rrt alnienf.—As inflammation of the la( ryinal sae is dependent in most cases upon disease of the laerymal duet, any obstruction existing- there should be com bated in the manner presently to be de scribed. If this has been. neglected, how ever, aud an acute exacerbation has been inaug-urated. hot applications should be made to the tumor, and any pus evacu ated by direct incision into the sac as soon as its presence is manifested. Calo mel and quinine should be administered internally. If seen early, before this pro cedure is rendered. impossible by the swelling of the parts, an entrance should be effected into the sac by slitting up the lower canalierthis, and the abscess cavity washed freely with a solution of biehloride of mercury (1 to S000).
Flexible sound of whalebone employed when the sac is the seat of obstruction. Suarez (Recueil d'Ophtal., .May, '90).
If pericystitis is seen in the first two or three days, before suppuration be es tablished, it n)ay be aborted by a single catheterization. If suppuration is estab lished, early incision advocated. Bari nand (Ann. d'Ocul., :May, June, '91). Ten-volume peroxide of hydrogen suc cessfully used in an 8-year-old case of lacrymal abscess with fistula. McCul lough (Canada Lancet, Jan., '92).
In blennorrlicea oi the lacrymal sac in newborn infants, mechanical expression of the contents of the sac is, in many eases, unnecessary. Heddaeus (Zehen der's klin. f. Augenh., Mar., '92).
In lacrymal obstruction it is possible to thoroughly cleanse the laerymal s.ac and to inject any desired application for the relief of inflammation of its walls through the dilated or enlarged punctum without slitting the eanalieulus. Proper treatment of acute blennorrhcea of the sac, when seen early, should consist in the use of hot compresses and antiseptic injections. If the swelling is great and suppuration threatens, an incision into the sae advised, and, after slitting the canaliculus, the passage of proper probes. Risley (Jour. Amer. Med. Assoc., Sept. 17, '92).
Sodium fluoride, 0.5-per-cent. solution, recommended in dacryocystitis. Duclos (Archives Clin. de Bordeaux, June, '95).
Rhinalgin highly extolled in acute and chronic daeryocystitis. Rhinalgin is pre pared according to the following formula: Fl Alumol, '/, g,rain.
01. valerian, 3/, drop.
:Menthol, 8/, grain.
Cocoa-butter, 15 grains.
Make one suppository.
Sig.: Use one morning and night in each nasal fossa. Thomalla (Centralb.
f. prakt. Augenh., Aug., '95).
Rapid cure of daeryocystitis by a free external excision into the sac. After curetting the sae a cannula, made of the decalcified femur of a large toad, intro duced into the previously dilated nasal duet. Guaita (Ann. d'Oeul., Jan., '92).
Ten-per-cent. solution of zinc chloride preferred as the application in dacry °cystitis. Frohlich (Klin. INIonatsb. fiir Augenh., Jan., '96).
Chronic inflammation of the laerymal passages. The treatment should be di rected (1) toward the removal of patho logical processes and malformations of the nasal chamber; (2) toward the restoration of the patency of the pas sages; (3) toward the alleviation of all the factors conducive to the production of ocular irritation: (4) toward the proper correction of any existent dys crasia. O. Nance (Jour. Amer. Med. Assoc., Oct. 27, 1900).
Stricture of the Lacrymal Duct.
are the same as in the first stages of dacryocystitis. and con sist chiefly in obstinate lacrymation and in the ability to express a viscid matter into the by pressure with the finger upon the lacrymal sac. .
Two cases in which unsuspected ob struction of the lacrymal ducts has given rise to symptoms closely resembling the prodromes of glaucoma. Galezowski (Recueil d'Ophtal., Dec., '89).
Three cases in which stenosis of the lacrymal ducts was responsible for un pleasant symptoms of asthenopia. Trous seau (Recueil d'Ophtal., Feb., '90).
Stricture of the lacrymal duct is favored greatly by its relationships and by the anatomy- of its parts. The mucous membrane which lines the bony walls of the canal is very vascular, and at certain parts is thrown into folds, which swell under slight provocation and offer suffi cient obstacle in themselves to prevent the proper canalization of the tears. Again, the duct bears such a close rela tionship to the nose, that it is necessarily exposed to all inflammations of this cav ity. Indeed, tbe g,reat majority of cases of lacrymal obstruction are secondary to acute or chronic disease of the nose. This is particularly true of nasal disease of syphilitic origin. As a consequence of its liability to inflammation by direct continuity of structure, the nasal end of the duct is the most frequent seat of stricture, the commencement of the duct at the extremity of the lacrymal sac offer ing the next most favorable site for the development of stricture.