GALVANISM IN THE TREAT- 
MENT OF CORNEAL OPAC- 
ITIES. 
BY 
L. A. W. ALLEMAN, M.A., M.D. 
REPRINTED FROM 
THE BROOKLYN MEDICAL JOURNAL. 
November-December, 1890, 
M. J. Rooney, Printer, 
Corner Broadway and 35th Street, 
NEW YORK. Reprinted from The Brooklyn Medical Journal, November and December, 1890. 
GALVANISM IN THE TREATMENT OF CORNEAL 
OPACITIES. 
BY L. A. W. ALLEMAN, M. A., M. D. 
Cases of corneal opacity are very frequently discouraging ones, 
alike to the patient and to the physician. It is almost an occasion of 
reproach to the physician that he should so frequently be unable to 
afford any relief to a patient who presents an eye, healthy in every par- 
ticular, and capable of giving the best visual results save for some loss 
of transparency of corneal tissue, limited perhaps to a superficial layer. 
To the patient, likewise, a corneal opacity is particularly unfortunate, 
not only on account of the visual defect, but because it aggressively 
invites the attention of others to its existence. 
Recent corneal opacities will sometimes respond quite readily to 
treatment, and the reparative power of nature is undoubtedly greatly 
assisted by stimulating applications, massage, and the like, but we 
soon reach the limit of our usefulness; and for old opacities, little 
remains but surgical interference. This is frequently inadvisable, and 
always unsatisfactory. 
Corneal transplantation offers an inviting field, but thus far has 
accomplished but little. The clearing of the cornea surrounding the 
transplanted area will, it seems, be more frequently obtained than the 
permanent transparency of the engrafted tissue. Even were it a more 
generally successful operation, its utility is limited to those cases in 
which no benefit can be obtained from an iridectomy, and where the 
opacity does not extend through the entire thickness of the cornea. 
It is impossible to obtain satisfactory statistics as to the frequency 
of lesions of transparency of the cornea. Having once applied for 
relief and receiving little encouragement, patients do not drift from 
one eye clinic to another, consequently the records of these institutions 
would lead us to infer that such cases are more rare than is actually 
the case; but when we remember the vast number of cases of keratitis 2 
L. A. W. ALLEMAN, M.A., M.D. 
that we daily see, many of them so severe that they must leave perma- 
nent traces of their existence, we are convinced that corneal opacity 
must be a very common affection. 
It is with great pleasure that I present a contribution to the thera- 
peutics of these unfortunate cases, which I believe to be of some real 
value, and that offers at least some hope of improvement in nearly 
every case. 
The method of treatment to which I refer, is the application of 
galvanic electricity directly to the surface of the cornea. So extrava- 
gant have been the claims of some of the advocates of electro- 
therapeutics that the profession in general, having been disappointed 
in their endeavors to justify these statements by their own experience, 
are inclined to look with great distrust upon any plea for the further 
extension of this method of treatment. 
I have, therefore, endeavored in making the experiments with which 
I have been for some time engaged, to avoid as far as possible all 
errors which may arise from careless observation or too vivid imagina- 
tion on the part of patient or physician. 
In testing the vision from time to time I have used artificial illumia- 
tion of unvarying brilliancy, and, by frequently changing the test- 
letters, have endeavored to prevent the patient from committing them 
to memory. 
I have measured the vision exactly in each instance, using a steel 
tape as a measure of distance, to obtain greater accuracy. 
When in any case I have used a mydriatic, either to ascertain what 
vision could be obtained through the clear cornea surrounding the scar 
when the pupil was dilated, or to better observe the condition of the 
lens, iris, etc., I have either taken no records of the vision till the 
effects of the mydriatic have passed away or have indicated in my 
record that the pupil was dilated at the time the record was made. 
Curing treatment the visual record was always taken before the 
instillation of cocaine or the application of the current. 
The idea of using galvanism for the removal of corneal scars first 
suggested itself to me from noticing the good results obtained by gynae- 
cologists in some cases of old inflammatory deposits in the pelvis. It 
seemed to me reasonable that a similar absorption of repair-tissue 
could be brought about in the cornea, and that electricity would prove 
a most valuable therapeutic agent, could it be so applied as to produce 
sufficient molecular disturbance in the cloudy area to bring about its 
absorption, while at the same time it should have no ill effects upon 
the healthy tissue of the eye. 
I concluded that a small electrode applied to the surface of the 
qornea was indicated, since by this means a current of great density GALVANISM IN CORNEAL OPACITIES. 
