In the second edition of Benjamin Moseley's Treatise on Sugar (1799), Moseley, a doctor practicing in Kingston, nests a section on obeah into a discussion of the disfiguring illness yaws, which ...causes sufferers' bodies to become "shocking grotesque figures, resembling woody excrescences, or stumps of trees; or old AEgyptian figures, that seem as if they had been made at the ends of the human, and beginnings of the brutal form." This in turn is part of a larger section on "Miscellaneous Medical Observations" that also includes descriptions of cowpox, leprosy, and plague, illnesses defined by their rapid spread and their highly visible compromise of bodily systems and functions. Because of its inclusion here, obeah is classed as an infectious cultural disease that, like the illnesses Moseley discusses, can spread quickly through colonial populations, threatening the bodily and mental integrity of slaves and white planters alike. Taking a cue from Moseley, I analyze obeah as a cultural contaminant that embeds itself within the colonial and British imagination. Reading the Treatise on Sugar alongside the wildly popular British stage play, Obi, or Three-Fingered Jack (1800 and 1830), which tells the story of outlaw and murderer Jack Mansong, and Matthew Lewis' autobiographical Journal of a West India Proprietor (1834), in which Lewis constantly struggles to stifle the practice of obeah on his Jamaican plantations, I argue that colonists and residents of the metropole responded to obeah much as they did to infectious agents like yaws and yellow fever - through a mixture of quarantine, suppression, ignorance, and failed treatments that ultimately allowed for its continued spread.
Morbid Conditions McGhee, J. Alexandra
The Edgar Allan Poe review,
04/2013, Volume:
14, Issue:
1
Journal Article
Peer reviewed
At first glance, Edgar Allan Poe's worldview as presented in his writings seems to deal more with experiences of uncanny horror than sublimity. However, Poe's perversity cannot simply be understood ...as calling attention to the horror of existence. Through an analysis of “The Fall of the House of Usher” (1839) and “Berenice” (1835), this essay claims that accessing the sublime experience in Poe depends on a combination of perverseness, disease, and the uncanny. Because Roderick Usher and Egaeus are able, through their monomania, to dissolve meaning in the objects around them, their contemplation of these newly unheimlich objects gives them access to the inexpressibility and ineffability of the sublime state.
I employ Poe's essay “The Imp of the Perverse,” which focuses on “perverseness as a radical, primitive, irreducible faculty or sentiment of the soul, the propensity to do wrong for the wrong's sake,” in my treatment of these stories. Although an obsession with the abyss is what drives these characters over its edge, my analysis reveals that only perverseness makes the sublime experience possible. The result is not the upward transcendence of eighteenth-century philosophers like Edmund Burke and Immanuel Kant, but rather a journey downward to a total loss of control and a destruction of the self rather than an affirmation of the individual intellect over natural forces. However, this collapse accords with the cosmology Poe sets forth inEureka, which posits that all things diffuse and radiate throughout the universe from a common source, eventually dissolving back into oneness.
Between the seventeenth and nineteenth centuries, the Caribbean became a site of racial, biological, and cultural contamination for Europeans, not only because of its environmental differences from ...Britain, but also because of the perceived cultural and moral shifts that occurred when colonists moved from a structured, moral British lifestyle to a more languid and corrupt Torrid one. My project asserts that the dual influences of climate and culture unite in the literary, artistic, and medical discourses of the period as cultural influences and tropical infections were collapsed in colonial and British works about slavery. Colonists and residents of the metropole alike responded to perceived cultural threats much as they did to infectious agents—through a mixture of quarantine, suppression, ignorance, and failed treatments that ultimately allowed for their continued spread. My first chapter reads the dual forces of creolization and curiosity as contagions in Aphra Behn’s Restoration-era Oroonoko, or the Royal Slave (1688). I argue that Behn’s classification of the protagonist as a both hero and wonder makes him a degenerative force in the text. Chapter Two turns to the syncretic cultural practice of obeah in Jamaica, arguing that it was aligned with the tropical illness yaws in the British theatrical production of Obi, or Three-Finger’d Jack (1800 and 1830). Based on the actual story of the infamous Jamaican maroon and obeah practitioner Jack Mansong, the play evacuates the historical and social context of Jack’s crime spree and instead focuses on his relationship with a yaws-afflicted obiwoman. My third chapter argues that Matthew “Monk” Lewis’s Journal of a West India Proprietor (1834), which details his two voyages to Jamaica, theorizes the threat of obeah as akin to yellow fever and other miasmatic, pestilential illnesses that decimated colonial populations in the Caribbean. My final chapter examines Isaac Belisario’s Kingston-published lithographs, Sketches of Character (1837-8), and argues that Belisario attempts to revise the negative image of the creole as a dangerous, degenerate, and infective presence through his representation of Jamaican performers and black laborers. The Sketches are thus an effort to dismantle the prevailing belief that life in Jamaica was inevitably corrupt.
