As a result of bacterial study of fifty cases of suppurative keratitis, it is con cluded that the pneumococcus is invari ably the exciting agent in hypopyon keratitis. The lacrymal and nasal pas sages abound with this particular organ ism. Uhthoff and Axenfeld (Berliner klin. Woch., Nov. 25, '95).
From a clinical study of interstitial keratitis it is considered that in the ma jority of cases this affection of the deeper layers of the cornea is secondary to in flammation of the anterior part of the uveal tract; also that it is due to con genital syphilis. Cook (Jour. Amer. Med. Assoc., Mar. 7, '96).
No specimen ever seen that would tend to show that pus-cells ever do or can pass through Descemet's membrane into the anterior chamber; their only way lies through the meshes of the ligamentum pectinatum. Alt (Amer. Jour. Op May-June, '96).
Ocular lesions due to obstetrical inter ference are uncommon. Case of keratitis observed in the newborn which seems to have resulted from a prolonged applica tion of the forceps. The left eye alone was affected, and its appearance sug gested a purulent oplithalinia; but the eyelids were more markedly swelled than is the case in commencing ophthalmia, and there was scarcely any discharge. On separating the eyelids it was seen that practically the whole cornea was cloudy, and there was intense conjuncti val hypermmia. The treatment consisted in the application of ice, atropine, and boric lotions. Dujardin (Jour. des Sci. Med. de Lille, Nov. 28, '96).
The etiology of interstitial keratitis is not well defined, but hereditary syphilis is undoubtedly the usual origin. Von Hippel (Arch. f. Ophth., vol. xlii, pt. 2, '96).
The most various infectious diseases, nutritional derangements, etc., may cause an interstitial keratitis. Among such causes by far the most frequent is heredi tary syphilis; then comes tuberculosis, acquired syphilis, influenza, malaria, di abetes, etc. A. Greeff (Sammlung Zwang loser Abhand. aus dem Gcb. der Augenh., '97).
Case of relapsing interstitial keratitis of uterine origin. A young woman aged 25 years, for a period of eighteen months has had at each menstrual epoch visual troubles pertaining mostly to one eye, and marked by the appearance of white spots of infiltration in the cornea. The
ocular trouble came on eight days before the appearance of the menses, and disap peared on their cessation. On one or two occasions almost the whole cornea was affected, and there was intense peri corneal injection and photophobia, per sisting for a month. The patient was of a scrofulous disposition. Vaginal injec tions and attention to hygienic measures sufficed to disperse the ocular attacks, and the corrie have regained their trans parency. Kcenig (Soc. Franc. d'Oplital., May, '97).
Horner's conception of the relation be een eczematous eruptions of the skin and the anterior nares and the plilyetenu lar diseases of childhood is not always apparent, but nearly constant. The con ditions that predispose to these local dis turbances are essentially constitutional and no local treatment is in any large proportion of cases to be regarded with favor. On the other hand, constitutional measures are of the first importance and may alone be relied upon even in com plicated cases, so far as the eye is con cerned as a participating organ. D. S. Reynolds (Phila. Med. Jour., July 16, '93).
Prognosis. —Interstitial keratitis is always slow. In rare cases it may run its course in one or two months; quite as frequently it will require that many years. Until it has fairly begun to sub side no one can tell how severe or how protracted the attack will be. If seen early it is pretty safe to predict that the eyes will get worse in spite of all treat mtnt It tort tht v N1'11 begin to get better. If n at the height of the al tack- great .11,pro‘t int lit may be promised. continu oNt r a long ptriod. Useful vision %%II I prof ablv be restored even when t ler\ thin:- but li-lit-perception has been lc,t. P.m complete recovery with nor mal ision rarely, if ever, occurs. If the I aeitV iS most marked at the centre of the eornt a and many fine vascular loops are setn which extend but a little way on the cornea. the disease is still in an Lady sta;_le. If thc vessels are rather sparsely diffused throughout the cornea, and tilt opacity chiefly confined to the ttntral region, it is probable that the yeriphery of the cornea has already (limed, and that the most rapid improve ment of vision is about to take place.