OPIITHAL3[OLOGY. — In inflammatory diseases of the eye, the active principles of suprarenal hare the power of suddenly stimulating the vasomotors, thus deplet ing the engorged vessels. In a method recommended by Barraud, sheep-capsules are used, and with the product of evapo ration a solution is prepared with equal quantities of sterilized water; this is done, as much as possible, at the time of using, for the solution becomes rapidly altered. One drop of Barrand's suprar enal solution instilled into the eye pro duces an energetic vasoconstriction of the conjunctiva at the end of thirty to forty seconds. In a few minutes this action is sufficiently marked to cause pallor of the mucous membranes, and continues about twenty minutes, after which the vessels return to their former condition.
In an inflamed conjunctiva, the pain and redness completely disappear for the time being. Its application causes no pain even when the congestion of the eye renders it hyperresthetic.
In ophthalmology, therefore, the aque ous extract of suprarenal capsules finds its application as follows: 1. In con junctivitis, kerato-conjunctivitis, vascu lar keratitis, episcleritis, and glaucoma as an aid to the usual medication. 2. In cases in which extreme inflammation of the tissues and intense congestion of the media of the eye limit the action of cocaine, it regains its analgesic power, owing to the ischmmia previously pro duced by the suprarenal extract. 3. Finally, whenever there is reason to fear a hmmorrhage during surgical interven tion on the eye, the extract acts either as a preventive or as a radical haemo static agent. (Maurange.) Dor was first to recommend the ap plication of suprarenal extract in cases where, an operation being urgent, it was difficult to obtain local anmthesia with cocaine alone, owing to hyperwmia of the conjunctiva. (Darier.) The method for preservation of suprar enal solutions employed for over a year now in Buffalo with excellent satisfac tion is as follows: One-half gramme of the extract of suprarenal capsule is rubbed to a paste, the water is added gradually until there is a solution of 1 ounce. This is then heated for some time
to 100° F. Water being constantly added as the solution evaporates so as to keep the amount of liquid always up to 1 ounce. Fifteen grains of boric acid are then added and the solution is ready. It will keep for weeks. The suprarenal ex tract is used in the eye in the shape of small wafers. To make these the extract is rubbed up into a paste and •then mu cilage added to give it consistency. These feel somewhat rough, but are un irritating when moistened. The addition of formalin, 1 to 10,000 or the employ ment of a concentrated extract in glyc erin diluted as required are good methods for preserving the substance. But both the formalin and the glycerin have proved irritating to some eyes. Lucien Howe (Med. News, Mar. 24, 1900).
Adrenalin may be employed in very oilute solutions in the form of a collyr ium with boric acid. One drachm of the 1 to 1000 solution in 2 ounces of distilled water, with 10 grains of boric acid. is effectual when frequently used. To relieve the congestion, irritation, and lacrymation caused by ordinary con junctivitis, and to combat blepharo spasms. To relieve trachomatous pan nus. To enhance the action of cocaine, atropine, eserine, and pilomrpine, by promoting their absorption. Adrenalin is first used, followed during the period f blanching by the drugs named. To re duce the tension in trachoma. To facil itate the introduction of lacryinal sounds, the solution being first injected into the ductus ad nasum. To relieve ciliary pain in keratitis, iritis, and ey elids with glaucoma. To modify opac ities of the cornea. To produce cosmetic effect. G. E. de Schweinitz (Therap. Caz., July 15, 1902).