ACUTE MANIA FOLLOWING THE ENUCLEA- 
TION OF AN EYE. 
By W. CHEATHAM, M. D., Louisville, Ky. 
1 1 
F. B., age thirty-five, carpenter, was struck in the left eye, on 
September 30th last, by a spike six inches long, rupturing the eye 
at the inner sclero-corneal junction, and also at the insertion of 
the external rectus. I saw him late in the afternoon of October 
1st. The whole organ was greatly inflamed, the chemotic con- 
junctiva, even at this early stage, overlapping the cornea. I 
advised immediate enucleation, which was done early on the morn- 
ing of October 2d, quite a good deal of hemorrhage following. 
The instruments were washed in boiled carbolized water, the 
sponges put in boiled water and hyd. bi-chlo., and the eye 
dressed with iodoform. The spike he was struck with was very 
dirty and rusty, and the patient fell on his face in the dirt when 
he was struck ; he was brought home with a dirty cotton hand- 
kerchief of a fellow-workman over his eye. October 3d there was 
great swelling of the parts, with great pain, and the patient was 
controlled with much difficulty ; he imagined he was from home, and 
some one wished to force him to join the church. Morph, sulph. 
was given him hypodermically and by mouth. October 5th he was 
very violent ; the parts were very tense. Pot. brom., in large 
doses, was added to the morphine. He would allow no local 
applications to be made. Drs. Mason and Cartledge were asked 
to see the patient with me. Thinking the morphine had some- 
thing to do with his present condition, bromidia was given in 
teaspoonful doses, every one, two, or three hours, until October 
8th. This failing to quiet him, the morphine had to be used 
again occasionally. Sometimes it required four or five men to 
hold him in his bed. He recognized no one ; endeavored to do 
violence to his wife. October 13th I gave him hydrobromate of 
hyoscine, gr. four times a day. Just at this time the inflamma- 
tion began to subside and his mind to clear up. During his ill- 
ness his pulse and temperature were both normal, except the 
afternoons of October 10th and nth, when the former was 96 and 
the latter 99$°. The patient was discharged October 20th well. 
Reprinted from the Archives of Ophthalmology, Vol. xix., No. 1, 1890.