To assess the aetiologies, clinical characteristics, treatment regimens, and outcomes of acute chemical injuries treated at an emergency eye clinic. Retrospective, observational study of all cases of ...chemical eye injury that presented acutely to the Greenlane Clinical Centre in Auckland, New Zealand from 1 January 2012 through 31 December 2021. Patient demographics, activity at the time of injury, causative chemical, clinical characteristics of injury at presentation, severity (Dua) classification, admission and discharge best corrected visual acuity (BCVA), treatment regimen, time to epithelisation and number of follow-up appointments were recorded. In total, 1522 cases involving 1919 eyes were studied. The mean age was 40.6 ± 18.8 years and 65% were male. The majority of cases occurred at home (62%) and cleaning was the most common activity (38%). There were 1490 Grade I (98%), 22 Grade II (1.5%), 5 Grade III (0.3%), 1 Grade IV (0.07%), 0 Grade V, and 4 Grade VI (0.3%) cases. An epithelial defect was noted in 409 cases (26.9%), of which re-epithelialisation occurred within one week for 378 cases (92%) and within 30 days for 384 cases (94%). Moderate vision loss (BCVA ≤ 6/12) attributed to the injury occurred in 152 (10%), while severe vision loss (BCVA ≤ 6/60) occurred in 30 (2%). Lack of irrigation at the scene was associated with an increased risk of severe injury and longstanding visual impairment (p = 0.0001). Most acute chemical injuries are mild with good clinical outcomes. Although rare, severe injuries are associated with a lack of irrigation at the scene and worse visual outcomes.
Purpose To assess the repeatability and comparability of corneal power and central corneal thickness (CCT) measurements obtained using Orbscan II (Bausch & Lomb), Pentacam (Oculus), and Galilei ...(Ziemer) tomographers. Design Prospective, comparative study. Methods setting: Departments of Ophthalmology, University of Auckland and Auckland District Health Board, Auckland, New Zealand. study population: Thirty eyes of 30 healthy participants. observations . CCT and corneal power measured using Orbscan II, Pentacam, and Galilei tomography. main outcome measures: Degree of agreement in and repeatability of CCT and corneal power measures. Results Orbscan II measured significantly lower CCT compared with Pentacam (20 μm; P < .0005) and Galilei (18 μm; P < .0005). The Orbscan II had wide limits of agreement when compared with both the Galilei (−11 to 47 μm) and Pentacam (−88 to 47 μm). For each device, the intraclass correlation coefficient for CCT was higher than 0.9. The coefficient of variation ranged from 0.33% to 0.93%. There was no significant difference in mean steep keratometry or mean flat keratometry between instrument pairs. However, there was poor agreement in flat keratometry and steep keratometry obtained by Orbscan II compared with those obtained by the Galilei and Pentacam. Conclusions The keratometry and pachymetry measurements obtained by Orbscan II, Pentcam, and Galilei tomographers were sufficiently disparate that the 3 devices could not be considered equivalent. All 3 devices demonstrated a high level of repeatability, although the Galilei exhibited the best repeatability.
PurposeThe purpose of this study was to investigate the clinical features, tumor characteristics, including histopathology and cytogenetic analysis, and management of patients with uveal ring ...melanoma in New Zealand.MethodsA retrospective review was conducted on all uveal melanoma cases treated in a single national oncology center in New Zealand. The study period was from January 1, 2013 to December 31, 2022 (10 years). Written consent was obtained from all patients included in this case series.ResultsUveal ring melanoma of ciliary body origin (n = 4) comprised 0.7% of all uveal melanomas (n = 571). Ethnicity distribution was three patients of New Zealand European ancestry and one patient of Chinese/Pasifika ancestry. Three patients (75%) were symptomatic at presentation (spontaneous hyphema, glaucoma, and cataract), whereas one was asymptomatic but subsequently developed painful refractory glaucoma. All eyes underwent enucleation. Three eyes had primary iris biopsies with subsequent enucleation for refractory glaucoma and pain and one eye underwent primary enucleation. All cases demonstrated malignant tumor characteristics including diffuse 270 to 360-degree ciliary body ring growth pattern, epithelioid-cell type and presence of either BAP-1 expression loss or gain of MYC gene. Two cases (50%) developed distant organ metastasis - liver, parotid gland, and breast. Of those, one patient was deceased at the time of follow-up whereas one had completed treatment for metastases.ConclusionsUveal ring melanoma is a rare tumor that is highly invasive and malignant. When detected, prompt definitive treatment should be advocated, and patient counselling should be given regarding the high risk of developing a painful, blind eye with increased risk of metastasis in the absence of treatment.
