LACHRYMAL GLAND DISEASE.
This rare affection, when not due to malignant disease or syphilis, is caused by the admission of septic organisms which may cause acute suppuration of the gland requiring a free incision for the evacuation of pus. The indications for treatment are local applications for the relief of pain—Cocaine, leeching or hot fomentations; the pus usually finds its way into the lachrymal sac, with speedy relief of the swelling of the eyelids and all tension.
The writer has met with a hitherto unrecognised acute enlargement of the lachrymal gland which pushed the eyeball downwards and forwards, causing an alarming degree of lagophthalmos without any inflammatory action. The condition occurred in a male adult soon after an attack of weeping. The gland could be easily made out by its smooth outline and firm elastic feel. Resolution suddenly set in after about 6 weeks without any treatment, and in a few days the tumour entirely disappeared. He
has observed a somewhat similar condition of the salivary glands super vene in a physician who had placed a hypodermic tablet of Pilocarpine under the tongue, great enlargement of the salivary glands setting in on the day following. The sudden resolution in each case pointed to some temporary obstruction of the duct which spontaneously yielded.
Mikulicz's Disease is a rare chronic inflammatory enlargement of both lachrymal and the salivary glands on each side of the body, and yields to Iodides in full doses with Arsenic, and also to X-ray treatment.
The treatment of Dacryocystitis or inflammation of the lachrymal sac and of the deformities which arise from stricture of the nasal .duct are dealt with in the article on Epiphora.