A   TREATISE
DISEASES   OF   THE   EYES,
INCLUDING
DISEASES OF THE EYELIDS, INFLAMMATIONS OF THE CONJUNCTIVA, SCLEROTICA,
      AND CORNEA; ALSO, CATARRHAL, RHEUMATIC, SCROFULOUS,
               AND PURULENT OPHTHALMIA.
THEODORE J. RUCKERT'S CLINICAL EXPERIENCE IN HOMOEOPATHT.
/
BY  JOHN  C.  PETEKS, M.D
pK-ftelt:
PUBLISHED  BY WILLIAM  RADDE, 322 BROADWAY.
     Philadelphia: Rademacher & Sheek.—Boston: Otis Clapp.
       London: J. Epps, 112 Great Russell St., Bloomsbury.
           Manchester: II. Turner, 41 Piccadilly.
                     18 5 4. 

     Entered according to Act of Congress, in the year 1854, by
                       ■WILLIAM  RADDE,
In the Clerk's Office of the District Court of the LTnited States for the
                 Southern District of New-York.
Joh.v A. Gray, Printer and Stereotype?;
   95 and 97 CM, cor. Frankfort St., K Y. 
                 TO K. E.  DUDGEON, M.D.,

Lecturer on Theorj and  Practice in the Hahnemann Hospital School of
  Homoeopathy; Physician to the Hahnemann Hospital, (London;) Editor
  of the British Journal of Homoeopathy;  Editor and Translator of Hahne-
  mann's Organon, and Lesser Writings, etc., etc.:
Dear Sir:
  Although personally a  stranger to you, I venture to dedicate this little
volume  to you, on account of your numerous and valuable contributions to
the cause of scientific medicine, but especially for your labors in the cause
of Ophthalmic Medicine.               Yours very truly,
J.  C.  PETERS. 
AMERICAN  EDITOR'S   PREFACE.
  I do not claim the possession of any extraordinary amount of knowledge
of diseases of the eye, sufficient to warrant me in thrusting an original book
upon the public.  Hence the major part of my portion of the present work
is merely compiled and collated from other sources, such as Haynes Wal-
ton, Tyrrel, Mackenzie, Lawrence,  Dudgeon, Hartmann, K. Muller, and
others.   I only claim,  from  knowledge gained  from   the Cliniques of
Jungken of Berlin, and Jalger of Vienna, the New-York Eye and Ear Infirm-
ary, from dispensary, asylum, and private practice, and  from  study, to be
in possession of sufficient knowledge to make my selections  practically
useful.
  It is impossible to withhold admiration for the careful manner in which
Ruckert and Dudgeon  have conducted their laborious compilations, or to
regret that one or the other did not attempt to furnish a complete treatise
on Diseases of the Eye.
  From the Reports of  the New-York Dispensary, General Hospital, Pro-
testant Half-Orphan, and Home for the Friendless, we learn that
  Of 22 cases of blindness, 8 were relieved, none cured, and rest not known.
  Of 265 cases of acute and chronic ophthalmia, 166 were cured, 20 relieved,
rest not reported.
  Of 621 cases of scrofulous and catarrhal ophthalmia, 538 were cured, 56
relieved, rest not known.
  Of 11 cases of cataract, 2 were cured, and 5 relieved.
  Of 14 cases of opacity of the cornea,  9 cured, 3 relieved.
  Of 40 cases of purulent ophthalmia, 34 cured, 4 relieved.
  In the present Treatise, 106 successful cases of simple inflammation of the
eye are given.
15 successful cases of rheumatic ophthalmia.
133	U (	' scrofulous	«<
11	(1 <	' catarrhal	K
40	u <	1 purulent	«
15	(I <	1 iritis.	
12	It <	' hypopion.	
11	11 <	' chemosis.	
2	(I <	' ophthalmia of	newborn children.
6	u <	' fistula lachrymalis.	
742 Broadway, New • York
J.  C.  PETERS. 
                   ON

DISEASES   OF   THE   EYE

                   AND

         ITS APPENDAGES.
DISEASES  OF THE EXTERNAL SURFACE  OF THE EYELIDS.
                        INJURIES.

                 1. Bruises of the Eyelids.
  In  whatever way " black eyes" are produced,  every body
is  generally anxious to get rid of them as  soon  as possible.
Old School writers, such as Lawrence and Walton Haynes,
question whether any of the ordinary allopathic means are of
service in hastening the absorption of the effused blood,  and
the removal of the marks.  Haynes thinks that gentle friction
is the only means of hastening the natural process of absorp-
tion.  He says that there does not appear to be any satisfactory
evidence that cold applications are useful in promoting absorp-
tion—on the contrary, he would rather expect them to retard
this process ; but they may be useful if the extravasation be
increasing in consequence of oozing of blood from some of the
injured blood-vessels. The English prize-fighters, according
to Tyreel, have much faith in a poultice made with the  root
of the Black bryony, finely scraped, after the bark  is removed,
and mixed with crumbs of bread ; to be enclosed  in a muslin
bag and renewed every 6  or 8 hours, until all traces of injury
are removed, which will  often take place in  48  hours, even
when the  discoloration  is considerable.  Hays  has  known
                   1 
2
DISEASES OF  THE EYE.
common tallow,  thickly applied,  used with  apparently the'
desired result.
   The Homoeopathic treatment is doubtless far more successful;
in all  ordinary cases the internal and external use of Arnica
Will  probably suffice: 15 to 20 drops of the tincture may be
put  in a tea-cup half or quite full of water,  and cloths wet
with this solution frequently applied to the bruised part; a
few  drops of the tincture may also be taken at a dose inter-
nally every 2, 4, or 6 hours, according to the severity of the
symptoms.   If the  skin  is broken, Tallow, or simple Cerate,
or Glycerine, or Magnesia-ointment may be applied, or Calen-
dula used in the same way as above recommended for Arnica.
   When the extravasation  is considerable, the probability of
suppuration is to be borne in mind, and all febrile threatenings
attended to.   Haynes says leeches are always  worse than use-
less; Aconite should be given if fever, pain, or redness set in ;
Rhus, if much cedematous swelling arise ; if the bone, or peri-
osteum about the  orbit has been injured, Symphytum will
prove the best remedy;  if the blackness and blueness  remain
obstinately, Conium,  internally and externally, is by far the
most homoeopathic remedy ; finally, if a large and firm coagu-
lum  of fibrin remain, the solvents of fibrin must be used, such
as Nilrum) Phosphor., and Hyd. pot.

                    2. Burns and Scalds.
  Haynes  says that burns  and scalds of the eyelids require
the most careful  management, as under  ordinary treatment
they are  generally followed by distressing contractions of the
lids,  owing to the thinness  and looseness of the skin, and the
mobility of the cartilages of the lids.  To  prevent or lessen
the suppurative  stage', of all the  applications which  he has
tried or seen used, none are equal  to nicely dressed cotton
wool;  it is soft, light, and cleanly; when there is merely an
abraded surface from loss of the cuticle, it excludes the air and
soaks up any superfluous moisture; if suppuration  sets in,  it
absorbs the excess of fluid, and leaves enough for the purpose
of sufficient moisture; with it the  sore does not grow flabby
and  indolent, requiring stimulants, as so frequently happens
with cold-water dressings, and the  granulations  are kept in a
condition that prevents  all necessity for caustic applications. 
INJURIES.
3
 He has frequently seen sores that have resisted all other appli-
 cations heal under this, the simplest of all means ; the chang-
 ing of the dressing is readily effected,  as any portion adhering
 to the edges, or to the sound skin, needs only be wetted, while
 that  over the raw surface will always separate  readily when
 surcharged with moisture.
   No ordinary mode  of treatment will prevent subsequent
 contraction and deformity of the lids, if much of the true skin,
 or cutis vera be damaged, or destroyed.   But it  is all-import-
 ant to check the period of suppuration.  Professor Miller, of
 Edinburgh, has used successfully a thick,  semi-fluid, watery
 solution of Gum  Tragacanth.  He lays it on  gently and  uni-
 formly over the  raw surface, and reapplies it, if  any  part
 becomes imperfect;  this material  being transparent, permits
 complete watching and observation of the injured part without
 removing  the  dressing;  as the sore  improves, gold-beater's
 skin is a useful application.  The application of a thick emul-
 sion of white Castile  soap, sweet oil and lime-water, &c, some-
 times proves too  irritating; then a weak magnesia  ointment,
 prepared from the best Henry's magnesia, or an emulsion of gum
 Arabic and milk,  or gum Arabic and almond oil, or sweet oil,
 may be used.   Rhus,  Cantharides, and Urtica urens are recom-
 mended as the most homoeopathic remedies in the first or acute
 stage, but only about  one fourth of the quantities recommended
 for Arnica should  be  used.

   CASE 1.  Dr. Dudgeon says that Aconite is also useful in
 the inflammation produced by the action of acrid substances in
 the eye, by wounds,  and by burns.  A striking instance of
 ophthalmia  from  the last-named cause,  cured by Aconite, is
 recorded in the Allopathic Bulletin Medical, Beige, (Aug. 1840,)
 by Dr. Brow.  It was a case  in which the  eye and face  had
 been  scalded by hot  butter; the lids were  red  and swollen;
 the cornea had lost its brilliancy and was covered with a whit-
 ish film ; the conjunctiva was inflamed, and intolerance of light,
 excessively violent pains  in the  eye, and vesicles on several
 parts  of the face were present.
   Treatment and Result.—Compresses moistened with a solution
of 8 drops of tinct. Aconite in 8 ounces of water were laid over
the eye and face, and some of the solution was  occasionally 
4
DISEASES OF THE EYE.
dropped  into the eye.  Alleviation of pain and quiet  sleep
soon followed, and on the fifth day the cure was complete.

  CASE 2.   In a case where the eye was burned with a can-
dle, the inflammation yielded  speedily to the internal use  of
Aeon. 3.-Brit. Journ. Horn.  Vol. 6, pp. 214.  Dr. Dudgeon.

  If the edges of the lids  have been burned or scalded, espe-
cial care must be used to prevent them from uniting; this may
always be prevented if the corners have escaped injury.  The
careful application of gold-beater's skin, or touching the raw
surfaces with collodion, after  they have  been  well dried, are
thought by Hayes to be superior to all other methods, although
a slight depression of the lower lid and elevation of the upper
lid, by means of strips of adhesive plaster, so that the  edges
may always be kept some little distance apart, would doubtless
be a valuable adjunct.

                3.  Wounds  of the Eyelids.
  Of course it is all-important to bring together the edges of a
wound of the eyelid or eyebrow very accurately, and to attend
to the prevention of inflammation in order to attain that speedy
and perfect union which is the best security against  subsequent
deformity.   Accurate union can scarcely be accomplished by
means of adhesive  plaster; at all events, sutures  answer the
purpose much better.  Small, thin, sharp, almost homoeopathic
needles should be used with single silk threads, and as  many
sutures should  be placed as  may be  necessary to unite and
keep the divided parts in their proper relation to each  other.
Soft linen rags, or lint dipped in Arnica, or Calendula-water, may
be applied frequently.  Plasters, compresses, and bandages are
generally not only useless, but injurious.   The  threads may
be cut out in 12, 18, or 24 hours,  for in that space  of time the
edges  of the wound will have become agglutinated either  by
coagulated blood or coagulable lymph, so  as to remain perma-
nently in their proper apposition; by this early removal  of the
threads we avoid all inflammatory irritation from them, as this
does not come on in so short  a time.—Lawrence.
   If no  undue  inflammation  supervene, wounds of the eye-
brow and lids  generally heal readily; even when lacerated or 
INFLAMMATION OF THE EYELIDS.            5
contused, but little suppuration may take place, and but a slight
scar be left, without injury to the eyelid.  Still the least ne-
glect may allow the edges of the lids and lashes to be turned
in against  the eyeball, causing great irritation  followed  by
destructive inflammation of the eyeball, (entropium;) or, if the
cicatrix be  allowed  to contract too much, the lids  may be
turned up, or over from the  eye, (ectropium.)  In wounds of
the upper eyelid the  levator muscle of the lid may be divided,
and falling-down of the lid, or ptosis, occasioned.   From rely-
ing upon strips of adhesive plaster in place of sutures, or from
other neglect,  fissures of the eyelid, like a button-hole or hare-
lip, have been met with, the edges of the wound not having
been kept close together, but allowed to  cicatrize separately,
forming the so-called coloboma of the  lids.  When the eyelid
is  entirely  cut or torn through, the  ball of the eye may be
injured or  irritated,  and growing together of the eyelid  and
eyeball take place, unless the possibility  of this is constantly
kept in mind,  and care taken to prevent it.
  It is well known that weakness of sight and blindness have
occurred in consequence of wounds of the eyebrows;  this will
be fully treated of under the head of Amaurosis.
INFLAMMATIONS OF THE EXTERNAL SURFACE OF THE EYELIDS.

                       BLEPHARITIS.

  These  are most common in children, and in the upper lid;
when the cellular tissue is involved and suppuration occurs,
which it  is very apt to do, the only point which it  is very
important to attend to, is to limit the extent of suppuration as
much as  possible;  if medical treatment does not do this, it is
all-important to  open the abscess as early as possible, because
if the skin of the lids be allowed to become detached from the
subjacent  parts by a large collection of matter, the consolidation
of the abscess will produce such contraction of the lid  that it
will no longer be able to cover the eyeball, and Lagophthalmus,
or a constant open state of the eyelids will be  produced, ex-
posing the eye to the frequent entrance of foreign particles and
other causes  of  irritation;  in more favorable cases a turning 
6
DISEASES OF  THE EYE.
 over of the lid, or so-called eversion, or Ectropium, will ensue.
 Lawrence has seen at least half a dozen instances  in which
 distressing deformity has resulted from this cause.  In  scrofu-
 lous  inflammation of the cellular tissue of the lids the physi-
 cian  should be particularly on his  guard, because the  matter
 extends laterally, and has but little disposition to approach the
 surface.   The opening  should be made parallel to the natural
 folds or wrinkles in the skin  of  the lids, as the scar  will then
 be hardly perceptible, appearing like one of the ordinary trans-
 verse folds  of the skin.  Hayes relates  a  case  in which  an
 inflammatory abscess of the upper lid was mistaken for severe
 purulent ophthalmia with excessive secondary swelling  of the
 lid, that  part being of a dark red color, greatly swollen, hot
 and painful; the edges of the lids being encrusted with matter,
 and the patient unable to separate them to the smallest extent;
 the whole presenting  a  sufficient resemblance to purulent oph-
 thalmia to mislead an ignorant, or careless practitioner.
   In the lower lid, it is not uncommon to meet with a small
 circumscribed abscess immediately over the  lachrymal sac,
 which might readily be mistaken for disease of the sac itself;
 for the swelling, either  by its pressure on the sac, or by dis-
 placing the inferior punctum lachrymale and interrupting the
 course of the secretions of the eye  from the nose, occasions a
 watery condition of the eye, {epiphora,) ami a dryness of the
 nostril of the same side.
   Chronic abscess of the upper lid is also very apt to be over-
 looked ; the pain is trifling, the lid is tumefied and cedematous,
 but the skin does not appear tense and shining, and in fact, as
 Tyrrell says, the whole feels like a dropsical swelling when
 the cellular membrane is not fully distended.
   Treatment.—In the early stages of acute abscess, Aconite and
 Belladonna will be required in alternation, aided by  an occa-
sional dose  of Mercurius;  when  matter has formed it should
 be let out at once, and Hepar. sulph. and Silex given in alterna-
 tion ;  if there be much inflammatory suppuration, Tartar emetic
 is the best remedy ;  in chronic abscess, Hepar. sulphur may  be
 relied upon in alternation with China, if there be a feeble  state
 of the system.  In erysipelatous inflammation  of the  lids,
 Aconite and Rhus, or Cantharides, Mezereum, or Euphorbium will
 be required.  Crocus has been recommended homoeopathically 
INFLAMMATION OF THE EYELIDS.
7
 after surgical operations upon  the eyes and  lids,  especially
 when throbbing and itching pains are present; it has also been
 used in traumatic ophthalmia with good effect
   Attomyr recommends quite  a number of remedies in Ble-
 pharitis, or in inflammation of the outside of eyelids, viz: Aco-
 nite, Bryon, Calc,  Euphorbium, Graphit., Hepar.  s.,  Kali.,
 Lycopod.,  Magnesia,  Mercurius,  Natrum, Phosphor,  Ehus,
 Senega, Sepia, and Sulphur.—Aconite, Bryon., Euphorbium,
 Kali, Mercurius,  Phosphor, Ehus and  Senega doubtless being
 most homoeopathic to quite acute attacks ;  Graphite, Hepar s.,
 Sepia and Sulphur being  most  suited to the intractable sub-
 acute and irritable varieties; while Calcarea, Lycopod., Mag-
 nesia, and Natrum are best suited to slight and sluggish attacks.
 Aconite is thought to be  most useful in acute inflammation of
 the right upper lid, with red, hard swelling;  Hepar in sub-
 acute inflammation of the upper lids, with redness and  swell-
 ing ; Kali, when there is great swelling of the right upper lid,
 especially toward the nose;  Natrum, when there is swelling
 of  the upper lids  without much pain,  or redness; Bryonia,
 when there  is redness, swelling, and acute inflammation of the
 lower lids ;  Calcarea, when there  is sub-acute inflammation and
 swelling, especially of the left lower lid;  Graphite, when there
 is redness and painful sub-acute  inflammation of the lower lids
 and internal angles of the eyes;  Magnesia, when there is a tor-
 pid and chronic inflammation and swelling of the lower lids,
 with redness of the angles  of the eyes ; Mercurius, when there
 is acute disease, with great swelling and burning pains, espe-
 cially in  the left lower  lid;  Phosphor, when there is  acute
 inflammation and swelling  of the lower lids; Euphorbium, when
there is  severe inflammation of both lids, with  violent itching
 and  irritation, but  with  a  rather pale  swelling,  and profuse
 secretion of pus  from the  edges; Lycopodium,  when there is
 chronic inflammation  of loth lids, with  swelling,  pain, and
much secretion ; Mercurius, when there is violent inflammation
of the upper and lower lids, with burning pains, profuse secre-
tion of tears, and matter; Rhus, when there is the most violent
inflammation of both upper and lower lids; Senega, when there
is swelling,  burning and aching of the eyelids, without very
great redness, especially when the upper and lower lids of the
right eye are  principally affected; Sepia,  when  there is sub-
l 
DISEASES OF  THE EYE.
 acute inflammation, with  much swelling and some redness of
 both upper and lower lids; Sulphur, when there is a sub-acute,
 but pamful and irritable inflammation of both lids.—{See Pri-
 mordien  eine Naturgeschichte der Krankheiten.    Vol. 2. pp. 90
 to 105.

             Secondary Inflammations of the Lids.

   Lawrence says that the eyelids are often involved in external
 inflammation of the  ball of the eye; that is, in common, ca-
 tarrhal, purulent, and scrofulous ophthalmia.   We do not see
 a severe  case of these affections, particularly of the first three,
 without more or less inflammation  of the lids ; hence, from the
 condition of the lids we may derive considerable information
 respecting the state of the eye, when we cannot actually see the
 latter.  This influence, Lawrence says, is not  reciprocal;  the
 more important organ, the eye itself,  reacts upon the subor-
 dinate parts, viz., the lids; but the latter do not act upon it.
 The conjunctiva is only a little reddened in erysipelatous inflam-
 mation of the lids, although they are often enormously swollen
 and bright red, with the cellular tissue in a state of purulent
 infiltration, and mortification. The same observation holds good
 in most cases of variolous and traumatic inflammations of the
 lids.  But in internal ophthalmia, the lids do not often become
 secondarily involved, that is, if the disease is confined to the
 internal tunics.—Lawrence.
  Too much confidence must not be placed in these assertions;
 in a case of true erysipelas—still under treatment—about the
 right forehead, temple, and right lids, attended with vesication,
 rapid formation of almost gangrenous sloughs upon the temple,
 forehead,  and upper  eyelid;  also  with excessive cedematous
 swelling of both upper and lower right lids, with entire closure
 of the right eye and partial closure of the left from the exces-
 sive swelling, I found the conjunctiva not only greatly swollen
 and cedematous, but the cornea became  dim, the pupil con-
 tracted and irregular, with a hazy or smoky appearance of the
 eye, and  discoloration of the  iris,  evidently proving  that the
external inflammation had extended as far as the iris, causing
erysipelatous inflammation of the conjunctiva, cornea, and iris. 
INFLAMMATION OF THE  EYELIDS.
9
          Dropsical Swelling of the Lids.  {(Edema.)

  The lids are swollen and dropsical in Bright's disease of
the kidneys, and in general dropsy, and in anasarca of the face.
  Treatment.—Arsenicum, Marsh marigold, and Merc, corrosiv.
If the swelling be so great as to close the lids, the watery fluid
should be let out by puncture.

  Inflammatory  oedema  of  the  lids occurs sometimes from
trivial causes, such  as the irritation of styes, bites or stings of
insects,  or leeches; the lids are often  enormously swollen in
inflammation of the lachrymal sac ;  the eyes are often closed
in  erysipelas.  But  these  inflammatory oedemata  of  course
generally subside without much  harm when the disease which
caused it is subdued.
  Treatment.—If the ball of the eye become at all  involved,
punctures and scarifications of  the outside of the lids  are
extremely important, in order  to reduce the swelling which is
pressing upon the eye, as rapidly as possible.  Ehus, Canthari-
des, Apis mell., Mezereum, Urtica urens, all deserve  attention.

  CASE 4.  A child, aged 2£ years, had suffered for 2 days
with redness of both eyes, lachrymation,  and nocturnal agglu-
tination ; he rubbed his eyes very much, was restless  and sleep-
less ;  finally,  the whole neighborhood of the right eye became
cedematous, involving the orbit,  cheek-bones, and wing of the
nose.
  Treatment.—Ehus 30, removed the whole affection  in 2 days.
—Annals.  Yol. 1. p. 203.   Buschk.

  CASE 5.  A man who worked much by artificial light, and
who had long been  troubled with styes, first on  one lid, then
on another, was suddenly attacked with burning pains in both
eyes, and dimness of sight, followed by an cedematous swelling
of the lids of the left eye, extending over the neighboring parts,
and preventing the  opening of  the eyes.  The  glands  about
the neck and ear of the same side were swollen, red and painful.
  Treatment.—One dose, each,  of Ehus 12 and 18, and of Pul-
sat  12, removed  the  whole disorder  in 10 days.—Genl.Hom.
Jour.   Vol. 12. p. 22.  Dr. Hartmann. 
X)
DISEASES OF THE EYE.
                  Emphysema of the Lids.

  This may arise from injury of the lachrymal  sac, or from
fracture of the bones  of the nose, or nasal sinuses  near the
orbit.  It is generally not extensive, and soon disappears.
          INFLAMMATION OF THE EDGES OF THE LIDS.

    This  disorder has  received many long names, such as  Oph-
■  thalmia  Tarsi,  Psor-opthalmia, Lippitudo,  Tinea  Ciliaris,  Blear
  Eyesj d'c.
    According to Lawrence, in  acute  and simple Ophthalmia
  Tarsi, the margin of the lids, the  tarsal  cartilage and glands,
  and the adjoining mucous membrane of the internal  surface of
  the lids are involved.   The edge and neighboring part of the
  lid are swelled, bright Ted, and painful;  the mucous membrane
  under the lid is of a scarlet color and villous; motion of the lids
  causes an acute pricking pain, with feeling as if there was sand
  in the eye and grit on the edges of the lids; there is a watery
  condition of the eye, intolerance  of light, and more or less fever-
  ishness.  The roots of the eyelashes are dry and stiff at  first,
  then become moistened by increased secretion, and finally be-
  come more or less stuck together every night.  The Meibomian
  glands soon participate in the affection, which originally begins
,  on the margin of the  eyelids, in the thin and delicate skin in
  which the eyelashes are placed, and upon which the duct of the
■  Meibomian glands open; these glands are situated so near the
^primitive seat of  the disorder, that they soon become involved
  \by contiguous sympathy; they  no longer pour out the  mild
  iinetuous matter which is destined to lubricate and soften the
  edges of the lids, but their secretion is suspended, so that in
  the morning the  edges of the lids are  stuck  together by the
  increased conjunctival discharge, which has  become  incrusted
  by the evaporation of its watery parts during the night.  In
  this way the lids are often so firmly agglutinated together every
  morning as to require a tedious process of softening and bath-
  ing with warm liquid applications before they can°be parted.
  Finally,  when the secretion from the Meibomian glands is re- 
INFLAMMATION OF  THE EDGES OF THE LIDS.
newed, it is altered in quality, being thick and viscid, and very
apt to accumulate in hard lumps or masses at the roots of the
eyelashes.   Some of these morbid secretions of course get into
the eye itself, spread over the cornea and irritate its surface,
rendering it dull and turbid, impairing the vision, and causing
various ocular delusions, such as  rings  or haloes around the
candle, or its flame seems split into stars.
  So many tissues are involved in this disorder, viz., the root
of the eyelashes, the edges of the lids, the Meibomian glands,
and the conjunctiva of the lids, that the disorder is apt to prove
obstinate, as the cure depends  very much upon an accurate
selection of the few remedies which act upon all these parts, or
upon an adroit alternation of those which act specifically upon
the Meibomian glands, with those which act  more particularly
upon the edges and conjunctiva of the lids.  When the patient
is scrofulous,  or cachectic, or careless, of course the disorder
becomes still more intractable.
  The name of Tinea ciliaris is given when pustules like those
of Tinea capitis form on the edges of the lids, especially about
the roots of the lashes ; these break  and pour out a yellowish
matter, concreting with more or less firm, yellowish, or yellow-
ish-brown scabs, which mat the  eyelashes together, and some-
times adhere very closely to the surface of the  lids.  As this
affection is seated  along the  roots of the eyelashes, it  affects
their growth, altering their form and direction; the ulcerations
may finally extend deeper and deeper, and at last destroy the
roots or bulbs  of the eyelashes, which come away with the
scabs.—Lawrence.
  A still more obstinate and intractable variety of the disease
has received the  name of Psorophthalmia, on account'of the
severe irritation and itching which  attends it, and from the
supposition that the vesicles or pustules are true itch-pustules.
  Blear-eye and Lippitudo are other names given to some
stages or peculiarities of chronic inflammation of the edges of
the lids, especially when the free margin of the lid becomes
thickened and  the regularity of the  eyelashes disturbed; for
instead of having a uniform direction, some of the lashes become
directed  upwards, others downwards, or in  various irregular
positions. The collection of coagulated secretion about the root?
of the lashes becomes more abundant, and when taken  away, 
12                DISEASES OF THE EYE.
extensive ulceration around the hairs  will  often  be found.
These  ulcers gradually spread,  and  at  length  communicate
together, so that the margin of the lid presents  a continuous
raw surface;  at the same time the ulceration extends in depth
so as to destroy the follicles from which the lashes grow ;  then
the lashes fall out, and are not again reproduced.   The destruc-
tion of all the lashes subjects the patient to constant attacks of
inflammation, excited by the  lodgment  of particles  of dust,
&c, upon the globe of the eye, which else had been warded
off by the lashes in the process of involuntary winking.  The
edges of the lids finally exhibit a thickened, florid and excori-
ated condition, constituting true Lippitudo.—TYRREL.
   Treatment.—A very large portion of the treatment falls to
the share of the patient, or his attendants.  The lids if possible,
should always be  prevented from  becoming  agglutinated at
night; or, if  this  cannot be accomplished, they  never should
be separated  in  the morning  until the  matter by which they
are glued together has  been completely softened.  By forcing
the lids  roughly open the irritation is  kept  up, and the dis-
charge daily aggravated; tepid milk and water should  be used,
or the  agglutinated eyelashes should be smeared for some five
minutes with warm milk, in which a bit of fresh butter, i. e.,
without salt, has been melted; then, a soft sponge wrung out
in warm water should be held to the lids, and finally the soft-
ened crusts carefully removed.   At night, the edges of the lids
should be  touched with Glycerine, or perfectly fresh Simple
Cerate.
   The edges  of the lids should be  examined carefully by the
physician, every few days, with a magnifying-glass, and all the
inverted lashes carefully pulled out, for these hairs are  a source
of great irritation  to the eye, and will speedily induce inflam-
mation  and opacity of the cornea.  This process also enables
the oculist to get at the excoriations and small ulcerations, and
apply the specific remedies directly to them.
   From Dr. Hempell's New Eepertory to Jahr's  Manual, page
241,  we  learn that Borax is homoeopathic when  the  eyes be-
come closed at night with a hard, dry gum, which irritates the
eyes like sand ; Alumina, when there is  a profuse secretion of
mucus, especially at night, with dry eye-gum  in  the morning;
Argentum nitricum,  when the eyes are filled with mucus, and 
        INFLAMMATION OF THE EDGES OF THE LIDS.      13

closed with crust of dry gum, which has to  be soaked before
it can  be removed, or the  eyes  opened;  Muriate of Am-
monia,  Nitrate of  potash,  and Carbo animalis  also deserve
attention.  On page 271,  we find that Kreosote is indicated
against chronic swelling of the margins of the lids; Eupatorium,
when there is redness of the margin of the lids, with glutinous
secretion from the Meibomian glands; Spigelia, when there is
inflammation of the margins  of the lids, with  ulceration and
smarting soreness ;  Mercurius, when there is swelling and red-
ness of the edges of the lids,  with  scurf and ulcerations; Cle-
matis, when there is inflammation  of the margin of the lids,
with ulceration;  Euphrasia, when  the same  state  is present,
with much headache.
   Calcarea and Sulphur are homoeopathic to the more obstinate
and chronic  cases, and we  find that Hayes, of Philadelphia,
recommends equal parts of rhubarb and prepared oyster-shells,
every night, in sufficient doses to produce two stools daily; or
equal  parts of Cream of Tartar and  Milk of Sulphur; and
asserts, under this treatment, he has cured cases in a few weeks,
which  had run on for years, and in  one case for 19 years.
   In the Dominant School, a variety of more or less stimulating
and hence homoeopathic remedies  are generally applied to the
edges of the lids:  of these, the  preparations of Mercury and Sil-
ver are the most common,  and, it is said, the most successful.
I have seen a solution of Merc, corrosiv., 1 grain to the ounce of
water,  or an ointment of 1 or 2 grains to the ounce of  simple
Cerate, used with very great, and radically curative benefit.

              Syphilitic Affections of the Eyelids.

   Syphilitic ulcerations sometimes  affect the eyelids, generally
at their edges, but sometimes on their external or internal .r^-
face; in the one case, going on to destroy the whole thickness
of the lid;  in the other, producing  a deep and foul ulceration.
It is of course of great  importance to distinguish their true
nature, in order that, by the timely  employment of the general
treatment for Syphilis, the  progress of the ulceration may be
arrested.  This of course will be easy for any one  at all con-
versant with the disease or  its treatment. 
14
DISEASES OF  THE EYE.
             TURNING IN OF THE EYELASHES.

                        TRICHIASIS.

  This is  a  growing-in of some or more of the  eyelashes
against the eyeball; the border of the lid remains in its proper
position, which constitutes the distinction between Trichiasis
and Entropium.
  Distichiasis, again, is merely a variety of Trichiasis, in which
the misdirected eyelashes  are disposed, though not very regu-
larly, in a row distinct from the others which remain properly
directed.  The faulty eyelashes in these two disorders are gen-
erally the natural hairs which have been made to take a wrong
direction, in consequence  of disease  of the  edge of the lids,
cicatrices, &c.  Sometimes, however, the hairs are supernumer-
ary, and of new formation.  Sometimes the misdirected eyelashes
are  confined to a part only of the border of the eyelid, in other
cases the whole border of the eyelid is involved along its whole
extent.  It is not uncommon to find both Trichiasis and Dis-
tichiasis affecting the lids  of both  eyes.  The offending eye-
lashes are sometimes very few in number, and so pale and fine
that they very frequently escape even- somewhat careful notice,
and the inflammation  of the eye which they occasion will be
attributed to  some other cause, unless a careful exploration of
the state of the edges of the lids be made with a good magni-
fying-glass.   (Wharton Jones.)  It is one of the most com-
mon affections  of the eye, and  although it  does  not rapidly
destroy this organ, yet, if allowed to proceed unchecked, or if
merely partially relieved, it becomes, from the constant irrita-
tion and  inflammation of the eyeball which it causes, one of
the most destructive diseases.  It is scarcely necessary to  say
that Trichiasis and Distichiasis are merely varieties of the same
affection;   the supposed independent,  or new row  of  lashes
which has been assumed to exist in the latter, is a mere  decep-
tion, arising partly from the irregular though  natural manner
in which the  eyelashes are placed  on the edges  of the lids,
owing to the  different planes in which their follicles lie ; a fact
which seems to be frequently overlooked, although familiar to
the  earlier anatomists.  In fact this so-styled Distichiasis may
be artificially produced, and the permanent misdirection accur- 
TURNING IN  OF THE EYELASHES.
15
ately imitated in a perfectly healthy lid, by separating the inner
row of eyelashes, and  bending them toward the globe of the
eye.—Haynes Walton.
   It is far more important, however, to trace out the mode of
origin of the disease.  It may arise from the matting together
of the lashes in long-continued  purulent discharges from the
eyes ; but by far the largest number of cases arise from certain
diseased changes in the lid itself,  nearly all of which  arise from
scrofulous   inflammation.   The  misdirection  of  otherwise
healthy eyelashes  is supposed by Haynes  nearly  always to
arise from unhealthy changes in the fibro-cellular tissue in which
the cilia-follicles lie; thickening or other apparent disease of the
lids is not a necessary accompaniment, although it may be and
often is  superadded.  When the eyelashes, instead  of having
their natural  shape  and size, are also imperfectly developed,
then more or less disease of the hair-follicles has been added,
arising from unhealthy states of the edge  of the lid.
   The disorder, as before said, requires very careful examina-
tion of  the edges of the lids;  the eyelashes that fret the eye
may be so minute as  to escape even careful observation of
those unaccustomed to search for  them, and  unfortunately,
minuteness does not diminish  their power of mischief.  Some-
times only one or two  hairs are inverted without any apparent
cause, the lid and the rest of the lashes being quite natural, and
in this ease, the misdirected hair is almost always so slender and
light-colored as to render close examination necessary to detect
it.  But the sensations of the patient are very accurate;  the
feeling of a foreign body rubbing the eye is almost always ex-
pressed ;  it causes, at times, merely uneasiness without inflam-
mation ; or  inflammation may be caused with  ulceration and
opacity of the cornea, severe pain, with intolerance of light and'
the greatest irritability;  finally, sight may be destroyed by the
effects of repeated attacks of acute inflammation of the cornea,
but even then the patient's sufferings are not at an end, for pain
will be excited as often as he moves his eye, until all the offend-
ing lashes have been extracted.
   Treatment.  When the irritation  is caused by well-formed
but inverted eyelashes  proceeding from a healthy lid, they may
be pulled out with advantage, because although the lashes soon
grow again there  may not be a return of the  inversion, and 
16
DISEASES OF  THE EYE.
even if the hairs so pulled out show a tendency to become dis-
torted to a like degree, their injurious effect can be anticipated,
and the process of extraction  repeated, again and again, with
advantage.   But when the pulling out of the offending lashes
is followed, as it often is, by an increase of inverted or abortive
lashes, then the use of  the  Cilia forceps has reached its limit
and should be discontinued.   The length of time, or the fre-
quency with which this will become necessary, depends very
much upon the manner  in which the lashes have been extract-
ed, and the general  care which  the  patient takes of his eyes,
diet and general health,  and the judicious use of specific rem-
edies  against  the  disease  of the lids,  hair-follicles,  &c.  The
majority of the finest eyelashes are not pulled  out, but  are
merely broken off, because they  are generally carelessly pulled
at with a jerk, and the short portion left irritates like  a short
bristle.  The patient should present himself weekly; a magni-
fying-glass should  be used, and  if the hairs  be very fine and
pale, some  black extract  like Belladonna may be applied to
the edge of the lid which if rightly used will blacken even the
finest lashes so as to render them quite visible;  then  forceps
without teeth should be  employed,  the  holding part being
merely rough-polished, so as not to cut  or break off the hairs,
and they should be held close up  to .their points.  When the
eyelashes are exquisitely fine and  slip through even the best-
made forceps, Hays has found  it an infallible plan to damp
their points with a saturated solution of Shellac in alcohol, and
to grasp the hairs  for a moment or two before pulling them.
Finally, the  eyelash should be  grasped near  its root and
slowly drawn out in a straight line,  by which means it will
generally be  drawn out by its root.   Unless all these precau-
tions are used, there cannot be a doubt that the frequent pull-
ing out of the lashes is very hurtful to the hair-follicles, renders
the direction of them more perverse, tends to  irritate  the lids
and  involve  the  contiguous follicles,  and so to multiply the
trichiasis.
  In  some  obstinate cases  the careful application of some
depilatory to each offending follicle may be resorted to.
  But, besides these palliative means, the judicious  use of
remedies which act specifically upon the edges  of the lids must
be carefully followed up.  (See page 12.) 
     INFLAMMATION OF THE ANGLES OF  THE EYELIDS.   17

 Thickening and induration of the edges of the lids.  (Tylosis.)

