The flattaning of the cornea against the iris by too firm pressure may set up iritis. Joeqs (Le Bull. MAd., Mar. 8, '96).
oi 670 eases of irilis seen, but 1 was rheum:It ie in oat lire. (Ca lent ta Oph t hal Ink Hospital Reports: Ceutralb. f.
prakt. Apr.. '96.) The enii,e of primary frills investi gated in S4 rows. 'Hie average age was -10.3 :coal... Tilliercillosis wits the cause in :11 f3S.S per cent.), chronic ne phritis in 29 (34.5 per cent.), disease of the circulatory- apparatus in 13 (15.4 per eent.1. syphilis in 5 (5.1.1 per cent.), and various other alivetions in 6 (7.1 per cent.), General diseases play au impor tant part in the production of primary Alichel med. :lune 19, 1900).
Syphilitic iritis °emus in the transi tion or secondary period of the disease —as a rule. between the fifth and twen tieth months. It may rarely be found earlier or later. The writer reports six cases, in all of whieli syphilitie iritis ap peared from six to thirty year- after the primary lesion. All these patients had mercurial treatment in the begin ning. As no other caus-es were found to explain the iritis, and injections of mer curial biniodicte eaused recovery, the eondition, t hough la t e,. wa s probably syphilitic. Terson (Jour. de.s Praticieus, Aug. 23. 1902).
The patient never lived in a malarial district except for one month. The in cubation period from the time she was bitten to the time that she became ill was less than fonr weeks; there were no other sig.ns of malarial infection to suggest an examination of the blood: dilatation of the pipit with atropine was accomplished with difficulty, and finally prompt relief followed the of quinine. S. 11 Jacobison (Amer. 3Iedi eine. Fel.). R, 1902).
—Iritis and cyclitis nearly always co-exist. Iritis may be considered absent if there is no visible alteration of the iris and the pupil dilates widely and evenly under a mydriatic. Cyclitis is ab sent if there be no deposit on the cornea, or haziness of the vitreous, or tenderness of the ciliary region. Iritis and cyclitis must be distinguished from keratitis by absence of change in the cornea; from glaucoma of the contracted pupil, and the absence of dilated scleral veins, in creased tension or cupping of the optic disk; from panophthalmitis by the ab sence of swelling of the lids and dense opacity of the vitreous; from neuralgia by the redness of the eye and the altera tion of the iris; from conjunctivitis by the slight swelling and freedom from discharge of the conjunctiva. The alter
ations in the pupil are best seen with the ophthalmoscope or after the use of a mydriatic.
Study of the manifestations of syphilis in the ciliary body-. Conclusions: 1. When ever syphilitic iritis is accompanied by a punctate keratitis, either chronic or re cent, areas of atrophic choroiditis will be found in the ora serrata. 2. In paren chy-matons interstitial keratitis, when due to hereditary syphilis, disseminated plaques, which sometimes reach to the posterior segment, are seen in the ora serrata; more often, however, they are confined to the ciliary region. 3. Diffuse syphilitic choroiditis with disease of the vitreous always presents atrophic alter ations of the ora serrata, and the opaci ties of that humor are due to this latter lesion. 4. In ataxic atrophy of the disks atrophic and pigment changes occur in the ora scrrata. 5. In syphilitic inflam mation of the cerebral or cerebro-spinal nei-vcs characteristic signs of the disease appear in the ora serrata. Galezowski (Gazette des 115p., Apr. 18, '94).
1. It is important, from a clinical point of view, to differentiate a tubercular variety of iritis. 2. This form of inflam mation is premonitory of the tubercular nodular eruption, which it may precede by several weeks. 3. It is characterized by its subacute mode of invasion; its evolution is slow and torpid, being marked by faint reactional signs, al though in addition there may be dense synechim more or less completely ob structing the pupil. 4. The absence of pathognomonic symptoms renders the diagnosis difficult. 5. The tendency to spontaneous cure of miliary tuberculosis of the iris depends upon the individual resistance, and especially upon the resist anee of the iris. The incapsulation of tubercle of the iris and the rapid obliter ation of the surrounding capillaries favor its isolation and the protection of the sound tissue. It is not the attenuation of the bacillus nor of the toxins which brings about resolution, but the character of the tissue which receives the poison. Vignes (Reeueil d'Ophtal., Apr., '94).