"To the Editor of the Medical Gazette.
"Perth, December 31st, 1842.
"Sir,—If you deem the following case of diseased cornea, &c., worthy of a place in the Medical Gazette, I shall feel myself obliged, while I have the honour to be, &c. &c.,
"G. K. H. Paterson,
"Surgeon."
"Case.—M. J., æt. 29, of a strumous diathesis, has been repeatedly attacked with inflammation in both eyes alternately, accompanied with more or less intolerance of light, and pain of head, ever since she had small-pox, about her ninth year: to relieve this her friends sought various means, but without any avail, and on entering her eighteenth year she became blind. The catamenia had never appeared before she was twenty; and from that period onwards, till about four years ago, menstruation had always been scanty, and attended with the usual symptoms of dysmenorrhœa.
"On the 28th September, 1842, her eyes presented the following state:—The right cornea transparent, with an unusual quantity apparently of aqueous humour on the anterior chamber, so as to give it externally a somewhat conical aspect; iris of a dark red colour, and its pupillary edge contracted to the size of a pin-hole, and in close contact with the capsule of the lens. No vision in this eye remaining. That of the left cornea was all but opaque, from coagulated lymph between its layers, with the exception of a small lucid segment, at the upper and outer margin of its circumference; behind which, on the eye being turned downward and inward, the pupil could be seen contracted also, and of an oblong shape, along with a great increase of aqueous humour in the anterior chamber, and the cornea, to external appearance, much more bulged forward than that of the right. With this eye she could only distinguish an object when it was rolled downward and toward the inner canthus, on being passed between her and the light.
"This ill-fated woman being altogether an object of charity, her friends solicited me to take up her case, of which I was not at all sanguine. However, having previously perused, with much pleasure, a brief extract by Dr. Turnbull, on the fumes of prussic acid as a valuable remedy in certain diseases of the eye, I was led to make trial of a few applications of it in the above case, according to his method; and I must candidly confess, that ere long I was completely astonished on observing the rapid effect it produced on the opaque cornea before mentioned; more so, as the longer I cautiously and perseveringly used it, the greater in proportion did the inspissated lymph become absorbed, and the layers of the cornea, over a wide space, begin to assume their natural transparency, as also in dilating the pupil to a considerable extent; so much, indeed, that before one month under its use, she could observe objects in a very different light, and ere another had elapsed, she could find her way out of doors by herself, and come to my residence for any medicine she required; since which she has gone on gradually to progress favourably, without any more applications, and the vision is now sufficient to enable her to go about free from the dread she had before, or the use of a guide.
"During the use of this potent remedy, it struck me very forcibly that the extract of belladonna might assist the case considerably (more especially when one had reasons for suspecting adhesions to exist), in keeping up a greater effect on the pupil than that arising from the use of the acid, which every one will admit at once, who has seen its powers depicted upon the human eye, to be only temporary, and, I believe, still less so in disease of the cornea and iris than in any other incident to such an organ. With such an object in view, and after once applying the extract, smeared round the eye, at bed-time, I soon found it to be also of considerable service, along with the daily use of the fumes of the acid, which were both, afterwards, employed assiduously in this manner, for the rest of the treatment.
"But in drawing my remarks to a close at this time, I cannot refrain from saying less, in regard to the utility which is likely to arise from this medicine, when properly applied, than that, in such a similar case as I have stated, I would not for a moment hesitate again in giving it and the extract of belladonna a fair trial, so convinced am I now, after employing it pretty freely by itself, in different affections of the same organ (in all of which more or less improvement of vision was manifested), of its potency to remove many of those formidable diseases of the eye, more especially that of the cornea, which are so often the opprobium of our art. However, before I have done, it is but justice to ascribe this noble discovery to Dr. Turnbull, whose indefatigable research has not failed to find out others, no less wonderful in their effects, as they are useful to mankind; and for such he cannot but claim to himself the best thanks of the profession at large."