  The edges of the lids, after long-continued slow inflammation,
become  thickened, indurated and  knotty,  especially in scro-
fulous subjects; they ulcerate  irregularly, and incrustations
form about the lashes;  this swollen and  knotty state of  the
lids, in which their margin often  loses  altogether its natural
figure and appearance, has been  technically  called tylosis.—
Lawrence.
  All the lashes should  be extracted, the crusts removed, and
specific  remedies  applied  locally  and  internally;  especially
Argent  nitric, Mercurius, Kreosote, Clematis, and Euphrasia.

        Loss of the Eyelashes.  (Ptilosis, Madarosis.)

  Destruction of the  hair-bulbs either by ulceration or injury
causes a permanent loss of the eyelashes, which may be either
partial or general.   The loss is irremediable, but the effect on
the personal appearance is much less  than would have been
expected, especially in those with  light hair.  In some cases
the local application of  Cantharides, and dilute Ung. Hydrarg.
Nitrat.  have  ultimately restored the lashes of natural  size,
number and  color.  The homoeopathic remedies for Alopecia
may be  tried, viz., Plumbum acet., Paris quad., Hepar, Alumina,
and Phosphor.
      INFLAMMATION OF THE ANGLES OF THE EYELIDS.

   The most important of these are the diseases of the internal
ano-le of the lower lid, either seated in the lachrymal sac and
passages, or external to these.
   According to Attomyr, a swelling often appears at the in-
ternal  angle of the eye,  near the lachrymal  sac; it  is  red,
yellowish-red, or bluish-red,  shining, tense, and painful;  it is
apt to be bean-shaped, and extend downwards and outwards
over the neighboring parts of the lids and cheek. The eyelids
and part of the face are apt to swell and become cedematous:
very frequently the inflammatory swelling extends  to  the ad-
jacent lachrymal organs, to the meibomian glands,  and the
                  2 
18
DISEASES OF  the eyelids.
white of the eye.  The lids are apt to stick together at night,
the tears to run over the eyelids, and the corresponding nostril
to become sensitive and dry, while sneezing is easily provoked.
  As long as suppuration and ulceration  do  not set  in, the
disorder  is technically called by the old-fashioned name, An-
chlyops;  when these latter do  occur, it  receives the equally
absurd name of JEgilops.   The disorder  seems  more  closely
allied to phlegmonous erysipelas,  or to boils, or styes in  its
nature;  at least, it usually is as obstinate  and intractable in its
course, and rarely ends short of  suppuration.  The  abscess,
when formed, either opens outwardly .upon the cheek,  or else
bursts into the lachrymal sac, or progresses in both directions
simultaneously.
  It may be  distinguished from  acute inflammation  of the
lachrymal sae, by the much slighter degree of pain  and fever
with which it is  accompanied.   In acute Dacryo-cystisis, or  in-
flammation of the sac, the local suffering and the  constitutional
disturbance are much more considerable than might have been
expected from the small extent of the disorder; but not more
than can be accounted for by the great vascularity of the tis-
sues of the sac, and from its being surrounded by an unyield-
ing bony receptacle.—Lawrence.
   Treatment.  According to Attomyr, Belladonna, Mercurius,
Natrum,  and Petroleum are the principal remedies.   The  indi-
cations for Belladonna are: throbbing pain in the lower eyelid,
near the internal  angle,  with great inflammatory swelling at
this point, and profuse flow of tears.  Inflammation and sup-
puration of the left punctum-lachrymale,  with  burning and
aching pains.  Great painfulness of the internal angle of the
left eye, with itching, sticking together of the lids, involuntary
lachrymation, frequent sneezing, and redness of the whites of
the eyes.
  Mercurius is indicated when there is an inflammatory swell-
ing near  the lachrymal  bone;  great swelling,  redness and
agglutination of the lids, which are very sore to the  touch;
many red vessels on  the white of the eye; heat and  lachry-
mation of the eyes; watering and weeping of the  eyes, frequent
sneezing.
  Natrum is indicated when there is violent inflammation and
purulent swelling of the lachrymal sac, which bursts in about 
      inflammation of the angles OF the eyelids.    19

four days; inflammatory swelling of the right upper eyelid, with-
out redness  of the white of the eye, with aching, dimness of
the vision, and some hard mucus in angles of the eye;  lachry-
mation ; sticking together of the lids ; unusually violent, fre-
quent and long-continued sneezing.
  Petroleum  is the most homoeopathic remedy when  there is
an inflammatory swelling in the internal angle of the eye,
almost as large as a small pigeon-egg, with burning and aching
pains, and lachrymation; when much water can be  pressed
out of the corners of the eye; and there is frequent sneezing,
with drowsiness.
  Among other remedies, Argentum nitricum, Bryonia, Calcarea,
Cinndbaris, Graphit, Sepia,  Silex,  Stannum, and Zinc  deserve
attention.

          Polypi and Fungi of the Angles of the Lids.

  CASE  6.  A child aged 1 year, had a Polypus with a neck,
growing from the external  angle of  the  right eye; it  had at-
tained the size of a sugar-plum.
   Treatment.  In 8 days  after taking Lycop. 200, the swelling-
was smaller; in 14 days it had disappeared entirely.—Dr. Gross.

  CASE  7.  Field-Marshal Eadetzky, when 70 years of age,
was attacked with  inflammation of the eye,  followed; by  a
swelling in the internal angle of  the eye, about the  size of  a
bean, and which soon took on  the  appearance of a- spongy
fungus.
   Treatment.  After the use of various homoeopathic  remedies
this dangerous disorder gave way before the use of Thuya 30,
1 drop in 8  ounces of distilled water, a table-spoonful per dose
3 times a day, aided by the external use of Tinct. Thuya,  6
drops in 4 ounces of water, to be  applied warm every  2 hours.
Every 8 days the  above treatment  was  alternated with Carb.
animalis 30, in daily doses, aided  by the external  use of a
solution of Carb. an. 12, applied to  the fungus with a camel's
hair pencil.   The cure was rapid.   Genl, Horn. Jour.   Vol. 20,
p. 165.  Dr. Hartung. 
20
diseases of the eyelids.
             HORDEOLUM,  OR],  STYE.

  Stye, as is well known, is a  small inflammatory tumor at
the edge of the eyelid, attended with more or less  heat  and
pain,  and going on to suppuration.  It is closely allied in its
nature to boils and felons, differing perhaps only in its location.
It has been supposed by some, but erroneously, to be an abscess
of the meibomian glands;  others suppose that like a boil it is
merely seated in the cellular tissue near the edge  of the  lid;
while Dr.  Zeis  has suggested that styes have their seat in the
capsules, and glands of the roots of the eyelashes.  In accord-
ance with the  latter  supposition, Dr. Zeis asserts that styes
may be arrested at once by plucking out the eyelashes at the
part affected, and Wharton Jones says, as the lashes fall out
at any rate, there can be  no objection on the score  of saving
them ;  besides,  they almost always grow again.
  Treatment.  According to Lawrence a stye generally goes
through its regular course, under the old treatment;  he thinks
premature lancing is injurious, and in general it is best to leave
the disorder to its natural course, probably because no specific
remedies  are known  in  his school against this trifling but
annoying  disorder,  while  leeches, purgatives,  poultices,  and
low diet are altogether too severe for such a lilliputian disease.
According to Attomyr, Ferrum aceticiim, Phosphor, Pulsatilla,
Rhus, Sepia, and Staphysagria are the principal homoeopathic
remedies.  Ferrum is indicated when there is redness and swell-
ing of the upper and lower lids, with a kind of stye filled with
pus, on the upper one, while the lower is covered with purulent
mucus; when the eyes are red  and burning, and  the eyelids
stick together.
  Phosphor.—-When the styes are most frequent on the lower
lid, the eyes being sensitive to light;  when the whites are red,
with itching, soreness, and much burning; when  acrid water
flows from the eyes ; when the lids stick together, are hot and
sore, and the internal angles are ulcerated;  all attended with
dimness of sight.
  Pulsatilla has been recommended by Knorre against styes,
from personal experience.   Gross thinks that it will disperse 
hordeolum,  or stye.
21
them in two or three days, although Sulphur  will have  to
be given afterwards, if there is a chronic disposition to relapses.
Lobethal also speaks highly of it.  It is most indicated when
the styes are attended with inflammation of the  whites of the
eyes, with sores of the corners of the lids, and of the nostrils;
when the eyes water, and stick together.
  Rhus is recommended when there are large, red swellings,
like styes, on the left lower lid, near the angle of the eye, with
aching pains, and lasting for six days ;  when the eyes are red,
and  stuck together with matter in the morning, and there is
much purulent mucus about the lids.
  Sepia is one of the best remedies when the styes are extremely
slow in suppurating, and have an obstinate and chronic pre-
disposition to return again and again.   Vehsemeyer cured a
boy, aged twelve, who had been troubled with a hard  tumor,
of the size of a small pea, on the lower lid, remaining  after a
stye, which  he  had had two years before; it was attached to
the tarsus, and obstructed the motion of the lids.   He received
Sepia 30, one dose every eight days;  after the  second dose,
pain, inflammation, and suppuration set in, in the indurated spot,
which broke after the third  dose, and he  remained perfectly
cured.
  Sulphur is also  almost indispensable in chronic cases,  espe-
cially when  there  is much swelling of the lid,  with redness,
burning pain, and  hard matter between the lashes ; when the
eyes are sensitive to light, and the lids are apt to stick together.
  Staphysagria has been recommended  by Hering when  styes
recur frequently on the lids, or  leave  indurated spots behind
them, or when they do not gather and break, but  become indu-
rated, especially when the lids are apt to  glue together, with
biting and burning pains in the corners, and much dry matter
collects between the lashes.

  CASE 8.—Tietze cured a  man, aged 44, who had frequently
suffered with inflammations of the eye, and who had been for
nine weeks in the  following state :
  Symptoms.—Both eyelids of the right eye were somewhat
swollen, and bluish-red; the  whites of the eye  were red and
injected, especially at the internal angle;  both eyelids  were
covered with styes in their first  stage;  at night  the lids  were 
22
diseases of the eyelids.
stuck together by hard, yellow scabs ;  he complained of aching
pains when  the  eye  was uncovered, and often had burning in
the lids.  His pulse was hard and frequent, and he was costive.
  Treatment—Staphysagria  15,  3  doses, one  drop per  dose,
cured him entirely.—Archiv. Vol. 19, part 3, p. 170.

  In  ordinary homoeopathic  treatment, Pulsatilla is recom-
mended as the first remedy to be used;  while Merc, and Hepar
are to be relied upon when suppuration has set in.   Hartlaub
has recommended Alumina when there is predisposition to the
frequent recurrence of styes on the upper lid ;  Colocynth proved
homoeopathic to a stye on the left eye ; Mercurius to styes on the
upper eyelid, when this was  thick, swollen, and red;  Natrum
mur. to a large  stye on  the internal angle of the right  eye;
Senega to styes on the edge of the right lower lid.   Thuya cured
a chronic case, in a woman who had suffered so long and fre-
quently, and had received so little benefit from allopathic treat-
ment, that extirpation of the edge of the lids was  thought
of; it was used both internally  and externally.


      Inflammation and Abscess  of the Meibomian  Glands.

  The appearance of this disease on the external surface of the
lid  resembles that of stye very decidedly; but it is  of much
rarer occurrence, and its nature will at  once be recognized on
everting the lid, when the affected gland, or  glands, will be
seen distended with yellow matter, extending on the under sur-
face of the lids,  from their edges some little distance towards
the attachments of the lids to the orbits.
   Treatment.—When ripe, the  turgid gland may be  opened,
and the matter be evacuated by a touch of the lancet. According
to Attomyr, Colchicum has been found homoeopathic to inflam-
mation and ulceration of the Meibomian glands of the lower lid
of the left eye, with swelling  of the lids, and great irritation of
the nerves of the eye ; Digitalis, in simple inflammation of these
glands;  Indigo,  when the  inflammation of  the Meibomian
glands of the lower lids was attended with slight headache,
toothache, noises in the ears, and beating in the forehead; Nickel,
when there is burning pain in both eyes, much watering of the
eyes, and decided swelling of these glands. 
diseases of  meibomian glands.          23
           Enlargement of the Meibomian Glands.

  According to Tyrrel, we sometimes meet with an irritation
of the eye, as if some foreign substance were in it, between the
lid and the ball of the eye;  on everting the lid, a small tumor
may be found of a deep red color, and having a close resem-
blance to a small cluster of healthy granulations, only being
more firm to the touch ; the white of the eye is usually a little
inflamed, and sometimes a considerable  degree of ophthalmia
will be present.   This disease differs from stye, in being seated
on  the inner surface of the  lid, and more frequently on the
lower  lid, while  styes  are most  common on the upper lid. and
always on the outside of any of  the lids.
   Treatment.—Thuya, Colchicum, NicM, and other remedies are
suited to this disorder.

                    Tumors of the Eyelid.

   They are generally small, and  consist of Styes, Horns, Warts,
 Glandiform-, Steatomatous-, Vesicular-, and Tarsal-tumors.
   Styes have already been fully  treated of.
   Horns on the lids are said by Haynes Walton to consist of
 inspissated sebaceous matter, and owe  their existence  to the
 drying  and  hardening, as fast as it escapes, of the contents of
 encysted tumors, or of the sebaceous  follicles which supply
 the soft material.
   Treatment.—When medical treatment fails, a single stroke of
 the knife will be sufficient to remove a horn from the lid; the
 excrescence should first be pulled forwards, and the separation
 should  be made through the skin, in order that the cyst from
 which it grows, may be entirely taken' away, or else a return of
 the disease will almost surely take place.  Hartmann says he
 has cured them with Antim. crud.
    Warts should, as a rule, not be excised, on account  of the
 injury which will be inflicted  upon the cartilage of the lids.
 Thuya, Soot, Sabina, Causticum and Calcarea are the principal
 homoeopathic remedies.
    Glandiform tumor is common in children, and was so named
 by Tyrrel, from its resemblance to a salivary gland; it is fre-
 quently present on the  lids  and  face  simultaneously, and 
24
diseases of the eyelids.
 Haynes says it is, he believes, never solitary.  When fully
 formed, its appearance is chafacteristic, being mottled, and the
 gland-like  structure is at once recognizable.  In a very recent
 state  it resembles a sebaceous tumor.  As several are almost
 always seen in the different stages of development, some of
 them may  have softened in the centre and suppurated, and
 having burst their cyst, protrude and become surrounded with
 an incrustation which makes them look like  warty growths.
 Mackenzie thinks that it is an albuminous tumor; while Law-
 rence supposes that it commences as a small, smooth promi-
 nence, with a flattened surface and a small pin-like hole in the
 centre.
   Treatment. — Thuya, Merc.-corrosiv.,  and Calcarea, are  the
 most homoeopathic remedies.  The surgical treatment consists in
 cutting the tumor across with a free incision, and squeezing
 out its contents with the thumb-nail; if the cyst does not separate
 at the same time, it must be pulled out gently with the forceps.
 Walton Haynes.
   Steatomatous - tumor, or Milium,  is  a  superficial deposit of
 Steatoma, generally called milium, from its resemblance to a
 millet-seed;  it is  not confined to  the  eyelids,  but  frequently
 appears on the cheeks in great numbers ; it seldom exceeds a
 pin's head in size, except when it grows at the edge of the eye-
 lid, or between the eye and nose.
   Treatment.—Whether large or small, they may be cut across,
 and their contents squeezed  out.   Dr. Gueyrard has cured
 even large steatomatous tumors with Thuya, 15th dilut., a dose
 every night and morning, in about one month.

   Vesicular Tumor.—Tyrrel says that he has frequently seen
 the cuticle  elevated near the free margin of the lids into a
 small vesicular tumor containing  water, or serum.   They are
 not attended with any pain or marked symptom, unless they
project inwards toward the  eye, which they rarely do. These
vesicles, from  the thinness of their contents,  are semi-trans-
parent; seldom larger than a swan-shot; and several are  often
present at the same time upon the lids.  They are  sometimes
very slow in growing, lasting from five to twenty-five years,
when, instead of serum, they are apt to contain a glairy  fluid.
   Treatment—When small,  a simple  puncture will  effect a 
tumors of the eyelids.
25
cure;  or  Rhus, or Cantharides, Mezereum, Euphorbium, or
Marsh-Marigold may be required internally and externally.
When of a large size, the cyst may be required to be removed,
or cauterized.

   Tarsal  Tumor.—The  situation of this differs from  that of
stye in being above the edge of the tarsus, or cartilage of the
lid, and some distance away from the eyelashes.  When small,
the tumor is scarcely visible on the  outer  side of  the lid, and
can only be felt beneath the skin of the eyelid like  a small shot
under the finger; but if the lid be everted, or turned  over, a
discolored spot on the  under  surface will indicate the point
of attachment between  the tumor and the cartilage of the lid.
It slowly  increases in size,  so that many weeks or months may
elapse before it has acquired  sufficient size to  attract much
attention on the outside of the lid.   The spot before alluded to
on the under or inner side of the  lid is at first red, then be-
comes yellow in its centre, and finally acquires a bluish tinge.
When it is very visible externally, it has been termed Grando;
while the  barbarous name of Chalazior is applied to the internal
tumor.  It is supposed to. have its seat in the structure of the
tarsal.cartilage; and to have a more decided disposition to point
on the inner  side of the lid than the outer.  Tyrrel truly
says that  the diagnosis  of  this little disease is important, as it
is very readily cured, when recognized, by simply  everting or
turning over the lid, and puncturing its cyst  through conjunc-
tiva of the  lid and tarsus.  On the other hand, if an attempt
be made to excise it from the outer side of the lid, the cartilage
will be injured, and  much deformity of  the lid will  follow,
occasioning the patient  subsequent and permanent inconveni-
ence.  If  the tumor be allowed to increase  and burst of itself,
a small fungus-like substance will rise up through the opening.
The tumor itself is  said to consist  of gelatiniform  fibrinous
matter, not  inclosed in  a  cyst, but  simply contained  in the
cavity which it has formed for itself in the  substance of the
tarsal cartilage.
   Treatment.—Bryonia is said to have proved homoeopathic to
a tumor as large as a pea upon the lower lid of the left eye;
Calcarea cured an inflamed tumor upon the right lower eyelid,
as large as a big pea, in  the person of a  child aged 1£ years; 
26
diseases of the eyelids.
two doses caused resolution, without the occurrence of suppura-
tion.  When the digestive organs are deranged, Colocynth may
prove curative to  both disorders; Mercurius and Natrum de-
serve attention, although Staphysagria or Silex may be required.

  Encysted Tumors of the Lids,  not connected with  the Tarsal
Cartilage.—These are  most frequent in  children; they rarely
originate in the adult, although they occasionally exist at that
period of life, having been allowed to remain untouched from
infancy.  They are more common  in the neighborhood of the
lids and the orbit than in any other part of the body;  they are
generally not discolored ;  arise without pain or inflammation;
and have a rounded, firm  and elastic feel; they are generally
movable, but occasionally are attached firmly to the perios-
teum ; they vary in size from that of a small pea to that of a
pigeon's  egg,  or larger.
  It is thought  that  nothing  but excision will remove these
tumors.   If  this be decided upon,  the cyst should be dissected
out entire.  The contents are usually sebaceous, but occasion-
ally glairy.   Frequently, a number of small and fine hairs are
mixed with  these  matters, and then the  interior of  the cyst
presents  a decidedly cuticular appearance, from the  surface of
which numbers of these fine hairs are often  found growing.—
Lawrence.
  When the  cyst is firmly attached to the periosteum or bone,
it is thought  advisable not to operate upon them, as very ex-
tensive mischief sometimes results ; inflammation and sloughing
may ensue,  by which the bone  may  become exposed, and
finally exfoliate very decidedly.   Baryta, Sepia, and Silex are
the most homoeopathic remedies.

  Naevus Maternus.—The e3relids,  as well as other parts of the
body, are occasionally the seat of the so-called mother-marks and
moles,   I have cured several  cases by the local application of
Muriate  Tincture  of Iron; while my friend, Dr. Bolles, has
cured several cases by internal remedies alone.

   Scirrhoid  Induration of the Eyelids.—This is  not cancerous,
although it resembles cancer.   It consists of a hard, tubercu-
lated warty-like degeneration of the whole thickness of the edge 
          INTERNAL SURFACE  OF THE  EYELIDS.         27

of the lid, commonly of the lower, traversed by varicose ves-
sels, and ending in ulceration.  It  is most common  in  old
people.
   Treatment.—Thuya, Baryta muriat, Iod. pot, Iod. hydrarg.,
and other remedies, deserve attention.
INFLAMMATIONS OF THE INTERNAL SURFACE OF THE EYELIDS.

                  A. Simple Inflammation.
              (CONJUNCTIVITIS PALPEBRARUM.)
  This differs from the catarrhal, or muco-purulent  variety,
principally by the lesser quantity of mucus, or muco-pus which
is secreted; by the minor degree of swelling of the lids, and
by the smaller size and more vivid color of the blood-vessels
which form  the  inflammatory  redness of  the affected  part.
According to Tyrrel, it commences with a slight degree of
pricking pain, a feeling of heat and stiffness in the lids, either
with a sense of dryness of the surface, from the want of mois-
ture, or with  a scalding sensation, from an increase  of  acrid
tears  which flow over  the lower  eyelid  to the cheek.  Fre-
quently, there is  a feeling as  if some foreign  substance  were
lodged upon the  inner and under surface of one or the other
lids.   Great intolerance of light is not often present, although
exposure to bright light augments the  suffering.   Unless the
attack be speedily relieved, pain of a sharp and severe character
is apt to set in, and it, as well as the sense  of heat about the
eye, is aggravated by lying down.
  The blood-vessels of the white of the eye, (conjunctiva of the
eyeball,) are remarkable for pursuing a  slightly tortuous course
from the circumference of the orbit towards the margin of the
cornea.  The largest vessels may be seen passing from near
the attachments of the recti muscles, and gradually diminishing
in size as they proceed towards  the cornea, but at the same
time sending off  numerous minute branches, which freely con-
nect with others from  neighboring vessels;  so that a beautiful
web-like aspect results.  These  crooked  and  tortuous blood-ves-
sels  are also remarkable  for the ease with which they may be 
28
DISEASES OF THE EYELIDS.
pushed for a short distance from side  to side, by  means  of
slight pressure of the lid against them.
   The principal causes are: sudden  changes of temperature,
exposure  to cold winds and damp, especially when  influenza
prevails;  lodgment of foreign bodies under the lids, especially
the upper, such  as dust, sand, metallic  particles, etc.   The
lodgment of particles of dust, fine sand, mortar, or cinders, is
so frequent a cause of simple inflammation of the internal sur-
face of the lids, and of the conjunctiva of the ball,  that careful
inquiry and search should generally be made for them, espe-
cially if the patient has been exposed to injury from any of these
exciting causes, or the disease  has set in very suddenly with-
out other evident exposure, and the suffering is instantaneously
acute, and remains obstinately persistent.  Foreign substances
are easily detected  on the inner surface of the lower lid, or
upon  the  conjunctiva over the cornea or sclerotica; but when
they have lodged under the upper lid, unless the  physician  is
familiar with the  manner of everting or turning this over, he
will find much difficulty in detecting them, or his rough and
clumsy attempts will soon oblige the patient to refuse to sub-
mit to further bungling.  Some of the lashes and part of the
lower edge of the upper lid should be grasped by the surgeon;
the patient be directed to look  downwards,  so  as  to  turn
the ball of the eye as far down as possible, while the upper lid
is gently drawn away, or out and down from the eyeball; a
fine probe should be laid upon the lid, just above the upper
edge of the tarsal cartilage;  and then, if the lid be  lifted up
against the probe, it will readily turn over, so as to expose the
greater part of the under surface of the upper lid.  The offend-
ing particle may  easily be wiped  off; and if the patient be
directed to turn the ball of the eye upwards, the surgeon still
retaining his hold  of the lid,  it will promptly return to its
natural position, and the whole operation will have been per-
formed  with great celerity, and very little suffering  to the
patient.
  Treatment—Simple inflammation of the internal surface of
the eyelids is almost always a very manageable disease, rarely
withstanding judicious treatment  longer  than three or four
days.   Aconite and Antimony, or Aconite and  Pulsat., or
Aeon, and Euphrasia, internally; gentle bathing of the eye, and 
             INTERNAL SURFACE OF THE EYELIDS.         29

 a weak solution of Aconite or Pulsatilla, followed  by a small
 quantity of Alumina or Zincun, applied three or four times a
 day to the  internal surface  of the  lower lid,  will  generally
 suffice to effect a cure in the above-mentioned space of time.

             B. Catarrhal Inflammation of the Lids.

   This is distinguished from simple inflammation by the greater
 profuseness of the serous and mucous discharges from the lids;
 and from purulent-, Egyptian-, and gonorrhceal-ophthalmia, by             •
 the lesser severity of the local symptoms, lesser  malignity of
 the inflammation, and the more mucous than purulent nature
 of the discharges.  In catarrhal ophthalmia there frequently is
 little or no accompanying constitutional disturbance, but some-
 times all the symptoms of catarrhal fever are present, such as
 lassitude, chilliness, with fever at night, quick  pulse, hot and
 dry skin, and restlessness. . There is at first a watering of  the
 eye, from increased flow of tears, combined with serous exuda-
 tion from the congested vessels of the conjunctiva;  but a muco-
 purulent discharge soon sets in, formed of a profuse mucous
 flow from the conjunctiva,  and increased secretion  from  the
 Meibomian glands.  The conjunctiva of the lids, the semi-lunar
 fold and caruncle, are first attacked, and become red, thickened,
 and  villous.   Soon afterwards,  the  disorder extends to  the
 conjunctiva of the ball of the eye. This disorder will of course
 be treated of more fully under the head of general  catarrhal
 inflammation of the eye.
   Treatment—Aconite and Antimony,  or Aconite and Pulsa-
 tilla, or Aconite  and Baryta  muriatica, or Kali hydriodicum,
 are excellent remedies.

           C.  Granular Lids and Vascular Cornea.

  This is one of the most formidable consequences  of purulent
 ophthalmia, or of the catarrhal, in its severer forms.   The dis-
 ease may either be formed during the acute attack,  and remain
 after it  has subsided;  for catarrhal and purulent  ophthalmia
 commence in the conjunctiva of the lids, and spread  from
 thence to that of the ball;  but they disappear in the  contrary
order, leaving,  first, the ocular portion  of the membrane, or 
30
DISEASES OF THE EYELIDS.
that in which they appear last, and linger along in the palpe-
bral portion, or that in which they first appeared.  The disease
may linger in the conjunctiva of the lids in so trifling a degree
as to escape  the observation of the careless practitioner, who
may be satisfied with a  general marked improvement of the
white of the eye; but in order to prevent the insidious forma-
tion of granular disease, the under surface of the upper and
lower lids should be carefully examined, even after all  acute
disease seems to have been completely subdued;  and if the
mucous membrane of the eyelid has not perfectly recovered its
natural  aspect,  the  remedies should be continued  until all
appearance of disease has subsided.—Tyrrel.
  According to the same author, after acute catarrhal, or puru-
lent inflammation of the eye has subsided, so that the  sight
becomes  almost perfect,  the patient may retain some so-called
" weakness" or " irritation " of his eyes, attended with a watery
condition of them on exposure to bright light, or cold air.  The
increased secretion from the eye is as thin  and watery as the
tears at first, and it is apt to flow over the cheek; the eye feels
irritated, as if fine dust  or grit had got under the lids;  and
finally, a more sticky and  colored secretion is formed, which
collects about the angles of the eye, and among the roots of
the eyelashes.   Soon vision becomes impaired; the sensation
of the presence  of a foreign body between the eyelids and ball
of the eye is felt whenever these parts are moved suddenly;
there is  a sense of weight and stiffness in  the upper eyelid;
vessels carrying red  blood  will be seen passing from the upper
part of the eye  towards  the upper part of the cornea, and the
cornea itself soon becomes opaque and dim, especially at its
upper part.
  If the under  surfaces  of the lids be  examined in  the  way
already pointed out,  the conjunctiva will be  found more  red
than natural, and roughened from the enlargement of its villi.
Besides the florid appearance and the small elevations upon the
mucous membrane of the lids, this becomes thickened, and by
degrees the red color assumes a deeper tint; the enlarged villi
become more numerous and prominent, so that when the under
surface is exposed by everting the lid, it resembles very much
the surface of a healthy  ulcer, and  this resemblance is height-
ened in some cases by the adherence of quantities of the opaque, 
INTERNAL SURFACE OF  THE EYELIDS.
31
viscid, and puriform secretion.  In consequence of this resem-
blance, the disease  has been termed  Granular conjunctiva, or
granulated lids; and from the accompanying redness, dimness
and vascularity of  the  cornea, the  collective disorder has re-
ceived the name  of Granular lids and vascular cornea.  But, in
fact, the  small  red  projections are  not real granulations, like
those formed during the healing of a healthy ulcer, but merely
the natural villi of  the mucous membrane greatly enlarged.—
Tyrrel.
   When the disorder is fully formed and established, it is  a
most troublesome  affection, and  extremely obstinate; subject
to sudden and violent exacerbations from the slightest causes,
and often aggravated in the course of a few days by the very
treatment which  seemed most beneficial a short time before.
This great tendency to relapse is  a marked feature of the dis-
order ; it might with great justice be termed relapsing ophthal-
mia.  It must also  be regarded as the local manifestation of a
constitutional disorder, as no one  who has seen several hundred
cases of the disease, or who has repeatedly seen from twelve to
twenty afflicted with it, in the same room with dozens of other
patients with  diseases of the eye, will have the slightest diffi-
culty in  recognizing these cases,  from the pallid and suffering
expression of their countenances, even  at a distance at  which
it would  be perfectly impossible  for him to  detect  the vascu-
larity of the cornea.   Tyrrel says that he has observed that
granular  lids and  vascular cornea arises most  frequently in
those  persons who have been treated very actively and allo-
pathically, and much reduced in strength; and that it generally
proves obstinate  in proportion to the feeble  condition of the
patient.   The  Sycotic diathesis may  have much more  to  do
with it than  the scrofulous,  gonorrhoeal, or syphilitic, upon
which so much stress has been laid.
   Hays admits four varieties or  stages:
   1st. The conjunctiva is simply reddened and villous.
   2d. It  resembles an ulcerated surface, the granulations ex-
hibiting  most of the phases presented by such  a sore; some-
times being small  and pale, at others large  and flabby,  and
bleeding on the slightest touch.
   3d. The granulations may have a warty appearance, being
firm and pale, cutting like cartilage, and bleeding but little. 
32
DISEASES OF THE EYELIDS.
   4th. The mucous membrane is thickened and fissured like
 the surface of a mulberry.
   The granulations  are  most frequent and abundant on  the
 whole under  surface  of the upper lid, and on that small por-
 tion of the lower where it passes from the lid to the ball of the
 eye, especially  towards  the outer  angle.  The vascularity of
 the  cornea is frequently confined to the upper  half of this
 body, viz., to that portion over which the rough surface of the
 upper lid  moves;  consequently, the lower half  of the  cornea
 generally  remains transparent'.  In some  cases, however, the
 vascularity may cover the whole surface of  the cornea like a
 net-work,  and its mucous covering, or the conjunctiva  of the
 cornea, may become  so loosened and thickened as to exhibit
 that state  which has  been technically called  Pannus, in which
 the boundary of the  cornea can hardly be seen.—Lawrence.
   Treatment.—Sa'unders has the credit of being the first who
 discovered the  true  character of  this chronic disorder, and
 explained the mode  in which it destroys sight; but, unfortu-
 nately, he  always endeavored to correct it by operative means,
 and frequently employed either the knife or scissors to remove
 the prominent villi, and to render the surface smooth.  Tyrrel
 supposes that he considered the projecting parts  to be really
 granulations,  and did not dream of their being enlarged mucous
 villi.  Of  course,  great  injury was  often  done by removing
 them.  The surface  rendered  smooth. by operation with the
 knife or scissors, often presented greater irregularity a few days
 subsequent to the operation, but of a somewhat different cha-
 racter; the projections, which in the first instance had been
 uniform in size  and elevation, afterwards became  much more
irregular, both in shape and projection; in fact, real and irregu-
lar, spongy granulations sprang up  from  the wounded surface,
 and took the  place of many of the uniformly-enlarged villi of
 the mucous membrane.   Finally, more or less  hard  scars  or
cicatrices formed, and incurable disease of the lids and cornea
 was the consequence.
  But the most common allopathic treatment is by means of
escharotics, of which Sulphate of  Copper,  Nitrate of Silver,
 Acetate  of Lead, and Alum, are the most  common.   These
remedies are, of course, more or less homoeopathic to the dis-
ease, and,  if used  at  all, should be used carefully  and gently. 
GRANULAR LIDS.
33
We have seen that the disease generally arises from  preceding
purulent, muco-purulent, or  severe  catarrhal  ophthalmia;
yet Hayes  says, if Nitrate of Silver or dilute Nitric Acid be
-applied, the first effect of the application  is to produce a puffi-
ness of the lids with increased lachrymation, with some burn-
ing, which subside  in a few hours, and  a purulent discharge
takes place.  In some cases, the effects just mentioned become
excessive, and persist for several days, arising either from the
remedy having been too severely or frequently applied, or the
wrong one being selected; and a change must consequently be
made, either in the remedy, or the  freedom of applying it. A
very common error is the too frequent repetition of local appli-
cations.—Hays.   I  have succeeded best with rather weak
applications, applied  not more than once a week, and then
merely as adjuncts to proper internal treatment.  If they be
•applied every two or three days, it will soon be found  that a
remedy, which at first seemed to have a most happy effect, will
soon exert a most injurious one, and the patients will go on
for weeks  and months together, sometimes improving, some-
times relapsing, and  altogether making  a very unsatisfactory
progress, until they become completely tired out, and  cease to
attend.  The local application should not produce more than a
slight smarting, when employed.  If it  causes pain of more
than one minute's  duration, it is too strong.  It is rarely that
an application which causes continued  suffering effects any
good. In the dominant school, these applications are generally
used so much too  strong, that  Tyrrel even thinks that  in
obstinate cases, the cure will be promoted by a frequent change
of the local remedy; and he rarely  allowed a patient to use one
kind of local application more than four or five days continu-
ously.  He would have been much more successful, if he had
only allowed them to be used once in four or five, or more
days.
   But, as the constitution  sympathizes so largely with this
local disorder, local  treatment alone will  not suffice.  Law-
rence says that he cannot adduce much personal experience
in favor of escharotic treatment.  Walther, from abundant
experience, says that the benefit derived from them is, on the
whole, inconsiderable, even when  methodically and cautiously
employed;  they either do  not effect*a complete cure, or else 
34              diseases of the EYELIDS.
bring it about very slowly.  He is, indeed,  often astounded
when he sees one of the most delicate organs attacked with a
series of applications so powerful and destructive as nitric acid,
corrosive sublimate, and arsenic.
  The methodical internal use of Aconite, Arsenicum, Baryta,
Thuya, Sabina, &c, aided  by the local  application of a weak
solution of the same remedies, and occasional resort to Argenturo
nitricum, Plumbum aceticum, Zincum  sulph., &c, will  gene-
rally suffice to effect a cure.
  CHANGES OF THE SHAPE AND POSITION OF THE EYELIDS.

          EVERSION, OR TURNING OVER OF THE LIDS.

                       {Ectropium.)