3 
would be applied directly to the diseased point and since the greatest 
molecular activity is induced at a point directly in contact with the 
electrode, the indication of strictly limiting the current's action would 
be best fulfiled. I apply the other electrode to the cheek, making the 
path of least resistance through the soft tissues of the face, in order 
not to bring the intra-cranial organs nor more of the globe then neces- 
sary within the circuit. By reference to Fig. i, the advantage of the 
small electrode in immediate contact with the cornea may be readily 
seen. The current is represented as consisting of a certain number of 
strands, in both instances the same. It is apparent that the current is 
brought to bear much more directly upon the cloudy area in A than it 
is in B. (Fig. i.) 
Fig. I. 
It was my original intention to make use of some of the prepara- 
tions of mercury commonly employed in the treatment of corneal 
opacities, hoping by the combined action of mercury and electricity to 
obtain better results than from the use of either agent alone. I made 
several experiments, usually with the yellow oxide, but found it well 
nigh impossible to find any vehicle for the mercury which would at the 
same time act as a good conductor and prove unirritating to the eye. 
I finally hit upon an expedient which has proved very satisfactory : it 
was to make the tip of my electrode of silver, which plunged into a 
bath of metallic mercury, would form with it an amalgam and hold a 4 
L A. W. ALLEMAN, M.A., M.D. 
globule of mercury on the end of my electrode. This makes a smooth 
and adjustable cushion to apply to the cornea ; it fits itself perfectly to 
the corneal curve, and precludes the possibility of any unevenness on 
the surface of the electrode damaging the cornea. Whether or not the 
mercury in any way assists the action of the current it is quite impos- 
sible to say, but be this as it may, it furnishes in practice a most satis- 
factory tip for the corneal electrode. 
After trying various forms of electrodes, I find the most desirable 
model to be the one shown in Fig. IL It consists of a small silver 
bar, a, 12 mm. in length, insulated, except at the ends, by a hard 
rubber shell ; the exposed surface at the lower extremity is slightly 
concave, the better to hold the globule of mercury, and is 7 mm. in 
diameter. The upper extremity carries a thread which screws into a 
metal collar at b, allowing the tips to be changed when corroded by 
the action of the mercury. The collar is attached to a copper spring, 
c, which still further protects the cornea from injury when the electrode 
is moved in the fingers, and at the same time being perfectly flexible, 
allows the tip to be adjusted to any desired angle, which greatly assists 
the convenience of application. The spring is fastened to a hard 
rubber handle, d, 10 cm. in length and 1 cm. in diameter, through 
which a conducting wire is carried to the binding post, e, at the upper 
extremity. (Fig. II.) 
Fig. II. 
I have found this electrode most convenient in practice, and fulfil- 
ing all the desired indications. 
In the immediate application of electricity to the cornea some form 
of galvanometer is essential. My first few expertments were conducted 
without one, and I soon became convinced that an accurate measure- 
ment of the current was demanded alike for the safety of the patient 
and to insure the utility of the treatment. For the small current upon 
an anaesthetized cornea produces no sensation whatever, therefore the 
patient cannot inform you whether or not the current is passing. 
Should the battery be reasonably constant and always in repair, an 
ideal condition scarcely to be hoped for in practice, the resistance in 
different patients, and even in the same patient at different times, varies 
so enormously that it is impossible to judge even approximately the GALVANISM IN CORNEAL OPACITIES. 
5 
amount of current which the patient is receiving. I have obtained 
from the same number of cells used, as nearly as I could judge under 
Similar conditions, currents ranging from % to 3 m. a. 
lam using a milliamperemeter made by Fleming of Philadelphia. 
This instrument will measure m. a., and has proved extremely satis- 
factory.' Beside a variation of resistence from varying conditions of 
conductivity at the beginning of an application, we have to take note 
of the diminution in resistance during the passage of the current. 
Erbe1 has experimentally demonstrated this, and the deflection obtained 
during the continuous passage of the current, by first increasing and 
then diminishing the number of cells, is shown in the following table : 
With 8 cells o° defl. 
" 12 " 6° " 
" 16 " 28° " 
" 20 " 420 " 
" 24 " 500 " 
With 20 cells 46° defl. 
" 16 " 40° " 
" 12 " 34° " 
" 8 " 26° " 
" 4 " 12° " 
To avoid the annoyance from such variations in resistance, I found 
it convenient to use a rheostat; and since, the satisfactory instrument I 
am at present using is the only one with which I am familiar, suf- 
ficiently delicate to be available with the extremely small currents with 
which these applications are made, a brief description may be of 
interest. 
The rheostat was made by Mr. J. A. Barrett, and depends in prin- 
ciple upon the diminished resistance, under pressure, of a pledget of 
cotton permeated with powdered graphite. Its construction may be 
better understood by reference to Fig. III. It consists of a hard rub- 
Fig. III. 
ber cylinder, a, containing the cotton which rests between a metal 
plate at one end of the cylinder connecting with the post, b, and a 
metal plunger, the rod from which passes through a thread at c, and 
terminates in the milled head d. By the rotation of a the density of 
the cotton, and consequently the resistance offered by the rheostat, 
may be increased or diminished at will. Wires conduct from b and e 
to the binding posts f and g, by which the rheostat is included in the 
circuit. (Fig. III.) 
