For the photophobia all sorts of meas iires have been reeommended—hlisters, setons, insufflations of calomel or pow dered gla ( ! ), and holding the child's head under water. None of these are to he thought of. The development of fis sures and excoriations at the outer nau tili is one of the chief eanses of the photophobia, cure of which is half the battle. The best treatment is stretch ing the fissures so S to make them bleed, preferably under 11 amesthetic. At the same time they may be painted with R. solution of nitrate of silver, 5 to 10 grains to the ounce. Cocaine, though it may be of great use in aiding the surgeon to make a thorough examina tion, should never be giN-en to the pa tient; 'neither should alum or sulphate of zinc. All three of these agents tend to destroy the epithelimn and favor per foration. Marshall (Practitioner, Jan., 1903).
Pannus requires the thorough treat ment of the morbid conditions of the lids which cause it, sometimes including canthoplasty, or other operations on the lids to relieve the cornea from abnormal pressure. Other special measures for the treatment of opacity are mentioned in volume ii.
In oyster-shucker's keratitis the yel low salve has proved useless. A compress bandage and a, mild sublimate solution (1 to 4000) used every four hours, to gether with an occasional drop of a solu tion of atropia-1 pe.r cent.—have given the best results. To this treatment the keratitis responds promptly, and in a week or ten days the subjective phe nomena have been so ameliorated that the shucker can resume work. The opacity can be detected by oblique illumi nation, and is permanent. R. L. Ran dolph (Johns Hopkins Hosp. Bull., Nov., Dec., '93).
Suppurative keratitis requires the prompt and thorough removal of infect ive discharges and infected tissue so far as possible. Corneal abscess should be freely opened as soon as it is recognized. For infected ulcers the simplest and most generally applicable treatment is scrap ing or curetting. The tissue around the ulcer should be thoroughly and repeat edly scraped toward the ulcer so as to empty the interlamellar spaces of their contents; and all softened tissue should be removed. After scraping, the ulcer s.bould be closely watched; and upon any evidence of farther extension of the infective process thoroughly scraped aaain n • In eases of ulceration of the cornea oc curring in "lymphatics" where the proc ess cf repair is sluggish, notwithstanding that a leash of blood-vessels supplies the ulcer, the performance of peritomy ad vised. Dunn (N. Y. INIed. Jour., June 17, '93), Equally as efficient as scraping, though a little more alarming to the patient, is the application of the actual cautery. This application may be made with the galvanocautery tip; or with a piece of steel knitting-needle, one end of which is held in an alcohol-flame until white hot, and then quickly applied to the af fected portions of the cornea. The cau terization should include all infected parts of the tissue. After cauterization the 00 111.1V rctuarn undisturbed for a tin. or more t xec pt [lint it must be kept ;tank d.
L.(1.; trainnatie keratitis suc xtssfully trtated. after they had resisted tlar intasures. by cauterizing the ulcer ith pure earbolie acid. A. 1). Williams St. Louis Med. and Surg. Jour., Jan., '90 .
IN. liquescent cal holic acid highly nc,nimended as a cauterizing applica tn to corneal ulcers. A single cauter
ization in the commencing stage will at once convert the ulcer into a healing wound. Suarez de Mendoza (Annales May, June. '91).
In the treatment of infectious ulcers of the cornea, excellent results obtained from touching the ulcer once or twice daily oith tincture of iodine. The ad antages claimed are the prevention of staphyloma and the formation of corneal eicatrices less opaque than those result ing. from other methods of treatment. Chibret (liecueil d'Oplital., Sept., '91).
Scraping and cauterizing, the diseased tissue instantly relieves the pain and photophobia in ulcerative keratitis. The r.ew tissue is xnore transparent than that ohich folloos any other mode of treat ment. De Weeker (Ann. d'Oeul., July, '93).
The actual cautery considered appli cable especially to sloughing ulcers. to ulcers in which the spread of local infec tion is the dominant symptom, to ulcers which decline to heal under moderate means. De Schweinitz (Amer, Jour. of Oplithal., Apr., '91).
A powerful agency for draining the affected tissue, and establishing lymph currents that shall check the progress of infection, is the Saemisch incision, made by thrusting a narrow cataract-knife be r.eath the ulcer and letting it cut directly clut dividing all the affected tissues and permitting the free drainage of fluid from the anterior chamber.
In eases of hypopyon from traumatic ulcer the instillation of a drop of a weak solution of sulphate of quinine and atro pine, every two or three hours, rarely fails to cause absorption, if the case be seen before the pus has become thick and glutinous. 11. Williams (Liverpool Medico Chin Jour., July, '91).
In case of estensive ulceration of the cornea and conjunctiva, adhesion pre vented by the employment of an eye-shell made of vulcanized rubber. Searles (Amer. Jour. of Oplithal., June, '93).
In 'liens cornea serpens any procedure tlmt induces long-continued abolition of thc anterior chamber may induce glau coma, and is, therefore, to be rejected. Saelisalbcr (licit. z. Augenh., Feb., '96).
Thioform found better than iodoforrn, boric acid, and all other dry applications in ulcer of the cornea. Rognian (Ann. d'Oeul., Mar., '96), Methyl-violet and subjunctival injec tions recommended in corneal ulcers. Darier (Rec. d'Ophtal., Mar., '96).
In keratitis personal treatment is to apply to the floor of the corneal ulcer silver nitrate in 30-grain solution. Woods (Presb. Hosp. Rep., Jan., '93).
Excellent results obtained in the treat ment of hypopyon keratitis by subcon junctival injections of corrosive subli mate (1 to 1000). Nikclikin (Vestnik of Ophthal., July-Oct., '96).
Subconjunctival injections of mercury used in infectious keratitis associated with hypopyon in eighteen cases. The writer prefers a solution of the cyanide, 1 to 100, and injects as much as 5 centi grammes. Fromaget (Ann. d'Ocul., Apr., '96).
The treatment of filamentous keratitis ronsists in abrasion of the filament, at the surface of the cornea, and the em ployment of a collyrium of methyl-violet 1 to 10,000. Sourdille (Le Prog.
Apr. 4, '96).
Hypodermic injections of iodine suc cessfully employed in cases of parenchy matous keratitis. Loclato (Vestnik of Ophtbal., May, June, '97).
The acrid expressed juice of the bit ter cassava is a useful remedy in the treatment of corneal ulcers. S. D. Risley (Archives of Ophth., July, '98).