  By the turning over, or outwards of the lids, they are ne-
cessarily drawn away from the eyeball, their conjunctival surface
turned out, the edges of the lids and the lashes are displaced up-
wards or downwards, according as the upper or lower lid is the
seat  of Ectropium.  The  eyeball, being thus  deprived of the
protection of the eyelid, is exposed to constant irritation, by
which a chronic conjunctivitis is kept up, weakening the eyer
and leading to specks, ulcerations, and vascularity of the cornea.
In some bad cases, repeated attacks  of inflammation lead at last
to destruction of the eyeball.—Wharton Jones.  Still Ectro-
pium is not only more rare, but generally much less severe in
its effects than its opposite affection,  Entropium, or turning  in of
the lids.   In  the former, the eyeball may suffer from want of
necessary moisture, and from a distressing sensation of cold in
the eye; the patient is annoyed  with the flowing of the tears
over the cheek, especially when the lower lid is affected, and is
perpetually exposed to injury of the eye from inability of the
lids to wipe off, and brush away flying particles  of dust.   The
exposed surfaces of the mucous membrane of the lids are always
irritated and congested, or inflamed, and this irritation always
extends more or less to the ball of the eye; yet it is surprising
how seldom  such  influences prove absolutely  destructive to
vision.—Haynes Walton. 
ectropium,*                    35
  Although it is generally supposed in the dominant school,
that these affections of the lids can only be remedied by a more
or less severe operation, still it would seem that a very large
proportion of cases  may be prevented or removed by appro-
priate medical treatment.
  1.  According to  Wharton Jones, the  simplest and most
common form of Ectropium is usually the result of some chro-
nic inflammation of  the conjunctiva, or of Ophthalmia tarsi;
and it is almost always the hwer lid which is the seat of this
form of the disease.  The skin'of the  eyelid and cheek becomes
excoriated by the discharge constantly dropping from  the eye,
and finally becomes contracted, drawing the eyelid downwards
and outwards.   This displacement is also favored by a general
relaxed  state of the tarsus, and protrusion of the thickened
and sarcomatous conjunctiva,  the whole forming Ectropium
from excoriation and contraction of the skin of the eyelid, together
with a thickened and sarcomatous state  of the conjunctiva.  In old
people, the thickened and sarcomatous state of the  conjunctiva
seem in W. Jones's opinion to operate more frequently in pro-
ducing eversion of the lid, than does any appreciable amount
of  contraction of the skin.
   Treatment. — W. Jones  advises the  occasional  application
of  Nitrate of Silver; but the internal remedies  for chronic
catarrhal inflammation, especially of the angles of  the lids, for
relaxation of the tarsus,  and for a thickened and  sarcomatous
state of the  lids, should also be perseveringly used.   Thuya
deserves particular attention.
   Haynes Walton, however, gives a rather different view of
these cases; he says certain changes of thickness of the conjunc-
tiva may alone evert the tarsus, while the edge of the lids, the'
lashes, and the glands all remain intact.  In all such cases, which
had come under his  observation, irritating substances had been
used for the conjunctival affections, and had, he believes, been
the cause of the eversion of the lids. He refers to the case of
a soldier, who  had  been  discharged for some inflammatory
affection of the eye, and who assured him, that when he left:
the army the lid had not  turned out, but that the Ectropium
had come on a few'months after the regular  application of Sul-
phate of Copper, three times a week  for nine months, when he
would no longer submit to it. 
36
DISEASfS OF THE EYELIDS.
   2.  As has already been mentioned, one of the effects of cica-
 trization of abscesses in the Jsubstance of the eyelids, is also
 one of the most common causes of Ectropium.  (See p. 5.)
   According to Walton Haynes, the most frequent seat  of
 this suppuration is the lower and outer point of the edge of the
 orbit; and it is most important in the treatment of these ab-
 scesses to manage them rightly, and open them early, so that  as
 little of the cellular tissue of the lid may be lost by suppura-
 tion as possible; for  the actual loss of skin from the presence
 of the abscess may be very slight, yet if much of the cellular
 tissue be destroyed, it will contract^ so much in healing, as  to
 pull aside the skin and bind it down.
   Treatment. — The operative proceedings  are best given by
 Haynes Walton.  (See Operative Ophthalmic Surgery, pp.
 182-202.)  Arsenicum,  Thuya,  and other remedies, will be re-
 quired internally.  The  excoriation and consequent contraction
 of the skin may be palliated by the use of Glycerine, Sweet-
 oil and Lime-water, &c.
  3.  Acute Ectropium is apt to take place in  purulent oph-
 thalmia, in  consequence of the  great tumefaction of the con-
junctiva  of the lids.   When the inflammatory oedema of the
lids, which  was  for a time excessive,  begins to subside, no pro-
portionate diminution of the swelling of the mucous membrane
may take place, and  the swollen and granulated conjunctiva
loses that counterpoise which the external swelling  of the lid
afforded it; finally, it is forced outwards by the  action of the
muscles of  the lids.   If the protrusion  be not immediately re-
 turned, the upper point^of the eyelid and retroverted cartilage
will act like a ligature upon the parts protruded, and thus lead
to still greater  swelling;  and  as the  swelling increases,  the
 stricture  will become still greater by the involuntary and spas-
modic effort of  the orbicularis muscle to bring the tarsus into
its proper position.—Wharton Jones.   The same author also
says, that in the ophthalmia of new-born infants, eversion of the
lids readily takes place when the child cries, or when the eyes
are being washed'and cleansed. The lids may be easily returned
to their proper position, if the attempt be made at once; but,  if
they be  left everted for any considerable time, the spasmodic
efforts of the muscles, and  the increased accumulation of blood 
ECTROPIUM.                      37
  in the protruded mucous  membrane, will render the return  of
  the lids painful and difficult.
    Treatment—The remedies for inflammation and swelling  of
  the mucous membrane of lids must be relied upon,  viz., Bellad.,
  Pulsat, Euphrasia, Baryta muriatica, &c.
    According  to Haynes Walton, another class of cases  of
  Ectropium is the consequence or termination of disease of the
  lid itself,  and  occurs  principally in  the  under lid,  owing
  generally to inflammation of the eye, and almost always of a
  scrofulous kind.  The white of the eye is first inflamed, and
  lachrymation follows with more or less intolerance of light;
  afterwards, the  Meibomian glands are involved, and the entire
  edge of the lid becoming  implicated, the eyelashes drop out,  or
  become stunted, followed by that state generally called Lippi-
  tudo ;  and finally, eversion of the lid  occurs.  In this  form,
  Haynes  says, there seems to be not only actual  loss of sub-
  stance of the lid in the rounding of the edge, but the cartilage
  and tarsal ligament shrink.  This seems to him to receive cor-
  roboration in the circumstance, that in the Lippitudo which
  generally  precedes the  Ectropium, it is  not uncommon  to
  observe inability to close the lids,  except with great effort.
  He thinks that  one may venture to surmise that the inflamma-
  tion which lingers so long about the lid may so far alter that
  portion of the orbicularis muscle on the edge of the lid, as  to
  impair its supporting or binding influence.  Again, it is gene-
  rally supposed that the eversion of the lid is owing principally
  to the contraction of  the  skin, from the excoriating influence
  of the tears ;  but he regards roughness, and even excoriation
- of the skin, as  a frequent consequence,  not  the cause of ever-
  sion ;  because both are common in lippitudo, where eversion is
  absent.  The direction of the tarsus, too, somewhat indicates
  that it is not entirely influenced by the tension and contraction
  of the skin; for it is not  so much pulled down or away from
  the eyeball as turned outwards.  The bright, villous, puffy, and
  swollen condition of the conjunctiva of the lids he  also regards
  as generally the result of its constant exposure, and cannot be
  the cause of the eversion, when, as is frequently the case, only
  a small portion of this membrane, and merely that which  is
  permanently exposed,  is so altered.
    Ulcerations of the skin, however, namely, such  as penetrate 
38
diseases of the eyelids.
the skin and sub-cutaneous cellular tissue sufficiently to pro-
duce a scar  and great  contraction of the cellular tissue, will
doubtless  be followed by  eversion of the lid;  but simple
ulceration, which does not involve the whole depth of the true
skin and some of the  cellular  tissue beneath, is not usually
associated with Ectropium.
  Treatment.—The debility  of the orbicular muscle, caused by
long-continued  neighboring inflammation, may be removed by
the patient internal and external use of Nux vomica, Ignatia,
or Angustura;  the disease and contraction of the  cartilage, by
Mezereum, Merc, corrosiv.,  or Staphysagria.
         INVERSION, OR TURNING IN OF THE LIDS.

                       (ENTROPIUM.)

  This is more injurious to the eye than Ectropium, as it is
generally accompanied with great mechanical irritation, from
the rubbing of the inverted lashes' against the ball of the eye,
which  often produces severe inflammation, with ulceration and
opacity of the cornea.   The distress occasioned by the friction
of the margin of the lid and the eyelashes  against the ball,
when an attempt is made to  use the eye, together with the
intolerance of light, which is  usually present in  a greater or
less degree, forces the  patient to keep the eye always  closed
or half-closed, and as much as possible at rest.
  According to Lawrence, a temporary inversion, particularly
of the lower lid, will sometimes occur  in chronic, and some
cases of acute ophthalmia;  the edges of the lids are then  drawn
inwards by a spasmodic action of the orbicularis  muscle, occa-
sioning constant winking, particularly when attempts are made
to use the eye; and while the contraction of this muscle forces
the eyelid inwards, and retains it in its unnatural  position, the
swelling of the inflamed conjunctiva, between the ball and the
lid, pushes the opposite margin of the tarsus outwards.  If we
draw  the skin gently downwards, the  lid  will  return to its
natural position; but the patient will soon wink,  and the orbi-
cularis muscle will turn the lid in again. 
TURNING IN OF  THE LIDS.
39
  Another variety occurs in aged persons.  In them there is a
relaxation of the integuments; the skin of the lids loses its
elasticity, and falls into wrinkles; the fat is absorbed from the
surrounding parts, and thus loose folds are formed in the lids;
the balance between the external surface and the mucous lining
of the lids is lost, and inversion is the consequence.   {Entro-
pium Senile.)  The entire lid  forms a round roll, with the eye-
lashes lying in its interior; but as the lashes and edge of the
lid do not rub against the eye, there may be little or no irrita-
tion, and inversion may be present without the patient being
aware of its existence.—Lawrence.
  Wharton Jones places great stress upon  the combined
influence of relaxation of the integuments of the eyelid, and
spasmodic contraction of the orbicularis palpebrarum muscle,
in the production of turning in of the eyelids.  But as the
relaxed and superabundant state of the skin of the lids is not
insisted  upon as the  essential cause  of the Entropium, while
spasmodic contraction of the orbicularis muscle has been known
to cause it, the principal part of the medical treatment should
be directed to allaying the spasm.  It might be possible  to do
good by applying to  the lid some preparation  of Plumbum,
sufficiently strong to cause contraction of the integuments and
paralysis of the muscle.
  A contracted and deformed state of the tarsal cartilage is also
put  down as an efficient cause of Entropium, when it occurs
in long-continued ophthalmia tarsi, or catarrhal-, or scrofulous
conjunctivitis.  The cartilage then often becomes indurated
and contracted on its inner surface, whilst it is shortened trans-
versely,  or from angle to angle;  the effect of which is, that the
margin of the eyelid is turned in directly against the eyeball,
and cannot be brought back to its proper position by any trac-
tion upon the skin of the lids, as in Entropium from relaxation.
The edge of the eyelid remains curved inwards; the margin is
often thickened and irregular; while the eyelashes are few and
dwarfish, and also inverted ; the whole forming a combination
of Entropium with Trichiasis.—W. Jones.
  Haynes Walton  almost  entirely  denies the influence of
any other causes, except excessive development and spasmodic
contraction of the orbicularis and tensor tarsi muscles.
  Treatment.—Dr. Dudgeon has the credit of being the first to 
40
DISEASES- OF THE EYELIDS.
suggest a homoeopath^ r.emedy for the curable cases of Entro-
pium.   He  suggests  Borax, as applicable to  some form of
catarrhal and senile ophthalmia, particularly when accompanied
by Entropium.  It is homoeopathic to itching of the inner
can-thus, so that  the patient must rub it;  itching of the eyes,,
with feeling as if sand were in  them; rawness of the outer
angle of the eye;. burning in the- eye; the lashes incline to turn
in towards the eye, and inflame it,.especially at the outer angle,.
where the edges of the lid are quite raw; inflammation of the-
outer angle of the right eye, with derangement of the  lashes,.
and  agglutination of  the lids at night; inflammation of the
edges and inner angle of the lids, with nocturnal agglutination,
so that the eyes are glued up with hard gum, which irritates-
the eye like sand; sticking together of. the lids;  irritation of
the eyes, and lachrymatiom
  The  spasm of  the orbicularis' and tensor tarsi muscles may
be allayed by the use of Nux, Jgnatia, or Angustura; or, if
these fail, by the external and internal use  of Bellad., Stramon..
or Conium.
           CONSTANT OPEN STATE OF THE LIDS.

                    (lagophthalmos.)

  This barbarous name is given to a constant open, state of the;
eyelids; the consequence of which is,, that the eye is exposed
to the entrance of foreign particles,', and other causes of irrita-
tion, as in eversion of the lids..  Wharton Jones admits three
principal forms:
  1st. From paralysis of the orbicularis muscle, allowing un-
restrained and excessive contraction of the levator musle of
the lids.
  2d. From shortening of the upper lid to such an extent as
not to cover the  ball of the eye properly; the- consequence of
cicatrization of wounds, ulcerations, and other causes.
  3d. Congenital imperfect development of the lids.
  In the first variety, the paralysis of the orbicularis is merely
one of the symptoms of paralysis of the portio  dura of the 
FALLING DOWN OF THE UPPER EYELID.       41
seventh pair of nerves.  It may be so complete, that the upper
eyelid is. immovably drawn upwards;  but generally it is not
so complete, the eyelids being capable of closing somewhat,
although not  perfectly.   While  the upper eyelid is drawn
upwards, the border of the lower lid falls down and somewhat
out from the  eyeball, and allows the tears to fall down upon
the cheek.  The most common removable causes of this para-
lysis is the pressure on the nerve by an enlarged lymphatic
gland, or other tumor ; or the paralysis may hi rheumatic.
  Treatment-—When an enlarged lymphatic gland is the cause
of the disorder, Calcarea, Silex, Baryta, Kali hydriod., Conium,
&c, may be used.  When there is paralysis of the orbicularis
muscle, Arsenicum,  Plumbum, or Conium,  and  Bellad.,. or
Stramon., are  the most homoeopathic remedies; although the
internal and external use of Nux vom,, Ignatia,. or Angustura
may be required.
           FALLING DOWN OF THE UPPER EYELID.

                         (ptosis.)*

   This is the opposite of Lagophthalmos, as the upper lid, instead
 of being retracted upwards, falls down over the eye, and cannot
 be raised sufficiently to admit of free vision; the levator muscle
 is paralyzed, and allows the unrestrained and excessive  con-
 traction of the orbicularis.  The patient can  only open his eye
 by raising the lid with his finger.   The third pair of nerves is
 involved, in the simple paralytic variety.
   In  other cases, ptosis may arise from injury of the levator
 muscle, in wounds of the upper eyelid.  When but little of the
 substance of  the muscle is destroyed or torn, the ptosis may
 disappear after the healing of the wound, from reunion of the
 muscle;  but if the muscle be much torn, this will not be the
 case.—W. Jones.
   It is also asserted, that extension and relaxation of the skin
 of the eyelid will allow the lid to fall down permanently, espe-
 cially when the muscles have long been macerated in chronic
 cedema about the eye.
   Treatment—Arsenicum, Plumbum, Nux,  Ignatia, and An-
gustura are the principal remedies. 
42             diseases of the eyelids.
       ADHESION OF THE EYELIDS TO THE EYEBALL.
                    (SYMBLEPHARON.)

  The most common accidental cause is the aetion of quick-
lime or mortar upon the eye.  H. Walton says, he has twice
watched  the  effects of quick-lime from the commencement,
and, like every one else who has attempted it, totally failed in
stopping the accustomed after-effects, viz., adhesion of the lids
to the ball.
  Walton also  suspects that in  other cases,  the prevalent
treatment of ophthalmia in the dominant school by escharotics
may sometimes play no unimportant part in producing these
adhesions, knowing, as  he  does, that nitrate of silver is often
used in substance, and in very strong solutions and.ointments,
in a most lavish  manner;  a practice which he  has known to
produce sloughing.  He quotes Desmarres, (who is fully alive
to this abuse of caustic,) who  says, he has been informed by
Dr. Furnari, that during  his stay in Africa, he had seen and
operated on so large a number of symblepharons from  that
cause, that he was quite tired of them.
  Severe purulent ophthalmia, or burns or scalds of the  con-
junctiva, may also be followed by loss of substance, sloughing,
or ulceration, followed by adhesion.
  Treatment—This can only be preventive, or operative.
        ADHESION OF THE EDGES OF THE LIDS.

                (ANKYLOBLEPHARON.)

This does not require particular description.
Treatment—Principally preventive.
ENCROACHMENT OF THE  SKIN OF THE NOSE  UPON  THE  IN-
               ternal angle of the eye.
                      (epicanthus.)
  This can only be remedied by operation. 
INJURIES OF THE EYEBALL.             43
            DISEASES OF THE EYEBALL.

  A.  DISEASES OF  THE EXTERNAL COAT OF  THE EYEBALL.

                     1.  INJURIES.

     a.   Bruises of the conjunctiva,  cornea, and sclerotica.

  The majority of  slight injuries of the conjunctiva require
the simplest treatment only.
  Ecchymosis, or effusion of blood into the sub-mucous cellular
tissue, may come on spontaneously, or be produced by violent
efforts, such as coughing, especially in hooping-cough,  or  be
the result of mechanical injuries to the part.  The darkness of
the color is so great  that the patient  is generally frightened
when he sees it, and the appearance may puzzle any surgeon
who is not familiar  with it.  The color of the effused blood is
at first bright  red, but gradually becomes of a deep brownish
red; when it is deep-seated and abundant, it has a dark, liver
color.  It is well to  know that the blood is often very slow in
being absorbed, although it sometimes disappears in a week
or two.
   Treatment.—Millefolium, Hammemelis, and Chamomilla  are
the most important  remedies.

                   K  Burns and  Scalds.

   These have been sufficiently alluded to under the  head of
Symblepharon, p. 42.
                       c.  Wounds.

   Of the conjunctiva.—These are generally not serious, unless
very extensive, or in persons whose state of body is favorable
to inflammation.
   Of the cornea.—The effects of  wounds or irritations of this
organ are far more serious.  Lawrence has seen considerable
uneasiness follow a  small and scarcely perceptible scratch from
the finger-nail of an infant.
   According to Wharton Jones,  when chips of fine metal,
splinters of glass, stone, or hard wood, penetrate only so  far
into the cornea that a portion of the foreign body remains pro- 
44
DISEASES OF  THE EYEBALLS.
jecting, very great irritation ensues ; but if the offending body
has sunk fairly into the substance of the cornea, it may pro-
duce very  little reaction;  or it may  become  enveloped in a
capsule of lymph, and cease to be a cause of irritation, although
the affected part of the cornea will remain permanently opaque.
More frequently, however, ulceration of the cornea takes place
around the foreign body, which thus becomes loose at the bottom
of the  ulcer, and requires but a touch of some instrument to
effect its detaohment.  The use of'a cataract-needle, or -knife,
is often  required to remove  particles of steel and the  like,
which  are firmly lodged in the cornea; but the attempt at ex-
traction  should not be continued too  long, for by-and-by they
will become looser, and be more readily removed.
  Injuries, or even slight scratches of the cornea, by means of
the spurs of wheat or rye, such as often happen to reapers, or
from chestnut-burrs, may lead to an abscess of the cornea, which
may break into the anterior chamber of the eye, causing hypo*
pion, or deposit of pus behind the oornea. This latter accident
is particularly apt to occur if the injured person continues to
work in the heat of the  sun, and to  eat  and drink heartily,
When such inflammation begins, a pink  zone is first seen in
the sclerotica, around the oornea; this redness becomes deeper
and more  extensive;  the  cornea loses its transparency, often
becoming  dull and turbid, and finally ulcerates  around the
foreign particle; the ulcer may break externally and the foreign
particle  drop  out, or it may penetrate  internally, and both
matter and the foreign body may fall into the anterior ohamber
of the eye.
  Injuries  from wounds received from fire-arms and percussion-
caps, whether exploded by means of a hammer, or by children's
cannons and pistols, are a most frequent cause of blindness.  In
939 cases of blindness, in children from 6 to 15 years of age,
no less than 341 were. caused by these dangerous  playthings;
while  only 37 cases arose from accidents while playing ball, or
with bows and arrows, &c.; and only 201 cases arose from  in-
flammation of the eye, not excited by mechanical causes.  It
is well to know, that in some cases the fragment of a percus-
sion-cap has been driven  into the posterior  chamber of  the
eye, while the wound in the cornea has healed so  rapidly and
perfeotly, that the entrance of a foreign body into the depths 
INJURIES OF-THE EYEBALL.
45
of the eye has remained entirely unknown ; but in the course
of a few days or a month, violent inflammation may come on,
and the cornea will become dim, especially at the previously-
injured part.
  Penetrating wounds of the cornea, are peculiarly mischievous
from their allowing the aqueous humor to escape, and the iris
to prolapse into the wound, and adhere there.—Lawrence.
   Of the Sclerotica.—Wounds of this membrane are said not to
be of much consequence in themselves, but they become im-
portant from the accompanying injury of the  conjunctiva, but
especially of the adjoining internal tunics of the  eye.   Still
Lawrence- has  seen  complete blindness  caused by a single
small shot which struck the sclerotica obliquely, and did not
enter the eye; the state of the health of the patient  at the time
of the injury is,  in the majority of such cases,  a matter of more
consequence than the  extent, or manner of the injury.
   It  is peculiar to the sclerotica, that cutting wounds of this
membrane do  not unite; the  opening remains permanent,
and this is the case even in the punctured opening made in the
operation for cataract.  The sclerotica is also so  much harder
and more brittle than the conjunctiva, that a violent blow on
the eye will sometimes  burst  it, without dividing the mucous
membrane outside of  it.

      B,   INFLAMMATION OF  THE WHITE OF THE  EYE.

            Simple-,  and 'Catarrhal-conjunctivitis.

   This disorder is generally produced by exposure to cold, and
although it is frequently a simple inflammation, still its seat in
a mucous membrane impresses upon it all the peculiarities of a
mucous, or so-called catarrhal-inflammation, which many sup-
pose to be specific in its character.  It certainly requires for its
cure the remedies which act specifically upon the mucous mem-
branes, yet it  is difficult to conceive of a simple  inflammation
of a mucous membrane, which does not bear all the signs of a
catarrhal inflammation.
   According to Dudgeon, it  is the  most common of all the
ophthalmias; is usually accompanied by catarrh of other parts,
more especially of the nose; and it seldom penetrates deeper 
46             DISEASES  OF THE EYEBALLS.
 than the conjunctiva; therefore it is not generally dangerous.
 There are three stages:
   1st.  The dry stage, in which there is itching and stiffness of
 the lids, burning and heat in the ball of the eye, and sensation
 as if sand or dust had got into it; this proceeds from the dry-
 ness of the eye, owing to a deficient secretion of mucus.  The
 white of the eye loses its usual bright and  clear white  appear-
 ance, and seems dim; the lids are somewhat red  externally,
 slightly swollen, heavy and stiff;  the white of the eye  is more
 or less  red.
  In the  2d,  or sero-mucous stage, there is a watering of the
 eye from increased secretion of tears, and excessive exudation
 of a  thin sero-mucous discharge from the  vessels of the con-
junctiva; these secretions often possess a peculiar acridity, so
 as to produce scalding, and to corrode and  inflame  the cheek.
 In this  stage, the peculiar redness of the  eye, which is  distinc-
 tive  of conjunctival inflammation, becomes very violent;  the
 redness is superficial, and of a bright scarlet color, forming a
 striking contrast to the rose or pink tint, which belongs to in-
flammation seated in the sclerotica. The enlarged and reddened
bloodvessels in conjunctivitis also present  characteristic pecu-
liarities ;  they are quite superficial, and by pressing  the lid
against  the ball of the eye, they will be found to be movable,
or may  be pushed in every direction, showing that they belong
to the conjunctiva, and not  to  any deeper  seated membrane;
they also pursue a peculiarly tortuous course, subdividing and
inosculating as they approach the cornea, presenting a marked
contrast to  the small, straight, pink, and rectilinear  vessels
of an inflamed sclerotica.  The redness is  generally irregular,
or in patches, as some bundles of vessels are commonly more
filled with red blood than  others ;  numerous minute branches
also shoot off  from the main bundles, and freely join or ana-
stomose with neighboring  vessels, so that a beautiful web-like
appearance is formed, through which parts of the sclerotica
may be seen of its natural color, especially in the neighborhood
of the cornea.   But in the  severer  attack of the disease the
whole white of the eye becomes  uniformly red and swollen •
and spots  of extravasated blood may even be noticed here and
there.   Sometimes little vesicles or pustules are formed by the
effusion of serous,  or sero-mucous, or muco - purulent  fluid 
CONJUNCTIVITIS.
47
tinder  the  conjunctiva, especially in the neighborhood of the
cornea.
  Catarrhal inflammation seldom produces much swelling of
the conjunctiva, at least nothing like the state of chemosis,
which occurs in erysipelatous inflammation, or purulent  oph-
thalmia.
  The  pain is generally not great;  the intolerance of light is
often slight, so that the patient may be able to open his eye to
the light, even when there is considerable redness.   But when
the neighboring mucous membranes are also  involved, there
may be pain and sense of weight about the frontal sinus and
antrum, more  or less catarrhal fever,  chills,  heat, headache,
disordered  stomach, foul tongue, and impaired  appetite.
  In the 3d, or puro-mucous "stage,  there is increased  mucous
secretion from the conjunctiva, often of a purulent appearance,
so that the whole disorder may in some  cases be scarcely dis-
tinguishable  from mild purulent ophthalmia.  Still,  this in-
creased mucous discharge is  one of the principal characteristics
of catarrhal  ophthalmia, although the quantity may  be just
sufficient to collect in  small masses  at the corners  of the eye,
or form a whitish streak at the bottom  of the fold of the  con-
junctiva of the lower  lid;  or there may be enough  to form
copious incrustations about the root of the lashes, to agglutinate
the edges of the lids at night, and to form a more or less thick
layer over the cornea, giving rise to  so many imperfections and
delusions of vision.
  It may be complicated with scrofulous ophthalmia, or with
rheumatic disease of the sclerotica.
  Treatment.—Simple inflammation of the conjunctiva  is gene-
rally very amenable to treatment, although Attomyr gives a
long list of  no less than twenty-nine different remedies,  as
useful  against it.   Of  these,  Aconite,  Ammonium, Argenti
nitras,  Arsenicum, Belladonna, Borax,  Bromine,  Clematis,
Mercurius,  Phosphor,  Pulsatilla, Staphysagria, Stramonium,
Thuya, and Zinc, may  be selected as most homoeopathic to the
acute varieties;  while  Alumina, Calcarea, Graphite,  Hepar,
Kali, Lycopod, Nux, Sepia,  Silex, and Sulphur may be more
appropriate against the sub-acute, chronic, and obstinate cases.
  Dudgeon says, when the affection is recent, in the first stage,
and the chief symptoms are: dryness, itching or smarting sen- 
48
DISEASES OF  THE  EYEBALLS.
 sation in the eyes and lids, feeling as if something had got into
 the eye, frequent winking and occasional  discharge of tears,
 the white of the eye being uniformly or  partially reddened,
 little or  no mucus secreted, and the conjunctiva of the lids  is
 comparatively redder than the ball, then a dose or two of
 Sulphur  in almost  any dilution,  usually suffices  to  effect  a
 rapid cure.
   When there is an  excessively annoying, dry, and burning
 feeling in the eye, with frontal  headache, and more or less con-
 gestion to the head,  Belladonna will be useful, although it may
 have to be preceded, or alternated with Aconite.
   If the flow of tears is considerable, and of an acrid character,
 with a corresponding watery discharge from the nose, attended
 with sneezing and other indications of the first stage of catarrh
 of the nose, Euphrasia will be  the best remedy.
   If along with a copious flow  of tears, there is much smarting
 and burning pain, the tears being peculiarly acrid and corrosive,
 or if there is much swelling of the conjunctiva of the ball, {che-
 mosis,) or an cedematous condition of the lids, then Arsenicum
 will be found useful.
   If there be much mucous  discharge,  or extravasation of
 blood {ecchymosis) into  the substance, or from the surface of
 the white of the eye, Chamomilla should be borne in mind.
   When the inflammation is intense, the mucous secretion ex-
 cessive, the redness of  the eye considerable, and  the caruncula
 particularly inflamed and enlarged, the internal and external
 use of Argentum nitricum will prove specific.
   When the  Meibomian glands are much affected,  and the
 edges of the lids are red and  swollen, the secretion forming
 deep yellow crusts upon the eyelashes at night, Mercurius and
 Hepar s.  may be given with advantage.
   When the evening exacerbations, which are usually present
 are well marked, Pulsatilla will be found useful.
   In slight catarrhal ophthalmias from exposure to cold  and
wet, Dulcamara is regarded as specific.
  These, Dudgeon says, are the chief remedies for simple acute
catarrhal ophthalmia, and will generally be found sufficient to
meet all  its varieties.   Still  Knorre found  Digitalis useful
when the eye-disease occurred after the sudden suppression of
coryza; and Kali bichrom. should not be forgotten. 
            INFLAMMATION OF THE SCLEROTICA.         49

  In the chronic forms, when the secreting apparatus of the
lids is much involved, Mercurius, Hepar, Euphrasia, Arseni-
cum, Pulsat. and Sulphur, are chiefly to be trusted to. Where
the caruncula and general conjunctiva are the seat of the chro-
nic mucous affection,  Argent,  nitric,  Lycopod., Zinc, Ehus,
and Bryonia may be called in play. When there is a tendency
to the formation  of pustules, vesicles, or indolent ulceration,
Euphrasia, Arsenicum, Sulph., Cole, Mercurius, and Silex may
be indicated.  The sensitiveness to  light {photophobia) accom-
panying pure catarrhal ophthalmia, is seldom important, but
when it exists to any degree,  and fails to yield to  the other
remedies, Conium and Belladonna will almost certainly bring
relief.—Dudgeon.
  To those who are practically familiar with the above mode
of treatment, especially if associated with the local application
of a weak  solution of Sulphate of Zinc, or Nitrate of Silver,
it will be a matter of surprise, that the blood-letting, cupping,
leeching, purging, low diet,  blisters, recommended by Law-
rence and all the writers of the dominant school, should  ever
have been  considered necessary, even in the  dark ages, much
less at the present time.  Still it  may be, that many homoeo-
pathic physicians  overlook the attendant functional derange-
ments  of  the  liver,  stomach,  skin, or uterus,  upon which
Tyrrel places  so much  stress; or  neglect to remove  those
peculiar conditions of irritability or  debility, which render so
many cases intractable.—Peters.
      INFLAMMATION OF THE SCLEROTICA.
                       SCLEROTITIS.
                  Rheumatic Ophthalmia.
  The sclerotic coat of the eye is  that which is immediately
under the mucous, or outer coat, or the so-called white of the
eye; inflammation of the sclerotica is generally a much more
painful  and troublesome affection than inflammation  of the
white of the eye, or conjunctivitis; it also extends much more
readily and frequently to  the cornea and iris, and sometimes
from thence to the internal structure of the eye.
                    4
» 
50
DISEASES OF  THE  EYEBALLS.
   According to La wren ce, the symptoms of sclerotitis are red-
 ness of the eye,  pain, intolerance of light, increased flow of
 tears, and more or less fever.  The redness of the  eye in scle-
 rotitis is quite peculiar :
   1st.  There  is a red, or pink zone, or circle immediately
 around the cornea.
   2d.  The  red and distended blood-vessels pursue an almost
 straight  course from  the  edge of the  cornea outwards  in all
 directions towards the circumference of the eye, while, in con-
 junctivitis, the redness commences in the circumference of  the
 eye, and diminishes the nearer it approaches to  the cornea;
 while the enlarged blood-vessels pursue a remarkably tortuous
 course.
   3d.  The character of the red tint differs remarkably in  the
 two cases, being  of a rose-red, or pink, or almost violet hue,
 forming  a striking contrast to the bright scarlet-color which is
 peculiar  to conjunctival inflammation.
   In severe cases, however, the conjunctiva soon participates
 in the affection;  the cornea quickly assumes a dull appear-
 ance, and loses its transparency and polish; the iris is also  apt
to become involved in the attack.
   The pain is often very severe, and extends to the back of the
 orbit of the eye, to the neighboring parts, and more  or less to
 the corresponding side of the head.  Not unfrequently the  eye
 itself is comparatively easy, and the patient complains of pain
 in the brow, temples, cheek, or side of the nose.   Often  the
 suffering increases towards night, and becomes so much aggra-
 vated as to prevent sleep,  and only abates considerably towards
 morning.  The pains are also worse in cold, windy, and wet
 weather, and relieved by a mild and warm temperature of  the
 air,  although warm applications to the eye  increase  them.
 Intolerance  of light is also a marked symptom from the com-
 mencement ; the pupil contracts to exclude the  light, and  the
 patient avoids exposure to it;  this also forms another striking
 contrast between sclerotitis and conjunctivitis; for, in the latter
 the patient generally opens the eye  freely, and experiences no
 pain from exposure to light.
   Sclerotitis may arise indirectly from  unhealthy states of  the
 system, but  most frequently it is rheumatic in its nature, and is
.caused by exposure to cold.—Lawrence. 
              INFLAMMATION  OF THE CORNEA.           51

  Treatment.—According to Hartmann, in the commencement
of the disease, if the inflammation be slight, Pulsatilla will
remove the pain, and the accompanying inflammation of the
conjunctiva, while Bryona will remove the inflammation.  In
severe cases, Mercurius will be required; while Ckmatis erecta is
pronounced the most suitable remedy when there is pressure in
the eyes, intolerance of light,  profuse flow of tears, sticking
together of the eyelids in the morning, and a decided tendency
to inflammation of  the Iris.  Euphrasia is thought to be the
most  useful remedy, when the pains in the eye have become
intolerable, and the inflammation has extended to the cornea,
with severe hemicrania.
             INFLAMMATION OF  THE  CORNEA.
                      CORNEITIS.

  According to Lawrence,  inflammation of the cornea may
be either acute, or chronic;  but its course and character  are
most frequently of the latter description; in general, the appear-
ances commence gradually and proceed slowly, and hence  the
uneasiness is greater than the mere degree of visible change
would lead us to expect; for the same reason, the recovery is
tedious.
  The complaint begins with dullness  of vision, the cornea
being at the same time hazy; it loses its transparency and  ex-
hibits a general cloudiness, with  increasing imperfection of
sight, objects appearing as if seen  through a cloud or mist.
This nebulous condition of the cornea may be general, or par-
tial ; in the latter case, it is continued insensibly into the healthy
structure.   The cornea may be generally of a dull gray  color,
or like  ground-glass;  it  may exhibit the various degrees of
haziness, or opacity so dense as to conceal the iris and pupil.
   Frequently, small vesicles or pustules form on the surface of
the cornea; occasionally pus or matter is deposited into  the
substance, or between the layers of the cornea, and may  break
into the anterior chamber of the eye, forming hypopion, or may
accumulate at the lower edge of the cornea, producing an  ap-
pearance which  has  been called onyx,  or unguis, from its re- 
52        TREATMENT  OF DISEASES OF THE  EYES.

semblance to the white  mark at the root of the nails.  Slough-
ing of the cornea rarely occurs  except in  the purulent  oph-
thalmia of new-born infants, and in gonorrhoeal ophthalmia, or
when the inflammation is very acute and excessive, or happens
in persons with great general debility, and reduced local  action.
  Considerable pain and sense of tightness in the eye,  and
pain in the  brow, or forehead, often accompany the affection,
especially in its early stages, in which we also find  the  tongue
coated, and the system feverish.  There is increased sensibility
to light, which is the more' remarkable,, as the dimness of the
cornea must diminish the quantity admitted into the eye;  but
it must be remembered  that the sclerotica is generally involved
in the inflammation, and that  intolerance of light usually oc-
curs when that membrane suffers.  Inflammation of the  cornea
is often of long duration, continuing for many months; orr
after going through an  acute stage with pain and feverishness,
it assumes a more indolent character, and is protracted  indefi-
nitely; the disease lasts, but the patient does not suffer.  It
may be produced by cold and wet, but especially by external
injuries, although it is common enough as a spontaneous affec-
tion in  persons of unhealthy constitution, especially the scro-
fulous.—Lawrence.
  The Iris is  generally involved to a  greater or less degree,
and is often followed by contraction of the pupil, effusion of
lymph,  and  consequent permanent adhesion of its margin to
the capsule of the lens.
  Treatment—Euphrasia, Hepar sulph.,  Iodine, Baryta,  Mer-
curius, and Spigelia have been recommended.
  Having thus made some general and cursory remarks upon
the various diseases of the external parts of the eye, I now
proceed in accordance with Euckert's  plan, to treat  more
particularly  of the action of the  different remedies for some
of these states.
                        1. aconite.