1 Electro-Therapeutics, p. 48. 6 
L. A. IV. ALLEMAN, M.A., M.D. 
In making an application, I stand behind the patient whose head 
is thrown back in a reclining chair, I give one electrode to the patient 
and direct him to press it against the cheek on the same side as the 
eye to be treated. I. then place the binding post of the eye electrode 
against the patient's tongue and turn the rheostat, until the needle 
indicates the strength of current I desire to use, when after dipping it 
in a bath of mercury, I place the electrode upon the cornea, which 
has been anaesthetized by the previous instillation of cocaine. The 
rheostat is now intrusted to an assistant, who carefully watches the 
needle of the milliamperemeter, and by turning the screw of the 
rheostat, maintains a uniform current during the application. With 
the thumb and first finger of the left hand the lids are separated suf- 
ficiently to prevent their coming in contact with the electrode, since a 
current easily tolerated by the cornea is painful and irritating when 
passing through the margin of the lids. The electrode is held with the 
right hand, gently, in contact with the cornea, and careful watch is 
kept during the application that the contact is not broken nor too firm 
a pressure made against the cornea. 
It is perhaps unnecessary to test the current by first passing it 
through the tongue, which offers practically the same resistance as the 
eye, but as there is always the possibility that by some accident the 
rheostat or milliamperemeter may be out of order or short-circuited, I 
think it safer to first try the current upon the tongue, where, if it is too 
strong, the patient will quickly inform you. 
The cathode is applied to the cornea, being theoretically indicated 
for the stimulation I wish to produce. 
The strength of current that may be safely employed varies widely 
in different cases. I begin treatment with %or%m. a. for one min- 
ute ; should this be easily borne, I gradually increase the time up to 
three or four minutes, which is about as long as it is possible to hold 
the electrode firmly in contact with the cornea without fatigue. The 
strength of current may be slightly increased at each application, until 
the patient's point of tolerance is reached. I place as the limit in any 
case a current which is followed by a slight irritation, which shall sub- 
side before the next application, which I usually make after an interval 
of one day. The strongest current that I have employed is 4 m. a. for 
three minutes; but I do not think any better results were obtained by 
this than by a smaller current repeated at more frequent intervals. 
A current of 4 m. a. will only be borne in exceptional cases, and 
1 to iM will, I think, give the best results. With this current consid- 
erable irritation is sometimes experienced at the anode by thin-skinned GALVANISM IN CORNEAL OPACITIES. 
7 
people, and I have frequently produced marked vesication on the 
cheek without setting up any disturbance of the cornea. 
During the passage of the current the iris is seen to dilate, even 
when already somewhat dilated by the action of cocaine. 
It is perhaps worthy of note that with the electrode on the cheek, 
as a rule, no light sensations are observed by the patient during the 
making or breaking of the current, which I think indicates that the 
current does not deeply penetrate the eye, because the same current 
strength through the closed lids with the electrode at some indifferent 
point does usually excite such sensations. 
The following series of cases are some of those upon which I have 
carried out corneal galvanization during the last year and a half. I 
have been obliged to omit some cases which have been interesting and 
instructive to myself when no visual record was obtainable, the patient 
possessing only 1. p., and where I depended for my record of results 
upon a photograph ; such patients having disappeared without giving 
me an opportunity to obtain a second photograph. 
When first recording my cases I endeavored to obtain a record for 
comparison by measuring the opaque area, but this proved not to be 
satisfactory. The boundary of the opacity, especially when under 
treatment, is not well enough defined to allow of accurate measure- 
ments being taken. 
I have also tabulated all but the longer cases, in order that the 
duration of treatment, progress, and result may be more readily seen. 
Ca.se I.-E. C., male, aged nineteen. Patient at the N. Y. Eye 
and Ear Infirmary. Referred to me for treatment by Dr. Mittendorf, 
on December 13, 1888. The patient had probably suffered, when an 
infant, from ophthalmia neonotorum, which had left an opacity cover- 
ing the lower two-thirds of the cornea. The eye deviated upward and 
inward. His vision in the affected eye was at that time 2/200. I gave 
him an application of electricity, the negative Dole applied to the 
cornea, using three cells for one minute. As this application was 
followed by no reaction, finding on December 15th vision slightly 
improved, I repeated the application, intending to somewhat increase 
the strength of the current. The battery had in the meantime been 
recharged, a fact of which I was uninformed, and I was very much 
surprised to discover a very peculiar appearance of the eye under the 
electrode. The secretions in contact with the electrode had been 
decomposed by the current, and the small bubbles covering the surface 
of the cornea gave it the appearance of having been severely burned 
by the electrode. 8 
L. A: W. ALLEMAN, MA., M.D. 
This very forcibly impressed upon me the danger of using a cur- 
rent in direct contact with the cornea without a milliamperemeter. 
