Some recent theories regarding the pathogeny of sympathetic ophthalmia, viewed from a macroscopic standpoint / by Samuel Theobald.

  • Theobald, Samuel, 1846-1930.
Date:
[1884]
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Licence: Public Domain Mark

Credit: Some recent theories regarding the pathogeny of sympathetic ophthalmia, viewed from a macroscopic standpoint / by Samuel Theobald. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    debate was presently cut short by the announcement that the suspicious neoplasm was, after all, but a half-digested oyster, a harmless specimen of our should-be-familiar bi- valve, which, probably, during a previous spell of vomit- ing had become lodged at the point where it was discov- ered. There is a resemblance, not altogether fanciful it seems to me, between this oyster episode and the study of the path- ogeny of sympathetic ophthalmia, as recently conducted by certain microscopists. Intent upon the threads of fibrin, the emigrant round cells, and the microphytal organ- isms which their microscopes reveal, these investigators appear to have lost sight of the macroscopic picture of the disease, with which, as clinicians, they should have been familiar, and as a consequence they have promulgated theories regarding its nature which are satisfactory only when viewed from the narrow standpoint of their authors. Although Mackenzie and the other earlier writers upon sympathetic ophthalmia were disposed to regard the optic nerves as the probable route by which the inflammation extends from the primarily to the secondarily affected eye, this view, as is well known, was afterwards universally abandoned, and it was taught by all authorities, among them Von Graefe, Bonders, and Bowman, that the ciliary nerves are the medium through which the sympathetic in- fluence is transmitted, and that the inflammation in the second eye is not the result of direct extension from the one first affected, but is due to a morbific influence reflected through certain of the nervous centres. In support of this latter view, numberless observations have been recorded : as, for instance, the cases reported by Bowman and by Von Graefe, in which the starting-point of the sympathetic inflammation in the second eye occurred at a spot of. the ciliary region which corresponded symmetrically to that at which the first eye had been injured ; the numerous dissec- tions, by Donders and a host of other competent observers, of eyes enucleated for sympathetic irritation or inflamma- tion in the fellow-eye, in which the ciliary nerves exhibited signs of inflammation, were found torn, compressed, em-