   General Remarks.—It is regarded in the dominant school as an
arterial sedative, and anaesthetic remedy, yet Fleming found 10
drops of the tincture of the root  to cause general trembling, 
ACONITE.
53
violent headache, pain in the eyeballs, constant lachrymation,
and intense photophobia, although the white of the eye was not
at all reddened.  He also says that slight giddiness and dimness
of vision are very common effects of Aconite, and that it may
cause dull, heavy pains in the eyeballs, dimness of vision, pro-
fuse secretion of tears, pain and watering of the eyes without
redness of them, black specks floating  in the field of vision,
dazzling, and dimness of vision.
  Claudius Eichard had a case, in which it proved homoeo-
pathic to such a frightful and painful inflammation of the eyes,
with lachrymation, that the patient wished himself dead rather
than to be obliged to  endure such agony long.
  Dudgeon supposes that the above case resembled an attack
of purulent ophthalmia, but I can  find no proof to that effect;
besides, Aconite acts far more specifically upon the serous and
fibrous tissues than upon the mucous, and is much more homoeo-
pathic to rheumatic inflammation than to purulent, or suppura-
tive   This is a very important point, as Dudgeon has been
led to recommend it as homoeopathic to purulent, Egyptian,
and gonorrhoeal ophthalmia.   It probably exerts a  more spe-
cific action on the Sclerotica, Cornea, and Iris, than upon other
parts  of the eye, except perhaps the Eetina; the severe pains,
intolerance of light and lachrymation, with but slight redness
of the eye, point rather to irritation or inflammation of the
sclerotica  and cornea, than of the conjunctiva
  Its action  upon  the  Iris is  equally decided and peculiar.
Flemming says, when the conjunctiva is slightly painted with
Aconitine, contraction of the pupil speedily takes place, and
continues for several hours.  Pereira has observed it to cause
contraction of the pupil in some  amaurotic cases of  several
years standing, and in which the  iris was insensible to, and
underwent no  change on exposure to strong light.  Flem-
ing also applied Aconitine to the eyeball  of a rabbit; the pupil
commenced to contract in three minutes;  in five minutes it was
scarcely one sixth the size of  that of the other eye; when the
contraction was at its extreme, the pupil was insensible to light;
at other times it retained some of its mobility; this contraction
of the pupil persisted for nine hours.  It will be seen, that its ac-
tion upon the iris is  opposite to that of Bellad.  and Stram.;
it may prove homoeopathic and curative to the contraction of 
54        treatment of diseases OF THE EYES.
the pupil which attends Iritis; to headaches, congestions, in-
flammations, and  dropsy of the brain, and apoplexy when
attended with contraction of the pupil.
  Fleming says, that it3  sympathetic action on the retina is
remarkable; for, when applied  to one of the temples, or one
side of the forehead, more or  less blindness of the same  side
will be produced;  it is  apt to  cause giddiness with confusion
of sight; headache,  with vertigo and dimness of vision; in
four cases Fleming found it  homoeopathic to almost  total
blindness from paralysis  of the Eetina, or  Iris.  In one of
Matthiolus' cases  it proved homoeopathic to  intermitting
amaurosis;  three  times the patient became perfectly blind,
and recovered his sight.—Peters.
  b. Noack advises it in catarrhal ophthalmias  only when
they also bear a rheumatic character, especially when chemo-
sis,-—that is, great redness and swelling around the cornea—has
taken place; when there is heat and burning in the eye,  espe-
cially in the left, great photophobia, inflammation and lachry-
mation of thejeyes, with excessively severe pain; swelling and
inflammation of the eyes,  with redness of the conjunctiva and
sclerotica; in inflammations excited by the presence of a for-
eign body in the eye, attended with redness, stinging pain and
aching in every part of the eye, intolerance of light, and lachry-
mation ;  dryness of the eyes and heaviness  of the upper lids;
painful, tense, red, and hard swelling of the lids, especially in
the morning; sensation as if the whole eyeball were pushed
into the orbit; prickling and smarting  of the eyelids, as if a
cold were about to set in; soreness and itching of the eyelids;
yellowness of the whites of the eyes; sparks and mist before
the eyes, with flashes and scintillations; luminous vibrations,
and tremulousness of light.—Peters.
  c. According  to Haff,  Aconite is a useful remedy against
inflammation of the eyes,  excited by mechanical injuries;  it is
most beneficial  in the early stages, although it may be used at
a later period, especially if severe pain and intolerance of light
are present.—Archiv., vol. viii., part 8, p. 185.
  d. Hering recommends it when the eyelids are red, inflamed,
swollen, and hard,  attended with burning, heat, and dryness of
the eyes; it may  then  be given in repeated doses;  and  also
when the lids are yellowish-red, swollen, or  of a shining  red, 
alumina.
55
and almost transparent, attended with burning and tension, and
with secretion of much mucus from the eyes and nose.
  e.  Gross says, that Aconite, 30, if used early, will frequently
break up attacks of Ophth. neant.—Archiv., vol. x., part 2, p. 63.
  CASE 9.—A coachman, aged 45, addicted to  brandy-drink-
ing, had had severe catarrhal ophthalmia for 7 days; the lids, es-
pecially the upper ones of both eyes,  were much swollen,  red,
hot, and  painful;  profuse secretion and  discharge of purulent
mucus from the eyes, with lachrymation.  The white of the
eye was much swollen, reddened, and formed a soft wall round
the cornea—chemosis;  the cornea of the right eye was clear and
sound, while that of the left eye was dull and gray, with a small,
flat, roundish ulcer.  There was great intolerance of light,  con-
stant flow of tears, continual tearing and shooting pains in and
about the eye, so much aggravated at night as to render sleep
impossible.  There  was  the  sensation as if the eyeball  was
swollen and enlarged, and would come out of the socket.   The
sight of the left eye was imperfect and dim;  there was constant
confusion in the head, and fever in the evening.
   Treatment and Result.—Aconite 12,  every two  hours for  two
days, and then the 15th dilution was used; after the second night
the patient could sleep comfortably; in five days he could open
his eyes himself, as the swelling of the lids, inflammation of the
white of the eye, the purulent secretion, and  intolerance of
light were much lessened; on the tenth day, he was compara-
tively well, although the ulcer still required the use of Tinct.
Sulph.— Gen. Horn. Journal. Vol. 19.  Dr. Knorre.
   CASE 10.—A woman, aged 28,  suffered with a similar, but
still  more severe attack of inflammation of the eye.
   Treatment.—Aconite 3, was given in two-drop doses, every
two hours,  and two drops of Tinct. Sulph. every evening; the
cure was perfected in 7 days.—Ibid.  Dr. Knorre.

                       2. alumina.
   General Remarks.—Dr. Dudgeon has recommended this re-
medy in Ophthalmia senilis, which is a chronic inflammation of
the conjunctiva of the eyes and lids, in which  the angles and
edges are also  much involved.  It  is   most indicated when
there is a burning, prickling,  smarting pain, as if from an acrid
substance in the angles of the lids; violent itching in the eyes, 
56        treatment  of diseases of the eyes.
canthi, (angles,) and lids; smarting as if from soap in the eyes,
and burning, with increased mucous secretion and itching, redness
of the eyes, with rawness in the angles, and weakness of  sight;
in the evening he sees a halo around the candle, and must often
wipe his eyes, which become glued together at night;  redness of
the right eye, with raw feeling and lachrymation; inflammation of
the white of the right eye, without much pain; falling out of the
eyelashes;  weakness of the lids; they are disposed to droop,
without the patient being sleepy;  partial paralysis of the upper
lid, (ptosis;) it hangs down and half covers the eye ;  lachryma-
tion and increased secretion of mucous fluid;  nocturnal agglu-
tination of the lids, persisting for several weeks, and attended
with diurnal conjunctivitis, and increased mucous secretion.—
Brit Journ. Horn.  Vol. 6, p.  217.
   b. I have often used a weak solution of Sulphate of Alumina
in chronic  catarrhal affections of the lids,  with very great be
nefit; the local, combined with the internal application of spe-
cific remedies, often proves far more efficacious than the internal
use alone.—Peters.
                      3. ammonium.

   General Remarks.—Attomyr recommends  this remedy in in-
flammations of  the conjunctiva, especially when the conjunc-
tiva of the cornea is particularly involved, and vascularity of
the cornea is present;  if the irritation of the  eye be very great,
it may  be  assisted with Tabacum, used internally, in small
doses.—Peters.
               4.  ANTIMONIUM TARTARICUM.

   General Remarks.—Dudgeon says that  it has been recom-
mended in rheumatic ophthalmia, while the known anti-rheu-
matic virtues of this drug are  a further confirmation of the pro-
priety of using it in such cases.  I have always regarded Anti-
mony as a remedy peculiarly apt to excite  suppuration and
purulent inflammation, and have used it with much success,
both internally and externally, in the several forms of catarrhal,
muco-purulent, and purulent inflammations  of the eyes. Dud-
•geon also hints that it may prove homoeopathic to gouty oph-
thalmia, as  it causes burning and smarting of the eyes, with red-
ness of the  conjunctiva, especially in the evening; redness and 
ARGENTUM NITRICUM.
57
inflammation of the eyes, with swelling of them, and disten-
tion of the ciliary vessels.  It ought  to prove homoeopathic
and specific against Pustular ophthalmia.—Peters.

                 5. ARGENTUM NITRICUM.

  General Remarks.—Dr. Dudgeon, after quoting the effects of
Nitrate of Silver upon the  eye, observed by Dr. Muller, of
Vienna, from small doses taken internally, remarks: " The symp-
toms of Nitrate of Silver, which we owe to the industry of Dr.
Muller, are the more valuable, as they were not produced by
the heal action of the drug upon the eye, but by its action when
taken internally in small doses, (from the 2d to the  30th dilu-
tion ;)  they afford a remarkable corroboration of the long cre-
dited specific  action of Silver upon the eye, and, he believes,
prove the employment of  eye-washes  containing lunar caustic
to be efficacious in virtue of their homoeopathic action.  They
teach us, moreover, that in Nitrate of Silver we possess a reme-
dy of remarkable powers in some very important and danger-
ous inflammations of the eye; a remedy, which, to judge & pri-
ori, is second to none in affections of the mucous membrane of
the eye, especially in those of a hcemorrhagic character; a pos-
teriori,  we have ample proof of its efficacy from the records and
experience of the old school.  It may be objected that the Allo-
pathic cures, were effected by the local application of solutions of
lunar caustic to the eye, and that they were  owing to the general
stimulant, astringent or corrosive properties of the drug, and that
the quantity used was  such  as  to be  quite opposed  to the no-
tion of a homoeopathic specific action.   To this Dudgeon says,
he may reply that the  stimulant or astringent properties of a
solution  of lunar caustic  dropped into the eye, are insignifi-
cant with those of many other substances that have little effect
in inflammatory diseases of the eye; one obvious reason of this
being,  that the instant  the solution comes in contact with the
secretions of the eye, it is decomposed, and an inert chloride of
silver is formed, which is speedily washed  away by the gush of
tears which ensues; thus the action  of the caustic is but mo-
mentary, and the quantity infinitesimal.  Dudgeon also says that
he must be allowed to  say a few words respecting the use and
utility  of local applications in eye-diseases: " Many eye-diseases 
58        TREATMENT OF DISEASES OF THE EYES.
 are  of a strictly heal character, attended by no constitutional
 symptoms whatever;  whilst others again are eminently depend-
 ent on the constitution of the patient.   It is obvious, then, that
 though it would  be vain to attempt the cure of constitutional
 eye-diseases by local remedies, there is no absurdity in treating a
 purely local disease by local means." He would have no hesita-
 tion in employing the appropriate remedy locally;  experience
 has shown the advantage of using a solution of Arnica in cases of
 wounds and bruises of the  eye; and he doubts not, that other
 remedies may be applied locally with advantage.  For his own
 part, his experience of the local employment of Nitrate of Silver,
 especially in Ophth. neonatorum, and the severer kinds  of ca-
 tarrhal ophthalmia, has been so striking, that he would be very
 sorry to dispense with this remedial means in  these and other
 diseases.  The solution which he. has been in the habit of em-
 ploying contained from 2 to 4 grains of the nitrate to an ounce
 of distilled water, and should be carefully introduced beneath
 the eyelids with a camel's hair pencil, once every two, three, or
 four days, according to the severity of the  symptoms.—Brit.
 Journ. Horn.   Vol. 6, p. 218.
  b.  Lawrence gives the credit to Mr. Melin for being the
 first to use nitrate of silver, locally, in diseases  of the eye; he
 was led to adopt this mode of treatment in ordinary conjunc-
 tival inflammation, because he was unwilling to treat the disease
 as actively as was the common practice  in the dominant school,
 and because he could not believe that a mere local disorder
 could require such extensive depletion  and depression, as was
 usually practiced and recommended.  He  used 4 grains to
 the ounce, applied twice a day; it excited pain and a sensation
 of roughness,  with an increased flow  of tears, for about 20
 minutes, after  which the eyes felt much relieved, and in a few
 days the cure was effected.   Since that period, up to 1840, he
 had treated nearly 300 cases of acute ophthalmia, some of them
of a severe nature, in a similar manner, without either local or
general bleeding,  and thus has had ample opportunities of prov-
 ing its efficacy.
  CASE 11.—A male infant, aged 14 days,  had suffered since
its birth with severe inflammation and swelling of the eyes, with
profuse muco-purulent discharge, (oph. neonatorum.)
  Treatment—Argent, nit. 6 was given internally, and a solu- 
ARNICA.
59
tion of one grain to  the ounce of distilled water was applied
twice a  day; a  cure was effected in 7 days.  Similar happy
results were witnessed in many other cases.—Brit. Journ. Horn.
Dr. Dudgeon.
  CASE  12.—A girl, aged 7, had measles, 3 weeks before, and
inflammation of the white of the left eye for 2 days, with pro-
fuse flow of tears, great intolerance of light, discharge from the
nose,  and constipation.
  Treatment—Bellad. 3 was given twice a day,  and on the 6th
day, the eye was much worse, there was great pain, with fever;
Aeon. 3 was given 3 times a day, and soon removed  the pain
and fever, but the inflammation of the eye persisted with more
or less intensity, for  7 weeks, notwithstanding the use  of Puis.
Euphrasia, Arsenicum,  Sulphur,  Nux.,  Aeon., and Calcarea,
and even attacked the other eye; the  pain was often violent
and the intolerance of light was often excessive during the day,
although it lessened  towards night.  Dudgeon now resolved to
try the Silver, but as he had no dilutions  of the Nitrate, he ad-
ministered Argent, met. 6, in solution, a spoonful every night
for a week; this completely and permanently removed a very
troublesome inflammation, without  the necessity for any local
application.—Brit. Jour. Horn.   Vol. 6, p. 220.  Dr. Dudgeon.

                        6. ARNICA.
   General Remarks.—This remedy has  long been supposed to
possess the power of promoting the absorption of extra vasated
blood, such as occurs from injuries, bruises, or rupture of blood-
vessels.   Sobernheim asserts that it facilitates the circulation
of the lymph, and increases the absorbent powers of the whole
lymphatic and venous systems, and thinks that  this conjecture
will account for its well-known efficacy in extravasations of blood
induced by mechanical injuries, such as falls, blows, concussions,
and rupture of blood-vessels.  But there is another side to  this
picture; the same author says, that in consequence of its acrid
properties, it may cause congestion  of blood towards  internal
parts, such as  the heart, chest, and  head, causing palpitation,
headache, pain in the chest, and difficulty of  breathing; its
acrid  action upon the skin and kidneys may even go so far as
to produce  extravasations of  blood  from both these parts.
Eichter says that one of its most marked actions is upon  the 
60        TREATMENT OF DISEASES  OF THE EYES,
activities of the skin, whose functions it may arouse from the
deepest torpor; and the breaking out of perspiration, which,
at times, is of a reddish color, on the chest, is one of its most com-
mon and constant effects.—Peters.
  b. Dudgeon says, besides the obvious use of Arnica in wounds,
bruises, and traumatic  inflammations  of the eye, some of its
effects would indicate that it might prove, useful in rheumatic
inflammation of the eye.  He also adds, that we are more in-
debted to experience and analogy for its use in traumatic affec-
tions of the eye, than we are to any aid which we receive from
the record of its pathogenetic effects  upon this part.  He also
says that the local application of a weak solution of Arnica is
advisable in some cases of recent traumatic ophthalmia, but care
must be taken that it be not  too  strong; five or  six  drops of
the tincture, in an ounce of distilled water,  will suffice.—Brit.
Jour. Horn.  Vol. 3, p.  220.
  CASE 13.—A man injured his eye,  15 days before, with the
spur of an ear of grain;  there was an ulcer, of the size of lentil,
on the cornea, and the white of the eye was much inflamed and
reddened.
  Treatment.—Arnica water was applied externally; and 1 drop
of the tinct. was given, internally, twice  a  day.  A cure was
effected in 7  days.—Gen. Horn. Jour.   Vol. 3, p. 78.   Turrel.
  CASE 14.—A man aged 30, received a violent blow on the
right eye thirteen days ago;  the eye was violently inflamed; the
cornea was dim, and marked by a small whitish-gray spot;  the
sclerotica was  covered  with a net of red vessels;  there was
lachrymation and intolerance of light.
  Treatment.—10 drops of Tinct.  Arnica in water, was applied
externally from time to  time, and effected a complete cure.—
Archiv. Vol. 19, pp. 3, 163.   Dr. Tietze.
  CASE 15.—A lad, aged 18, received a violent kick from a
horse upon the right eye, followed by considerable inflammation
and swelling of the lids, inflammation  of the white of the eye,
lachrymation, and violent pains.
  Treatment.—Arnica 6. In the course of six days all the symp-
toms were improved, except the  profuse flow of tears and the
pains  in the eyes, which were relieved  by Euphrasia.—Archiv.
Vol. 5. pp. 3, 24.  Dr. Baudis.
  CASE 16.—The following case from  allopathic practice, Dud- 
ARSENICUM.
61
GE0N thinks will prove the efficacy of Arnica in rheumatic inflam-
mation of the eye.  A robust man, aged 50, caught cold, and on
the following day there was considerable lachrymation, shooting
and tearing pains in both eyes, and in the surrounding parts,
increased in bed and by warmth.   The next day the white of
the eye was much reddened; there was intolerance of light, and
all the symptoms of. a violent rheumatic fever.
  Treatment   The patient was kept in a dark room, was bled,
leeched, purged, and sweated, all in vam;  the disease increased,
the pains, lachrymation, and  intolerance  of light grew worse,
and finally the eye-ball resembled a piece of red flesh.  For a
fortnight more, anti-rheumatic and derivative remedies were
used, and even  Corrosive Sublimate was used internally and
externally without effect; finally an infusion of Arnica-flowers
was  given (from 1 to 1£ drachms in 6 ounces of water, one half
to be taken night and morning for three days, then omitted for
two days, and resumed again;)  in seven days the inflammation
and intolerance of light were much diminished, and soon entirely
removed.—Brit. Jour. Horn.  Vol. 6, p. 221. Dr. Ehummel.

                      7. ARSENICUM.

   General Remarks.—Christison says that in persons under
the  influence of  this  drug,  the  conjunctiva is  often  so
injected as to  seem inflamed;  the  eyes are apt  to be  red
and  sparkling;  giddiness   and  intolerance  of  light  may
occur;  and  the  eyes  become bloodshot,  attended  with
burning  pains.  Wood  and Bache say that  it  is  homoeo-
pathic to oedema, especially of  the face and eyelids, attend-
ed with a feeling of stiffness of these parts, and  a livid cir-
cle about the  eyes.   Hunt says if the use of Arsenicum be con-
tinued in small doses for a few  days, or possibly weeks, a prick-
ing  sensation  will be felt in the tarsi, and the white of the eye
will become slightly inflamed,  and that a slight  degree of con-
junctivitis in  forty-nine cases out of fifty, takes precedence of
the  more grave affections which indicate  an over-dose.  In one
case, Hunt gave five-drop doses of Fowler's solution, three times
 a day, for thirty-five days, when a conjunctivitis set in, which
 lasted  for  seven weeks.   In  a  second  case, the  same doses
 caused tenderness of the tarsi, but no redness, in the course of 
62        TREATMENT OF DISEASES OF THE  EYES.
five days; in fifteen days, the conjunctiva of both eyes was
slightly and partially inflamed;  in five days more, the eyelids
became stiff and  itchy,  with increased stiffness and pricking
every evening.  In a third case, the white of the eye became
inflamed, and the eyelids puffy, in a fortnight.  In a fourth case,
the eyes became exceedingly weak in fourteen days; the lower
lids were puffed and swollen, the conjunctiva reddened, and the
eyes watery, so that the  tears were always ready to flow.  In a
fifth case, the conjunctiva became inflamed in twenty-six days;
the lower eyelids  swollen and puffy, the eyes itched  and were
weak; the conjunctiva was much inflamed, with severe pain in
the orbit.  In a sixth case, the whites became slightly inflamed
and the eyes weak, at the end of eighteen days.  In a seventh
case, from five drops, three times a day, the patient complained
at the end of three days,  of excessive weakness of the eyes, sen-
sations of smarting, itching, and pricking in the eyelids, and of
a copious secretion of tears; in seven days more, from two and
a half drops, three times  a day, decided conjunctivitis ensued;
from one drop, three times a day, for five days more, the con-
junctivitis did not improve, but rather grew worse; even from
half-drop doses, the conjunctivitis remained very troublesome;
dimness of sight set in,  and the left eye became so singularly
affected, that the patient could only see half of an object with it.
In an eighth case,  five drops, three times a day, for three weeks,
rendered the conjunctiva very red, sore, and  injected; at the
end of six weeks,  the conjunctiva still remained inflamed, and
the lids  tumefied.   Judging from a few other facts, and from
those afforded by  the ninth case, it would seem that Arsenicum
acts more decidedly and injuriously upon the left eye;  after
taking it for some weeks, both eyes became inflamed; then the
right eye became better,  but the left one remained considerably
inflamed; in two  weeks  more, the  medicine being continued,
both eyes again became inflamed and painful; but the right eye,
though somewhat inflamed, looked more natural than the left;
finally, both eyes became inflamed, attended  with a copious
fluid discharge from the nose.— Hunt on Diseases of Skin.
  b. Dudgeon says that Arsenicum exerts a  most extensive
action upon  the eyes; the  conjunctiva is not alone the seat of
its action, but the sclerotica and choroid membranes also.  It
is homoeopathic to some  stages or varieties of catarrhal,  scrofu- 
ARSENICUM.
63
lous, rheumatic, arthritic, and  scorbutic ophthalmia; also in
some stages of Egyptian and  gonorrhoeal, and more especially
when the pains are extremely violent and burning, and the se-
cretions of an acrid, serous nature.  An intermittent character
of the symptoms is another indication for its use.   He has also
found it very useful in exanthematic  ophthalmia, in that fol-
lowing measles, especially when the lachrymation is excessive,
and the tears produce  corrosion of the cheek, and doubts not
that it will be found equally serviceable in some cases occurring
during,  or after scarlet fever, or varioloid.  It seems to him to
be the only remedy from which we may expect any advantage
in the ophthalmia from uterine phlebitis.  From its producing
swelling of the eyes and a beating like that of a pulse in the eyes,
each throb being attended with  a  stitch; and from its well-
known specific  influence  upon the hoemorrhoidal  vessels, and
the typical character of some of its effects, it would seem that
it must prove homoeopathic and useful against hcemorrhoidal-
and menstrual-ophthalmia.—Brit Journ. Horn. Vol. 6, p. 318.
   c. According to Gross, it is almost the only reliable remedy
in obstinate  inflammations of the eye, occurring in connection
with influenza, and attended with ulcerations of the cornea, and
very annoying  intolerance of light.—Archiv. Vol. 13. part 2.
p. 96.
   d. Hering recommends it when  the lids  are only inflamed
on their internal side;  are red, painful, burning; and the eyes
can scarcely be opened.
   CASE 17.—A maiden, aged 14, of delicate constitution, and
who had suffered for 48  hours  with a violent inflammation of
the conjunctiva, was cured by Arsen. 24, in 12 hours.—Archiv.
Vol. 8, p. 2, p.  75.  Ag.
   CASE 18.—A man of  athletic  frame, and bilious, sanguine
temperament, had suffered, for 6 days, with a violent and pain-
ful inflammation of the white of the eye, with simultaneous in-
ternal ophthalmia; he had already been bled  and leeched with-
out benefit;  then received Puis.  6 with  some relief; but Arsen.
12, 2 drops in water, taken in the course of 7 hours, improved
the case decidedly ;  the cure was  then perfected by Puis, and
Euphrasia.—Gen. Horn. Jour. Vol. 34,  p. 76.   Bechet.
   CASE 19.—A maiden, aged 22, who had frequently suffered 
 64       TREATMENT OF DISEASES  OF THE  EYES.

with erysipelas, had had inflammation of the conjunctiva, with
swelling of the lids for 8 days.
   Treatment—Arsen. 800, in solution, every 2 hours, cured her
in 48 hours.—Gen. Horn. Jour. Vol. 36, p. 148.  Dr. Schelling.
   CASE 20.—A servant-girl was attacked with inflammation of
the eyes, after taking cold, and had suffered for several weeks
with inflammation of the conjunctiva and sclerotica, attended
with great intolerance of light.
   Treatment.—Allopathic treatment had  been  tried without
avail; and  Bellad. did not  afford any relief; but Arsen. 30
effected a cure in a few days.—Archiv. Vol. 12, part  3, p. 11.
Dr.  Hermann.
   CASE 21.—A man, aged 28, of delicate, weakly, and cachec-
tic habit, had suffered for 14 days with a typically recurring in-
flammation of the eye.
   Treatment.—Aeon, and  Bell, were  given  without  effect;
Arsen. 30 effected a cure within three days.—Archiv. Vol. 18,
part 2, p. 43.  Dr. Stapf.
   CASE 22.—A delicate  and slender woman, aged 32, had suf-
fered for some time with an inflammation of the white  of the
eye,  which recurred, regularly, every  afternoon at,4 o'clock.
   Treatment.—Arsenicum 30, a dose every night and morning,
soon effected a cure.—Quarterly Jour.  Vol. 1, part 2, p.  257.
Dr. Lorbacher.
   CASE 23.—A violent inflammation of the eye, with effusion
of pus in the anterior chamber, was considerably relieved by
Ehus; but a relapse occurred from imprudence in diet, attended
with aggravation of all the symptoms, and the addition of con-
gestion to the head, bleeding of the nose, constipation, anxiety,
restlessness, and despondency.
   Treatment—Arsenicum 4 was given every 3 hours, and the
whole disorder was gradually removed in 14 days, the gradual
absorption of the pus going  on all that time.  Euphrasia was
applied externally.
   CASE 24.—A woman, aged  54, had suffered with catarrh of
the head for 5 weeks, and with inflammation  of  the eye for 8
days, attended with swelling of the lids, redness of the, sclerotica
and  pain in the eye-balls.
   Treatment.—Arsen.  6,  1  drop  every night and morning, 
ARSENICUM.
65
effected a cure in 5 days.—Gen. Horn. Jour. Vol.  39,  p. 36.
Dr. Haustein.
  According to Euckert, the above 8 cases furnish the follow-
ing clinical indications for the use of Arsenicum in inflamma-
tion of the eye.
  Swelling and spasmodic closure of the eyelids, which cannot
be opened on account of the inexpressible pains; adhesion of
the eyelashes; injection of the conjunctiva, which is covered
with red blood-vessels and  forms a wall around the  cornea,
(chemosis ;)  redness and  granular appearance near the cornea;
bluish redness of some of the blood-vessels.  Violent pains from
opening the eye, especially at night, when  the  sufferings are
most  severe;  violent  burning in the eye, which prevents the
patient  from eating or  sleeping;  burning and piercing pains in
the eye; profuse  discharge of corrosive tears on opening the
eye;  hot tears;  small ulcers upon  the  cornea; dimness of
sight; contraction of the pupils.  Excessive intolerance of light;
feeling  as if the eyes had not room enough in  the orbit, and
were  being  pushed or pulled out; redness of the white of the
eye, and dimness of the cornea;  intermittent inflammation of the
eye, commencing in the morning or afternoon, and diminishing
by 10 o'clock at night.  Aching and  throbbing  pains ;  annoy-
ing pulsation in the  ball of the eye and  its  neighborhood.
Dimness of vision; cannot see small  objects, even when quite
near; and large objects only at  the distance of 10 feet.

                          Review.

   Arsenicum is most suitable against congestion and inflamma-
tion  of the conjunctiva,  with  swelling, inflammation,  and
spasmodic closure of the lids, and ulceration of the cornea.
   It is  most beneficial against  burning and  intermittent pains,
when all the sufferings are increased at night.
   Doses.—Arsenicum 4,  12, 16,  and 24, were each  given in  1
case; the 30th dilution in 3 instances; the 800th in 1 case.
The  12th, 30th,  and 800th potencies were given in solution,
and in  repeated doses ; the 4th dilution was administered every
three hours.
   It  was given  both in  acute and  chronic cases,  and the-
cures were  effected in  a  few days, in every instance.
                 5 
66        treatment of diseases of the eyes.
                        8. AURUM.
   General Remarks.—Dudgeon supposes that gold acts not only
on the superficial, but  also on the  deeper-seated structures of
the eyes;  that it will be found useful in some cases of rheuma-
tic and syphilitic  ophthalmia; while its efficacy in  fcrofulous
affections should lead us to think of it in strumous ophthalmia;
indeed it was employed successfully by Dr. Lobethal in such
a case.
   CASE 25.—A girl, aged 7, affected with scrofulous ophthal-
mia and great photophobia, was rapidly cured by the internal
use of aurum 3, and the external application  of an eye-wash
made with 3 grains of  aurum  1, in water.—Brit. Journ. Horn.
Vol. 6, p.  321.
                          Baryta.
   This remedy exerts a very specific action upon the eyes;  ac-
cording to Pereira, it has caused dimness  of sight,  double
vision, ringing in the ears,  pain in  the head, and throbbing in
the temples; also catarrhal discharges from the eyes, nose, and
ears.   Still, Pereira  says that Hufeland has used it with
very great benefit in scrofulous affections of delicate and sensi-
tive parts, such as the lungs and eyes.
   Dudgeon says that it is  homoeopathic when the eyeballs  are
painful;  when there are violent pains in the left eye, and thence
over the temple to the  ear; itching, burning, pressure, raw and
dry feeling in the eyes, with sensations as if dust or grains of
sand were in them;  dry heat, burning and pressure in the eyes
with lachrymation;  redness of the white  of  the eye, with a
white  vesicle  or pustule near the cornea;  collection of matter
on the lids in the  morning; sticking  together  of the lids at
night; inflammatory redness of the  internal surface of the lids;
swelling of the lids, especially in the morning.
   Dudgeon has found  it useful against ulceration of the cornea;
Schreter used it with benefit in glandular swellings, eruptions
■ behind the ears, and well-marked scrofulous ophthalmia.

                        Belladonna.
   General Remarks.—At present we will confine our attention
■ as far as possible  to the effects of Bell, upon the external parts 
BELLADONA.
67
of the eye; in two cases the conjunctiva was highly injected,
the whole  eye prominent and preternaturally brilliant;  in
another, the eyes were prominent, dry, and exceedingly brilliant,
the conjunctival vessels fully injected, there was a total absence
of lachrymation, and motion of  the eye was attended  with  a
sense of dryness and stiffness;  the face was red and turgid. H.
M. Gray.  Christison says that it sometimes renders the eye-
ball red and prominent, with flushing of the face and glistening
of the eyes.  Pereira says it may cause suffusion of the eyes,
injection of the conjunctiva with bluish blood, protrusion of the
eye, with dull appearance in some, or ardent and furious ex-
pression in others. Dubreyne says that in some cases the eyes
are dull and haggard, in others red, and the pupils exceedingly
dilated.—Peters.
   b. Dudgeon says: In the pathogenesis of Bellad., we find in-
dications for its use in almost every kind of ophthalmia;  but
 it is not so homoeopathic to the blenorrhagic  forms as some
other remedies, and consequently is less to be trusted to as a
 sole remedy in Egyptian and gonorrhoeal, and the purulent
 ophthalmias of young children, than for the removal of casual
 symptoms, such as violent pains, congestion, and excessive in-
 tolerance of light.   It is highly serviceable in catarrhal, scrofu-
 lous, arthritic, rheumatic, syphilitic and erysipelatous inflam-
 mations of the eye;  and for excessive intolerance of light, when
 it occurs in the course of other ophthalmia.  The experience of
 most homoeopathists will furnish them with examples of the
 power of belladonna over the slighter forms of catarrhal and
 scrofulous ophthalmia.  As a sole remedy, Dudgeon  has sel-
 dom found it sufficient in these affections, but eminently use-
 ful in subduing the attendant photophobia and the congestion
 of the head so often accompanying the various inflammations of
 the eye.—Brit. Journ. Horn. Vol. 6, p. 324.
   c Hering recommends it when there is burning and itching ,
 in the red and swollen lids, which stick together and bleed when
 they are pulled apart, or even become everted, or are at least
 heavy, and as if paralyzed.
   d. Gross recommends Bellad. 3, in  repeated doses every
 night and morning, against frequently-recurring inflammatory
 redness of the internal surface of the eyelids.
   CASE 26.—A man, aged 38, of scrofulous constitution, and 
t'S        treatment of diseases of  the eyes.

subject to sick-headaches, was attacked with inflammation of the
right eye, after taking cold;  the white of the eye was much red-
dened and swollen;  the eyelids itched and burned;  the pupils
were contracted;  there was great intolerance of light; piercing,
burning,  and aching pains in the eye, and  finally the left eye
began to be involved; the attack was preceded by rending and
drawing pains in the bones on the right side of the forehead.
  Treatment—Bellad.  30, in one-drop doses, removed the whole
lisorder in four days.—Annals, Vol. 2, p. 198. Dr. Trinks.
  CASE 27.—A young man, aged 23, of scrofulous constitution,
who had been subject to inflammations of the eyes since his
14th year, was attacked with inflammation of the right eye,
after taking cold;  there was profuse lachrymation, with drawing
and piercing  pains, increased by use of  the eye, and attended,
with intolerance of light.
  Treatment—-Bellad.  30,  three  doses effected  a  cure  in ten
days.— Gen. Horn. Journ., Vol. 12. p. 10.   Dr. Hartmann.
  CASE 28.—A  young, blooming maiden was the subject of a
perfectly intermitting inflammation of the right eye, which com-
menced regularly every morning at  8 o'clock;  it was attended
with violent throbbing pains in the right temple, piercing pains
in the eye, swelling and redness of the lids, great redness of the
conjunctiva,  profuse flow of  tears, and intolerance of light.
The whole attack passed off in a few hours to return  again next
day.
  Treatment—Bellad.  24, and Arsenicum 3,  were given without
effect; Aconite 20, in solution,  produced relief. A relapse which
occurred several months afterwards was not relieved by Aconite,
but  was promptly cured by Bellad. 12, two drops in  water,
three doses per d&j.—Hygea., Vol. 4, p. 130. Dr. Griesselich.
  CASE 29.—A man, aged 25, had suffered for three weeks
with a violent inflammation of the right eye; the eye looked like
a raw piece of flesh; the conjunctiva was dark  red; there was
an ulcer upon the cornea; the lids were much inflamed, and
the  lower one everted; there was  a profuse discharge of an
acrid, corrosive  matter; intense piercing and  digging pains,
with excessive intolerance of light.
  Treatment—Bellad.  400, removed the inflammation and pains
in nine days; the cure of  the ulcer and the corrosion of the
lid was effected by sulphur and euphrasia.—New Archiv. Vol. 5,
part 1, p. 85, Dr. Stapf. 
BELLADONNA.
69
  CASE 30.—A girl, aged 20, was exposed to a draught of air
after being over-heated; there was aching and watering of the
left eye;  inflammation of the conjunctiva ; the cornea became
dim and  turbid (corneitis;) the sight was almost extinguished,
and objects were only seen  as if through a thick, black mist:
black stripes seemed to move to and fro before the eyes.
  Treatment.—Bellad. 400, caused improvement at the end of
four days, and on the tenth day, the patient was comparatively
well, except that  objects seemed  dim and indistinct, and as  if
seen through a fog.  Cannabis effected a perfect cure.—New.,
Archiv., Vol. 3, part 2, p. 117. Dr. H., in F.

