Frederick William Payne
The following cases of cataract are reported, not on account of their infrequency, or unexpected profundity, but in order to again prove, that, contrary to the old school dictum, such cases are amenable to treatment, and that restoration of the sight is often permitted by the use of the simillimum, in cases that, by other means, prove irreparable.
Opacity of the lens of the eye has its origin in malnutrition of the part, either from traumatism or disease. Its possessor may or may not be apparently in a condition of ill health. The following cases illustrate widely different expression in physique and constitution, and in no two of them were cures effected by the same remedies, thus illustrating the homoeopathic need and plan of individualizing.
Case I – This was a lady 55 years of age. Her case was a peculiar one. Striae of opacity existed in both lenses, but in the left one it was so prominent, as to interfere greatly with acuteness of vision. The history of the case showed a condition of inflammation of the choroid in the left eye, thus inducing a degenerating change in the crystalline, with stripes of opacity, marked and numerous, existing in consequence, in its cortex.
Her symptoms, all being referred to the left eye, were those of severe bruised, sore, smarting, burning, itching and stinging sensations, at intervals, coming suddenly, almost as if pepper had been thrown into the eye, causing lachrymation; these spells occurred more markedly, and more often in the evening. The eye and lids had spells of burning and dryness, so intense as to cause a feeling as if the eyelid had become firmly adherent to the ball, accompanied by a sensation as of a stick in it. Slight conjunctival irritation, with tendency to agglutination existed. Eye symptoms were all worse by the warmth of the day, and also by artificial heat, both causing a notable aggravation of all her symptoms. She was impatient, nervous and tremulous, the tremulousness being aggravated by every mental emotion.
A marked choreic tendency existed, with jerking of individual muscles of the face, nose, ears, mouth, and sometimes of the arms, which latter necessitated much effort of the will to restrain, and which proved only partly successful. She had some jerking of the body during sleep. The remedies studied with reference to the case were Zincum, Causticum, and Sepia. Zincum was the remedy chosen, and the only one given. The acute eye symptoms, and the choreic expressions were rapidly dissipated, although the latter had been of long standing. The cataractous condition gradually improved, so that in six months the right eye was perfectly clear, and the vision in the left grew steadily clearer. A compound hyperopic astigmatism, to +o.5oD., existed in both eyes; in the right, at an axis of 900 and in the left, exactly at right angles to this, viz., 1800. Glasses were adjusted that perfectly neutralized this dissimilarity and defect, and made the use of the eyes comfortable.
Now eleven years have passed, and the right lens remains perfectly transparent, while a few dense streaks still occupy places in the cortex of the left, though other parts of the lens have become perfectly clear, so that vision is as comfortable and complete as ever. Boennighausen s Therapeutic Pocket Book does not give Zincum as a remedy having aggravation from heat, but this marked condition of aggravation from all kinds of heat was speedily and surely dissipated by the remedy, making it evident that we may, with confidence, ascribe this condition of aggravation to Zincum.
Case II – That is a lady, 66 years of age. Six months before her visit to me she wakened, after a good night’s rest, with a noticeable blur before the left eye, accompanied by a dull pain, with sense of fullness and pressure and luminous flickerings in the whole visual field. She was subject to Hay fever, and at the time of the occurrence of the visual blindness, had had an attack of hard coughing followed by the condition of blur, flickering and pressure, which rapidly increased until vision was almost entirely obliterated; though peripherally, in all parts, she was conscious of light and of moving objects. Centrally no perception of vision remained.
Accompanying the eye symptoms was much feeling of weight in the vertex extending to the forehead, with sense of tightness around the head, as of a band tightly drawn. In the blind retinal area she had occasional flickerings, as of the extinguishing of the flame of a lamp at intervals, while, always present, and occupying the same blind area, was a rolling motion, as of dark and light colored smoke, constantly curling before her.
On ophthalmoscopic inspection, striae of opacity in both lenses were noticeable, while the left eye gave every evidence of having been subjected to a haemorrhage within the sheath of the left optic nerve, though no hemorrhagic spots were visible occupying any part of the retinal area. The symptoms of the case seemed difficult to cover, and owing to their profundity, gave much apprehension of a possible cerebral apoplexy supervening. On account of the central amblyopia, and the condition of vertigo with confusion, Crocus was given, and the patient kept under its influence, with occasional repetition of the dose, for the four following months, during which evident gain in the pressed feeling of head and eyes, and relief to the vertigo were markedly noticeable, though the eye gave no signs of clearing, and the objective manifestations in the visual field continued. Causticum, Conium and Crotalus horridus were prescribed at intervals, one at a time, of course, in succession, during the following seven months, and still the eye symptoms persisted. On carefully reviewing the symptoms I found the mind considerably confused, rather slow in collecting her thoughts; she had a constant dread, as if she would become unconscious; had severe pressure in the vertex, as if pressing downward upon the brain; had fine black specks appearing on objects looked at, especially on awaking in the morning; upper eyelids were heavy, and felt as if they were dry, and would not raise easily.
