145 Op. cit., pp. 109-129.
Examination of large numbers of cases has, I believe, established the general accuracy of these statements; and although there is still much difference of opinion as to the exact relation between syphilis and this form of keratitis—whether, for example, it is a symptom of syphilis itself or of a cachexia frequently produced by syphilis, but often by other systemic diseases affecting nutrition—yet, on the whole, so far as I am able to judge of the question outside of its purely technical and ophthalmological relations, I think the weight of modern authority is chiefly on the side of a distinct and practically invariable relation of cause and effect between inherited syphilis and the corneal inflammation.
Mr. James Dixon,146 for example, proposes to call the disease syphilitic keratitis, and says it is met with exclusively as a sequel of an inherited taint. He adds: "We may meet with some syphilitic keratitis in patients with healthy physiognomy and deformed teeth, or, still more rarely, in those with faultless teeth and the syphilitic cast of features; but to find the true form of keratitis in connection with both good teeth and good complexion is, I think, next to impossible." Many other ophthalmologists express themselves to the same effect more or less strongly. Nettleship,147 Noyes,148 Förster,149 Macnamara,150 De Wecker,151 and Carter152 may be mentioned as having ranged themselves upon this side. On the other hand we have Schweiger,153 Maunther,154 Sæmisch,155 Soelberg Wells,156 and others who are not convinced that syphilis is the sole nor even, in the opinion of some of them, the principal cause of this disease.
146 Article on "Diseases of the Eye," Holmes's System of Surgery, Am. ed., vol. ii. p. 71.
147 Op. cit.
148 Text-book of Ophthalmology.
149 Handbuch der gesam. Augenheilkunde, vol. vii. p. 186, 1876.
150 Op. cit.
151 Ocular Therapeutics, trans. of Forbes, 1879, p. 124.
152 He even asserts the converse to be true, which is going beyond what I believe can be established in regard to the invariable connection between the two diseases. He says: "The subjects of what we call simply inherited syphilis are liable—nay, are almost sure—to suffer from a peculiar form of interstitial keratitis."