                           Review.

  Of these five cases, three occurred in males;  two in females
all between 20  and 38 years of age.
  In two cases, the patients were scrofulous; in three cases, the
attacks was brought on by cold.
  In all five cases, the inflammation attacked one eye only; the
right eye in four instances, the left in one.
  In four cases, the conjunctiva was much reddened and swollen ;
in two cases the cornea was affected, or even ulcerated.  Great
intolerance of light and lachrymation were present in  every case.
In three cases,  the lids were much inflamed and reddened; and
in one, they were everted.
  The attending pains were throbbing, piercing, aching, and
drawing, and extended to the neighborhood of the eyes.
  Chamomilla  and Belladonna have proved useful when there
was haemorrhage from the  eyes.
  The symptoms were aggravated by use of the eyes, by bright
light, by external pressure, and in the evening.
   Dose.—Bellad. 12, 2 drops, in  solution, proved useful, after
            "     24, had failed;
            "     30, was given in two cases;
            "     400,  do     do    do
   The attacks were generally acute, but chronic in one case,
and intermitting in another.
   The cures were effected in from four to nine days. 
70        TREATMENT OF DISEASES  OF THE  EYES.
                   BERBERILS VUGARIS,
  Dudgeon suggests  that this remedy will be found useful
against arthritic ophthalmia, especially when there is  a fine,
frothy or gritty deposit on the  edges of the lids; also against
rheumatic inflammations of the eyes,  when there is constant
burning and dryness,  with feeling as if  sand were in them,
with great redness of the inner surface  of the lids, inflammation
of the caruncula, stiffness of the lids, pressing  out  and throb-
bing in the eyes, pains darting into the eyes from the temples
or forehead, or from the eye to the forehead, &c.—Brit. Journ.
Horn. Vol. 6, p. 325.
                         BORAX
Is recommended in affections  of  the  edges of the lids, espe-
cially when accompanied by entropium; when there is itching,
burning, and rawness of the eyes, as if sand were in them; when
the lashes turn in towards the eye  and inflame  it, especially at
the outer angle, where the edges of the lids are quite raw;  in-
flammation of the corners of the eye, with displacement of the
lashes, and sticking together of the lids;  glueing up of the lids
at night,  with a hard, dry gum, which irritates the  eye  like
sand.—Ibid, p.  325.
                         BOVISTA
Is recommended by Dudgeon  in affections of the eyes, con-
sequent upon, or attended by eruptive cutaneous diseases, es-
pecially when there is burning in the eyes, with extraordinary
heat in the cheeks; inflammation of the eyes and angles of the
lids,  sticking together  of the lids.

                        BRYONIA.
  Dudgeon thinks that it will  prove useful not only in rheu-
matic ophthalmia, but  also where the sclerotic coat and aqueous
humor are principally affected; when the inflammation is at-
tended with an  unusually copious secretion of purulent mucus;
when there is sudden swelling of the eye, with pain, discharge
of matter, and redness and swelling of the conjunctiva.

                  calcarea  carbonica
Is recommended by  Hahnemann when there  is burning
and excoriation of the lids; burning and cutting in  the eyes 
CALCAREA CARBONICA.
71
when reading by artificial light; cutting pains in the eyelids;
piercing, and itching in the eyelids, with sticking together.—
Chronic Diseases, Vol. 2, p. 209.
  Hering recommends it when there are burning and cutting
pains in the lids, especially while  reading;  it is often useful
after Sulphur.
  Dudgeon thinks that it is one of our most important oph-
thalmic remedies, especially in  scrofulous cases;  also in affec-
tions  of the  eyes, attendant  upon or subsequent to cutaneous
eruptions,  especially when there is excessive itching; it  has
proved useful in a few cases of rheumatic and traumatic oph-
thalmia; also in arthritic cases, and in most chronic cases of in-
flammation of the eyes, consequent upon measles, scarlet fever,
small-pox, or dentition.
   CASE 31.—It proved useful in a chronic case of inflamma-
tion of the eyelids, in which the lashes were much disturbed
and destroyed,  the lids swollen, sore, ulcerated, and secreting a
sticky, purulent fluid, attended with violent piercing and burn-
ing pains.
   Treatment.—Calc. 30, in  8  ounces of water, 1 tablespoonful,
per day.—Archiv. Vol. 14, part 1,  p. 6. Dr. Gross.
   CASES 32 to 39.—Dr. B., of D., has published seven cases,
cured by Calcarea, but his  detail of symptoms is scanty, and he
generally used sulphur previously.
   The instances in which Calcarea alone effected a cure, or pro-
duced marked  beneficial effects, collectively present the follow-
ing "group  of symptoms:"
   Both eyes were much inflamed, with violent piercing pains;
profuse secretion of matter, and sticking together of the lids.
   Burning of the eyes in  the evening; feeling of  sand in the
eyes;  stitches of pain  in the eyes;  watering  of the eyes in the
open air.
   Whitish opacity of the cornea (corneitis,) so that the patient
only saw a faint glimmer of light; great opacity of the right
cornea, so that the patient could no longer see with that eye; ul- ■
ceration of the cornea, and  flocculent opacity  of it.
   Eed and green haloes around the candle in the evening;  in-
tolerance of candle-light.
   Among the accompanying affections, were:  drawing and rend-
ing pains in the forehead and right shoulder-blade; frequent dry 
72        TREATMENT OF  DISEASES  OF THE  EYES.
cough;  sensitiveness to every shock or emotion; profuse and
long-continued menstruation.
  Dullness of hearing.—The author remarks that he has cured
numerous cases of inflammations of the eyes with Calcarea, espe-
cially when caused by the suppression of itch with some mer-
curial ointment; but that the results with Calc. were invariably
most favorable when deafness was simultaneously present with
the eye-affection.
                          Review.

  Of the above seven cases, four were males and three females,
from the ages of 4 to 25 years.  In two cases the patients were
of a spongy, scrofulous constitution; in  one case, the ophthal-
mia remained after measles; in one, from itch suppressed by
mercury;  in  another from the suppression of scald-head.
  The inflammations were chronic,  attended with profuse secre-
tion of matter, considerable disease and ulceration of the cornea,
and with destruction of the eye-lashes.
  Dose.—Generally Calcarea 30, frequently  preceded by Sul-
phur.   (Also see page  13.)

                       CALENDULA,
According to Dudgeon, deserves  attention in lacerated and
incised  wounds of the eye;  it is supposed to  be  as  useful as
Arnica  is  known to be in  bruises, and, like it, may be applied
externally, in the form of a  wash or lotion.  It may also be of
use when  the white of the eye is inflamed,  attended  with
headache.
                        CAUSTICUM,
According to Dudgeon, is deserving of attention in the treat-
ment  of most cases of chronic inflammation of the eyes, and has
been found of especial service  where  opacities of the  cornea
•have resulted from inflammatory affections of the eye. He also
thinks that it will prove as useful in some rheumatic, arthritic,
and scrofulous  affections of  the eyes, as it is known to be in
rheumatic, gouty, and scrofulous affections in general.
  CASE 40.—A woman, aged 40, had inflammation of the left
eye, with  corrosive lachrymation and shooting pains; the can-
dle seemed surrounded with a green halo ; shooting pains ex- 
CAUSTICUM.
73
tended from the eye into the head; there was an exacerbation
of all the symptoms in the evening and at night.
   Treatment—Sepia 30, produced some amelioration, which re-
mained stationary at  the end of a month, when  an  eruption
broke out over the whole body;  two doses of Sulphur 60  and
30, allowed the disease of the eye to  regain all its former in-
tensity.  Then Causticum 30, was given, and the  affection ra-
pidly declined, no further medicine being required.—Archiv.
Vol. 17, part 27.  Dr. B. in D.
   CASE 41.'—A peasant woman, aged 40, had suffered with
her eyes for 14 years; they were always reddened, had violent
shooting pains, and her sight was so dim that she only saw as if
through a mist; there were continual beatings and  noises in the
head, flowing catarrh of the head, and an eruption about  the
neck.
   Treatment.—Sulphur 30, was  given  without effect;  three
weeks after, Causticum 30, was administered, and  removed all
the symptoms in six  or seven weeks; no other medicine  was
required.—Ibid. p. 30.
   CASE 42.—A robust man, aged  30, had had bad eyes for
several years; he  felt, especially in  the  evening, burning  and
shooting pains, with a feeling as if  he had sand in  them; he
had continual noises in the head, putrid taste in the mouth,  and
dull pain in the stomach  after eating.
   Treatment.—Pulsat. 30, produced marked benefit at first,  but
at the end of three hours, all  the symptoms reappeared; then
a single dose  of Causticum 30, effected a complete and radical
cure.
   CASE 43.—A girl, aged 18, had  had itch  during the pre-
vious summer, and was treated with sulphur and mercury, inter-
nally and externally;  soon afterwards she was attacked with a
violent ophthalmia, with purulent discharge and great swelling
of the lids.  She was giddy in the evening, and had never men-
struated.
   Treatment.—Pulsat.  4,  removed the giddiness, but left  the
other symptoms as before;  a fortnight afterwards, a single dose
of Causticum 30, sufficed to cure her, and to cause the appear-
ance of the menses.
  It is supposed to be most homoeopathic when there is exces-
sive itching of the  eyes, with smarting, as if from  the applica- 
74        TREATMENT  OF DISEASES OF THE  EYES.
tion of salt, with burning and dryness, stiffness, intolerance of
light, and constant winking.
                      CHAMOMILLA,
According  to Dudgeon,  is best suited to catarrhal  ophthal-
mia with much mucous secretion, and to the  ophthalmias of
new-born infants, when the white of the eye only is  affected;
it would be unsafe to rely upon it alone when  there is ulcera-
tion of the cornea, or  inflammation of the more deeply-seated
structures of the  eye.  It is particularly indicated when the
attack  is recent,  and when there is  a tendency to  bleeding
from the congested mucous  membrane.   If a remedy be re-
quisite for the ophthalmia accompanying dentition, chamomilla
will generally suffice, particularly if the infant is not decidedly
scrofulous.
  CASE 44.—A child, aged  3 weeks, had had constant diar-
rhoea for a fortnight, at first greenish, then like clear soup, and
finally  watery and fetid, attended with violent screaming and
squirming.   The eyes were closed by great swelling of the lids,
and on opening  them forcibly, the white was  found much
reddened; blood  flowed from the eyes every time the infant
cried;  its whole body was covered with a miliary eruption,
and the face was excoriated,  probably from the acridity of the
secretions from  the eyes.  There was extreme  restlessness, en-
tire loss of sleep, heat of head and body, without perspiration,
and coldness of the extremities.  The child refused all nourish-
ment, even from its mother's breast,  and was excessively ema-
ciated.
   Treatment and Result—Chamomilla 12, one drop ; in an hour
it fell asleep for three hours,  then awoke quietly and took some
drink; in two days its diarrhoea lessened,  it had ceased crying,
the eyelids were less  swelled, but it could not open  its eyes;
the whites and  edges of the lids were less red, but the bleeding
had  not diminished;  the heat of the body was moderate, the
eruption less red, and  desquamation had  commenced.  The
 Chamomilla was allowed to act for two days more, when Bellad.
30, removed the remainder of the symptoms;  for in two days
after, the bloody tears and swelling of the lids had disappeared,
and the eyes had resumed  their natural appearance.  Three
weeks after, the emaciation had much diminished.—Archiv., Vol.
 6, part 2, p. 38.  Dr. Hartmann. 
CHAMOMILLA.
75
  CASE 45.—An infant,  aged 6 weeks, had, from its birth, a
considerable swelling of the lids, with redness and profuse puru-
lent discharge; the disease went on increasing,  especially that
of the left eye, which could not be opened ■ at all, whereas the
right still opened, but only when the light was dim.   On sepa-
rating the lids forcibly, the eyes were perceived highly reddened,
especially the left.  The mouth was covered with small canker-
sores ;  the child cried very much, and had liquid, yellow, and
chopped stools.
  Treatment.—Chamomilla 12, was given, and in two days the
child was quieter, the  lids less swollen and  red, and the eyes
opened spontaneously; in two days more there was no more
.swelling or redness of the lids, the eyes opened without difficul-
ty,  the intolerance of light and the inflammation  had entirely
disappeared;  the  aphthas had much diminished, but there
were still several  glairy  stools per day.   A small dose  of
Mer. sol. 12, removed the remainder of the complaint.—Annals,
Vol. 2,- p. 200.  Dr. Seidel.
   CASE 46.—A lad, aged 14, of robust constitution, was  sud-
denly seized with severe inflammation of the eyes, from change
of weather.   His physician immediately ordered a large number
of leeches, a blister, and some internal remedies; but his parents
objected, and a homoeopathic physician was called.
   Symptoms.—Severe tearing headache, painful  pressure on the
orbits, throbbing in the temples; eyelids so swollen as com-
pletely to close the eyes;  the white of the eye was. all inflamed
and red, and so much  swollen as to form a  projection around
the iris, ( chemosis;) the cornea was somewhat opaque, especially
that of the right eye, in which the inflammation was most in-
tense; objects could not be distinctly seen;  they seemed  as if
covered by a thick mist; candle- and day-light were intolerable,
so  that he was obliged to remain in darkness; the least change
in the air of the room, the slightest examination by the physi-
cian, or the approach of night, caused great suffering.   There
 was want of sleep; great restlessness; fever, increased at night;
feeling as if the right eye  would burst out of its orbit; sensa-
tion as if grains of sand were in both eyes.
   Treatment. —Chamomilla 6, to be repeated in two hours;  on
the next day the inflammation was much diminished, the swell-
in o- of the conjunctiva around the cornea was less, but the pain 
76        treatment of diseases of the  eyes.
in the head and eyes still persisted.  Phosphoric acid 30, caused
a quiet night and peaceful sleep,  and the improvement was so
rapid that a cure was perfected on the fourth day.—Dr. Scudery.

                          china.
  Dr. Dudgeon says: "The great benefit that has been found
to result, in allopathic practice, from the  employment of bark
and its preparations in certain affections of the eye, more espe-
cially in scrofulous and rheumatic ophthalmia, would naturally
induce us to bear them in mind in our homoeopathic  practice;
in fact, until future provings shall have furnished us with more
accurate indications for its employment, we must be content to
be guided,  in a great measure, by the experience of our allo-
pathic brethren.   It is most useful in chronic scrofulous  oph-
thalmia, when the redness  of the  eyes is  slight, but the intole-
rance of light, and other symptoms, severe; in certain stages of
rheumatic and other chronic ophthalmia?;  and in those inflam-
matory affections  of the eye, consequent upon onanism.
  CASE 47.—A  girl, aged 17, scrofulous, and subject to fre-
quent attacks of  ophthalmia from  her infancy,  was  attacked
with a recurrence of the disease.   The white of the left eye was
slightly reddened; motion of both eyes was difficult, as if sand
were beneath the lids.  There was a periodical aggravation every
evening, about 11 o'clock,  when the following additional symp-
toms  occurred: great lachrymation of the left eye, sensitive-
ness to light;  pressing pain on the orbit, which pain sometimes
descended  from the eyebrow into the lid, and caused this to
close spasmodically; remission of the pains for several minutes;
frontal headache.
  Treatment.—Three hours before the  next attack, one drop of
China 12, was given, but the paroxysm  occurred at the usual
hour with increased violence; still, it did not recur on the third
day, and there was no relapse.—Archiv., Vol. 3,  part  3, p. 77.
Dr. Caspari.
  CASE 48.—A  lad, aged 8 years, was  attacked  last autumn,
after a slight cold, by a periodical ophthalmia of a peculiar cha-
racter.  Every morning at 10 o'clock, he experienced a painful
pressure and drawing in of the forehead and temples, which in-
creased every day in violence;  soon afterwards his  eyes be-
came red,  and commenced to weep; there was contraction of 
CHINA.
77
the pupils and great sensitiveness to light.." -Touch and motion
gave him great pain.   The paroxysms lasted severely for three
hours, after which the pains gradually diminished; then there
was a remission until evening, during which the skin was cov-
ered with perspiration.   During the attack the pulse was quick,
and face red;  after the paroxysm, the face was  pale and the
debility great.
   Treatment.—The catarrhal origin,  and morning paroxysms
led to the use of Nux vom. 30, but without effect;  Euphrasia
lessened the pains, but the attacks came on at the usual hour.
Then China 12, was given, and on the following day the attack
came on an hour later, and was less severe;  two  doses more of
China, within forty-eight hours, effected a perfect cure.—Eau.
   CASE 49.—A young lady had suffered for some days with
the following  remarkable symptoms: a pain in the eye, which
included not only the eyeball and all the part contained in the
orbit, but also the superciliary sinus, and extended along the
eyebrow to the  temporal bone; it was of  an excessively vio-
lent character, as if a knife were thrust betwixt the orbit and
ball, and moved around in the orbital cavity, in order to scoop
out the eye; while it lasted the eye wept, but was  neither in-
flamed, nor particularly red.  This pain commenced every morn-
ing about 8 o'clock,  with the same violence, and the last  trace
of it disappeared about two or  three o'clock, p.m.
    Treatment—After using some general means,  China was ad-
ministered; and with such rapid effects that a cure was effected.
—Dr. St. Martin.
    CASE 50.—A man, aged 40, healthy and robust, felt much
 weakened immediately after bathing in the river in June ; the
 next day he had heaviness of the head, disagreeable taste, eruc-
 tations, and furred tongue; the day after, notwithstanding the
 use of full doses of Senna, he could not open his eyelids, which
 were glued together; the conjunctiva was reddened, the pupils
 contracted, the lids red  and swollen, there was epiphora, ex-
 treme intolerance of light, heat, tearing in the orbit, disagree-
 able taste, violent headache, and thirst, moderate  fever, with
 full and hard pulse, and dryness of the skin.
    Treatment and Result—Leeches, cold compresses, tartar emetic,
 and calomel were given without effect, but on the following day
 not a trace  of the ophthalmia was observable;  but the day after 
78
TREATMENT OF DISEASES  OF THE EYES.
it returned with all its former intensity,  and its intermittent
character was fully recognized.  Another intermission and
subsequent fit were allowed to elapse, after which a  few doses
of Sulphate quinine were given; no trace of the ophthalmia
returned, although the patient was obliged to write a great deal.

                         CONIUM,
  This remedy will be more fully treated of under the head of
scrofulous ophthalmia.   It has been  found useful  in some cases
of traumatic ophthalmia.
  CASE 51.—A man, aged 60, was attacked with inflamma-
tion of the eye, after an injury with  a splinter of  wood.
  Symptoms.—Enlarged blood-vessels ran from the inner cor-
ner of the eye to the edge of the cornea, which was opaque and
depressed in the centre;  there was aching pain in  the eye-ball,
increased by looking at a  bright light; a sensation of  swell-
ing of the eyeball, swelling of the lids and cheek of the same
side;  itching, lachrymation, and adhesion of the lids, with dim-
ness of sight; rending pains in the right side of the head; and
aggravations every evening.
  Treatment.—Conium 2, ten drops in a teacupful of water, one
teaspoonful every morning and evening;  a cure was effected in
six days.—Genl. Horn. Journ., Vol. 39, p. 34.  Haustein.

                          CROCUS,
According to Dudgeon, has  long  enjoyed a reputation  in
allopathic practice, as  an  external remedy against  various
ophthalmic affections; it enters into the composition of many
eye-washes.   It has been recommended homoeopathically after
surgical operations on the  eye, when there are throbbing and
itching pains.  It  has been used in traumatic and  scrofulous
ophthalmia with good effect.
  It is very useful against pain in the eyes, produced by look-
ing through spectacles of too  great magnifying power.  Also
against the  consequences of exposure of  the eyes to smoke;
and inflammation of the eye, produced by weeping; as it pro-
duces a sensation in the eyes  as if the patient  had wept too
much, the eyes being all swollen and tense, and  looking as if
one had wept violently. 
EUPHRASIA.
79
                     DULCAMARA
  Is supposed to be the most homoeopathic remedy against in"
flammation of the conjunctiva, with chemosis.
  CASE 52.—A soldier, aged 24, of robust constitution, had
inflammation of the eyes with chemosis; the disease had lasted
a week.
  Treatment.—He took  Tinct.  Dulcamara in drop doses,  and
was much  better at  the end of 7 days;  the  chemosis  having
ceased, he  then took Tinct. CoccUl.  for redness of the conjunc-
tiva.   Dr.  Horatus.
                        EUPHRASIA.
  Dudgeon  says, it is  immaterial  now to  inquire whether  it
first obtained a reputation as a medicine for the eyes from its
signature, that is, from  some fancied resemblance between its
form and  the human  eye;  or, as is  more probable, from the
experience of peasants relative to its beneficial influence on the
eye.  Certain it is, that  its ophthalmic virtues have been pretty
generally believed  in,  as is still farther c<atfoborated by the
passage in  Milton:
              " Then purged with Euphrasy and Rue;
               The visual nerve, for he had much to see."
  Many treatises have been written by allopathic authors, com-
mending it as a true polychrest medicine in eye-diseases; but
the most  modern panegyrist of Euphrasia is  Dr. Kranich-
FELD, of Berlin, who has given a detailed account of all that has
been said about it by ancient authors, and lauds its efficacy not
only in inflammation of the  eye,  but in  cough, hoarseness,
earache, headache, and  vertigo, and brings  forward cases  illus-
trative of its power.  Still, Dudgeon says, that its pathogenesis
gives only obscure indications for its  employment in catarrhal,
rheumatic,  and scrofulous  ophthalmia, while experience has
taught that it is peculiarly useful when there is a constant  flow
of tears, and intolerance of light, with disease of the cornea.
   b. According to Eummel, Euphrasia, when used both inter-
nally and externally, not only accomplishes much against specks
of the cornea, but also  cures inflammation of the cornea, and
blenorrhoea of the conjunctiva.
   c. My practice, says Dr. Lobethal, compels me sincerely  to
recommend to my colleagues Euphrasia, whose curative virtues 
 80        treatment of  diseases of the eyes.

 have often been tested with success in ophthalmia.  It has ap-
 peared to me most useful in rheumatic, catarrhal, and scrofulous
 cases, and where there was considerable mucous secretion from
 the  inflamed eye; also in blenorrhoeas of the eye; in all of
 which cases I employ Euphrasia at once, internally and exter-
 nally ; in  the former case, in drop-doses  of the tincture; in
 the latter, from 2 to 5 drops in 4 ounces of water.
   CASE 53.—A powerful young lad, aged 14, had suffered
 for 4 months with considerable intolerance of light in both eyes,
 worst in the evening ; there was a rosy redness of the sclero-
 tica  with great vascularity of the conjunctiva ;  his whole state
 was  farther aggravated by accidental injury to the left eye, by
 a bit of straw.
   Treatment—Euphrasia  4th  dilut., 10 drops  in 3 ounces of
 water, in table-spoonful doses; and application of a wash made
 with 10 drops of Tinct. Euphrasia; a cure was effected in 10
 days.—Hygea.  Vol. 18, p. 42.   Dr. Segin.
   CASE 54.—A man, aged 50, had suffered for 6 weeks with
 ulceration of tiie cornea,  against which he  had already used
 several externir remedies without  avail.
   The left eye was most involved, and seemed  swollen  and
 smaller; the meibomian glands were  greatly inflamed  and
 enlarged;  red vessels passed  from the conjunctiva on to  the
 cornea, and emptied  themselves upon a deep ulcer there;  the
 whole cornea was dim, and conical in shape.  The iris was dis-
 colored, and the pupils contracted.
   Treatment—Euphrasia, 3d dilut., was given twice daily ; and
 a wash of Euphrasia 3d, in 100 drops of alcohol, was applied
 externally.  A cure was effected in 3 weeks.—Practical Observa-
 tions. Vol. 3, p. 17.   Dr. Thorer.
   CASE 55.—An infant, aged 6 months, had had inflammation
 and swelling of the lid of the right eye for 8 days, and of  the
 left for 1 day; the eyes themselves were also  inflamed; there
was  a  flow of mucous matter from them, mixed with blood;
the lids stuck together at night; there was a fluent coryza by
day,  and stoppage of the nose  at night.
   Treatment—One dose of Euphrasia produced marked amend-
 ment in 2 days, and a cure by the 6th day.—Annals  of Klini-
 cal Homoeopathy. Vol. 1, p.  167.
   CASE 56.—A robust woman, aged 22, had  suffered for 10 
•
                        EUPHRASIA.                     81

days with ophthalmia, from taking* cold; the conjunctiva of
the lids and eye-balls was red; large red vessels were  seen
running from the outer and inner angles  of the eye  to the
cornea; there was a continual itching  and feeling as if  sand
were in the eyes; lachrymation and intolerance  of light; the
right eye was more painful than the left, and the accompanying
catarrh of the nose was more troublesome in the right nostril
than in the left.
   Treatment and result.—Euphrasia, 3d dilut.;  in 2 days she was
improved in every respect, and the amendment went on, with a
few interruptions, until the 5th day, when the cure was  com-
pleted, without any other remedy having been used.
   CASE 57.—A gentleman  was attacked with  inflammation
of the eyes, without  assignable cause.   The symptoms were:
headache in the forehead, with pressure in the temples; inflam-
mation of the internal surface of the lids, with intolerable pains;
intolerance  of light;  abundant flow of  irritating mucus  from
the eyes; constant flow of tears; burning itching in the eyes ;
sticking together of the lids; black spots and mist before the
eyes; habitual constipation,  and depressed, restless disposition.
   Treatment—Aconite afforded only temporary  relief; Cham.
and Nux produced no good effect;  Euphrasia, on the contrary,
followed by Calc. on  the 3d day, effected a cure by the  10th
day.—Archives.  Vol. 5, p. 375.  Dr. Scudery.
   CASE 58.—An old woman had  dimness  of the cornea, fol-
lowing inflammation  of  the right eye,  after an attack of gout;
there was complete obscuration of the cornea.
   Treatment—After the subsidence of the acute  inflammation,
the prolonged use of Euphrasia removed the dimness of the
cornea  completely.—Gen.  Horn.  Jour. Vol. 5,  p.  163.—Dr.
Knorre.
   It has also been used successfully in one case against profuse
flow of tears, and piercing pains in the eyes;  in another, against
the  dimness or opacity  of the cornea, remaining after ulcera-
tion ; in a third case,  to  cure  ulceration  of the cornea; and a
fourth, to remove an  acrid discharge of tears.
   Dose.—The Tincture was  given  in drop doses inl case; and
applied externally in  2 cases.   The 1st dilution  was given in
solution, in 1 case.  The 3d was  administered internally and
externally in 3 cases;  the 4th, in 1 case, and the 200th in 1 case. 
•
82         treatment  of diseases of the eye.

                        graphite
Is indicated when there  is a paralytic pain in the lids;  itching,
smarting, and heat in the eyes;  burning in the eyes, with col-
lection of matter in the  angles;  lachrymation, redness, and in-
tolerance of light;  redness and painful inflammation of the
lower lid and internal corner, with acrid tears; suppuration of"
the eyes; weakness and redness;  frequent lachrymation and
much mucus; dry mucus on the lashes; sticking together of
the lids;  great sensitiveness to light, with redness  of the white
of the eye;  greater sensitiveness to sunlight than  candlelight.
  Dudgeon says, in the  above symptoms we have well  marked
indications for the employment  of Graphite in scrofulous, and
catarrho-scrofulous ophthalmia.    Knorre  found  it useful  in
scrofulous ophthalmia, with ulceration of the cornea and great
intolerance of  light.  It  may be used in herpetic  affections of
the eyes and lids; and Hartlaub says it  opens the gummed-
up eyes of scrofulous  children, when there is  a simultaneous
eruption  upon the  face.  Weber recommends it in gouty
ophthalmia,  in the contraction and irregularity of the pupils.
It may also be thought of against  chronic  or tedious ery-
sipelatous inflammation of the eyes.
  CASE 59.—A man  aged 40, formerly syphilitic,  had  inflam-
mation of the conjunctiva extending over the margin of the
cornea -T constant  secretion of purulent matter;  sticking to-
gether of the lids;  intolerance of day and candlelight; burning
pain about the eyes ; pains in the throat, as if  ulcerated; con-
stipation and dejection of spirits.
  Treatment.—Sulphur and Nux were given without benefit;
Graphite 30, was then given, one  dose per day, and in 4 days
improvement  commenced, while a cure was perfected in one
month.
                  HEPAR.  SULPHUR. CALC.
  Against pain and pressure in the eyes; burning  pains in the
bones above the orbit;  rawness of the external  angles, with
accumulation of mucus; inflammation and swelling of the eye,
with redness of the white; soreness of the eyes, which gum up
at night; mucus is secreted and the eyes become  dim, so that
he can not see well in the evening ; eruption of pimples on the
upper lids, and under the eyes;  intolerance of light. 
HEPAR.  SULPHUR.  CALC.
83
  Dudgeon says, it is homoeopathic to scrofulous, catarrhal, and
exanthematic inflammations of the eyes; there are  also some
indications for its use against  rheumatic eye-affections.  It is
more particularly suited when  the meibomian glands are much
involved, with copious secretion from them, intolerance of light
and  vesicles on the conjunctiva.  Schroen  says, he has fre-
quently used it with success in inflammation of  the  eyes at-
tended with burning pains at  the edges of the lids, redness of
internal  surface of lids, intolerance of light, lachrymation,
enormous secretion from the meibomian glands, and consequent
agglutination of the lids, pustules on the sclerotic, and even on
the cornea, with vascularity of the cornea.  Still he could not
discontinue its use for some time, or else the  same  symptoms
would return; when the intolerance  of light was excessive,
Belladonna was required.   Hartmann regarded it as indis-
pensably necessary in the cure of scrofulous blepharo-ophthal-
mia, given in alternation with Digitalis and Mercurius.
   Hering advises it when inflammations of the eye do not yield
to Aconite, when there are aching and pressing pains, with raw-
ness of the lids.
   The Tinct. Hepar. Sulph. is useful against inflammations of
the lids, when the meibomian  glands are involved, when styes
and much pus is present.
   CASE 60.—A  lady had been treated allopathically for 27
weeks, without benefit;. there was an ulcer  upon the cornea,
and several vesicles or pustules-upon its edges; pus was effused
into the  anterior chamber  of  the eye, (hypopion;) the globe of
the  eye was  inflamed; there, was  excessive intolerance of
light; burning,, piercing, and aching pains, increased by moving
the  eye;  and piercing, bursting headache.
   Treatment—Hepar. s.  9,  1  dose every other evening, for 8
days; then Euphrasia  3, in  the same way.   In 14 days, the
ulcer of the cornea was healed, and the pus had disappeared.
Pulsat. 3, in 1-drop doses, daily, was given against the remain-
ing  vesicles or pustules.—Dr. Elwert.
   CASE 61.—A piece of steel flew into a young man's eye
and remained adherent there,  followed by violent inflammation
of the  conjunctiva, lachrymation, intolerance of light, acute
pain, and difficult motion of the eyes. 
84         treatment  of diseases of the eye.

  Treatment—Re-par. 2, soon produced relief, and the foreign
body was easily removed.—Caspari.
  CASE 62.—A lad, aged 16, robust, blonde, and frequently
exposed to cold, had been sick for 14 days; the lids  were
swollen;  the conjunctiva of the lids inflamed ; the angles were
raw and ulcerated ; increased secretion from the glands ; stick-
ing together of the lids;  intolerance of light and use.
  Treatment—After several doses of Tinct. Hepar. Sulph., both
eyes were cured in  a  few days.—Hygea.  Vol. 6, p. 397.   Gries-
selich.
  CASE 63.—A  woman  of plethoric constitution had  been
plagued often and much with catarrhal inflammation and blen-
norrhoea  of the eyes for many years.   The lids  of both  eyes
were inflamed, excoriated,  running as if corroded, especially at
the internal angle; the  inner surface, especially of the  lower
lids,  were  red and inflamed; heat, pain  as  if  from  a burn,
smarting and itching of the lids; lids and angles stuck together
with purulent mucus; large red vessels on the conjunctiva;
intolerance of light;  colored and dim halos around the candle;
pressing pains in the  eyes, forcing her to shut them.
  Treatment.—The cure was effected by repeated doses of Hepar.
s. 3.—Knorre.
  CASE 64.—A  little  boy, aged 2 years, had tinea capitis
which had extended to his face; inflammation of the eyes, and
a small ulcer on the left cornea;  his  hair had fallen off pro-
fusely, leaving bald  places  on  his scalp; he  had crusts and
scabs on his head, face, and neck ;  his eyes were closed by the
swelling of the lids, and there was a profuse discharge of puru-
lent mucus; frequent calls to stool, difficult evacuations; some
perspiration at night; peevish, fretful humor.
  Treatment—One dose  of Hepar. s. 3, was allowed to act for 5
weeks; the improvement then still continuing, no further me-
dicine was given, and he was quite well in 5 weeks more.—Dr.
Schreta.
                         Review.
  These few cases are sufficient to prove the powerful curative
influence of Hepar. s. in  diseases of  the conjunctiva and cornea,
especially when the meibomian glands are also involved.  The
instance of Hypopion (case 60) is of great practical value. 
KALI  BICHROMICUM.                 85
                         IGNATIA.
  Dudgeon says we can infer from the pathogenesis of this
remedy, its utility in catarrhal, and catarrho-strumous ophthal-
mia.  Hartlaub says it is best suited against an irritated state
rather than in fully developed inflammations.  Wurzler re-
commends it after operations on  the eye, where there are vio-
lent shooting pains  in the temples and eyes.   Hartmann con-
siders it to be specific in the ophthalmia of new-born infants,
especially if preceded by a dose of Aconite.  Dessaix has cured
traumatic ophthalmia  with it.   The  well-known  efficacy of
Ignatia against the effects of great grief induced Watzke to
give it  in a case of injury of the eye, which seemed  to  be
much aggravated by that state of mind, and which had resisted
all the antiphlogistic treatment of the old school.