Iris melanoma and iris nevi can be challenging to distinguish clinically. This case series provides unique insight into the rare condition and variable clinical presentations of iris melanoma.
This ...study aimed to highlight the varying clinical presentations of iris melanoma and to demonstrate the overlapping features of melanoma and nevi.
This case series includes five patients of varying age and sex who presented to clinic with pigmented iris lesions. These five patients have differing timeline to presentation and very different clinical presentations of their lesions. Clinical evaluation was based around the established "ABDCEF" guide for the assessment of malignant risk in iris lesions. The presentation of each lesion is discussed in relation to this guide and the experienced clinician's clinical suspicion of malignancy. When comparing the clinical suspicion with histological analysis, after biopsy, the result may be unexpected. Notably, initially benign nevi may transform into melanoma over time. These five cases were managed on an individual basis because the management and prognosis of iris melanomas vary significantly. Importantly, iris melanotic lesions have variable metastatic risk based on cytology and genetic predisposition. Informed consent was obtained from all the patients, institutional approval was obtained, and no identifiable health information is included in this case series.
When presented with a pigmented iris lesion, clinicians must be vigilant with regular monitoring and have a low threshold for biopsy in pigmented lesions of high clinical suspicion.
Abstract Purpose To evaluate the long-term risk of endothelial rejection, graft survival, and associated factors following penetrating keratoplasty (PK) for keratoconus, with and without prior ...resolved corneal hydrops. Design Retrospective cohort study. Methods Primary outcome measures were endothelial rejection-free survival and failure-free survival. Secondary outcome measures were corneal neovascularization following hydrops and complications following PK. Results 245 eyes underwent PK for keratoconus with mean follow-up of 5.6 ± 3.6 years. Eyes with prior hydrops (n=74) had lower endothelial rejection-free survival rates compared to eyes without prior hydrops: 86.5 ± 4.0% vs 86.5 ± 2.6% at 1 year, 61.0 ± 6.2% vs 76.9 ± 3.3% at 5 years, and 45.8 ± 10.1% vs 70.9 ± 4.3% at 10 years, respectively (p=0.023). Multivariate analysis identified factors associated with endothelial rejection as: age ≤25 years (p=0.017), corneal neovascularization (p=0.001), donor trephination size >8mm (p=0.017), and poor clinic attendance (p=0.015). There was no difference in the failure-free survival rates with and without prior hydrops: 98.6 ± 1.3% vs 97.1 ± 1.3% at 1 year, 97.3 ± 1.9% vs 95.1 ± 1.9% at 5 years, and 97.3 ± 1.9% vs 92.2 ± 2.7% at 10 years, respectively (p=0.42). Corneal neovascularization was present at the time of PK in 44.6% of eyes with prior hydrops and 7.6% without prior hydrops (p<0.001). Conclusions Corneal neovascularization, a frequent complication of corneal hydrops, was associated with increased risk of endothelial rejection following PK. However, allograft survival was similar in eyes with and without prior hydrops.
Keratoconus is an ectatic disorder with highly complex and varied causes including genetic variations and environmental factors. Its prevalence varies widely between regions and countries. Many ...environmental factors have been proposed to be associated with keratoconus, but the interpretation of their individual contributions is difficult due to the presence of many confounding variables. The current literature was reviewed to evaluate the strength of the associations and the causative effects of environmental factors on keratoconus. Ethnicity and consanguinity have been revealed as important determinants for geographical variations in keratoconus prevalence. Eye rubbing, atopy, floppy eyelid syndrome, contact lens wear, pregnancy, and thyroid hormone disturbances are likely associated with keratoconus. The first 4 factors can induce ocular surface inflammation, matrix metalloproteinase release, and keratocyte apoptosis, consistent with the postulated etiology of keratoconus. The associations of keratoconus with UV exposure, cigarette smoking, personality, and sex were less convincing once confounding factors were considered. Future studies powered for multivariate analysis of factors discussed will hopefully shed light on what is truly important in the development and progression of keratoconus.
PDF
