Philosophical transactions, Vol. L. Part II. For the year 1758. / Giving some account of the present undertakings, studies, and labours, of the ingenious, in many considerable parts of the world.

by Various; Royal Society

Dear Sir,

Read Nov. 9. 1758.

IN October 1755. I communicated to you, and you inserted in the last volume of your Journal Britannique, the case of Susannah Earle, of Hemmingford-Grey in this County, who, in consequence of the whooping cough, was afflicted with a protruded eye. The case I now send you, somewhat similar to that young girl’s in its first appearance and progress, but by accident attended with a second disease, will perhaps deserve your attention, and not seem unworthy of being presented to the Royal Society.

John Law, of Fenny-Stanton, also in the County of Huntingdon, a strong and robust lad, thirteen years and six months old, in Easter week 1756, beating dung about a close with unusual force, on a sudden felt a violent pain in his left eye. The pain increased, an inflammation ensued, and the eye grew daily larger. The poor boy’s mother followed the directions, which she received, without the least benefit to her child, after having, besides other expences, been defrauded by a quack of two guineas; a great sum for a poor cottager!

The widow Law, in her distress, heard of Susannah Earl’s cure. She went to see her; and determined to bring her son to Huntingdon, for Mr. Hopkins’s assistance. Accordingly, October the 7th 1756, she came to Mr. Daniel Hopkins, surgeon, in this town; and having desired my opinion, we both examined the eye together.

The left eye was protruded out of its orbit, and hung down over the cheek to the upper lip. The coats were greatly discoloured, all the vessels turgid, the sight totally lost, and the humours appeared like fluctuating pus. We saw the necessity of an immediate extirpation, to save the right eye, already greatly inflamed; and having apprized the mother and boy of the state the eye was in, a consultation was desired with two surgeons of St. Ives. Mr. Dawkes, who was present with Mr. Skeeles at Susannah Earle’s operation, being dead since that time, Mr. Thomas Skeeles and Mr. Thomas Want very charitably met Mr. Hopkins and me the next day, October the 8th, at the widow Law’s cottage.

The eye appeared to these gentlemen as I have related: and upon Mr. Want’s pressing with his finger on the pupil, the globe burst at the edge of the Iris, and discharged pus. The extirpation of the eye was unanimously agreed upon, and immediately performed.

Mr. Hopkins made a puncture with a lancet close to the external and small canthus of the eye, and then with a pair of crooked scissars took off all the distended globe close to the eye-lids. He then cleaned the cavity of the purulent humours, and filled it with soft lint, over which he applied bolsters dipped in warm red wine and water, and the monoculus bandage to keep on the whole dressings. The lad was bled in the arm; nitrous medicines, and anodynes, were prescribed, and a suitable regimen. The fever, and inflammation of the eye, gradually decreased; the suppuration of the wound in few days was good, the distended eye-lids contracted, and a cure was soon expected.

But on November the 7th the lad went to open the street-door, and it being a cold and rainy evening, he quickly felt the bad effects of the cold wind, which drove the rain in upon him. That night the wound became again very painful, the eye-lids puffed up, and next day appeared much inflamed, as were all the contents of the orbit. Fungous excrescences soon followed, and an intermittent fever. An emetic being improper, he was purged with rhubarb, and afterwards took the bark infused in red wine. The fever was removed after some time; but the contents of the orbit continued increasing, and the fungous excrescences became so large and spongy, as to be of equal bulk with the diseased eye before extirpation. All topical applications, to contract this fungus, were ineffectual, and the application of caustics or escharotics was prudently avoided, lest they should produce a carcinomatous ulcer. The discharge was chiefly a purulent serum: on which account, ever since the beginning of November he was kept upon a dry diet.

In February 1757. the remaining coats of the eye began to appear at the most prominent parts of the excrescence, and seemed white like a part of the conjunctiva. On touching it with the finger, a distinct fluctuation was felt, and an hydrophthalmia perfectly discovered; but neither the thickness of the coats, nor the sensibility of the parts, would permit a puncture to be made, till the cyst, which appeared formed by the distension of one of the coats of the eye, was freer from the fungus.