                          iodine.
  Against pressure in the eyes, as if from sand; tearing pain
around and under the right eye; tension, shooting and cutting
stitches in the eyes, with,  some inflammation.   Watery, white
swelling of the lids ;  dirty yellowness of the whites of the eyes,
with some red vessels traversing them ;  lachrymation.
  It is supposed to  be useful against syphilitic, mercurial, and
scrofulous eye affections.
                    KALI  BICHROMICUM.
  Dudgeon thinks  that this will prove one of our most import-
ant ophthalmic medicines;  Dr. Drysdale and he have  found
it useful in catarrhal, and  catarrho-scrofulous ophthalmia, and
used it occasionally as a collyrium with advantage; its  action
seems nearly confined  to  the conjunctiva,  the  deeper-seated
strictures  being scarcely affected by it;  it may be thought of in
strumous  ophthalmia and in the Egyptian.
  It is indicated when there is excessive itching and smarting;
soreness of the caruncula;  great burning and smarting;  heavi-
ness, soreness, and  swelling of the eyes in the morning; pain
as if sand were in the eyes, lachrymation, intolerance of  light;
constant  winking of the eyes on account of excessive photo-
phobia,  with lachrymation and  burning pain;  tolerance of
candlelight; redness of  the edges of the lids of the conjunc-
tiva and of  the lids ; agglutination of the lids ; redness of the 
86         TREATMENT of  diseases of the eye.
whole conjunctiva, with  aching, heat, uneasiness, and lachry-
mation ;  sticking together of the lids;  yellowness of the sclero-
tica with some congestion ;  swelling and inflammation of the
eyelids, with eruption upon  them  and on  the face; tender-
ness of the  eyes, redness of the conjunctiva, with tendency to
granulation ; violent inflammation of the eyes, with intolerance
of light and dimness  of  vision; pustules on the  cornea, with
surrounding  indolent inflammation;  specks and leucoma of
the cornea ;  dirty yellowness, discoloration and swelling of the
conjunctiva; brown  spots  on the white of the eye,  heat  and
redness of the  eyes,  with  thickening and  roughness of the
inner surface of the lids, (granulation.)
                   •KALI HYDRIODICUM
Is indicated when there  is cutting, smarting, and burning in
the eyes, with secretion of muco-purulent matter  ; violent burn-
ing in the eyes; intolerable  burning  in the lids, with intole-
rance of light;  burning  of the eyes,  redness of the lids, and
lachrymation : considerable swelling of the conjunctiva around
the cornea, {chemosis;) great swelling of the lids, with  increased
mucous secretion; purulent mucus in  the angles  of  the eyes;
constant watering of the eyes; inclination to shield the eyes
from the light.
  It seems most  homoeopathic to catarrhal and catarrho-scrofu-
lous affections; but it has proved useful in the dominant school
against rheumatic iritis and scrofulous ophthalmia.
                        kreosotum.
  Dr. Wahle, to whom  we owe our knowledge of the physio-
logical action of  this drug, considers it indicated in a  variety of
diseases of the eye.   Dudgeon supposes it to be most homoeo-
pathic to catarrhal  and catarrho-strumous  ophthalmia, with
great epiphora and excessive acridity of the tears.
  It is indicated when there is continual great heat in the eyes,
with lachrymation ; pressure, burning and scalding,  with heat
and watering as if something had got into the  eyes; sticking
together of the lids ;  itching, smarting, and inflammation of the
sclerotica ; watering of the eyes ; constant watering of the eyes,
which swim  in tears; hot  acrid tears, like  salt water, causing
smarting and burning of the cheeks ;  the eyes look as  if one
had been weeping. 
LYCOPODIUM.
87
                         LACHESIS.
  Dudgeon  thinks  that the rather lengthy list of symptoms
attributed to Lachesis does not afford many distinct indications
for its use in ophthalmia; it is  perhaps most homoeopathic to
catarrhal and rheumatic imflammation.
  £5ASE 65.—A government official was forced to discontinue
his functions on account of a violent inflammation of the left
eye;  the conjunctiva of the eye and lids was red and swollen;
the cornea was depressed, there was  a  small ulcer and abscess
upon it; the eye burned, and felt as if sand was in it; there
was great dryness of the nose, and burning, acrid tears ran down
the cheeks; the eye  was excessively  tender; he was forced to
remain in  a  totally  dark chamber; the light caused him the
greatest agony;  tearing, throbbing pains were felt in the fore-
head, bottom of the eye and back of the orbit, and occasionally
became so severe that they forced piercing cries from the
patient;  he could only get a little relief in a kneeling posture
with his head resting on the bed, and bent down almost to his
knees; his pulse was frequent and sharp; there was much heat
of the head,  great thirst, and no  sleep, with extreme general
agitation; he was excessively irritable.
   Treatment—Mercurius,  Hepar. s., Pulsatilla,  Spigelia, and
Lachesis were given ; Hepar. and Lachesis contributed most to
the cure,  which was effected  in  10 days.—Clinique Homoeo-
pathique, p. 41.—Dr. Malaise.
                     LEDUM PALUSTRE
Is most useful in gouty and rheumatic  ophthalmia, when the
lids  stick together;  with great itching at the angles of the
eyes ; lachrymation,  acrid and  smarting, corroding  the  lower
lid and cheek ;  painful pressure behind the eye, as if it would
be forced out, without inflammation;  tearing pains in the head
and eyes, with inflammation; swelling  and great inflammation
of the sclerotica and conjunctiva; tearing pains and  burning
pressure in the eyes.
                       LYCOPODIUM.
  Hahnemann found it useful in inflammatory affections of
the eye, with nocturnal agglutination, and lachrymation by day;
it is homoeopathic to  inflammatory affections of the conjunctiva.
especially of the lids, and of a catarrhal,  scrofulous, or blen- 
88
TREATMENT of diseases of the eye.
norrhagic character.  In the two former affections, it has fre-
quently been used with advantage, and Dr.  Goullon attests
to its efficacy in the ophthalmia of  new-born infants.  It has
also been used successfully in most obstinate cases of scrofulous
ophthalmia.—Dr. Dudgeon, {Brit. Jour. Horn. Vol. 6, p.  483.)
                                                       #
                        MERCURIUS
Is indicated when there is agglutination of the lids in the morn-
ing;  pressure,  shooting, burning, and  smarting in  the  eyes,
with heat and lachrymation; inflammation of both eyes, with
many red vessels on the whites, with intolerance of light.
  Inflammation  around the edge of the cornea  of a peculiar
lilac color, with aching in the eyes.
  Inflammation  of the conjunctiva of the lids and ball; red-
ness and swelling of the lids ; excoriation of the angles of the
eyes ; burning and itching of the lids, with thick muco-purulent
secretion, and agglutination ; ulceration and eversion of the lids.
   Fluory inflammation  of  the membrane  of  the  aqueous
humor, and of the substance of the iris.
  Eetinitis with burning, pressing  pain  deep  in  the eye,  great
intolerance of light, constant lachrymation, colors, sparks of
fire before the eyes.
  Dudgeon says, it is homoeopathic to catarrhal, scrofulous
and exanthematous ophthalmia;  while rheumatic,  arthritic,
syphilitic, and gonorrheal inflammations have all been treated
successfully with this remedy.
  CASES  66 to 70.—A mother and four children were at-
tacked with inflammation of the  eyes; there was  inability to
open the lids; slight inflammation with  smarting pains;  much
lachrymation ; feeling as if a foreign body were under tke lids;
intolerance of day and candlelight;  stools slimy and acrid.
  Treatment—They all took  Merc.  Sol. 2, and recovered in 8
days, without relapse.
  CASE 71.—An apprentice had had inflammation of the eyes
for  3 weeks.  Both eyes were reddened,  especially the left; the
cornea was red  and dim, and surrounded by  a raised swelling
of the conjunctiva,  {chemosis;) the  eyelids were dry and swol-
len  ; the inflamed parts  burned violently; and there was in
tolerance of light;  it seemed to him as if fiery sparks  flew from 
NUX VOMICA.
89
his eyes; there were stitches of pain in the eyes and temples;
the sight was dim.
   Treatment.—Puis. 12, was given without effect; then Merc.
30 and 18,  produced so much relief in 9 days that he could go
to work again.
   CASE 72.—A woman, aged  67, who had frequently suffered
with erysipelatous  inflammations, was  attacked  with  violent
inflammation of the  eyes; the sclerotica  was very red, and
swollen up into  a high ridge, {chemosis;) the cornea was quite
dim, and pus was already forming between its layers; she had
headache, dizziness, slimy, yellowish and whitish coated tongue,
loss of appetite, much thirst, high fever,  with congestion to the
head, with intercurrent chills, inclination to perspire, moist skin,
fleeting stitches of pain here and there in the  limbs and body,
restlessness and sleeplessness at night.
   Treatment.—Mercurius 1st and 3d, was given internally ; and
a  solution was  also applied externally to the eye;   a rapid
cure was effected.—Hygea. Vol. 17, p. 372. Dr. Schelling.

                       NUX VOMICA.
   CASE 73.—A youth,  aged. 22, had suffered for several years,
every spring and fall, with ophthalmia, which generally lasted
several weeks.
   There was a burning, itching pain in. the eyelids; collection
of matter in the angles of the eyes; inflammation of the eyes,
with intolerance of light, especially in  the morning;  rending
pains at night;  constipation ; haemorrhoids.
   Treatment—Nux  24, removed  the whole attack in 4 days.
—Schreter.
   CASE 74.—A child, aged 6 weeks, had bleeding from the
eyes, which seemed protruded ; there was swelling of the lids;
the vessels of the sclerotica were much enlarged ;  small drops
of blood exuded from the surface of the eyes  ; eructations and
regurgitations after eating or drinking;  attacks of twisting and
screaming, relieved  by the expulsion  of  flatulence;  constipa-
tion,  with hard stools, great straining, and prolapsus of the
rectum; perspiration on the head ; coldness of the limbs ; rest-
less sleep; great restlessness.
   Treatment—Nux 30;  on the 3d  day the  constipation was
removed;  the  rectum did not prolapse;  the sleep was more 
9"0         TREATMENT OF DISEASES  OF THE  EYE.
quiet, and the turgescence of the blood-vessels had disappeared-
—Archiv. Vol 6, part 2, p. 42.  Hartmann.
                       phosphorus.
  Dudgeon thinks it indicated in some cases of catarrhal, scro-
fulous, rheumatic, and perhaps arthritic ophthalmia.  Knorre
found it useful  in  inveterate  catarrhal ophthalmia, when both
the eyes  and lids were inflamed; the edges of the lids raw and
sore; constant  lachrymation, causing smarting and  burning;
copious secretion  of thin, muco-purulent matter; itching, and
burning  in the  eyes;  sticking together of the lids; dimness of
vision.
                       PULSATILLA.
  Lobethal recommends it when there is decided inflamma-
tion of  the meibomian glands, with great lachrymation  and
profuse  mucous  secretion.    In catarrhal  ophthalmia,  with
agglutination of  the lids in the morning, it  is the principal
remedy ;  it is also useful in scrofulous and  syphilitic ophthal-
mia, and is the best remedy in 0. morbillosa, the most severe
cases of which it suffices to cure.
  It is most indicated  when there is  a smarting  pain in the
eyes, with dryness, and feeling  as  if some foreign  substance
were in them ;  swelling of the eyes, and sensation, as if one
were squinting ; red, inflamed spots near the cornea; burning
and itching of  the eyes; sensation as if hair or sand had got
into the eyes;  sensitiveness to  light, with  excessive tearing,
boring, and cutting pains; inflammation, swelling,  and redness
of the lids and their edges;  styes *upon the lids, with inflam-
mation of the whites of the eyes.
  CASE 75.—A  delicate  lady, aged 28,  was attacked  with
acute, bright-red inflammation of the left eye ; she had pricking,
burning,  and biting pains in the balls; lachrymation and dim-
ness of vision; there was a spot on the edge of the cornea;
fever, anxiety,  and oppression of the chest.
  Treatment—Pulsatilla 4, in solution, was used internally and
externally, and effected a cure in 8 days.—Hygea. Vol. 13,
p. 59.  Dr. Schelling.
  CASE 76.—In the autumn of 1845, an epidemic of ophthal-
mia occurred, in which there was profuse lachrymation, by day
and night, excessive  secretion of mucus, which  stuck the lids 
RHUS TOXICODENDRON.
91
 together at night, with feeling as if grains of sand had got be-
 tween the eyes and lids.
   Treatment—Pulsat. 2, 3, or 6, never  failed  to  afford relief,
 except in a few dyscratic subjects, in whom Sulph. 6,  was re-
 quired in alternation.—Genl. Horn. Jour. Vol. 30,  p. 110. Dr.
 Weber.
   CASE 77.—A healthy woman,  aged 36, had suffered for
 many years with ophthalmia and trichiasis, (see page 14 ;) the
 lashes were pulled out, but she had profuse lachrymation when-
 ever she went into  the open air ; her eyelids stuck together in
 the morning, and she had aching in the eyes, and a sandy sen-
 sation, also simple cataract.
   Treatment—Pulsatilla 9, removed the inflammation.—Archiv.
 Vol. 3, part 3, p. 70.  Caspari.
   CASE 78.—A gentleman, aged 30, had inflammation of the
 eyes  for 5 or 6 days, with dryness, and  burning heat, worst in
 the evening;   the  edges of  the lids were  red and swollen;
 muco-purulent matter glued the lids together;  the conjunctiva
 was lax, flaccid, and unequally red, as if mottled.
   Treatment.—Pulsat. 3, and lotions  of  tepid water cured him
 perfectly in 18 days.  Dr. Y.
   CASE 79.—Mrs. F., about the change of life,  had  suffered
 with  purulent ophthalmia for 3 weeks;  she had acute pain,
 especially towards evening; her  pulse was hard and full; and
 she had annoying pains in the region of the kidneys.
   Treatment—Aconite 24, was given 3  times  a day, and in  6
 days  the pains were  all  gone;  and the eyes  were in a satis-
 factory state,  except in the evening.   Pulsatilla 12, then cured
 her in a  few days.   Malaise.
   Dose.—The 2d, 3d, 4th,  6th,  and 9th potencies have been
 used with success.
                   RHUS TOXICODENDRON
 Is one of our most  important ophthalmic medicines, especially
 in the catarrhal, scrofulous,  exanthematic,  and erysipelatous
 varieties.—Dudgeon.
   Hering thinks that it is useful in  the inflammations of the
internal surface of the lids in new-born children, when the lids
are closed spasmodically, become  everted when they are opened,
and exude a thick, yellow, purulent mucus. 
92
TREATMENT OF DISEASES OF THE EYE.
  Hartmann  says, the inflammation  against which  Ehus  is
most serviceable is never very bright red in  color; the meibo-
mian glands are apt to be involved;  and there often is swelling,
not onlv of the lids, but also of the neighborhood of the eye.
  CASE 80.—A  child, aged  2£ years, had redness  of both
eyes, with lachrymation by day, and agglutination at night;
he had been restless and  sleepless for 2  days;  there was an
cedematous swelling extending far down on the cheek  to the
wings of the nose.
  Treatment—Ehus, 30 effected a cure in 2 days.—Annals. Vol.
1.  MSCHK.
  CASE 81.—After excessive use of the eyes by candlelight,
the following eye-affection set in : frequent styes, first on one
lid, then on another; burning pains in the eyes,  with dimness
of sight; cedematous swelling of the left lids, extending to neigh-
boring parts and preventing the opening of the eyes; the cer-
vical and parotid glands became enlarged.
  Treatment—Ehus 12 and 18, of each one dose, and Pulsat.
12,  removed the whole attack in 10 days.—Genl. Horn. Jour.
Vol. 12, p. 22.  Dr. Hartmann.
  CASE 82.—An infant, aged 6 weeks, suffered with ophthal
neonat., and received Ehus 9, 2 doses daily;  the eyes improved
continuously, so that they were  quite well  in 14 days.  Two
other similar cases were cured in the same way.—Hygea. Vol.
20, p. 359.  Dr. Maly.
  CASE 83.—A scrofulous child, aged 6 months, suffered with
ophthal. neonat., in full development; the inflamed lids were
perfectly closed, but from time to time a gush of purulent mat-
ter poured from them; attempts to open the eyes caused ever-
sion of the lids, the swollen internal surface of which prevented
all inspection of the eyes themselves.
   Treatment—Ehus 6, in 3 ounces of  water, was given in tea-
spoonful doses once a day, and  the lids were also bathed with
it.  A cure was  effected in 4 days.—Archiv.  Vol.  16, part 2,
p. 94.  Dr. Gross.
   CASE 84.—A pale, delicate, and weakly man, aged 54, fre-
quently  suffered with inflamed  eyes  every winter.  He had
been sick for a month with inflammation of both eyes, extend-
ing from the conjunctiva over the cornea, which was opaque;
he had piercing pains in the eyes and  temples, dizziness, pains 
SEPIA.
93
in the arm-pits  and arms, frequent eructations,  pains in the
stomach, yawning, and nausea;  his pulse was irritable, quick,
and small;  his skin dry.
  Treatment—Ehus 200, in solution, was given, and in 2 days
the redness of the eyes and pain in the head had almost sub-
sided ; sleep and perspiration had set in;  on the third day
the pains in the limbs were removed.  A relapse, 10 days
after, was cured by Ehus 200, in 24 hours.—Genl. Horn. Journ.,
Vol. 46, p.  136.   Dr. Schelling.
  CASE 85.—A woman,  aged  75, who had  suffered much
with gout, had suffered for' 22 years with intolerance of light,
so that she could only open her eyes at twilight;  every attempt
to open the eyes was followed by a profuse gush of tears; the
cheek was covered with a red, burning eruption, extending as
far as the wings  of the nose; the violent burning  disturbed
her sleep at night.
   Treatment—Ehus 200,  was given every night and morning;
in 8 days the eruption  and  burning had ceased, but the intole-
rance of light returned  after a marked improvement.—New
Archiv. Vol. 3, p. 52.   Dr. Nehrer.
  Dose.—The 6th, 9th, 12, 18th, and 200th dilutions, have all
been used successfully.
                          SEPIA
Is supposed to  be most useful  in  scrofulous ophthalmia;
according to Eueckert,  it has  been used successfully in the
following cases of simple (?) inflammation of the eye.
   CASE 86.—A strong and hearty child,  aged 4 years, had
suffered for a year with repeated attacks of inflammation of the
eyes; the lids stuck together at  night, so that they  had to be
softened and moistened apart in  the morning; there was great
intolerance of light, and much pain in the eye; pustules formed
upon the cornea, broke, and left dim spots  for a long time.
   Treatment.—After taking Sepia 30, he had no more attacks.
—Annals, Vol. 2, p. 202.   Dr. Tietze.
   CASE 87.—In an epidemic of asthenic inflammation of the
eyes, attended with  intolerance of light,  especially in the
morning, dingy redness of the conjunctiva, lachrymation and
swelling of the lids, with much heat.
   Treatment—Two or three doses of Sepia 30, generally suf-
ficed to effect a cure.—Dr. Schmid. 
94         TREATMENT OF DISEASES  OF THE  EYE.
  CASE 88.—A man, aged 24, had suffered with inflamma-
tion of the eyes for 4 days; he  had violent piercing pains in
both eyes;  the lids were swollen, and could  not be opened on
account of intolerance of light;  profuse lachrymation;  heat in
the eyes ; obstruction of the left nostril; confusion and empti-
ness  of the head.
  Treatment—Sepia 30, caused some improvement in one day;
and 2 doses more effected a cure.— Genl. Horn. Journ. Vol. 10,
p. 203.
  CASE 89.—A boy,  aged 12  years, had suffered in conse-
quence  of styes, with a hard tumor  upon  the lower eyelid,
which had persisted for almost 2 years; it was of the size of a
small pea, adherent to the tarsus,  and prevented the free mo-
tion  of the lid.
  Treatment—Sepia 30, 1  dose every 8 days;  after the 2d
dose, pain sat in, in the induration, and inflammation and sup-
puration commenced; after the  3d dose the swelling broke, and
the whole  disorder was  permanently removed.— Vehsemeyer,
Vol. 2, part 1, page 52.
                      STAPHYSAGRIA.
  This remedy is useful when styes occur frequently upon the
lids,  or leave indurated spots behind them, or do not suppu-
rate  and discharge  properly, but become hard; also, when the
eyelids are apt to stick together, with biting and burning pains,
especially in the angles of the eyes, and when crusts form be-
tween the lashes.—Hering.
  CASE 90.—-A man, aged 44, had frequently suffered  with
ophthalmia; he had been in the following state for 9 weeks:
both lids of the right  eye were  somewhat  swollen,  and of  a
bluish red  color; the white of the eye was reddened, especially
at the inner angle; both lids were covered with styes in their
first stage  of development;  the lids were also stuck together
with hard yellow crusts ; he complained of aching pains when
the eye was not covered, and at times of burning in  the lids;
his pulse was hard and quick, and his bowels constipated.
   Treatment—Staphysagria  15, 3 doses  of  1 drop each, re-
moved the whole disorder perfectly.—Tietze. 
SULPHUR.
95
                       SULPHUR
Is recommended by Hering when there is great swelling,  in-
flammation, and redness of the lids, with violent burning pains,
and profuse discharge of mucus and pus.
  Another physician says, that  in many very old and chronic
cases, a somewhat large dose of Sulphur will often effect a more
certain cure, even if it is preceded by a previous aggravation.
  A third physician always gives Sulphur before he administers
Calcarea, provided other symptoms do not  contraindicate it,
or it has  not already been taken in excess;  he has observed
from abundant experience that it  is as useful in chronic affec-
tions, as the previous use  of Aconite is in almost all  acute
inflammatory diseases.
  Kallenbach has  given Tinct. Sulphur  in the 1st or 2d
dilution in  ophthalmia  neonatorum,  with   the most decided
benefit; it cures acute cases in 4 or 6  days;  sub-acute- attacks
in 10 or 14 days.—Genl. Horn. Journ. Vol. 21, p. 88.
  CASE 91.—A child, aged 6, suffered almost habitually with
inflammation of the eyes;  it had but few free  intervals ;  the
last attack had persisted for 6 weeks;  there was great redness,
swelling, and  pain  of the  lids; intolerance of light, and out-
break of numerous small itching pustules.
   Treatment —Tinct.  Sulphur 5,  every 3 days, increased  the
eruption at first; but; it began to dry up after the 3d dose, and
a cure was effected in 18  days.:—HygeayY6l. 18, p. 40.   Dr.
Segin.
   CASE 92.—A woman, aged 47, had suffered from her youth
with weak eyes, which, often became inflamed and painful;  the
white of the eye and  meibomian glands were swollen  and in-
flamed ; acrid tears flowed from  the  eyes  whenever the  lids
were opened; both eyes were painful, as if salt had got into
them; the cornea  was dim; there was  intolerance of light r
imperfection  of. vision, and. the patient was discouraged and
tearful, fearing to lose her eyes.
   Treatment—1 dose of Tinct. Sulphur 1, produced a 3 days'
aggravation, which was followed by a permanent cure.—An-
nate, Vol. 3. p. 5.
   CASE 93.-—A previously healthy man, aged 43, had suffered
for 5 days with itching and burning pains in the eyes;  the  lids 
96         TREATMENT OF diseases  of the eye.
were  swollen;  the conjunctiva reddened, swollen, and pro-
jecting like a bag over the lower lid; there were cutting paims
in the eyes, and constant lachrymation.
   Treatment—Two doses of Sulphur, 3dtrit., cured him entirely
in 8 days.
   CASE 94.—An apprentice, aged 18, had suffered since his
5th year with ophthalmia;  the right eye only was involved ;
the conjunctiva was bright-red and inflamed;  the cornea very
dim,  dingy, and  dusty-looking,  as if a skin were over  it;
vision was much  impaired, so that he saw every thing indis-
tinctly as if through a thick mist; the eyelids were very red
and burning, they adhered together at night, and  secreted a
viscid, acrid, and biting fluid, which excoriated the neighboring
parts; the eyes watered constantly, especially in damp weather.
   Treatment.—In  8 days after taking Sulphur 400, there was
a marked  improvement; the  redness of the conjunctiva had
much lessened,  the cornea  was less dim, vision more certain,
ready, and extended, the burning pains were lessened, and the
lachrymation diminished.  At the end of 8 weeks the  patient
was entirely well, with the exception of  some watering of the
eyes,  which was  removed  by Euphrasia  200.—New Archiv.
Vol. 2, part 1, p. 73.  Stapf.
   CASE 95.—A  man, aged 48, had a staphyloma of the right
eye, after an attack of ophthalmia;  during the next year the
left eye became  afflicted; the whole of the white of the eye was
bloody-red and swollen ;  the naturally brown iris had a reddish
hue, (Iritis,) and a whitish spot of the size of a  pea on its base •
the eye was intolerant of light, watered much, and stuck together
at night; the ball of the  eye was painful when in motion; there
were drawing pains about the orbits; the lids  of the right eye
were reddened; there was  pain in the occiput on lying down.
   Treatment—Bellad. 30, did  but little good;  but after taking
Tinct. Sulph.  3, a rapid recovery set in.—Hartlaub.
   CASE 96.—Madam B., aged 30, had  been  afflicted for  12
days with diarrhoea and ophthalmia;  she had violent cutting
pains  at intervals, attended with diarrhoea and bearing down
pains, worse at  night; both eyes were affected, and  the lids
everted; the pulse was febrile and frequent.
   Treatment—Sulphur 2, effected a cure in 5 days.—Archiv.
Vol. 3, part 2, page 117.  Schnieber. 
SULPHUR.
97
  CASE 97.—A child, aged 1£ years, had been troubled for
8 days with inflammation of the left eye;  the white of the left
eye was much reddened, that of the right somewhat  so; the
eyelids were greatly swollen, and could only be opened with
difficulty and imperfectly; there was great intolerance of light,
lachrymation,  and agglutination of the lids;  general febrile
heat, rapid changes  in color of the face, gritting of the teeth
during sleep, and constipation.
  Treatment—Aconite 24, was followed by Sulphur 2, half a
grain; the child improved steadily up to the 10th day, when
it was entirely  restored.—Archiv.  Vol. 19,  part 3,  page  162.
Tietze.
  CASE  98.—A man, aged  54, had already had several at-
tacks of ophthalmia, attended with ulcers on the cornea;  after
much allopathic treatment with mercury, he was left in the
following  state:  the left eye wept constantly, and could not be
kept open  on account of intolerance of  light; the ball of the
eye as far as visible was violently  inflamed,  and the dark-red
vessels unusually filled.  There was an ulcer on the lower seg-
ment of the cornea, from which bundles of red vessels  radi-
ated ; sight was lost; there were piercing and  burning pains
about the orbit, and pus apparently had formed in 'the interior
of the eye.
   Treatment.—One dose of Aeon. 2, every night and morning
for 3 days; then Sulph. 2, was given in the same  way for 3
more days; in  8 days  the  inflammation was all removed.
Then  Sulph. 2,  6 doses was given, 1 dose  every other night;
afterwards, only every 4th night; constant improvement of
the sight occurred, attended with a progressive healing of the
ulcer of the cornea.   At the end of 4 weeks, Silex 6, was
given, 1 dose every 4th night.  He remained well for 5 years,
when  a new  attack was quickly  cured by Sulphur, Silex,
Euphras., Calc,  and Hepar.—Elwert, p. 117.
   CASE 99.—A boy was operated upon for cataract, and an
obstinate inflammation of the eye was the consequence; at the
end of many months he looked sickly, was weak, and had but
little appetite, with a quick pulse.   The eye watered, was con-
stantly inflamed, perfectly disorganized internally, and  atro-
phied, with entire and permanent loss of vision.  The well eye
began to be affected. 
98      treatment of inflammations of the eye.

  Treatment—Sulphur 4, 1 dose every 4th night, was given for
6 weeks;  the  inflammation  subsided  greatly, and finally was
entirely removed by Bellad. 4,1 dose every other day — El-
wert, p. 123.
  CASE 100.—A man,  aged 27, had suffered for years with
periodical attacks of ophthalmia, which sometimes lasted  for
3 months; had been treated allopathicallyfor 4 weeks-without
benefit.  The  whole conjunctiva of the left eye was blood-red;
there were aching, tensing, burning, and piercing pains in the
eye ;  mist  before the sight;  rending pains on the left side of
the head ; chilliness during the day, fever at night, with quick
and hard pulse.
  Treatment.—Aconit. and Pulsat. were given without much
effect; but Sulphur 30; produced  a rapid improvement, fol-
lowed by a cure in 14 days.—Practical Contributions, Vol. 1, p.
202.  Dr. Tietze.
  CASE 101.—A young man, aged 20, had suffered for 14
days with ophthalmia in consequence of injury to the eye with
a spear of corn;  the ball  was slightly reddened; there  were
burning and piercing pains-;  a small, white pustule close to the
edge of the cornea;  intolerance of light, and lachrymation.
  Treatment.—Sulphur 6, cured the inflammation, and Calca-
rea the intolerance' of light.—Annals, Vol. 2,  p. 198.  Dr.
IIartlaub.
  CASE 102,—A man,.aged 25, had had a violent ophthalmia
for  3 weeks ; the whole right eye was  inflamed in the highest
degree, and looked like a piece of fresh bloody meat;  the con-
junctiva was dark red ; there were ulcers on the cornea; severe
piercing and boring pains in the interior of the eye; excessive
photophobia;  the lids greatly inflamed; the lower one everted;
and there  was a profuse discharge of an  acrid, excoriating
fluid.
  Treatment.—Bellad. 400; in 9 days the inflammation, photo-
phobia, and pains were essentially relieved; but the ulcers,
eversion, and discharge were unaltered.  Ten days after tak-
ing Sulphur 400, the ulcers  were healing  rapidly, the inflam-
mation and discharge from the  lower lid materially lessened,
and the  disturbed  vision improved; in 35  days there was
only a little opacity of the cornea remaining.  Euphrasia 200,
then effected a perfect cure in 14  days more.—New Archiv.
Vol. 2, part 1, page 85.  Stapf. 
sulphur.
99
  CASE 103.—A woman, aged  30, had suffered for a long
time with redness and swelling of the edges of both lids ; the
meibomian glands secreted pus; the lids stuck together in the
morning; there was a burning sensation as if sand were  under
the lids; the patient could not work in the evening, nor read;
it was even difficult to do this by day; the pains increased in
the evening,  lessened while in the free  air,  when the eyes
watered  more than  in the  house.  Constipation;  menstrua-
tion only every 6 weeks, and then habitually scanty.
  Treatment—Three doses of Sulphur removed the whole dis-
order.—Hygea, Vol. 3, p. 13.   Griesselich.
  CASE 104.—A man, aged 52, received a blow over the right
eye, followed by inflammation, which had  been  treated allo-
pathically without success for 3 months;  the conjunctiva was
greatly inflamed; the cornea dim, with an ulcer upon it, and
the anterior chamber of the eye was half filled with pus.—
{Hypopion.)
  Treatment—Arnica and Senega did no good;  Sulphur 6, one
dose every other day, was then given,  and in 14  days the pus
had entirely disappeared, the ulcer had healed, and the dim-
ness of the cornea much lessened.—Vehsemeyer, Vol. 1, part
1, p. 18.
  CASE 105.—A woman,  aged 68,  had  been successfully
operated upon for cataract in both eyes, 6 months ago;  a sub-
sequent  inflammation  of the  right eye was followed  by an
effusion of pus in  the anterior  chamber,  {Hypopion.)  The
sclerotica and conjunctiva were inflamed, and the cornea so
hazy that the iris and pupil could not be seen; there was no
ulceration of the cornea, but a deposit of yellow matter could
be seen  at the bottom of the anterior  chamber; both eyelids
were puffy and  swollen, and their edges inflamed;  there was
lachrymation, heat in the eye, feeling as if the eyeball were
swollen, and burning and piercing pains increased at night.
  Treatment—In the course of 11 days, 80  drops of Tinct.
Sulphur were administered, followed by entire cessation of the
inflammation and swelling of the lids, and the pus was partially
absorbed ;  after taking cold, a relapse was followed by a visible
increase in the quantity of pus; but Sulph. 3d trit., 3 doses per
day, effected a perfect cure.—Genl. Horn. Journ. Vol. 19, p. 70.
Knorre. 
> 100    TREATMENT OF INFLAMMATIONS OF THE EYE.

   CASE 106.—A woman, aged 38, was attacked with a swell-
 ing at the internal angle of the  right eye, which discharged
 matter, succeeded by a flow of clear, limpid fluid ;  the eyelids
 were inflamed, the eye watered, and at the internal angle there
 was a sore of the size of a small pea, from which pus and tears
 exuded;  pressure on the lachrymal sac caused the same fluid
 to pour out of the punctum lachrymale;  the  right nostril was
 dry.
   Treatment.—The continued use  of Sulphur cured the fistula
 lachrymalis completely.— Genl. Horn. Journ. Vol. 37, p. 249.

                           Review.
   Of  the 15  patients cured by Sulphur, 7 were males and  5
 females, of the ages from 20 to 68 years;  and 3 were children,
 2 of which were less than 2 years old.
   The causes of  the disease were repelled  itch, in  1  case;
 mechanical injuries in 2 cases; operation for cataract in 1 case;
 and small-pox in another.
   The inflammations were violent, although often chronic ; the
 lids were  greatly inflamed, swollen,  and even everted;  the
 meibomian glands inflamed and swollen;  there were discharges
 of acrid, corroding matter;  the  conjunctiva  was bright red,
 swollen, sacculated,  and  resembling raw flesh ;  the cornea was
 dim, dirty, and apparently cuticulated, or beset with ulcers, and
 surrounded with a  radiating vascular  net-work; the Iris had
 become altered in color,  reddened and marked by a white spot
 of lymph); there was great intolerance of light; the sclerotica
 was  inflamed and ulcerated,  with violent cutting,  burning,
 piercing, and boring pains; and  there was effusion of pus in
 the anterior chamber in 3 instances.
   In 5 cases  out  of 15  the left eye was  alone effected; in  §
 cases, the right
   Dose.—The 2d and 3d triturations were used twice;  the 3d
 dilution of Spt. Sulph. also twice ; the 2d, 3d,  and 4th dilution,
 4 times; the 6th, twice,  in  repeated doses ;  the 80th, once; the
 400th, twice.
   The Sulphur alone effected cures  in  10  cases;  in others,
 Aeon, and Bellad. were given previously with but little effect-;
 while Euphrasia, Calc,  and Silex were used 3 times to perfect
 the cures. 
SIMPLE INFLAMMATIONS OF THE EYE.       101
  The duration of the disease varied from 5 days to 13 years,
and more; the  time  of cure varied from 5  to  14 days,  or  8
weeks.
GENERAL REVIEW OF THE TREATMENT OF SIMPLE INFLAMMATIONS
                       OF THE EYE.

  The  preceding chapter embraces 106 cases of disease,, in
which 18 or 20 different remedies were used.
  In the more acute attacks we  find  that Merc,  and Sulph.
were used 7 times;  Arsenicum 4 times; Am., Bell.,  Cham.,
Hepar, and  Ehus, each 3 times; Aeon., Nux, and Sepia, each
twice;  Conium, Puis., and Staphysagria, each once.
  In the chronic cases, Calcarea was given ten times ; Sulphur,
9 times;  Arsen., Bell.,  Euphrasia,  Ehus, and  Sepia,  each
twice ;  Conium, Hepar, and Puis., each once.
  When the attacks were typical and periodical, Bellad. effected
a cure in one case, Arsenicum in another, while Sepia proved
specific  in one epidemic, and Pulsat. in another.

                In  Affections of the Eyelids.
  Aconit., Arsen., Bellad., Calc,  Cham., Hepar, Merc,  and
Sulphur, were useful when the lids were swollen and inflamed.
  When they were  shining,  Aeon.;—red, Sulph.;—red  and
dry, Merc.;—everted,  Merc, and Sulph.;—forcibly contracted,
Merc ;—spasmodically closed,  Arsen., Bell., and Ehus;—the
internal surface  only inflamed, Arsen., Bell.,  Ehus;—redness
of the edges of the lids, Con. and Sulph.;—crowded with blood,
Cham.;—swollen, Conium;—ulcerated, Merc.;—itching, Bell.;
—burning and biting, Calc.;—cutting, Calc.;—as if  sore and
bruised, Hepar;—cedematous  swelling, Ehus  and Sulph.;—
inflammation of the meibomian glands, nocturnal agglutination,
profuse  secretion of  purulent  mucus, Aeon.,  Calc, Euphras.,
Hepar,  Puis.,  Sepia,  and Sulph.;—Styes and Tarsal  Tumors,
Puis., Sep., and Staphys.;—inflammation and blenorrhcea of the
conjunctiva of the lids, Euphras.,  Aeon., Hepar., Lycopod.,
Puis., and Ehus ;—Erysipelatous  inflammation, Hepar.;—in-
flamed and ulcerated angles, Hepar. 
TREATMENT OF INFLAMMATIONS OF THE  EYE.
         Inflammations of the Conjunctiva of the Eyeball.
    When it is inflamed and red, Bell., Graph., Hepar, Sulph. ;—
  when  slightly reddened with varicose vessels, Puis.;—bright
  red, Aeon., Ars., and Sulph.;—bluish red, Arsen. ;—as if in-
 jected,  Arsen.;—with net-like  bundles  of vessels, Arsen.,
  Merc,  Ehus;—spongy, Bellad., Sulph.;—bloated,  Ehus;—with
  chemosis—a dropsical wall around the cornea—Aeon., Arsen.;—
 granulated, Arsen.; —swollen,  Aeon.;—hanging down like  a
 bag, Sulph.
                       Of the Sclerotica.
   When it is blood-red, swollen, and spongy, Merc, Sulph. ;—
 rose-red, with great development of  the  blood-vessels, Eu-
 phrasia ;—swelled, Nux.;—ulcerated' or sore, Sulph.

                       Of the Cornea.
   When it is conical, Euphrasia;—when it is protruded like a
 vesicle or bladder, and has broken internally, Hepar.;—sur-
 rounded with a vascular zone, Arnica;—with tortuous vessels,
 Ehus;—with vesicles on the edges, Hepar.;—with  pustules,
 Sepia.
   When it is dim, Arnica, Calc,  Merc, Ehus, and Sulph. ;—
 when it is dingy, Sulph.,  Bell.;—when it is veiled  and misty,
 Arsen.  and Sulph.;—as if covered with a membrane, Sulph.;
 —when it only admits a little light, Calc
   When there is pus between its laminae, Hepar. and Merc.;—
 open ulcerations, Arm; Ars., Calc, Con., and Euphrasia;—
 when the ulcers are surrounded by a vascular net-work, Sulph.

