When Cocaine, Atropine, and Eserine fail to give satisfactory relief to pain, the remedies found useful in neuralgia of the affected nerve may be employed. 5 gr. doses of Butyl Chloral every two hours for 4 doses may be given; 3o grs. 'of Chloride of Ammonium, or 5 mins. of the Gelsemium Tincture every two hours, may he administered. In severe cases, especially in elderly patients with serpiginous the free adminis tration of stimulants with Sal Volatile in Decoction of Cinchona (4o mins. in i oz.) must be resorted to. Atropine must be replaced by Eserine where any increase of tension or glaucomatous signs show them selves.
When hypopion forms—i.e., pus appearing in the lowest part of the anterior chamber—if its absorption does not follow upon the continuance of the above treatment, a free incision or an iridectomv must be made under chloroform if only paracentesis of the anterior chamber be performed the operation will probably require repetition. Subcon junctival injections of Chloride of Sodium (2 to 4 per cent.) and of Cyanide of Mercury, i in 5,000, r c.c. daily, have been extolled, especially in hypopion cases. Swanzy recommends the application of Dionin and
praises the action of finely powdered Xeroform on sloughing ulcers.
Zeigler has drawn attention to the frequency with which corneal ulcer is caused by nasal disease, and the importance of treating this before any permanent improvement in the eye can be expected. The nasal chambers should be thoroughly cleansed, and a swab of lint soaked with Friar's Balsam should be applied to the nasal membrane far back and over the interior turbinated bone. If the patient is a child, and nasal obstruction exists, adenoids will probably be found, and, if found, they should be removed.
Interstitial Keratitis almost always depends upon inherited syphilis, and in addition to the remedies for the relief of pain and photophobia as mentioned above, with suhconjunctival injections of Cyanide of Mercury, the internal administration of Mercury must be pushed short of producing salivation. After acute symptoms subside, the Yellow Oxide of Mercury Ointment (r gr. to i dr.) should be daily applied.