To avoid repetition it seems well at this place to give the indications which call for the employment of hot and cold compresses, not only in the treatment of catarrhal conjunctivitis, but also of the other forms of conjunctivitis as well. hyperminia of the conjunctiva, in duced by ametropia or the presence of a foreign body, we have, in cold, a simple, but effective, means of restoring the membrane to its healthy condition. In these cases the douche or the compress may be applied over the closed lids, with the greatest advantage, for fifteen min utes at a time. The water employed should not be too cold, or excessive reac tion may follow its use.
In the treatment of the milder form of conjunctivitis the membrane ruay be sprayed with a solution of boric acid and salt, the good effects of this plan being probably due to the fact that the liquid thus applied penetrates the deeper tis sues and correspondingly increases the extent of the contact and prolongs the action of the drug. De Schweinitz (Amer. Jour. of Ophth., St. T.ouis, Jan., '94).
A 2-per-cent. solution of extract of suprarenal capsule will cause a certain amount of contraction of the blood-ves sels in an eye not inflamed, while a 3-, 4-, or 5-per-cent. solution will produce a decided blanching of the ocular and palpebral conjunctiva within a couple of minutes after the application is made, even though the engorgement of the ves sels be considerable. The contraction of the blood-vessels does not last long, how ever, and as they begin to dilate they re turn gradually to the condition existing before the application was made. Bates (.N. Y. Med. Jour., May 16, '96).
Aqueous extract of suprarenal capsule produces great bleaching of the conjunc tiva, but after the astringent action has passed away the inflammation returns in greater force than before. Hansel' (Editorial, Phila. Polyclinic, '97).
Attention called to effects of chloride of zinc upon cases of pneumococcic con junctivitis. Simple instillation of a ii„ of a 1-per-cent. solution of this salt gener ally causes the pneumococei to disappear from the sac; and, if upper lid be everted so as to bring remedy into upper retro tarsal fold as well as lower, a few appli cations almost always cure the worst cases. H. Gifford (Archives of Oph., Nov., '98).
In the severer forms of conjunctivitis, when there is a purulent inflammation or an exudate, ice is the sovereign rem edy. When employed in the manner in
dicated, disastrous results are not to be feared.
The direct application of iee to the lids affords the best means of getting rid of the chemosis and cedema of both lids and conjunctiva. Foncher (Annals of Ophthal. and Otol., Jan., '93).
At the commencement of the disease the board-like swelling of the disease is, doubtless, one of the chief causes of py rexia, and, as the swelling and indura tion prevent the cold from gaining access to the eye, it is necessary that the treat ment should be energetic and prolonged. The compresses, therefore, should be maintained night and day in such cases, and should only be desisted from when a corneal nicer threatens or the secre tion becomes excessive. If either of these two contingencies should arise, the ice compress should at once be substituted by the hot application, these being per sisted in for fifteen minutes every two or three hours. The hot water will re lieve engorgement of the corn.eal circula tion induced by the intense chemosis of the bulbar conjunctiva, and favor resolu tion of the cornea.
In the treatment of all forms of con junctivitis nitrate of silver occupies a leading position, the strength of the so lution employed being proportionate to the intensity of the inflammation and the quantity of the secretion. In the early stages, where the discharge is mucoid in character, it should be employed in the strength of from 2 to 4 grains to the ounce, and later, i.e., when the discharge has assumed more of a purulent char acter, from 10 to 20 grains to the ounce.
It is always best to apply the silver directly by means of a swab, and when the stronger solutions are employed it should always be neutralized by means of sodium chloride. If corneal ulcer oc cur, atropine should be at once instilled into the eye. 11Iany discontinue tbe ap plication of the silver as soon as this complication occurs, but if the discharge be very marked and care be taken to ap ply the silver in the manner just di rected, it will usually be found to exer cise a most advantageous action -upon the course of the disease.
Follicular Conjunctivitis.
Definition.—Follicular conjunctivitis is a form of catarrhal conjunctivitis at tended by a great development of the lymph-f ollicles.