Fortunately, in this case, no serious harm was done; the cornea had 
been slightly burned, and became a little more opaque at one point. 
Some inflammatory reaction followed, which yielded readily to atropine, 
and the patient's vision very rapidly improved ; vision of 10/20() being 
obtained. On January 23d, 1889, when the applications were again 
resumed. By February 9th, vision was improved to 2%00 ? After two 
more applications vision of 20/200 and J. 9 was obtained, which was not 
improved by March 16th. I then concluded that the eye was ambly- 
opic, and that no further improvement would be obtained, and treat- 
ment was discontinued. 
There was a marked improvement in the appearance of the cornea, 
which, after the inflammation following the second application had 
subsided, was found to have cleared most remarkably, and continued 
to improve while under observation. 
When last seen very little opacity was visible. 
Case II.-Mrs. M. H., patient at the N. Y. Eye and Ear Infirmary, 
also referred by Dr. Mittendorf. Three months before, she had suffered 
from suppurative keratitis. It was then two months since all signs of 
irritation had disappeared. She had then a slight cloud extending over 
the lower two-thirds of the cornea; vision = 20/200. On December 18, 
1888, she was given X m. a. for one minute. This application was 
followed by only a very slight reaction On December 20th, vision - 
^°/ioo ? M m. a. was given. On December 22d, vision = ?0/60; the appli- 
cation was repeated, but the patient was unwilling to return for treat- 
ment, as she lived out of the city, alleging, moreover, that her vision 
was now sufficiently good for all her requirements. The opacity was 
much less noticeable than before the treatment was instituted, and the 
eye had suffered in no way from the application, which fact is of inter- 
est, as the case had been one showing lack of nutrition. 
I wish here to note that the visual records in Case I., up to January 
23d, and in Case II., were made at the N. Y. Eye and Ear Infirmary, 
without artificial illumination, and that the distances were not accu- 
rately measured in each case, as in all subsequent records. The current 
strength in Case II. and in the first two applications of Case I. have 
been estimated-no milliamperemeter having been used. 
Case III.-J. M., male, aged thirty-six, suffered from interstitial 
keratitis some twenty years ago. At present there are corneal opacities 
of both eyes. The left eye alone was submitted to treatment. This 
was clouded with a dense opacity extending deeply into the substance GALVANISM IN CORNEAL OPACITIES. 
9 
of the cornea. An iridectomy had been performed without benefit: 
V. - fingers at 18". 
On January 15, 1889, treatment was begun with X m- a- for one 
and a half minutes, which was increased up to m. a. for three min- 
utes by January 30th, when, after seven applications, V. = fingers at 
54". I then found that with a -J- 12° lens, the fellow eye, which had 
V. = 10/200, could be greatly improved and so put the same correction 
on the left, which gave V. = B/200. The current was now increased up 
to M m. a. for three minutes, and vision gradually, but only slightly 
improved, till on the last of February V. = 10/200 was obtained with the 
correction. This was after nineteen applications. It was impossible 
for the patient to take the time necessary to continue the treatment, 
and it was consequently abandoned. 
Case IV.-Wm. B., aged twenty-eight, presented himself at my 
clinic at the Long Island College Dispensary, January 19, 1889, giving 
the following history : 
Eighteen years before, while living in Ireland, he suffered from an 
inflammation of the left eye. Removing to this country while the eye 
was still inflamed, he presented himself at the N. Y. Eye and Ear 
Infirmary, where he underwent treatment and an operation. His 
symptoms were entirely relieved after the trouble had continued for 
some four months. Since which time the vision of his left eve had 
been very poor. 
In November, 1888, he again visited the Infirmary, at which time 
I find his vision is recorded as 20/200 in the left eye. 10/200 under atropine. 
(Refraction 5 D. Hm.) He had, when first seen by me, a corneal 
macula occupying a little more than his pupillary area. His vision at 
this visit was 20/200. (This improvement in vision as compared with his 
record, taken in November, 1888, is probably due to the fact that my 
test-letters were brightly illuminated.) I began treatment by the appli- 
cation of electricity on January 19th. The patient was phthisical, and 
it was impossible to use any but the feeblest currents, and even with 
m. a. I obtained on several occasions very annoying irritation. 
I gave him, as a rule, m. a. for two minutes at each sitting, 
giving him in all ten treatments, vision being improved from 20/100 to 
20/40. When I last saw him, no cloud could be observed upon the 
cornea, save by oblique illumination. The patient reported that his 
vision had been greatly improved by the treatment, and that his left 
eye was now of the greatest assistance to him in his occupation. 
