DOI: 10.7925/drs1.ucdlib_280725
title: Malignant tumour in the orbit

description: Watercolour medical illustration depicting disease of the eye. It has the alternative reference number 1526, P15B and 230 on the front. The Richmond Hospital Museum reference is D.b.4. The entry for this in P263/1 pg. 29 reads 'Malignant disease of the eye. Fitzmaurice Power. 51. Mr Smith'. The handwritten note in the bottom left corner reads 'Fitzmaurice Power aet 51'. Includes stamp of Turnbull London papermakers in top left corner. The typescript and handwritten notes on the back read 'Malignant Tumour in the Orbit'.
description: Scope and content: The full typescript and handwritten notes on the back read 'Malignant Tumour in the Orbit – Professor R.W. Smith exhibited an eyeball which he had lately extirpated. The case was that of a man, aged 51, who had been admitted into the Richmond Hospital upon the 8th of September, 1850. He stated that eight years ago he was suddenly attacked at midnight with severe pain in the eye, and that a violent inflammation followed, which ended in total loss of vision; for this attack he had been salivated. Ever since, upon exposure to cold or wet, the eye became inflamed and swollen, and paroxysms of pain occurred, shooting through the temple, and from the orbit backwards to the brain. Ten weeks before admission, he had an unusually severe and prolonged attack of this description, for which he was again salivated. Three weeks before he applied at the hospital, and while his mouth was still sore, he went out to work in his farm, and upon the following day suffered a great increase of pain; and the eye was attacked with swelling, which soon extended to the eyelids, and continued to augment up to the time of his admission into the hospital, when the parts were in the following state: - The eyeball, seemingly greatly enlarged, projected from the orbit, the upper lid, of a bluish red colour, being stretched over its superior and anterior portions; the lower lid was oedematous and everted, exposing the conjunctiva, which was in a state of chemosis, exceedingly vascular and covered with superficial ulcerations. The conjunctiva of the upper eyelid was in a similar condition, and that covering of the eye was so much swollen as nearly to conceal the cornea, which occupied the lower and inner part of the tumour formed by the enlarged eyeball, and was a little opaque, but not so much so, as to obscure the lens, which was seen to be perfectly opaque and white. The surface of the tumour near the supra-orbital ridge was nodulated, and pressure here produced pain of a severe character and shooting back towards the brain. His general health was unimpaired. The disease being obviously of a malignant nature, it was resolved in consultation to extirpate the eyeball; the operation was performed upon the 20th September; the entire contents of the orbit were perfectly removed, nothing being left but the periosteum. Upon dividing the optic nerve, a profuse hemorrhage (sic) ensued, in arresting which some difficulty was experienced; the cavity was dressed from the bottom. Upon the 29th, a singular train of nervous symptoms set in. The right side of the forehead appeared to droop, and its wrinkles were obliterated; there was numbness above the right brow, and inability to open the mouth, which was drawn a little to the left side; the right side of the face was smoother than the left, and appeared swollen; the alae nasi were somewhat dilated, his speech was thick, and he could not whistle; there was, in short, a mixture of the symptoms of paralysis of one side of the face with those of trismus: they gradually, however, subsided, and had all disappeared by the 10th of October. He left the hospital upon the 26th, the wound being perfectly healed. In less than three months, however, the disease reappeared in the orbit & the man died in the country six months after the performance of the operation. Upon examining the parts which had been removed, the eye-ball was found atrophied & the lens opaque & hard. The optic nerve was atrophied, but not otherwise diseased. The malignant growth seemed to have originated behind the globe of the eye; it consisted of encephaloid and melanotic matter'.
description: Numbering/sequence: Original reference number: 1526.