Round, bright lights, red and green ones before left eye, especially when looking into the light. Left eye was sensitive to light, especially to sunlight. Although these symptoms are rather indefinite, and more or less present under other remedies, I chose Lac caninum as the Similimum, for all the above symptoms appeared under its proving, and the choice proved the solution of the problem. In an extract from a letter received from the lady three weeks after Lac caninum was prescribed, she said: “My eyes have been quite comfortable for the last two weeks. I have suffered less from all the disagreeable symptoms, like weight on top of the head, dryness of the eyes in the morning, and sensitiveness to light. They are surely no worse and I think vision is a little clearer in the left eye.” Three weeks after this report the gain had continued, the visual area having become still brighter, and the discomfitures largely abated. Vision thereafter gradually improved, the cataractous lenses growing steadily clearer, until with the aid of compound myopic cylinders to correct the refractive error, vision has become useful, and the crystalline lenses, when last inspected were perfect in translucency.
The cure of such a case of extreme profundity, after having been subjected to an apparent haemorrhagic pressure for over a year, is in itself a subject for much wonderment and amazement, so that one can truly feel that nothing is impossible under the astonishing influence of our law of similars.
Case III -. This is a lady 68 years old, generally well and active and unusually so for one of her age. Owing to a gradually increasing blurriness of the visual field, and tired feeling in the eyes on reading or sewing, especially evenings, she reported to me for treatment. The ophthalmoscope showed incipient cataract, with increasing fine, radiating striae in the lens substance, distinct in both eyes, though more in the left. Constitutionally she showed a marked puffiness over the eyes, between brow and eyelids, like little bags falling well down towards the eyes. She said that while reading, especially by artificial light, there was much sense of dryness and smarting induced. Bright spots at times floated before the eyes, and, especially if coughing, she had a flashing of sparks. She is subject to much eczema on hands and feet, and general roughness, worse in cold weather, when numerous deep cracks occur, keeping the parts extremely sore and painful.
Kali c.200 was the remedy that effected the cure; not only entirely clearing the opaque lenses, but apparently correcting, or at least making perfectly comfortable, the eczematous expression on the skin, that had been practically a life time annoyance. She was under treatment a little over a year.
Case IV – A case of traumatism in a girl, 14 years of age. As the result of a blow upon the left eye, the cornea had been abraided, and extensive haemorrhage had occurred, apparently filling the posterior chamber of the eye, with some appearance of blood in the anterior chamber; the pupil was irregularly round and dilated, and all perception of light was obliterated. The eyeball was sore and painful, and lachrymation was abundant. The condition warranted the supposition that the crystalline lens had been somewhat dislocated anteriorly, but as the eye cleared and the blood absorbed, this was found not to be the case, though the lens had swollen, pressing the iris somewhat forward and showing the hazy, opaque condition, due to the infiltration of the body. As the blood absorbed, perception of light increased, gradually emerging from intense blackness, to a reddish, then yellowish hue, till finally, as the ophthalmoscope showed, all evidence of the haemorrhagic effusion had departed, leaving the lens, throughout, hazy, with visual perception much dulled.
The remedy first prescribed was Arnica, selected upon general principles, though no especial Arnica symptoms were present, except as we are taught its usefulness for bruises and contusions. In searching the Repertory of Hering’s Guiding Symptoms, I was directed to the symptoms under Hamamelis virg. as follows, viz.: Sore pain in eyes, also aggravation from slight pressure. Traumatic iritis with hemorrhage into iris. After injury to the left eye and abrasion of cornea, some blood in anterior chamber; vitreous so dark from hemorrhage that fundus could not be illuminaied. The complete cure of the case was effected by Hamamelis virg.200. The restorative process began at once and steadily progressed; the absorption of the blood taking place rapidly, followed by clearing of the cataractous lens, and restoration of the paralytic condition of the muscular fibres of the iris, so that the pupil assumed its natural shape, size and mobility. In a month the effusion had entirely disappeared, and in two months more the lens was perfectly clear, and the pupillary opening normal in all particulars.
I wish to say concerning cataract, that in itself, uncomplicated, there is usually no painful discomfitures. On the contrary, it is, in fact, simply a silent stealing away of the visual ability, through the gradual advancing opacity of that body. In the treatment of this disease in such cases, by medicine, there is, at first, often but little to guide one in the choice of the remedy. Constitutional peculiarities are to be diligently sought for, however, and more or less of these expressions generally crop out, and guide us as the treatment progresses.
The cases herewith reported have, in the main, had more or less of complication, the symptoms of which acted as an aid, whereby the choice of the similimum was made more easy. The result establishes the fact of cures, which it would have been impossible to effect by any other known means.
I would like to ask if Dr. Payne considers senile cataract curable?
Dr. Payne : In several instances in elderly people I have been successful not only in fully arresting, but in some instances largely clearing the opacity in the crystalline lens. I have in mind a lady, the mother of one of the prominent journalists in Boston, who came to my office, at first practically guided by her attendants. The lenses of her eyes became subsequently so clear, from constitutional treatment, that she was able to read comfortably for several years before she died. She died several years ago, at about the age of 70.