This result is particularly gratifying when we consider the long 
duration of the opacity. 10 
L. A. IV. ALLEMAN, M.A., M.D. 
Case V. -Mrs. M. M., aged fifty-four; referred by Doctor Mitten- 
dorf from his clinic at the N. Y. Eye and Ear Infirmary on January 25, 
1889. In October, 1888, this patient had suffered from keratitis. All 
symptoms of irritation had been absent for six weeks at the time she 
first applied to me; but the scar had diminished only a little, and for 
some time past there had been no improvement in vision. 
Treatment was begun with the application of X m. a. for one min- 
ute, and at first, under such weak currents, the patient made very 
encouraging progress. Vision - 4V2oo> which the patient possessed at 
the first treatment, was increase to n/200 by the last of February. I then 
endeavored to use stronger currents, but the result was not encourag- 
ing. The treatment was followed by annoying irritation, and had to 
be discontinued for a time. The patient was very irregular in her 
visits, and it was therefore not possible by frequent applications of weak 
currents to keep up the requisite state of stimulation to produce con- 
tinuous absorption of the opacity. 
The last record of vision = 23/200 on July 5th. 
Case VI.-H. L., female, aged fifty, presented herself at the N. Y. 
Eye and Ear Infirmary, on January 25, 1889. Some two years before 
she had suffered from a corneal inflammation in the right eye, of very 
rapid development, which had at one time reduced V. to 1. p. The 
inflammatory symptoms had subsided after about eight months, and 
there remained at the time of her first visit a dense white leucoma, 
entirely covering the lower V5 of the cornea and extending well above 
the pupil at its maximum dilitation. So dense and complete was the 
scar that it was quite impossible to determine at this examination 
whether the pupil was obscured by any inflammatory deposits, although 
we thought this to be the case, and the margin of the pupil was seen 
to be very irregular when dilated with atropia. 
By throwing the head well forward, V. = ^Aoo could be obtained. 
1 secured an excellent photograph of this case, and trusted to it as 
a record for comparison; thinking that there was sufficient loss of 
transparency back of the cornea to preclude much visual improvement. 
This case has been most faithful in her attendance, and the result has 
been extremely satisfactory, but I have, unfortunately, no positive 
method of indicating the improvement. I have endeavored frequently 
to obtain a photograph which would show the improvement, but the 
varying position of the corneal reflection, even in a good photograph, 
is so confusing, that the photographs are useless as records of results. 
I have had this same difficulty in several other cases which I have 
not included in this report, as I had no means of indicating the 
improvement obtained. GALVANISM IN CORNEAL OPACITIES. 
11 
In this case I gave, as a rule, three applications a week for the first 
six months, and since that time once a week. 
The patient, on her own statement, is much improved. Vision is 
still about but she can now see with the head erect, the field is 
much enlarged, and as the fellow-eye is extremely near-sighted, this 
improvement is a great assistance to the patient. The iris can now be 
seen through any part of the scar, the density, even in the lower part, 
which was in the beginning almost as white as the sclera, is greatly 
lessened, and above, the cloud has entirely disappeared down to about 
the middle of the pupil. The capsular opacity can be clearly seen, 
and fully explains the lack of improvement in vision. 
The case has progressed but slowly since treatment has been 
applied but once a week, but I can see that it does improve surely all 
the time. 
Case VII.-J. Q., male, presented himself at the N. Y. Eye and 
Ear Infirmary on February 3, 1889. On the 3d of July previous he 
had been struck in the eye by a piece of coal. An inflammation was 
set up which lasted for some two months, after which time the eye 
became quiet and annoyed the patient only by its defective vision. 
The eye was at this time free from all irritation. Vision 20/200, with 
a mydriatic* 2%0? Patient was referred to me by Dr. Derby for treat- 
ment. I gave him m. a. for one minute, and as this produced no 
disturbance, I repeated it on February 5th. On February 1 ith, % m. a. 
for two minutes was given. On the 13th, vision was improved to 20/100 -|-, 
and % m. a. for three minutes was given; on the 19th, vision = 2°/70? 
the current at this sitting was increased to M m. a. for three minutes. 
This treatment was repeated on the following day, and on February 25th 
vision 20/60 was obtained; % m. a. for four minutes was given at this 
time. The patient subsequently presented himself, but as I was pre- 
vented at this time by sickness from seeing him, I lost track of him, 
and no further record could be obtained. 
Case VIII.-M. J., female, aged sixteen, patient of Dr. Mittendorf, 
referred by him for treatment, on February 9, 1889. This patient had 
suffered from an ophthalmia in infancy, which had produced in the 
right eye an adherent leucoma. The iris was adherent at the lower 
nasal side, drawing the pupil out to an oblong slit, which was covered 
by the leucoma, save at the extreme tip, where a little clear pupil was 
* Homatropine. 12 
L. A. W. ALLEMAN, M.A., M.D. 
exposed and vision of 8/200 (as taken by Dr. Mittendorf) was obtained 
by the patient when looking slightly down. The leucoma was very 
white and dense at the centre, and extended through the entire thick- 
ness of the cornea. The left eye was covered by a still larger leucoma, 
with closed pupil and only V. = 1. p. 
