Excerpt from The Edinburgh Medical and Surgical Journal, Vol. 3: Exhibiting a Concise View of the Latest and Most Important Discoveries in Medicine, Surgery, and Pharmacy; 1807
In the beginning of May 1804, the pain returned with greater severity, and the eye gradually increased in size, till the time of the operation, when it had acquired the size of a middle-sized lemon.
In the middle of September I first saw him; the eye-ball was very much enlarged, and protruded beyond the verge of the orbit; there was considerable hardness in the tumour; the vessels of the tunica conjunctiva were extremely turgid; and the patient complained of excessive pain. In a case like this, no advantage could be expected from external applications, or internal remedies. I therefore informed him, that extirpation was the only resource; but advised an opening to be made into the tumour first, as I thought I could perceive an obscure fluctuation. In the beginning of December, he put himself under my care; he informed me that poultices, fomentations, lotions of vitriolated zinc, &c. had been used with perseverance, but without any good effect; a puncture had also been made into the tumour, but with no better result, nothing being discharged but pure blood. The eye had evidently increased in size since I saw him in September; the vessels of the tunica conjunctiva had become more turgid; and that membrane, being very much thickened, presented a fungated appearance, covering the whole anterior part of the eye; the palpebr? were very much distended; the duplicature of the tunica conjunctiva, between the upper palpebra and the globe of the eye, was entirely inverted, and there was a small discharge of pus from the inner canthus. In consequence of the great pressure of the tumour upon the twig of the first branch of the fifth pair of nerves, which passes through the foramen orbitarium superius, the integuments of the forehead, and the parts which it supplies had become numb; pains frequently darted through the tumour in different directions; and he complained particularly of one, shooting to, and in the course of the coronal suture. The right eye had become much affected, there was a considerable cloudiness in the humours, and impatience of light; he was not able to distinguish letters, even with the assistance of spectacles; and an attempt to view an object elevated above a right angle with his body, was invariably succeeded by dizziness, which endangered his falling. For a considerable time, also, he had not been able to bear the admission of the air into the meatus auditorius externus, which constantly produced an uneasy twitching sensation, which compelled him to keep it covered.
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