                   Of the Iris  and Pupil.
   When they are contracted, Arsen., Bell., and Euphrasia;—
 when the iris is reddened and covered with  lymph, Sulph.
   Against intolerance of light, Bell., Con., Calc, Graph., Hepar.,
 Merc, Nux.,  Sepia, and Sulph.;—increased by crying, dust,
 or draughts of air, Bellad.;—especially by candlelight" Calc'
 Merc.
  Lachrymation, Arsen., Bell., Euphras., Hepar., Merc, Sepia,
Sulph.;—especially when in the wind, Calc.;—when the tears
are salt and biting, Pulsat.
  When blood flows from between the lids, Cham., Bell., Nux. 
          OPHTHALMIA OF NEW-BORN CHILDREN.        103

  When the attending pains are burning, Arsen., Bell.,  Calc,
Hepar.;—when biting and burning, Merc, Puis.;—burning and
piercing, Arsen., Bell.;—as if sore or ulcerated, Arnica;—when
there is a feeling as if the eyes were being torn out, or had not
room enough  in  the orbits, Arsen.;—aching pains, Bell.;—
especially when looking at the light, Euphras. and Hepar.
  Among  the accompanying  affections,  Bell.,  Hepar,  and
Arsen. were used against drawing and rending pains about the
orbit;—Calc,  against deafness;—gastric affeetions, and diar-
rhoea, Merc;—feverishness, Merc, and Pulsat.
  Doses.—These varied from the lowest to the highest  poten-
cies ;  still the latter were used less frequently, and sometimes
were so inefficient that more material quantities had to be used.
  Bellad. was used in a few cases  in quite strong doses; the
same remedy that was given internally, was  also occasionally
applied externally, a procedure which certainly should be em-
ployed more frequently,  especially in obstinate and chronic
cases.
  The above cases were furnished by 44 different physicians.
The hwer potencies, up to the 3d dilution,  were used  in 31
cases;  of these, 1 dose sufficed in 15 cases, repeated doses were
required in  12,  and solutions in 4.  The  higher  dilutions,
namely,  from the 4th to the very high, were employed in 62
eases;  single doses sufficed in 22 cases, repeated doses  in 24,
solutions in 6 instances.   The very high dilutions were given
in 10 cases, and repeated doses were required in 4.
            OPHTHALMIA OF NEW-BORN CHILDREN.
                  Ophthalmia Neonatorum.
  Lawrence says, this is  a disease of  considerable conse-
quence, and  the more  so from  its commencing  in a way not
calculated to excite the attention, or alarm the fears of the
mother or nurse.  It  causes more blindness than any other
inflammatory disorder  that happens to the eye;  and the num-
ber of children is very considerable, whose sight is partially or
completely destroyed by it.  Still, there are milder and severer 
 104       OPHTHALMIA OF NEW-BORN CHILDREN.

 varieties of it;  the milder forms  are caused by cold, by ex-
 posure of the tender eyes of the infant to too strong a light, or
 to dust, or some other transient or mechanical cause.  In the
 great majority of the severer cases, there is a vaginal discharge
 from the mother, such as leucorrhcea, or some other less simple
 affection; the eyes of the infant are exposed to the contact of
 these morbid secretions during labor, while passing  through
 the vagina.
   The  inflammation  commonly comes  on about 3 days after
 birth, and  in the  first stage is confined to the mucous mem-
 brane of the lids; the edges of the lids stick together a little
 when the child wakes from sleep, they are redder than natural,
 especially at  the corners, and if they be everted, their inner
 surface will be found red and villous, and  a little white mucus
 is seen  on the inside  of the lower.  The ball of the eye is at
 first in  a natural state.
   In the second stage, all the symptoms are  increased; the
 inflammation extends from the conjunctiva of the lids to  that
 of the  ball of the eye; the congestion  and redness are aug-
 mented ; the lids swell and become red, even externally; there
 is a copious secretion  of purulent fluid from the inflamed
 membrane, which agglutinates the  edges of  the lids,  then
 accumulates between  them, and finally pours over the  face,
 staining the cap and linen. The lids are apt to become everted
 when we attempt to examine their  inner surface, or even when
 the child cries; this eversion  is generally temporary, but it
 may be more permanent.
   If the inflammation should continue, and not be checked by
 suitable treatment, it soon extends to the cornea, and thus may
 reach the interior of the eye.
   Sloughing of the cornea is one of  the most  common of its
 effects;  when this  change is about  to take  place, the cornea at
 first becomes  whitish and dusky, then loses-its polish and firm-
 ness  of texture,  being convertad  into a dirty grayish,  or
 brownish slough.  The entire  cornea may thus perish and
separate, and then  the iris may protrude through the aperture,
presenting an irregular brownish prominence.  Or ulceration of
 the cornea may occur more or  less  considerable in depth and
 extent, followed by adhesion of the iris;  or opacity of the cornea
 may  ensue from a  deposit of lymph  into the substance of the 
                       LYCOPODIUM.                   105
                               •
corneal conjunctiva, producing a thin grayish film;  or, between
the layers of the cornea, causing a dense opacity.
  These several diseased processes occur very quickly, and go
on rapidly;  there is a singular contrast, however, between the
violence of this disorder in newly-born children, and the serious
consequence to which it  so  rapidly leads, and the readiness
with which it yields to suitable treatment.  Hence, Lawrence
says, if we see a case of purulent ophthalmia before any injury
is done to the cornea, we may assure the parents that the sight
will not suffer.
  Treatment — Klotar  Muller says, at  first it  is ad-
visable to give a few doses of Aconite; as soon as a conside-
rable secretion of mucus occurs, Ignatia should be administered
and followed  by Hepar. Sulphuris, if  improvement  does not
set  in,  in a day or two.  Teste prefers Aethusa Cynapium and
Kreosote  in the severer forms.   Hartmann prefers Aconite,
followed by Sulphur, or Hepar. Sulph., when the  secretion of
muco-pus becomes excessive.   He also advises Ignatia  in the
simpler forms; and Mercurius when the ophthalmia has been
caused by an ordinary leucorrhceal discharge, irritating the
eyes of the infant.  Nitric  acid  and  Thuya should also be
thought of in severe cases. Lawrence depends almost entirely
upon the local application of Alum to the eye,  from 2 to'4 or
6 grains to the ounce of distilled water, aided by an occasional
dose of Magnesia; out of many hundred instances he can
hardly recollect one where the eye suffered  in  any respect, if
the cornea was clear when the infant was first seen;  using no
other  means than Magnesia internally, and the solution  of
Alum  externally.
                         ACONITE.
  Gross says that Aconite  30, if used early, will frequently
break up attacks of oph. neonat.
  In one case, Aconite 200, broke up a recent case  in 24 hours.
  Wesselhgeft used to cure ophth. neonat. very quickly with
Dulcamara; lately* he gave Aconite, Pulsat., and Calcarea with-
out benefit; after a dose of Dulcamara the whole  attack sub-
sided in 24 hours.
                       LYCOPODIUM.
  CASE 107.—A  babe, aged 6 days, was attacked, from tak-
ing  cold during the jaundice, with an extremely violent inflam- 
 106                    hypopion.

 mation of both eyes; purulent matter exuded by the teaspoon-
 ful, on the oth day of the attack, from the cedematous and ex-
 tremely swollen  lids;  the conjunctiva looked like raw flesh;
 the cornea was dim.
   Treatment—Sulphur was given without benefit; Lycopod.
 30, internally, and Lycop. 9 applied externally produced rapid
 amendment, and  in 10  days  the  eyes were  entirely saved.—
 Archiv. Vol. 20, part 3, p. 54.  GoUllon.

                        RHUS TOX.
  Hering and Hartmann recommend this remedy, especially
 when eversion of the lids takes place when the eyes are opened;
 or when a red swelling protrudes.
  Maly cured 3  cases with 2 doses of Ehus 9, per day; and
 Gross 1 case with Ehus  6, in  solution, applied internally and
 externally.  In these cases a dark-red swelling  projected  be-
 tween the lids.
                        SULPHUR.
  When the disease  has  made great progress, Tinct. Sulph. or
 Calcarea given in alternation, will often be found useful.—
 Gross.  A relapse of  the disease was cured  in 24 hours by
 Sulph. 400.
  Kallenbach effected  cures of acute cases in 4 or 6 days,
with Tinct. Sulph. 1st and 2d dilutions; chronic cases required
10 or 14 days.
                    HYPOPION.
  This name designates the presence of  pus in  the anterior
chamber of the eye;  it is an occasional effect of inflammation
of the aqueous membrane; but more frequently  it  proceeds
from the bursting of a corneal abscess, and then is seen in con-
junction with more or  less opacity of the cornea, and  acute
inflammation of the external tunics of the eye. Abscess of the
iris breaking into the anterior chamber may produce hypopion;
it may also occur in iritis not proceeding to suppuration; in
inflammation of the internal tunics; and in general inflamma-
tion of the ball of the  eye; all depending upon  concomitant
inflammation  of the  membrane lining the  chambers of  the
aqueous humors.
  Treatment—Some of the most eminent allopathic oculists
such as  Eichter, Langenbeck, Benedict, and  Beer, once 
HEPAR.  SULPH.
107
strongly recommended operative measures to let out  the pus.
In his early writings, Beer recommended letting out the matter;
he appeals to his great experience, and will hardly condescend to
notice objections.  "Any one," he says, "who has successfully
and completely cured by incisions so many cases as I have, will
not think it worth while to hear or read,  and much less to
refute such objections."  But subsequent experience induced
him to  change his opinion completely, and to reprobate the
incision in equally strong terms.  It is now regarded as an
invariable rule, not to puncture the cornea in hypopion,  for
when the inflammation is  arrested,  the  pus will  be rapidly
absorbed.   Even Beer finally says, when matter shows itself
in the anterior chamber, the surgeon must on no account think
of opening the  cornea; for the eye will certainly be much
injured.  It is surprising how many centuries of malpractice
are tolerated before physicians  and surgeons learn to place a
little reliance on Nature.
  In 10 cases of violent ophthalmia with especial  affection of
the cornea, an  evident  deposit of pus was observed in the
anterior chamber of  the eye.  The following homoeopathic
remedies were used successfully:

                       ARSENICUM.
  See case  23, page 64.  A violent inflammation of the eye,
with effusion of pus  in the anterior chamber, was cured by
Arsenicum 4, given  every 4 hours; the whole disorder was
gradually removed in 14 days, the absorption of the pus going
on all the time.
                     HEPAR. SULPH.
  CASE 108.—A Woman, aged 38, of  weakly and relaxed
constitution,  had suffered much from scrofula in  her youth,
and for 14 days with corneitis of the right eye.  In the centre
of  the dull,  dim, and very protruding cornea there was a
pustule of  the size of a pin's head, which had broken into the
anterior chamber, which was filled with pus up to the level of
the iris.  There was fever,  aching, burning, and  bruised pain
in the eye, extending over the head.          ^
  Treatment—One grain of Hepar. Sulph. was given for 3 days
in succession; then foot-baths containing 1 drachm of the same
remedy were used for 5 days.   The disease gradually yielded, 
108
FISTULA LACHRYMALIS.
only a slight scar remained on the cornea, and the pupil was
perfect in color and shape.—Genl. Horn. Journ., Vol. 15, p. 4.
Bicking.
  Two more cases  were successfully treated with  the same
remedy;  see article, Hepar. Sulph., page 82 ;  also chapter on
scrofulous ophthalmia.
                       MERCURIUS.
  Merc, solub. was given in 1 case; see chapter on rheumatic
ophthalmia;  also Merc,  corrosiv. in  1 case;  see chapter on
scrofulous ophthalmia.
                        SULPHUR.
  See case 98, page  97; also case 104, page 99; case 105; and
the chapter on arthritic ophthalmia.
  Eummel says that it accomplishes extraordinary  results
in hypopion,  even when it arises  from gonorrhoeal ophthal-
mia ; in  one  case it caused resorption of  the  pus in a few
days.
  In all these cases,  although the quantity of pus was large  in
some, a cure was effected in from 8 to 14 days.
  The doses, in every instance, were of the strong triturations ;
Hepar. Sulph. was even given in the undiluted state.
  In 2 cases, Euphrasia was given to perfect the cure.
             FISTULA  LACHRYMALIS.
  Although Walther says that experience has shown that
the use of all and every allopathic internal remedy is invariably
fruitless,  while  counter-irritation, even  when faithfully and
patiently carried out, is  equally  powerless, still homoeopathic
remedies have occasionally removed this unpleasant affection.
  For remarks on the nature and treatment of acute inflamma-
tion of the lachrymal sac, see page 18.

                        SULPHUR.
 _ See case 106, page 100, in which Sulph., continued for a long
time, cured a fistula lachrymalis.
  CASE 109.—A teacher who had suffered from childhood
with fistula lachrymalis, was cured by Sulph.,  Stann., and
Silex.—Genl. Horn. Journ. Vol. 39, p. 280.  Dr. Weber. 
CALCAREA.                     109
                      LACHESIS.
  CASE 110.—A single dose of Lachesis  12, cured a fistula
lachrymalis in  14 days, together with a very disgusting and
obstinate eruption  upon the  face, after a number of other
homoeopathic remedies  had been used without avail for more
than a  year.—Archiv.  Vol. 20,  part  1, page 120.  Schell-
HAMMER.
                         NATRUM.
  CASE 111.—A corpulent, but otherwise healthy woman,
aged 50, had noticed for 3  months a considerable swelling on
left side near the nose;  pressure upon it forced  out mucus at
the inner angle of the eye.
  Treatment—Natrum m. 400, was given every 5th day ; in 2
months this imperfect fistula lachrymalis was entirely cured.—
Genl. Horn. Journ.  Vol. 40, p. M.  Gross.

                        CALCAREA.
  CASE 112.—A woman, aged 47, had suffered for 8 years
with  a fistula  lachrymalis of the right eye; the skin for an
inch around was ulcerated; and  watery pus exuded from the
opening.
  Treatment—Calc. 30, effected considerable improvement for
2 months: then Lycop. 30, was given; and finally Calc. 30,
perfected the cure at the end of 4 months.
  CASE 113.—A maiden, aged 13, had suffered for a year with
fistula lachrymalis, against which several  homoeopathic reme-
dies had been given in vain.  A scab frequently formed upon
the unnatural opening, which then remained closed for several
days; but  the scab soon fell off again, and the  fistula  was
reestablished.
   Treatment—Silex  and  Petrol, diminished the size of the
opening, and lessened the swelling, redness, and quantity  of
mucus which could be expressed from the sac   After giving
2 doses of  Calc. 200, the opening closed  in 14  days, and was
covered with  a thin membrane;  all swelling  about  the sac
had disappeared.—Genl. Horn. Journ. Vol. 34, p. 200.  Eum-
MEL.
   CASE 114.—A woman, aged 50, had a fistula lachrymalis
for 3 years ; the sac enlarged from time to time, and had to be
emptied of its  accumulation of pus by pressure. 
110
SCROFULOUS OPHTHALMIA.
  Treatment—S doses Calc. 30, effected a perfect cure.  Schulz.
  Hartlaub and Scholze were equally successful.
                         Review.
  Calcarea effected 3 cures, two of  which were  accomplished
by the 30th dilut., one by the 200th potency.   Lachesis was
successful in 1 case; Natrum, in 1; Stann. and Silex, in  1;
and Sulph. in 1.
  Euckert has noticed that this obstinate disorder will often
not yield to any remedies for a length of time; but finally the
right medicine will cure it.
                 SCROFULOUS OPHTHALMIA.
  According to Lawrence, this is an external inflammation of
the eye,  occurring in  scrofulous subjects.   In scrofula, the
morbid disposition is generally strongly marked ; certain forms
of disease are so easily excited, and return so readily, that it is
often  almost impossible to  keep them off;  and those mem-
branes which are exposed to the external  air are apt to suffer
the most; for instance, the eyes, nose, and lungs.
  " Two kinds of constitution, differing considerably in some
respects,  are observed  in persons called scrofulous.   In one,
there is a pale and bloated countenance, a swelling of the upper
lip and septum of the nose, and a tumid abdomen; the mucous
membrane of the  stomach and bowels  is easily disordered by
errors of diet, or  by trifling causes which would have little or
no effect  on other persons; the nutrition of the entire body is
more or less impaired;  there  is a languid state of the circula-
tion, so  that the skin is pale  and rough, the extremities are
cold, the muscles  are loose  and flabby, and there is  a kind of
torpor in all the  functions,  bodily  as  well as mental."  The
whole forming the so-called torpid scrofulous constitution.
   "In another set of scrofulous  subjects the  skin is fine and
thin, the veins distinct; there is an almost unnatural color in
the cheeks;  the circulation is rapid, the nervous system irri-
table, and both  are easily excited.  The various functions of the
body and mind are performed quickly ; a premature develop-
ment of intellect is often observed in such children,  and they
are powerfully affected by all external influences, forming the
;su called irritable scrofuhus constitution.  Lawrence justly says 
SCROFULOUS OPHTHALMIA.
Ill
we can not suppose that the phenomena and treatment of disease
will be the same in the two kinds of constitution just described,
though the term scrofulous is used in both instances.
   Of the remedies which have  been used successfully against
scrofulous ophthalmia, Arsenicum, Aurum, Belladonna, Euphra-
sia, Mercurius solub. et sublim.,  Pulsatilla,  Ehus, and Sul-
phur, are most homoeopathic to the irritable or  acute varieties.
while Calcarea, Causticum, Conium, Hepar. Sulph., Magnesia,
and Silex, are most homoeopathic to  the torpid or chronic
varieties.
   According to  Ancell,  in  Scrofula, the Red corpuscules of
the blood are deficient  in number and defective in structure;
the Globulin, Haematin, and Iron  of the blood-globules are all
deficient   Hence China,  Ferrum, and Manganese are important
remedies in the treatment  of the scrofulous constitution.
   The serum of  the blood, or the  liquor sanguinis is vitiated
in quality; the water,  albumen,  and lime being in decided
excess.   Hence albuminous articles of food, and those containing
an excess  of lime,  and lime-stone water, should be carefully
avoided in scrofulous persons.  The fibrin of the blood is rather
below  the natural standard,  except when irritation, fever, or
inflammation sets in, and  even  then  the  quantity of  fibrin is
manifestly lower than it would  be  if either local inflammation
of the same parts,  or  general inflammatory action occurred
in individuals whose  blood was previously healthy.  The
quality of the fibrin  is always defective.  The fatty matters are
often  decidedly  deficient,  also  the alkaline and earthy  salts.
Hence the food of scrofulous patients should contain a  good
deal of fibrin, an excess of fat,  and of alkali.  Professor Schultz
states that when blood is in its natural alkaline state, 2 drops
of acetous acid will neutralize one drachm of serum, while in
one scrofulous patient he found the serum quite neutral, and
in another scrofulous subject, one drop of acetous acid neutral-
ized 4 drachms of serum.  Bennett's theory  of scrofula is,
that too much albumen and too little of the oleaginous prin-
ciple is conveyed into the economy; that there  is a decidedly
acid state of the  primae viae,  which, while it renders the assimi-
lation of the albuminous principles more easy, by neutralizing
the alkaline pancreatic juice, prevents the solution and  assimila-
tion of the oleaginous principle;  hence,  in a short time the 
112
SCROFULOUS OPHTHALMIA.
blood becomes overloaded with albumen, and  decidedly defi-
cient in fatty substances.  In the treatment of scrofula by dietetic
means, it may be as important  to avoid albuminous articles of
diet, as it is well known to be to avoid sugar and all substances
which may be converted into  saccarhine matter, in diabetes.
Acids  should  be avoided; the use of alkalies may be  en-
couraged.
  It is impossible to point out all the articles of  diet which
scrofulous persons should avoid, or prefer.  The gravy from
the dish of beef, pork, and mutton, should be avoided, perhaps,
as the blood of ox, sheep, and pig contain from 18 to ^ of
albumen, while the muscle of beef, pork,  and deer contains
only from  jjjj to ^,  or M;  the flesh  of  veal and chicken,
from A t0 ||; that of trout and pigeon, from  ±± to •££; that
of carp, only j^.   Isinglass, white and yolk of eggs, liver of the
ox, and sweetbreads are, perhaps, objectionable,  as they contain
respectively,  from §| to |jf,  15.5, 17.47,  and 20.19.  Still,
in practice, some of these apparently objectionable articles are
not absolutely so; thus,  according to Magendie, the white of
eggs combines a number of conditions favorable to digestion.
It'is alkaline, contains  saline matters, and  especially common
salt in very large proportion; the animal matter which it con-
tains is the same as that found in the chyle  and in  the blood;
it is liquid, but is coagulated by the acids of the stomach, form-
ing flocculi having but little cohesion.   Lastly, white of egg
contains some organized membranes, which may perform  in
digestion some useful and perhaps indispensable function.
  Of the exciting causes of scrofula, cold is the  most powerful,
especially when combined with moisture.  The next in order of
the direct causes is insufficient or unwholesome  food, excess  or
irregularity of diet, especially when  aggravated by sedentary
habits, neglect of exercise, and  residence in an  impure atmos-
phere.  Hence, warm  clothing, active  exercise, fresh air, and
proper diet, are indispensable in the treatment of scrofula.
  To return  to the consideration of scrofulous  ophthalmia:
The  external redness  of the eye  is often inconsiderable, and
sometimes more apparent in the lining of the lids than in the
eye itself.   Single blood-vessels,  or  bundles of  them run
across the white of the eye to  the  cornea, and either  extend 
SCROFULOUS OPHTHALMIA.
113
over  its margin, or sttp short at the boundary  between it
and  the sclerotica.   Where  these blood-vessels terminate we
observe small elevations called vesicles, pustules, or phlyctenae.
These pimples, which may have a whitish appearance, or con-
tain  a little clear or yellowish fluid, may be single, or in great
number, situated on the cornea, or sclerotica, or, which is more
frequent, on the boundary between them.   The occurrence of
these elevations, which is characteristic, though not belonging
exclusively  to  the  present affection,  has  led Mackenzie to
regard scrofulous ophthalmia as "an eruptive disease, affecting
the white of the eye, not as a mucous membrane, but .as a con-
tinuation of the skin over the eye, and to call it phlyctenular
ophthalmia."  Lawrence.  '' I regard these vesicles or pustules
as eczematous or impetiginous in their nature, and that scrofu-
lous ophthalmia is  in reality an eruption  of eczema, or a salt-
rheum  of the eye; often  the eruptions upon the eye and skin
approach eczema impetiginodes in character."  An cell classes
eczema among the scrofulous eruptions.
  In scrofulous ophthalmia, the effect of light upon the eye is
peculiarly painful,  and the uneasiness produced by it is often
carried  to an extreme degree, so as to constitute a distinguish-
ing  symptom of  the complaint.   The  head of the patient is
always  held down  to avoid  the light; the lids are spasmodi-
cally closed, and a powerful  contraction of the muscles of the
eyelids  offers an effectual obstacle to any attempt  at opening
them.  The spasmodic action of this muscle, (the orbicularis,)
excited by exposure to light, causes actual pressure upon the
eye, and makes the patient scream or wince with pain ; it also
makes the lids  look as if they were swollen, although they are
not so.   The patient makes every effort to protect the eye from
the painful  impression of light, contracts the brows, throws the
skin between them into wrinkles, draws down the  skin of the
forehead, elevates the lips and wings of the nose, and in short,
puts into action all the muscles of the face to protect the suffer-
ing organ.  Hence arises a peculiar and characteristic expres-
sion of  the countenance.   The painful impression of light upon
the eyes, in  severe cases, is such, that the patient seeks the very
darkest corner of the room to escape from the light, and  if in
bed  it will turn the face against the pillow, or hide it under the
clothes ; or  if brought into the light it presses its hands against
                   8 
114
SCROFULOUS OPHTHALMIA.
the eyes" and  holds the head  down* great irritation, redness
and eruption being often produced upon the forehead, eyelids,
and nose by this cause.  Lawrence.
  This great sensibility of the retina {photophobia scrofulosa)
is  not the result of  inflammation,  but rather  the  result of
an irritation similar to that of  spinal irritation, which, in fact,
is  frequently  a  nervous,  scrofulous  irritation  of the  spinal
nerves; nor is it in direct  proportion to the increased redness
of the eye, being often excessive when the eye appears almost
natural.   Hence this symptom need not excite any fear of
injury to the eye.
  There is often a copious flow of tears; thus, when the eye is
exposed to light, a  copious  discharge of scalding tears takes
place,  the passage  of which into the nostrils often  excites
frequent sneezing or  redness  of the  lids, and  excoriation of
them, and of the face may ensue.   These irritating tears cause
itching and soreness in the parts over which they  flow, and
aggravate  the original  complaint;  the  patient  rubs  and
scratches  the  lids  and   face, which become  red,  sore  and
pimply;  finally, small, yellow pustules  form on this inflamed
skin,  and  produce a discharge which incrusts.   The eruption
may extend over the forehead, temples, and face, presenting all
the characters of eczema or impetigo.  Lawrence.
   The affection of the eyes is generally attended by disorder of
the stomach and bowels; there is costiveness, with white or
furred tongue, foul breath, distended belly,  morbid appetite,
and grinding of the teeth  during sleep.
   The edges  of the lids  are  often red, swollen, and painful.
The  mucous  membrane of the nose is frequently affected;
there is an acrid secretion with excoriation of the nostrils, with
swelling and redness of the wings of the nose, and often of the
upper lip.  The ears are often red and sore, and excoriated
behind, showing the wide extent of the eczematous affection;
and the glands of the neck frequently become enlarged.
   The inflammation of the eye will suddenly get better, and
may  return  as  suddenly.  Eepeated attacks often occur  at
longer or shorter intervals, and  slight exciting  causes  will
renew the disorder when the predisposition is strong.  In this
way  the affection may last for months and years, and it is diffi-
 cult  to say when the patient is permanently recovered.  The 
ARSENICUM.
115
affection of the eyes often alternates with other symptoms;
thus, the ears may become worse, and the eyes get better, or,
vice versa.  Hence the alternations of improvement and aggra-
vation and the obstinancy of the disease are strikingly similar
to those which happen to salt-rheum in other parts.
   Scrofulous inflammation of the eye often produces serious
changes, especially in  the  cornea;  and  this  may happen
although visible redness does not exist in any  great degree.
The elevations of the conjunctiva, previously mentioned, under
the names of  vesicle,  pustule, or  phlyctaena, may  subside,
leaving merely a thin  opacify, which gradually disappears;
sometimes a thick opacity remains, which becomes diminished,
but does not disappear.  But the vesicles, pustules, or phlyc-
taenae  more commonly ulcerate ; the ulceration may spread in
extent or  depth; and in the latter case may not only make
their way into the substance of the  cornea, but even  penetrate
into the anterior chamber, and thus lead  to prolapsus of the
Iris.   (Lawrence.)
   A thick and vascular corneal covering may be formed called
pannus ; or general dulness of the cornea from intestitial depo-
sition of lymph, or blood may be found ;  or the texture of the
cornea may become so weakened  as to yield to the pressure
from  within, and be enlarged into  the external protuberance
called staphyloma.
   Scrofulous inflammation rarely affects the interior of the eye,
unless the cornea be ulcerated or perforated.

                        ARSENICUM.
   Bonninghausen with characteristic assumption and ignor
ance  states that  Arsenicum is only useful in those cases in
which there is ulceration on the inner surface of the eyelids.
   For further remarks on the indications for the use  of Arsen.
see pp.  61 to 63.   This remedy not only exerts  a specific
action upon  the conjunctiva of the  eyes and eyelids, but also
has a well established reputation  in the  treatment of many
eruptive diseases, such as chronic eczema, impetigo, etc.  From
cases  furnished by Segin, Hermann, Widemann and others,
Euckert has  arranged the  following digest of  symptoms as
indicative  of the use of Arsenicum in scrofulous- ophthalmia,
namely: 
116             SCROFULOUS OPHTHALMIA.
   When  the eyelids are swollen; their  edges reddened;  the
.meibomian  glands  secreting  much  mucus; the lids  stuck
 together  in the  morning, loaded  with  crusts,  and  closed
 spasmodically, with piercing pains on  attempting  to  open
 them.
   The  conjunctiva, or white of the eye, traversed  with blood-
 vessels, degenerated and composed of spongy and bright-red
 cellular tissue, with many enlarged veins.
   The  cornea smoky,  dim, ulcerated, with opaque spots  on its
 outer edge, with deep ulcers about its circumference, deposit of
 pus between its layers, covered with bluish-gray spots, and so
 opaque that no trace of the iris or pupil can be observed.
   The sclerotica spongy.
   The punctum lachrymale swollen and inflamed.
   Intolerance of light in an  extreme degree, so that the patient
 sits in the dark, or lies upon his face.
   Lachrymation copious, acrid, gushing forth  when the lids are
 opened, attended with muco-purulent discharge.
   The pains in the eyes are biting, piereing, or burning in their
 character, attended with violent stitches when the eyes  are
 opened, and cutting pains deep in the orbits.
   Among the accompanying disorders are: pimples upon  the
 face, fine  rash, eruption about the eyes, itching soreness  of the
 lids with  scabs upon them, redness of the eyes with secretion
 acrid, watery mucus, and general restlessness.

                          Review.
   Of 6 cases treated with Arsenicum, all were between  2 and
 11 years  of age, and five were females.
   Doses.—Drop doses of the  3d dilution  were used  3  times
 daily, in  one case with evident improvement, which ceased as
 soon as  only 1 or 2 doses were given  per day.  In 1 case,
 Arsen. 6, in drop doses, was given every 2 days;  the 30th
 dilution  was administered in 4 cases ;  and 3 doses per  day
 were used in another case.
   The  disease  had lasted  in most cases from  1 to several
 years, and the cures were effected in from 1 to 6 weeks.
   Arsenicum was used alone successfully in 1 case ;  Conium
 was required in addition in one ease;  Sulphur was given in 3
 cases without marked benefit, while after  the  cure of  the 
BELLADONNA.
117
inflammation, Euphrasia, Calc, Cann., Crocus, and Nitric Acid
were given to remove the remains of the disease.

                         AURUM.
  See page 66.
  CASE 114.—A girl, aged 7, with scrofulous ophthalmia and
excessive intolerance of light, was quickly cured by the inter-
nal use of 1-grain  doses  of  Aurum  3, and external use of a
solution of the same.  Lobethal.

                         baryta.
  See page 66.
                      BELLADONNA.

  (a) Frank remarks that Belladonna is the most useful of all
remedies against intolerance of light, both in scrofulous and
catarrhal ophthalmia.  But he saw very little good effect from
infinitesimal and occasional doses; while drop doses, 2 or 3
times a day, of  the 1st or 3d dilution, or even teaspoon ful doses
of an infusion of 10 grains of the herb to  2 ounces of water, 2
or  3 times a day, coupled  with the  free external  use of the
same preparation, proved eminently useful.—Genl. Horn. Jour.
Vol. 18, p. 293.
  (b.) Hartmann says that  Bellad. is beneficial in  scrofulous
ophthalmia  when   frequent relapses occur,  and  the attack
approaches catarrhal inflammation in its nature, and is attended
with much intolerance of light.  Still, Hepar. Sulph. was often
required to bring back the patient to the state he was in before
the relapse, and then some other antipsoric remedy was re-
quired.
  (c.) Schreon says that he  has often  used Bellad. against
scrofulous ophthalmia with  benefit, especially when aided by
Sulphur.  When there was  great intolerance of light and pro-
fuse lachrymation, he gave the 3d or 6th dilution, from 3 to 6
drops in a tumbler of water, in spoonful doses every 12 hours,
with evident benefit, which was  carried still further by drop
doses of Tinct. Sulphur, also every 12 hours.  Still in many
other cases these same remedies and  doses proved of no avail.
If  they  had been used in more  massive quantities  and at
shorter intervals,  they would  probably  have proved more 
118
SCROFULOUS OPHTHALMIA.
useful, as Bellad. is antipathic both to intolerance of light and
excessive lachrymation.   (See page 67, P.)
  {d.) Hering advises Bellad. when there are aching pains in
the eyes, increased by opening  them;  when the  eyes are red
and much congested; when vesicles and ulcers are present upon
the cornea;  when  catarrhal  symptoms are  present,  and the
attack has been brought on by taking cold.
  CASE 115.—A scrofulous youth,  aged 19, with  swelled
upper lip and nose, who had suffered with  sore eyes when  a
child, was attacked anew.
  Symptoms.—The eyes were much  inflamed;  the lids were
red and swollen ; the lashes of the lower lids  had fallen out;
there was great intolerance of  light, profuse  lachrymation,
abundant secretion of muco-pus, and the lids stuck together at
night.
  Treatment.—One dose  of Bellad. 30, lessened  the photopho-
bia and intolerance of light considerably; and  then  a dose of
Aurum 6, removed the  disease  in so far that the patient was
able to resume his occupation as a tailor.—Genl. Horn. Journal.
Vol. 28, p. 23.
  CASE 116.—Bellad. 12, several doses, removed a scrofulous
photophobia in a few days, which had resisted many allopathic
remedies for a long time.  An attack of measles, shortly after-
wards, did  not bring back the scrofulous ophthalmia.   Dr.
Fielitz.
  CASE 117.—A  girl, aged 3,  suffered with scrofulous oph-
thalmia, great intolerance of light, profuse lachrymation when
the eyes were open; her eyes  were slightly reddened, many
blood-vessels ran to  the outer edge of the cornea; and there
were small ulcers on both eyes.
  Treatment—Bellad. 6, almost cured her in 6 days; the re-
mainder of the intolerance of light was removed by Ignat. 6.—
Annals, Vol. 4,  p. 401.   Dr. Maly.
  CASE 118.—A little  girl, aged  6, suffering with scrofulon
ophthalmia was not relieved by Bellad., Conium,  Calcarea,
Sulphur and  other remedies administered in various dilutions
for several weeks.  Then 1 grain of Extract of Bellad., solved
in 4 ounces of water, and applied freely to the eyes, produced
such good results that  the patient was able  to  open her eyes
in 2 days, and the intolerance of light ceased entirely in a few
days more. 
CALCAREA CARB.
119
  In similar cases, the 2d and 6th dilutions of Bellad. produced
like  good effects when applied externally.—Hygea. Vol. 8, p.
6.   Dr. Ohlhauth.
  CASE 119.—A  man  who had  suffered for 2  years with
scrofulous soreness and inflammation of the edges of the lids,
was quickly relieved of an acute attack by Bellad. 200.  But
a long continued treatment of the primary affection, with the
high potencies, was entirely without benefit.—Genl. Horn. Jour-
nal.  Vol. 31, p. 218.  Dr. Clotar Muller.

                          Review.
  It is remarkable that in the above cases the hwer potencies
of the remedy and even the Infusion  and Extract of Bellad.
had  to be used;  especially as many of them were  rather
slight than severe; and that Bellad. only removed'some of the
symptoms of the disorder, and then that other remedies had to
be employed.  In obstinate and chronic cases, Euckert himself
has seen but little benefit follow  the  use of Bellad. against
intolerance of light, although it is thought more useful against
this symptom than any other, especially when used externally.
[The explanation  is contained in  the  fact that Bellad. is not
particularly homoeopathic to intolerance of light and lachryma-
tion.]  (See page 67.)  P.