I endeavored to get a photograph of the case, but was prevented by 
the nystagmus which was present. 
The vision was 15/20() when I examined her under atropia. I did not 
wait till the effects of the atropia had passed away before beginning 
treatment, so have no record of the near vision till February 23d, when 
she could see J. 8 at 12". The patient improved quite rapidly at first, 
and by the last of March had V. - 20/200. In this case I used stronger 
currents than in any of the preceding. I began with m. a. for three 
minutes, and soon increased it to 1% or 2 m. a. for three to four min- 
utes, but little irritation followed the treatment. The patient was quite 
regular in attendance till the middle of April, when she informed me 
she had secured a place at service, her vision now being much 
improved. 
She could see J. 5 at 12", and the leucoma was certainly reduced 
in size. She had, at this time, had fifteen applications. 
After this I saw her at irregular intervals, and vision did not improve 
any further. I think, however, that the density of the leucoma was 
still further reduced while under treatment. She disappeared in July, 
and no further records were obtained. 
Case IX.-M. F., male. On May 14, 1889, patient presented him- 
self at my clinic at the Long Island College Dispensary, giving the 
following history: Twenty-seven years ago he lost left eye from an 
injury. Two months before his visit to the dispensary right eye became 
inflamed and painful. He was treated at the Brooklyn Eye and Ear 
Infirmary, and made a good recovery. Present condition : Leucoma 
in right eye, covering the pupillary area. V. = 6/200, with, atropia, 
V. 20/1()(), not improved with glasses. Pupil dilates under atropine irregu- 
larly. 
He was given 1 m. a. for one minute, and no reaction following, 
the current was gradually increased, and vision improved by June 8th 
t° 16/2Oo- The eye which had been somewhat irritated after treatment 
for a few preceding applications became quite severely inflamed at this 
time, and treatment had to be suspended. By August 5th vision had 
improved to 2°/100. Treatment was again resumed, and by August 27th 
vision of 20/70 was obtained. Wishing to determine whether or not the 
treatment was entirely responsible for the improvement, I suspended GALVANISM IN CORNEAL OPACITIES. 
13 
treatment from August 27th until October 20th, when I found V. = 20/,0, 
as on the last visit in August. 
Treatment was again for some time discontinued, to be begun 
again the latter part of February, after six more applications, V. =20/B(l 
was obtained March 7th; and after eleven more applications, V. 20/40 ? 
on May 14th. 
Case X.-K. L., aged thirty, female, patient of Dr. Joye at Brook- 
lyn Eye and Ear Infirmary, referred for treatment on May 17, 1889. 
In February of preceding year, patient suffered from keratitis in 
O. S., which lasted for about six weeks, and left a corneal opacity 
covering the lower two-thirds of the cornea. V. - 4,V2Oo, not improved 
by glasses, with atropia V. - 20/200. The patient was a phthisical sub- 
ject, well advanced in the malady, and the general nutrition was very 
defective. 
Treatment began with X m. a. for three minutes, which was increased 
up to xM for three minutes. The case never made very encouraging 
progress. The vision did improve somewhat, being 10/200 on June 2d, 
and 14/200 on July 15th, and 20/200 on October 9th, after a long interval of 
rest from treatment. The appearance of the eye was not noticeably 
improved, except at the lower nasal margin, where an area of clear 
cornea was visible. 
I think the very poor general condition of the patient prevented a 
more prompt response to treatment. The eye was never very much 
irritated after treatment, but I was in constant dread of the cornea 
breaking down and making trouble. The patient's health finally 
became so poor that I advised her to abandon treatment. 
Both the galvanic and faradic currents through the closed lids have, 
I believe, been employed in the treatment of corneal opacities, but 
have not thus far commanded the confidence of the profession. From 
a study of the foregoing cases, I am convinced that when applied 
directly to the opaque cornea, galvanism becomes a valuable and 
reasonably reliable method of treatment. I do not believe that I 
could have obtained equally good results from any other method, and 
in most of these cases the ordinary methods had been tried without 
benefit before I instituted treatment by electricity. As will be seen, 
the rapidity of visual improvement varies much in different cases, and 
in a large measure depends upon the position of the area of the 
greatest density of the opacity. The clearing is at first only observable 
at the periphery of the opacity, and when the scar is concentric with 
the pupil no improvement in vision is manifest until late in the progress 
of the treatment. When, however, the pupil is obscured by the less 14 
L. A. W. ALLEMAN, M.A., M.D. 
dense margin of the opacity, most rapid improvement will be obtained 
from the first few applications. 
