Medical Sketches of the Expedition to Egypt, from India

by Sir James McGrigor

It was said, that the sailors, on-board the fleet at Aboukir-bay, had the disease at the same time that it prevailed in the army on-shore. Several cases appeared among the troops after we sailed from Suez.

Ophthalmia prevailed most from May to December. At Kossier the disease was hardly seen, nor at Ghenné. It was not till the army was encamped at Rhoda, in August, that cases crowded in on us. In that, and the two following months, most of the cases made their appearance.

It will be seen, in part the first of these sketches, that, in the months of January, February, March, and April, very few cases appear in the reports.

About the middle of May the disease began to appear in Alexandria.

Some of our medical gentlemen thought this disease very different from the ophthalmia which they had seen in Europe or in India. In several circumstances there certainly was a difference, and we were obliged to have recourse to a different mode of treatment, finding we did not succeed with that pursued in England or in India. The disease, I think, might generally be resolved into, 1st, either of Cullen’s two species, the ophthalmia tarsi and the ophthalmia membranarum; 2ndly, to a combination of these two; or, 3dly, to a species of ophthalmia, frequent in India, symptomatic of disease in the biliary secretion.

The appearance which the disease put on, particularly the two first species of it, was nearly what we have seen in other parts of the world; except that the symptoms advanced with alarming rapidity to the highest inflammatory stages. In most cases the attack was sudden, and very generally at night. Speedily, the patient complained of a burning heat of the eye-ball, or of a sensation of needles being passed through the eye. There was a considerable swelling of the ball of the eye, of the eye-lids, and sometimes of the neighbouring parts. Almost always, there was a copious flow of tears, which felt hot and scalding, and, as they flowed down, excoriated the face. Very frequently, there was a racking headach and general fever. Œdema of the eye-lids was frequently met with in the early stage of the disease, and inversion of the cilia in the last stages.

The disease very often continued two or three months: after it had continued some time, the general health became much impaired. It often terminated in diarrhœa or dysentery, and sometimes the patient became hectic.

In the third species of the disease, which I have mentioned, there was not so much active inflammation as in the other two species; and it was generally known by a yellow tinge of the adnata, or by dyspeptic symptoms being present; though, sometimes, we have seen those appearances absent: and no topical application had any effect in removing the ophthalmia, till the gums were affected by calomel or some mercurial preparation.

In the two first species of the disease, the inflammation, in a great many instances, induced fever of many days duration, and the disease too frequently terminated in opacity of the cornea or in suppuration of the eye-ball.

In the treatment, it appears, from the reports, that different gentlemen followed very different modes. We said, in general, that the European practice did not succeed. Scarification and astringent collyria, in the first stage, gave intolerable pain, and generally aggravated the symptoms.