DEP/DUA/1/33/04 (Normalised version)

Lewis Baine

(1783-1784)

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Lewis Baine November 22

Of case of this patient unnecessary to make many observations.

For while case not in its nature very highly important reason to presume [from] absence during two successive weeks that will see nothing more of him in this place.

And shall therefore be disappointed of opportunity of that trial which intended.

Disease you will observe when came under our care an obvious one.

Consisted almost entirely of affection of left Eye

And these principally of inflamed nature

Could have little doubt therefore in considering it to be an example of Ophthalmia

This affection by nosologists¹ divided into different species

Mr Sauvages from distinguishing affection not only from nature & situation but also from remote causes has ranked under this genus 24 different species.

Dr Cullen however has in my opinion done better in referring idiopathic species to two only.

Ophthalmia Membrane & Ophthalmia [illegible]

And have no doubt that more useful in practice than more numerous divisions.

From case before us however appears that even this distinction liable to objections.

For here evidently an affection both of Tarsus & membrane of eye.

While at same time from intolerance of light may conclude that not merely in external membrane but internal also.

Or at least may infer that sensibility of retina augmented.

And indeed in cases of most simple, & strictly idiopathic ophthalmia more frequently happens that thus extended, than that exactly limited.

But besides Ophthalmia another effect of this eye also mentioned in history of case

An opaque speck viz of Cornea by which sight in some degree impaired.

These obfuscations to which nosological & practical writers, have given name of Leucoma, very generally the consequence of inflammation

And after repeated inflammation not unfrequently so much extended, [that] vision very considerably impaired.

Hence then with these before subjected to the affection, became always an object of attention.

And was here, more with view to this part of disease than to Ophthalmia itself that selected as subject of Practice & Lecture

The Ophthalmia which but of recent date & by no means very severe, would I trusted by proper means soon be overcome

And was afterwards my intention to attempt removal of Leucoma by a remedy which have oftener than once before employed, in such cases, with success.

A powder viz to which in shop of the Dispensary we give name of Pulveris Ophthalmia.

This powder consists of equal parts of Cream of Tartar and Sugar.

A little gently introduced into eye every night at bed time.

And have often seen from it good effects as tending to remove severe specks.

Probably from operating on mechanical principle.

For although Cream of Tartar soluble in fluids of eye, yet slowly so.

To use of this powder first led on recommendation of Dr Baldinger of Gottingen.

Receipt indeed which he has published a very complete one containing Armenian Bole & a variety of other articles

Was inclined to think, that from simplifying it, to two ingredients mentioned would suffer no diminishment of activity

While at same time, more safe from both articles being soluble which not the case with earths

Accordingly have often used it not only with safety but with manifest advantage.

And after repeated trials must own that consider it as preferable to eye ointment of Sir Hans Sloane or any other I have before used with same intention

While however ophthalmia remains every irritation to eye to be avoided.

Before having here recourse to it therefore, wished that Ophthalmia should first be completely removed.

And for this purpose, had recourse to Saturn solution externally applied, & to Cream of Tartar internally as a Cathartic

From use of these remedies affection soon considerably alleviated.

And to me seems very probable that by continuation inflammation entirely [removed].

And that desertion has proceeded from having no farther occasion for assistance

But of this can conject only.

At same time whatever may be cause has precluded us from intended trial, for removal of Leucoma

With him indeed degree not so considerable, as to occasion much inconvenience.

And not improbable, that even without aid of any medicine, may gradually diminish.

For unless supported, & increased, by repeated inflammation, this not unfrequently observed to happen.

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Explanatory notes:

1) Nosology is the branch of medical science dealing with the classification of diseases. Individuals referred to in the case notes as nosologists were commonly those who had published nosological, or classificatory, medical texts.