The age of the opacity seems to have little to do with the rapidity 
of the improvement under treatment. As will be seen in the foregoing 
series of cases, which include both very recent and very old opacities, 
the improvement was as rapid in those which had existed for a long 
time as in the very recent ones. I would not begin treatment by gal- 
vanism till the limit of improvement which would naturally take place 
had been reached, but as soon as the eye is quiet and no further clear- 
ing seems to be taking place, the treatment should be instituted by very 
weak currents. 
My experience with the treatment is not sufficient to warrant me in 
saying how much we may reasonably expect from it, and what cases 
we must decline as hopeless. In cases with dense opacities, treatment 
must be continued for a very long time to accomplish any noticeable 
results. But in cases I., III. and IV., all cases of long standing, with 
very dense opacities, there was a steady improvement while under 
treatment. How long this would have continued it is quite impossible 
to say. Our knowledge of the action of galvanism, when applied to 
the living human body, is not by any means as great as we could wish, 
and it is quite impossible to say at all definitely how it accomplishes 
the absorption of corneal opacities. It seems to me to be a matter of 
increased nutrition and of a retrograde metamorphosis of the scar 
tissue, accomplished by the electrolytic action of the currents. But 
since when we speak of the different actions of the current, that it is 
electrolytic in one case, cataphoric in another, etc., it is chiefly a mat- 
ter of words, the observed phenomena are of much more importance. 
After any destructive process in the cornea new material is hastily 
thrown up to repair the damage, and later on the scar tissue, which is 
opaque, is replaced by clear tissue. This process will continue till the 
new tissue becomes so firmly organized as to resist the effects of nature 
to remove it. 
During this process of repair there is a high state of vascularity in 
the part, and in those cases where vessels are seen running on to the 
cloudy area, the prognosis is, I think, more favorable. Now, during 
the application of electricity, this picture is reproduced. The vessels 
are no doubt dilated by the action of the current. They are seen in 
great abundance running to the corneal margin or on to the scar. In 
some cases the scar is seen to be covered during treatment with a fine 
mesh of vessels, vhich extend only to the edge of the opacity and dis- 
appear with it, as under treatment the clear cornea encroaches upon the 
scar. After the application the vessels almost immediately disappear, GALVANISM IN CORNEAL OPACITIES. 
15 
but I have no doubt that in a less degree the increased vascularity and 
stimulated nutrition continue for some time, and in treatment I en- 
deavor to keep this process as active as possible without over-stepping 
the limit and producing a condition of stasis. 
Case I.-Duration of Opacity 18 years.- 
Case V.-duration of Opacity 6 Weeks. 
DA TE. 
Vision. 
Current 
in m. a. 
Duration of 
Application 
in minutes. 
Dec. 13, '88. ... 
2/ 
/ 200 
X* 
1 
Dec. 15, '88 ... 
4/ 
/200 
i^* 
1 
Dec. 18, '88.... 
Vonn 
Jan. '23, '89. .. 
10/ 
/200 
1 
Jan. 25 '89 ... 
9/ 
/ 200 
Y4 
Jan. 27, '89 
18/ 
/200 
M 
Feb 9, '89 ... 
20/^? 
Feb. 26, '89 ... 
20/ 
/ 200 
Ya 
2 
Mar. 2, '89 
20/^ 
Yz 
2 
Mar. 16, '89 ... 
20/ 
/200 
Yi 
2 
DATE. 
Vision. 
Current 
inm a. 
Duration of 
Application 
in minutes. 
Jan. 25, '89 
4$/200 
1 
Jan. 28, '89 
8/ 
/ 200 
M 
2 
Jan. 30, '89... . 
8/ 
/ 200 
2 
Feb. 4, '89.... 
13/ 
/ 200 
3 
Feb. 8, '89 
17/ 
/ 200 
3 
Feb. 12, '89 
15/ 
/200 
M 
3 
Feb. 20, '89. . . 
17/ 
X 
3 
Feb. 26, '89. ... 
i7/200 
M 
&Y 
Mar. 27, '89 
17Aoo 
4 
Apr. 1, '89 
17/ 
/ 200 
4 
Apr. 11, '89. ... 
20/ 
/ 200 
2 
May 2, '89. ... 
20/ 
/200 
M 
1 
May 20, '89 
3 
May 23, '89 
4 
May 28, '89 
20/ 
/ 200 
4 
June 4, '89. 
Y 
3 
June 6, '89 
2°/9nn 
Y 
2 
June 10, '89... 
% 
4 
June 13, '89 
X 
2 
June20,'89. .. 
Yu 
4 
June 27, '89 
Y. 
3 
July 5, '89 
23/ 
/200 
3 
* Estimated. 
Case II.-Duration of opacity 2 Months. 
