Ocular infections

Trachoma in History

The word "trachoma", derived from ancient Greek, means “rough eye”, presumably due to the “cobblestone” appearance of the conjunctivae due to the presence of lymphoid follicles and papillae. A disease resembling trachoma appears in ancient Chinese writing, while the Ebers papyrus (c1550 BC) indicates that the ancient Egyptians were aware of entropion (distortion of the eye lids) and trichiasis (in-turning of the eye lashes), and contains 95 prescriptions for related trachomatous conditions. These included the use of the bactericidal minerals galena (lead) and malachite (copper), while the survival of a number of epilation forceps suggests that depilation may have been a treatment for trichiasis. Other treatments included invocations to the God of Fevers and the use of honey, which has natural, antibiotic-like properties. The ancient Greeks, most notably Hippocrates and Galen, studied Egyptian medicine at the temple of Imhotep in Memphis. Galen's description of trachoma is based on an improved understanding of the anatomy of the eye, rather than invoking the supernatural.

Although trachoma is often erroneously thought of as a tropical disease, it is in fact a disease of poverty and was common in Europe, where soldiers returning from the Crusades may have played a role in its spread. In Napoleonic times it was known as the "Military (or Egyptian) ophthalmia." Trachoma was known in Ireland until 1945 and in the former Soviet Union during the 1950s and 1960s. Some of today's prestigious public health and ophthalmological institutions were originally set up as trachoma hospitals. Evidence of active trachoma was even a possible excuse for refusing entry to the United States. In the latter country, trachoma was found comparatively recently in underprivileged communities in the Appalachian mountains or in the Indian reservations of the west.

The history of trachoma is, to a large extent, part of the history of the Chlamydiales [see: Chlamydiales history]. In particular. for an account of the cultivation of the trachoma agent, honouring Professor Tang Feifan, see: Wang, 1999.

[MEW] Updated June 2002

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Hirschberg, Julius The History of Ophthalmology. Vol 1: Antiquity.

Pharonica Medicine

Images from the history of the US Public Health Service, in the National Library of Medicine [images 20, 26, 76, 77, 162]

al-Rifai, K. M. (1988). Trachoma through history. International Ophthalmology 12 , 9 - 14.

Wang, Y. (1999). Etiology of trachoma: a great success in isolating and cultivating Chlamydia trachomatis. Chinese Medical Journal 112, 938 - 941. [In English].

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