disorder of the gastric organs, except in the case of worms. Richter, however, in classifying the remote causes of this affection, makes one subdivision to consist of irritations, most of which lie in the abdominal viscera; thence sympathetically acting on the eye.