DATE. 
Vision. 
Current 
in m. a. 
Duration of 
Application 
in minutes. 
Dec. 18, '88 ... 
2%nn 
y* 
1 
Dec. 20, '88 
20/ 
/100 
yy 
1 
Dec. 22, '88. ... 
20/ 
Ao 
y^ 
1 
* Estimated. 
Case VII.-duration of opacity 7 Months. 
Case IV.-Duration of oacity 18 Years. 
DA TE. 
Vision. 
Current 
in m. a. 
Duration of 
Application 
in minutes. 
Feb. 3,'89 
20/ 
/ 200 
X 
1 
Feb. 5, '89 
2 
Feb. 11, '89 
20/ 
/ 200 ' 
X 
2 
Feb. 13, '89 
20/ _L_ 
/JOO ' 
X 
3 
Feb. 19, '89 
20/ ? 
/ 70 ' 
3 
Feb. 20, '89. .. . 
20/ ? 
3 
Feb. 25, '89. .. 
20/ 
/50 
M 
4 
DATE. 
Vision. 
Current 
in m. a. 
1 
4 
4 
1 
J 
1 
1 
i 
Duration of 
Application 
in minutes. 
Jan. 19, 89. 
Jan. 21, '89. .., 
Jan. 22, '89. ... 
Jan. 26, '89 
Jan. 28, '89 
Feb. 6, '89 
Feb. 9, '89 
Feb. 13, '89.. . 
20/ 
/100 
20/ 4. 
/ 100 ' 
20/ 4. 
/70 ' 
20/ ? 
/50 * 
"Ao 
20/ ? 
/50 * 
20/ 
/ 50 
20/ ? 
/40 * 
20/ 
/50 
20/ 
/50 
20/ 
140 
"Ao + 
2%? 
20/ 
/40 
20/ * 
/ 40 
2 
2 
2 
1 
1 
1 
2 
3 
2 
2 
Feb. 16,'89. ... 
Feb. 23, 89. .. . 
Mar. 1, '89. . 
Mar. 10, '89. 
Apr. 1, '89 
Apr. 5, '89. 
Apr. 15, '89 
June 8, '89. 
Case IX.-duration of opacity 2 Months. 
DATE. 
Vision. 
Current 
in m a. 
Duration of 
Application 
in minutes. 
May 14, '89.... 
6/ 
1 
1 
May 16, '89.... 
1 
2 
May 18, '89 . 
'%oo 
V4 
3 
May 22, '89.... 
Von 
1k 
3 
May 24, '89.... 
13/ 
/200 
M 
3 
* With and without correcting glass. 16 
L. A. W. ALLEMAN, M.A., M.D. 
Case IX.-Duration of Opacity 2 months- 
Continued. 
case ix.-duration of opacity 2 months- 
Continued. 
DATE. 
Vision. 
Current 
in a.m. 
Duration of 
Application 
in minutes. 
May 28, '89 ... 
14/ 
/ 200 
1 
3 
May 30, '89.... 
14/ 
/200 
IM 
3 
June 4 '89.... 
1 
3 
June 8, '89.... 
16/ 
/200 
M 
2 
June 13, '89 ... 
16/ 
/ 200 
1 
3 
June 15, '89 ... 
18/ 
/ 200 
IM 
1 
June 18, '89 .. 
18/ 
2 
2 
June 21, '89.... 
20/ 
2 
2 
June 25, '89.... 
20/ 
/ 200 
1 
2 
June 28, '89 ... 
20/ 
1 
3 
July 5, '89.... 
20/ 
/200 
1 
2 
Aug. 5, '89. .. 
20/ 9 
/j 00 ■ 
1M 
3 
Aug. 15, '89 ... 
Aug. 27, '89... 
20/ J_ 
/100 ' 
20/ 
/ 70 
i 
3 
Feb. 17, '90 ... 
i 
3 
Feb. 21, '90 ... 
i 
2 
DA TE. 
Vision. 
Current 
in m.a. 
Duration of 
Application 
in minutes. 
Feb. 26, '90 . 
M 
3 
Mar. 5, '90 ... 
i 
3 
Mar. 7, '90 ... 
20/ ? 
i 
3 
Mar. 10. '90.... 
i 
3 
Mar. 21, '90. ... 
20/ ? 
i 
3 
Mar. 26, '90.... 
1 
3 
Mar. 31, '90 ... 
20/ ? 
7 50 * 
i 
3 
April 4, '90,.,. 
i 
3 
April 8, '90.... 
1 
2 
April 14, '90 ... 
3 
April28, '90 ... 
i 
3 
April 30, '90 . . 
1 
3 
May 5, '90 ... 
20/ 
/50 
1 
3 
May 11, '90... 
i 
3 
May 14, '90.... 
20/ ? 
740 * 
i 
3