                     CALCAREA.  CARB.
  (a.)  Stapf says that Calc.  has  almost always proved the
most reliable remedy in his  hands against  scrofulous oph-
thalmias, even  of  the worst description, in which ulcers and
specks had been present on the cornea for a long time.—Archiv.
Vols. 7 and 8.
  {b.) Lobethal says, that it is an admirable remedy against
morbid growths upon the cornea, resulting  from  scrofulous
ophthalmia, especially when aided by Nitric Acid and Cannabis.
Genl. Horn. Jour. Vol. 13, p. 6.
  (c.) Calcarea  has been used with great benefit in obstinate
and chronic cases of scrofulous ophthalmia when attended with
great intolerance of light, profuse secretions of tears, mucus,
and pus, with which the  lids become glued together, and when
there are aching pains  deep within the eyes.—Annals. Vol.
4, p. 139. 
120
SCROFULOUS OPHTHALMIA.
  (d.) Lorbacher says that he only succeeded in curing obsti-
nate and chronic cases of scrofulous ophthalmia perfectly and
permanently when he gave Sulphur  and Calcarea in alternation
for  a long time.  He even found the high dilutions useful..—
Quarterly Journal: Vol. 1, part 2, p. 256.
  (e.) See Hay's experience, p. 18.   P.
  (/) See page 71.
  From 13 cases reported by Drs. Muller, Diez, Knorre, and
Tietze, Euckert has arranged the following clinical indications
for  the use of Calcarea in scrofulous ophthalmia, namely:
  When the eyelids are red, inflamed, itching, closed and stuck
together, especially in the morning, and covered with pustules,
or closed spasmodically from intolerance of light.
  When  the conjunctiva  and   sclerotica are  inflamed  and
injected.
  Ulcers on the cornea, with specks and pustules, when there is
great intolerance of light, so that the patient lies upon his face ;
when the pupils are altered in color, and grayish, and vision is
almost lost; dilated  pupils; gushing of acrid, corroding tears,
stitches,  aching,  and burning in the  eyes, • especially  in  the
morning, violent piercing in the  eyes, especially in the evening,
by  candle-light.
                 Accompanying  Complaints.
  Swelling of the face, most evident about the nose; much
perspiration on the forehead; inflammation, and many pustules
about  the  eyes; pustules  and other eruptions upon the face,
scalp and body attended with  itching, oozing and formation of
thick,  yellow crusts; swelling and  redness of the nose, with
acrid discharge;  obstruction of the nose; swelling of the upper
lip; eruption upon, and swelling of the lips; eruptions  and
scabs upon the lips, even upon the inner surface; eruption
behind the ears ; swelling  and hardness of the abdomen ;  con-
stipation ; hard,  glandular swellings about the neck and under
the chin ; bloating of the whole body; inclination to profuse
perspirations; irritability and obstinacy of temper.

         »                 Review.
  Of the 13 patients 9 were between 2 and 10 years old.
     "     "         4  "     "    13 and 20   "    "
  Nine were  females. 
causticum.
121
  Dose.—Calc. 4, was used in 2 cases;  the  6th dilution in 1
case ;  the 15 th in 1 case; the 30th in 8 cases;  the 200th in 1
case.
  Calcarea effected cures alone in 5 cases;  it was assisted by
Sulphur in 6 instances; by Arsenicum, in  1 case.  A single
dose sufficed to cure in 10 cases; repeated doses were required
in S cases; it was given in solution in 1 case.
  In  5 cases, the disease had lasted from 2 to 12 weeks; in 5
others, from 1£ to 5 years.
  The cures were effected in from 2 to 6 weeks.
  Almost all the cases were characterized by the severity of the
symptoms, and by the presence of many of the signs of general
scrofula, especially of the torpid variety.
  Euckert substantiates Lobacher's experience with Sulphur
in  alternation with Calcarea; still he only gave the doses at
intervals of 4 days. Calcarea 6, often  proved useful  when
higher dilutions were entirely inefficient.

                        CANNABIS.
   Weber  and  LobethAl  have  recommended  this remedy
against specks  and growths upon  and  in the cornea,  and
against  ulcerations of the  cornea after scrofulous  ophthal-
mia.   It does not seem to have  effected cures unaided by
other remedies, but as  an  alternate remedy it  has  often been
used with benefit.—Genl. Horn. Jour.  . Vol. 13,  p. 6 and 83.

                        CAUSTICUM.
   It  is  remarkable,  says Euckert,  that this remedy  which
 offers so many indications in its pathogenesis against scrofulous
 ophthalmia, and which has been recommended by Kreusseler
 as a wonderful  remedy against this disease, is only reported as
 having cured one case.
    CASE 120.—A boy, aged 3, was  attacked with scrofulous
 ophthalmia, which resisted all  remedies; both pupils became
 invisible;  the  cornea  became bulging; and  the child  was
 entirely blind.
    Treatment—In 8 days after the first dose of Causticum 30, a
 remarkable improvement occurred both in the  eyes and in the
 general health of the patient.   An intermediate dose of Puis. 
122
SCROFULOUS OPHTHALMIA.
 and a second dose of Causticum effected a cure in 4 months.—
 Archiv. Vol. 17, part 1, p. 27.
   See page 72.  P.

                   CONIUM MACULATUM.
   This remedy has a well-established reputation against scrofu-
 lous affections; it acts powerfully upon the venous and glandu-
 lar systems, and is even supposed to have caused atrophy of the
 breast and testicles.
   It occasionally  produces an eruption upon the skin some-
 what similar to acne.
   As it is apt to cause paralysis of the voluntary muscles, it
 may prove antipathic and palliative to spasmodic closure of the
 lids from irritability of the eyes in scrofulous ophthalmia.
   As it produces  general torpor of the brain,  nervous system,
 and muscles, it is more homoeopathic to torpid scrofula than to
the irritable variety.
   Finally, it is more homoeopathic to  chronic and torpid affec-
tions of the eyes than to acute or irritable disorders.  In one case
after taking Conium in large doses,  the patient fell  asleep, and
when he awoke  he could not see;  in  another case there were
sparks before the eyes, with hiccup ; fixedness and glittering of
the eyes; dimness of vision ; a sensation in the eyes as if they
were pressed out, is characteristic of Conium;  which also  pro-
duces a headache, with sensation  as  if a large foreign body
were in the  anterior  half of the brain.  It is said  not to  pro-
duce dilatation of the pupils, even  when  introduced into the
eye or by any other  internal or external application of it.
 —Peters.
   Knorre found  it useful in purely nervous and scrofulous
photophobia, when attended with spasm of the eyelids ; when
there was  only a pale redness  of  the white of  the eye,  a
narrow  edge of redness around the  cornea,  or single large
large  red vessels  traversing the conjunctiva.  He says it is
wonderful,  in such cases, how quickly and certainly Conium
will act; but he  gave the undiluted juice of the plant  in fre.
quent doses, and often noticed  that moist eruptions would then
break out upon the face and head, followed by a marked dimi-
nution and speedy cessation of the intolerance of light.
   When inflammation was present, and the photophobia was 
CONIUM MACULATUM.
123
only an accidental symptom, Calcarea, Graphite, and Lycopo-
dium were more useful than Conium.
  It does not prevent relapses.
  Dr. Fielitz says: It is remarkable that Conium is not very
serviceable against scrofulous photophobia when administered
in homoeopathic doses, even when the undiluted  tincture is
given,  1 drop  at  a time ; while, when  given in large and
increasing  doses  of the  Extract,  according to Dczondi's
method, it  will remove  the disease far more frequently,  and
even with  a certain degree of  certainty.—Genl. Horn. Journ.
Vol. 17,  p. 246.
  CASE  121.—A scrofulous,  portly-looking  girl,  aged  16,
who had menstruated for about  1 year, was attacked with
ophthalmia.
  Symptoms.—Swelling of the upper eyelids, so that the lower
lids were entirely covered by them ; the swelling also extended
above  the eyebrows and  was attended with itching and burn-
ing ; the edges of  the lids were violet-red in color, hard;  the
rest of  the  outer  surface was pale  red, shining, doughy,
and  very sensitive to touch; on attempting to open the lids,
they became everted so that the thickly-swollen, dark-red con-
junctival surface was exposed.  The white of the eye was but
little inflamed ; the cornea sound;  there was great intolerance
of light; profuse secretion of a thin, yellowish muco-pus, and of
tears.  She complained of itching, burning, and piercing pains
in the inflamed lids, aggravated at night.
   Treatment — This case was  cured in  4 days with 20-drop
doses,  3  times  a day, of a solution of 1 scruple of Extract
Coni.  Mac. in 1 ounce of water.—Genl. Horn. Journ. Vol. 19,
p. 56.   Knorre.
   CASE 122.—A girl, aged 6,  of scrofulous constitution,  had
suffered  for a long time with ulceration about the teeth; 7
months after the cure of this, ophthalmia set in and was treated
allopathically for 4 months, without success.
   Symphms.—Great intolerance of light in  both eyes,  redness
of the sclerotica, dimness of the cornea, redness of the  eyelids,
profuse discharge of mucus and  tears, secretion of a  mucous
and acrid  fluid from the nose, eruption of small  and large
pustules upon the  right side  of the face,  want  of appetite
and sleep. 
124
SCROFULOUS OPHTHALMIA.
  Treatment—Conium 12, £ of a drop per dose, repeated every
3 or 6 days, effected a  perfect cure in 14 days.—Hygea.  Vol.
18, p. 37.   Dr.  Segin.
  CASE 123.—A boy, aged 6, had suffered for  a year  with
scrofulous photophobia, inflammation of the white of the eye,
with discharge of acrid tears, itching and  sticking together of
the lids,  especially in the morning; with the remains of an
eruption  on the scalp, and with suppressed foot-sweats.  The
neighborhood of the eyelids and nose was corroded by acrid
tears.
  Treatment—Sulphur 1st in  the morning, and  15 drops of
Tinct. Conium in the evening restored the  patient in 3 months.
—Genl. Horn. Journ.  Vol. 30,  p. 282.  Dr. Marschall.
  CASE 124.—In a scrofulous eye affection in a child, aged  3
years, Conium 1, in repeated 1-drop doses, acted very beneficially
against considerable intolerance  of light, not  arising from
inflammation.—Genl.  Horn.  Journ.  Vol.  16,  p. 134.  Dr.
Frank.
  CASE 125.—In a case of photophobia which resisted all
internal  remedies,  Conium 30, 2  drops  in §  oz. of water,
applied externally, proved very quickly serviceable.  Dr.
Thorer.
  CASE 126.-^Dr.  Lider relieved  scrofulous photophobia
with Tinct. Conii. diluted with water, and  applied directly to
the eye.
                          Review.
  The patients  were all  from 3 to 6, or 16 years of age.
  Considerable intolerance of light was present in every case ;
in many instances  there was  a  discharge of mucus  and of
acrid tears; also an inflammatory state of eyelids, and in one
case an acute blenorrhcea, which was relieved with unusual
rapidity.
  The majority of the cases required the lower  dilutions, or
even the use of the Extract or Tincture, and the local applica-
tion of the remedy.   Conium deserves  particular attention
when intolerance of light is present without decided inflamma-
tion.
  The cases were mostly chronic in their nature, and the cures
were accomplished in from 14 days to 3 months; in 1 case, in
4 days only. 
HEPAR.  SULPH. CALC
125
                        EUPHRASIA.
  See page 79.
  CASE 127.—A scrofulous little girl, aged 4, had suffered
from her birth with inflammation of the eyes, attended with
specks upon the cornea, and great intolerance of light.  Inter-
nal remedies  were of no  avail; but the juice of Euphrasia
dropped into the eye removed the disease so thoroughly that
in a few weeks the eyes could even be used in the sunshine.—
Genl. Horn. Journ. Vol. 1, page 40.  Kretschmar.
  CASE 128.—A little girl, aged 6, had suffered with scrofula
since she was vaccinated, when  10 months  old,  and with
ophthalmia for 1  year.
   Symptoms.—The neighborhood of the eyes was  red  and
swollen; the edges of the lids thick and  knobbed;  the lashes
were stuck together in bundles; the white of the eye was covered
with an unevenly reddened and  swollen vascular tissue;  the
cornea was  dim; the patient could not  see distinctly; there
was great intolerance of light, spasms of the lids, lachrymation,
discharge of purulent  mucus, adhesion of the lids  at night,
burning and piercing pains in the eyes, emaciation, swelling of
the glands of the  neck, and frequent attacks of colic.
   Treatment.—Five drops of a solution of 3 drops  of Tinct.
Euphrasia in water, was given 3 times a day; at the end of  3
weeks the patient was comparatively well, having merely some
redness and lachrymation of  the eyes when in  the open  air.
Then Euphrasia was  given every 3 days, and several doses of
Mercurius 3, also at intervals of-3 days, completed the cure.
   This remedy was also used in several eases to perfect the
eure of opacities of the cornea.

                    HEPAR. SULPH. CALC.
   (a.)  BlCKiNG found this remedy most useful in  scrofulous
ophthalmia when the patients were of a phlegmatic tempera-
ment,  stout,  with a  fine, white skin,  light hair, large  bellies,
thick necks,  and  troubled with enlarged  glands, eruptions and
ulcers.  And when their eyes in their healthy state were sur-
rounded with a  blue circle, and a plexus of venous vessels;
when the eyelashes were long, the white of the eye of a dirty
gray or bluish .color, the cornea very conical, and the pupils
unusually large. 
126
SCROFULOUS OPHTHALMIA.
  When there was chronic inflammation, great intolerance of
light, profuse discharge of tears and mucus, ulcers, and aching,
burning pains as if the eyes were bruised;  the more  decided
these symptoms were, the larger were the doses which were
required to effect a speedy cure.   If the attack had not lasted
long; if it did not occur as a relapse of previous disease;  if the
eyelids were particularly swollen and covered with crusts;  the
eye itself but slightly inflamed;  the cornea  free from vascula-
rity, and only slightly dim and smoky  in places,  then he
almost always saw evident improvement in 8 or 12 days, from
drop doses of Hepar. 12, every 2 days.
  If the blood-vessels had already  spread over  the  cornea,
especially if vesicles  or phlyctaenae, or ulcers  had  already
formed, then he could only attain the same results by  2-grain
doses of the  1st  or  2d  trituration, daily.   In still  further
advanced cases,  he was obliged to give 1-grain doses of the
crude article, every day, for 3  or 4 days.
  In those cases in which the alteration of the structure of the
cornea proceeded  rapidly, when ulcers  were  on the point of
perforating,  or exudations  threatened  to  obscure the entire
cornea, or the anterior chamber was filled with pus, then he
applied Croton Oil as a counter-irritant behind the ears and
on  the  neck, and only administered  Hepar. after the  Croton-
eruption had  made its  appearance.— Genl. Horn. Journ. Vol.
15,  p. 1.
  {b.) Gross corroborates the benefit of Hepar. Sulph.  Calc. in
corneitis scrofulosa, and adds  that in desperate cases the dilu-
tions are not  sufficient, but that 1  or  1^-grain doses of  the
crude article must be given.—Archiv.  Vol. 18, part 2, p. 50.
   (c.)  Schroen  often used Hepar. s.  with  excellent effects
against scrofulous  ophthalmia, with burning pains in reddened
edges, and inner surface of the lids, intolerance of light and
lachrymation,  profuse secretion from the meibomian  glands,
sticking together  of the lids,  pustules on the sclerotica and
cornea, and  a red zone  around the edge of the cornea; still
relapses were apt to occur, and Bellad. often had to be used in
alternation, against the excessive photophobia.—Hygea. Vol. 3,
p. 166
  {d.) Hering says that Hepar. is often useful after Bellad. or
Merc. Viv., when  the children have already taken much mer- 
HEPAR.  SULPH. CALC
127
cury;  when the lids and  eyes are red and sore,  tender  to
touch,  close spasmodically, can scarcely be moved, intolerant
of light at  night, and are  at times quite dim, and then again
bright  and clear; when the eye feels as if it would  be forced
out; when  there are ulcers or specks upon the cornea, and
small pimples or pustules about the eye.  But daily doses of
the 2d  trit. must be given for several days.
  (e.) Vogt says that this is one of the most excellent sulphur-
ous remedies; it acts more quickly, penetratingly, and  power-
fully than  any other preparation  of sulphur, and affects the
lymphatic and glandular systems in particular, although it has
its influences upon the assimilative processes, and the organic
cohesion, while it diminishes the  plasticity of the  fluids.  It
exerts  a less  irritating influence upon the circulation, and is
rather  apt to depress than excite the  heart and arteries.  It
was first recommended by Double and Senf against mem-
branous  croup, from its  decided action   in  lessening  the
plasticity  of  the blood;  they even  thought that  it was
superior  to Calomel, in this respect,  and that  it might be
used to facilitate the secretions of  the skin and mucous mem-
branes, even of the  lymphatic, glandular, and serous systems
in cases in  which Mercury was not  allowable; hence, it has
been employed to remove retentions, obstructions, accumula-
tions, deposits and indurations of the  most obstinate, chronic,
and deeply-rooted nature, in feeble and cachectic and dyscratic
constitutions.   In short, it  is  a  most  profoundly  alterative
remedy which has cured many chronic inflammations, old and
chronic eruptions, obstinate  coughs, catarrhs, and  lung-affec-
tions,  suppressed  menstruation, glandular obstructions, and
indurations.   Peters.
  (f.) According to Sobernheim it renders the pulse softer and
slower, the blood darker and considerably deficient in albumen;
its effect in this respect is so decided that Hartwig asserts that
in \ of an hour after taking Hepar. Sulph. in massive doses, that
the blood of horses in from f th to |ths deficient in albumen.  If
this be the case, it  must  be a powerful  antipathic remedy
against scrofula, in which we have seen there is a  great excess
of albumen.   Peters.
  CASE  129.—A scrofulous child, aged 7, formerly stout, but
now emaciated, was  attacked with ophthalmia after hooping
cough, and which had resisted all remedies. 
138             scrofulous  ophthalmia.
   The eye  was extremely painful, much  swollen externally,
a  bluish substance projected between the lids, and a watery,
offensive fluid which excoriated the cheeks, was discharged in
abundance.   There was lachrymation and intolerance of light;
the white of the eye seemed converted into a red mass of flesh,
and formed a raised wall (chemosis) around the quite opaque
cornea; pus was effused on the inner side of the cornea.
   Treatment.—Two-drop doses of Tinct. Sulph. fort, were given
for 8 days, when an offensive tinea capitis made its appearance,
and an eruption upon the breast and neck, attended with fever
and obstinate constipation.  The Sulphur was continued for 8
days more  in connection  with cold baths; the  eruption de-
clined, but  the  tinea increased; the painful irritation of the
eye subsided so that it could be examined.
   In the  anterior layer of the  opaque cornea, opposite  the
pupil, there was an effusion of pus, forming a small projection;
there was also a larger effusion deeper in the substance of the
cornea at its lower portion, and a semi-lunar deposition of pus
in the anterior chamber of the eye,  (hypopion.)
   Now  £-grain doses of Hepar. Sulph. Calc. were given for 6
days in  succession, at the end of  which time the  eye  was
almost free from pain, and secreted  a thicker and less acrid but
still offensive mucus.   No  remedies were given for  six days
more; then as the cornea  was  almost  disengaged from  the
swelling of the conjunctiva, and was brighter and more clear,
as the secretion of mucus had almost ceased, and the pain had
nearly disappeared, 4-drop doses  of Tinct. Euphrasia were
given daily  for 14 days, when the eye was perfectly  restored.
—Genl.  Horn. Journ. Vol. 23, p. 353.  Dr. Bicking.
   CASE 130.—A scrofulous boy,  aged 4, and suffering with
scald head,  had had  ophthalmia  for several weeks,  during
which he had been treated allopathically without success.
   Symptoms.—The neighborhood of the eye was inflamed; the
eyelashes encrusted, edges  of the lids swollen; the  left eye
could only be opened  with difficulty, and then a quantity of
tears gushed forth;  the conjunctiva was traversed by a number
of bluish-red blood-vessels;  the cornea was  hazy and covered
with ulcers; the right eye could be opened more easily, but
was  generally inflamed; the cornea was grayish and spotted,
and perforated by a penetrating  ulcer; the iris had fallen for-
wards into the perforation, (prolapsus iridis.) 
hepar. sulph. calc.
129
  Treatment—Grain-doses of Hepar. Sulph. were given for 3
days; on the 4th day, the eyes could be opened in a darkened
room, the lachrymation was less profuse, the redness  of  the
conjunctiva paler, the cornea clearer.  At the end of 4 days
more, the prolapsed iris had withdrawn, and the ulceration of
the cornea was in process of healing.  Sulphur and Euphrasia
were given to perfect the cure.—Genl. Horn. Journ. Vol. 16, p.
118.  BlCKING.
  CASE 131.—A child, aged 6, of delicate and weakly consti-
tution, with relaxed muscles, bloated face, swelled  upper lip.
deep-set eyes, irregular  stools, frequent  swellings and indura-
tions of single glands, was attacked with ophthalmia and treated
allopathically for a long time with Mercury and Antimony.
  The eyes were much reddened,  the  lids swelled, red,  and
burning hot;  there was great intolerance of light.
   Treatment—Hepar Sulph. 30, 4 doses at intervals of  6 days,
removed the affection entirely in 2 months.—Archiv. Vol. 19,
part 1, p. 78.  Argenti.
  CASE  132.—A child, aged 7,  markedly scrofulous, suffered
with ophthalmia of the left eye; the sclerotica was violet-red,
the cornea  dim, the eye watered profusely, the lower lid was
swollen,  and there was great intolerance of light.
   Treatment—Bellad. 200, was given without benefit; 10 days
after,' Calc.  200,  relieved  the photophobia somewhat,  but an
ulcer formed upon the cornea, and the patient wept and com-
plained of much pain..  Then  Hepar. Sulph. 200, was given
without  benefit; finally, Hepar. 3, 4 doses was given  with
relief from pain in 3 days; and the cure was perfected  in 9
days more, under daily doses of the same remedy; the ulcer
commenced  to heal on the 5th day after the stronger doses of
Hepar. began to be used.— Genl. Horn. Journ. Vol. 33, p.  101.
Kallenbach.
                          Review.
   The above 4 patients were all children from 4 to 7 years of
age, and suffering with the torpid form of scrofula, although the
ophthalmia sat  in with great violence, attended with decided
disease of the conjunctiva, cornea and  lids,  and even   with
effusion  into the anterior chamber of the eye, (hypopion,) and
prolapsus of the iris.
   Dose.—In 2 eases, the crude Hepar.  Sulph. was given  with
                       9 
130
scrofulous ophthalmia.
good effect;  in one case, Hepar. 200, failed, while  Hepar. 3,
succeeded;  Hepar. 30, was used in 1  case.  Eepeated doses
were required in every case;  and  the  lower dilutions were
generally  most successful.  Hartmann found  Hepar. to  act
most beneficially after the previous use of Bellad.
  The  cures were effected in from 10 days to 2 months, even
in the most unpromising cases.

                     MAGNESIA CARB.

  CASE  133.—A  girl,  aged  11, suffering  with scrofulous
ophthalmia, was left, after the use  of several remedies, with
dimness and opacity of the cornea, so that she could scarcely
distinguish any thing clearly ; the ball of the eye was inflamed,
and the lids swollen.
  Treatment.—After taking Magnes. c.  24, the inflammation
abated and the cornea commenced to be more transparent, so
that the little patient  could see almost every thing, although
somewhat indistinctly.   Nitric Acid 30, removed every trace
of disease in the  cornea.—Archiv.  Vol. ID, p.  1, page 157.
Euckert.
                   mercurius solubilis.

  Hering with characteristic complexity and impracticability
of advice says that Mercurius is suitable especially after the
previous use of Bellad. when  the pains in the eyes of little
children are cutting, especially  from using  the eyes, aggra-
vated in the evening by the warmth of the bed; with burning,
biting, and lachrymation while in the open air;  intolerance of
light, with dimness and mistiness of the eyes ;  or when small
pustules or pimples are present upon the ball of the eye ;  and
when relapses occur after every taking cold.
  CASE  134.—A little girl, aged 2, had suffered for 3 months
with ophthalmia.
  Symptoms.—The eyelids were  swollen ; there was a pimply
eruption upon the lids and cheeks;  crusts formed between the
lashes; there were whitish-gray specks  upon the cornea of
both eyes; intolerance of light, so that the little patient lay
upon her face;  the nose and lips were swollen ; there was a
discharge of much greenish, thick, and acrid mucus from the
nose, which had excoriated the nostrils and upper lip;  the 
MERC. SUBLIM. CORROS,
1S1
backs of the hands and the fore-arms were sore from wiping
off the nasal mucus;  the parotid glands were swollen;  and the
child was irritable, impatient, and tearful.
   Treatment—Several  remedies, and among them Arsenicum,
were given without  benefit;  then Merc. Sol.  2, 1 grain every
night and morning, relieved the whole disorder in 5 weeks.—
Genl. Horn. Journ. Vol. 31, p. 152.  Dr. Haustein.
   CASE 135.—A scrofulous  child, aged 2, had  suffered more
than a year, after being  vaccinated, with disease of the eyes,
and  swelling of the glands of the neck.
   Symptoms.—The lids of both eyes were reddened and swol-
len ;  the left eye was considerably inflamed and intolerant of
light; there was a white spot on the outer side of the  cornea;
frequent and acrid discharge of tears, especially from the left
eye;  adhesion of the lids at night; during the day the child
lay  constantly  upon its face," and was exceedingly  fractious;
her nose was obstructed with mucus.
   Treatment—Aeon., Bell., Sulph., Merc, and Calcarea, all in
the  30th dilutions, and Euphrasia in the 6th were given with-
out  benefit;  but Merc. Sol. 3, one dose every 2 days for
several  weeks, produced a rapid improvement  and  effected  a
cure by the time that 14 doses had been taken.
   In a similar case, the  author saw no good results from the
high dilutions, while Hepar.  3, and Merc.  3, soon  effected  a
cure.— Genl. Horn. Journ. Vol. 28, p. 24.
   CASE 136.—A girl, aged 8,  had a sore eye for a week.
   Symphms.—The conjunctiva was reddened, there was con-
stant lachrymation and intolerance of light, with piercing pains ;
there were several pustules on  the edge of the cornea, which
had burst and formed ulcers.
   Treatment.—Merc. v. 3, 1  dose, effected  a  rapid  cure; the
scars and specks disappeared in a few weeks.

                  MERC.  SUBLIM. CORROS.
   BdCKER used   this remedy  internally  and  externally  in
scrofulous ophthalmia; for external use he solved 1  grain in  1
ounce of pure water.   He treated 34 patients in one year; the
majority were children from 2  to'14 years of age;  many had
ulcers on the cornea; very few had pannus;  and in these the
cure was delayed  for several weeks.  In 3 cases, after using the 
132              SCROFULOUS OPHTHALMIA.
                                                     »
remedy for 6 weeks, he was obliged to omit it, as a very copi-
ous flow of saliva sat  in;  but these patients soon recovered
without the use of any other remedy.
  Most of them recovered in a short time ;  and he had oppor-
tunities of seeing many of them afterward, and of convincing
himself that they remained perfectly cured.
  Eelapses occurred in 5 cases, but these  were cured by the
same remedy.
  In another year, he treated 28 additional patients ; he only
found Merc useful in the erethistic form ;  in the torpid variety,
the remedy was not only  entirely useless,  but even  proved
injurious in 3 cases.
  In the 3d year, he treated 6 cases.  All were cured.—Hygea.
Vol. 21, p. 480.
  From these cases the following clinical indications have been
obtained for the use of Merc Corrosiv., namely:
  When the lids were greatly swollen and spasmodically closed;
the upper  lid projecting far down and over the lower;  much
dried mucus upon the edges of the lids.
  The meibomian glands much  inflamed;  discharge of thick
pus and mucus from the eyes; great intolerance of light; and
necessity to remain in the dark.
  The cornea covered with red vessels;  also with ulcers, which
threatened to perforate it; chalk-white specks;  and commence-
ment of staphyloma.
   The white of the eye greatly inflamed, swollen, velvety, and
covered with papillae.
   The anterior chamber filled with pus,  (hypopion.)
   The neighborhood of the eyes and the cheeks red, swollen,
and covered with small pustules; the glands of the neck hard
and swollen; eruption on the back of the head.
   Doses.—Half a grain of Merc. Sub. was solved in 5 scruples of
water, and  2  or 3 drops given  3 or 4 times a day; in 1 case,
the 1st dilution was used 4  or 5 times daily.   In some cases,
 an external application of 1 grain to 4 ounces of water was
 used.
   Some of the patients had suffered from 1 to 3 weeks ;  others
 from 1 to 3 months ; and several for 2 years.
   The cures were effected  in from 4 to 9 days;  or in from 10
 to 15 days;  or at the latest in 6 weeks. 
RHUS TOXICOD.
133
  This remedy deserves every consideration and confidence.
It is peculiarly  homoeopathic to scrofulous eczematous oph-
thalmia.
                       nitric acid.
  (a.) Lobethal says that it is  an excellent remedy against
vegetations on the cornea from scrofulous inflammatiohw
  {b.) Gross gave it in the very high dilutions, after the pre-
vious use of Calc. 200, and saw it cure ulcers of the cornea, and
partially remove opacities.
  (c.)  Bonninghausen recommends  it in alternation with
Pulsatilla.
  {d.)  Weber  thinks it  is the  most  useful of all remedies
against opacities of the cornea.

                        PULSATILLA.
  CASE 137.—A child, aged 4, was attacked with a purulent
and offensive eruption upon the head and face, and then with
a scrofulous ophthalmia, which  had already lasted for a year.
  Treatment.—Sulph., Bell., Calc, and Euphrasia did not help.
Pulsat. 12, in alternation with Nitric  Acid 12, produced  an
aggravation for some days, followed by so rapid an improve-
ment that the cure was entirely perfected in  20  days.  No
relapse occurred for 7 months. Haustein.

                           psorin.
  Stapf says that this remedy has  proved most useful  in his
hands against scrofulous ophthalmia.—Archiv.  Vol. 19, p.  3^
p. 148.
                      RHUS  TOXICOD.
  Fielitz says that.it is an important and useful remedy against
scrofulous ophthalmia, with intolerance of light, when the eyes
can not be opened, even at night; but it must be given at least as
strong as the 2d or 3d dilution, as the high potencies are entirely
inoperative.  It is most indicated when the meibomian glands
are swelled, and secrete much mucus;  when relief ensues  in
the evening, and the eruption appears  in  the form of tinia
capitis, but extends down upon the face in the  form of crusta
lactea, attended  with swelling of the  glands of the neck.   It
should not be given alone, but in constant alternation with
Bell, or  Sulph. or Calc.—Genl Horn. Journ. Vol. 17, p. 246. 
134
SCROFULOUS OPHTHALMIA.
   (c.)  Another author says  that  Ehus  is an  indispensable
remedy in scrofulous  ophthalmia, being most  indicated, how-
ever, when the scrofulous disease has manifested itself not only
upon the eyes, but also upon other parts of the body, especially
upon the  head in the shape of tinia favosa; and when the in-
flammation of the eye is attended with the formation of pus-
tules, great intolerance of light, and biting, aching pains.
  The inflammation  is generally not very  active; still the
piercing pains in the ball of the eye are often very acute, and
the pains are usually increased by exposure of the eye to light,
so that the patient fears to open it, and a  false photophobia is
produced.
  Swelling, not only of the eyelids, but of the whole neighbor-
hood of the eye, is often present, and then forms a farther indica-
tion for the use of Ehus.—Genl. Horn. Journ. Vol. 37,  p. 308.
  (c.) Lobethal says that he is convinced that the high dilu-
tions of Ehus are entirely  inefficient, and that it is  even not
prejudicial to the little patient to bring  on the primary effects
of the remedy by means of strong doses, in order to produce a
powerful alteration in the disordered lymphatic system.—Genl.
Horn. Journ. Vol. 14, p. 325.
  (d.) Thorer says he has lately  treated several scrofulous
ophthalmias,  in  all  of which,  vesicles and pustules were pre-
sent.  Ehus 30, 1 or 2 globules, every 2, 4, or 6 days, always
afforded the  most excellent result,  and  either perfected the
cure alone, or at least removed all danger  from the ulcera-
tions on the cornea.  Experience proved to him that Ehus 30,
was always sufficient if the remedy was indicated.—Practical
Remarks,  Vol. 3, part 2, p. 25.
   (e.)   Ehus  is particularly  homoeopathic to  erysipelatous,
eczematous,  and pemphiginous eruptions.  It has  been used
successfully against obstinate herpetic eruptions, and Delille
Flazac  has  even seen warty vegetations disappear under its
internal use.   Some allopathic physicians, such as Gescheidt,
Elsholz, and Scheibler have given it with brilliant success
against scrofulous ophthalmia  when attended  with very  ob-
stinate  and  excessive photophobia.   Also  Peithner and
Weitenweber found it very curative against scrofulous con-
junctivitis, inflammation  of the cornea,  with ulceration of the
cornea,  inflammation of the meibomian glands, spasm of the 
RHUS TOXICOD.
135
eyelids, and intolerance of light;  especially when these were
complicated with scrofulous  herpetic eruptions upon the face
and head.  It has also been used successfully against amblyo-
pia and amaurotic weakness of the eyes.  Dufresnoy, Eayer,
Mathai, and Willemet have confidence in it against herpetic
and scrofulous affections.
  The Ehus eruption is erysipelatous in its nature,  attended
with great and  inflammatory-cedematous  swelling,  with out-
break of pemphigous, or itch-like vesicles and pustules. Peters.
  From  cases furnished  by Thorer, Lobethal, and  Haus-
tein, Euckert has arranged  the  following clinical indications
for the use of Ehus in scrofulous ophthalmia:
   Great or  moderate swelling of  the eyelids;  conjunctiva
swollen and inflamed; red vessels running toward the cornea;
the cornea  covered  with phlyctsenas or vesicles;  small ulcers
on the  cornea, supplied  with blood-vessels from the white of
the eye; vesicles on the edge of the cornea; ulcers upon both
eyes; specks and  dimness of the cornea; loosening  of  the
sclerotica at the  outer edge of the cornea;  considerable lachry-
mation and intolerance of light, forcing  the patient to lie con-
stantly upon' his face ; acrid, hot discharge of tears ; sticking
together of the lids.

                 Accompanying Complaints.
  Eruptions  upon the head  and  face; large pustules  on  the
face, which change  to superficial ulcers;  the whole face is
covered with  a thick, whitish-yellow crust, which exudes moist-
ure at some places ; new vesicles spring up upon  the red skin
where the scabs  have loosened and form offensive scabs; swell-
ing of the face and nose, with roughness of the skin;  scrofulous
eruptions upon the  internal  surface of the  thick  and swollen
nose; discharge of a thick, greenish, acrid mucus from the nose;
watery discharge from the nose;  suppuration of the  glands
behind the ear;  thirst; hard and difficult  stools;  emaciation;
irritability  and inclination to  weep.


                          Review.

  The patients were from 1£ to 10 years of age; one was 19.
  Doses.— In one case, the first dilution was given in solution ; 
136
SCROFULOUS OPHTHALMIA.
the 3d was given in solution in one case, and in two-drop doses
in another; the 30th, in repeated doses  in  3 cases; the 200th
failed in one case, which was  relieved by Ehus  3d and 18th.
Ehus alone effected cures in 5 cases; Arsenicum was given as
an intermediate remedy in one case, and followed by Calc.
  The disease had lasted in 3  cases from 5 to 8 days, and was
cured in  from 5 to 9 days; 2 cases which  had  lasted each 1
and 4 years, were cured in  5 weeks.
  The above cases/even the chronic ones, do not seem to have
been of the most violent kind,  although attended with eruptions
upon the head and  face, and pustules upon the  eye.  Some
physicians prefer the lower dilutions, and Euckert has seen the
3d succeed when the 30th had failed.

                          silex.

  CASE 138.—A girl, who had suffered for a long time with
ophthalmia scrofulosa, was cured by Aqua Silic  10 drops 3
times a day, confined for several months.

                         SULPHUR.

  (a.) Knorre says that it is most useful when the eyelids are
most involved; when small vesicles are present upon the edge
of the cornea and nourished by vessels  running from the con-
junctiva ; the photophobia not great; and the inflammation of
the eyes is not as severe as that of the lids.—Genl.  Horn. Journ.
Vol. 6, p. 21.
  {b.) Hering says that it  is most useful when the lids are spas-
modically contracted in the morning; when the eyes do not
bear day-light well,  or the  patient  is quite blind by day, and
can only see in the dusk; when the sight is dim and misty, the
cornea dull and dusty;  and when the  lids are  most affected,
especially after the  previous use of Bell., Merc, or Hepar.
Also, when the white of the eye is reddened and crowded with
blood, with small vesicles upon it, attended  with lachrymation,
intolerance of light, and violent aching in the ball of the eye,
increased by sunlight.  The 3d dilution should then be repeat-
ed every day, or every other  day.
  (c.) According to  Bally, in the earlier  stages of scrofula,
when there is a general  coldness of the extremities and skin, 
SULPHUR.
137
vast quantities of Sulphur are sometimes separated from the
blood through the kidneys, also from the bowels, and from open
sores, as is evident from  the  blackening of lead-plasters and
silver instruments when brought  in  contact with scrofulous
pus;  clearly showing  that  sulphur is thus unnaturally dis-
charged from the system.  Again, cystine contains no less than
26 per cent, of sulphur, and is occasionally produced in excess
in the urine of scrofulous persons.
  It accelerates the capillary circulation,  the patient often feel-
ing a degree of warmth in the extremities; in fact it plays an
important part in the production and maintenance of the animal
heat.   It is most useful when  there is a tendency to coldness
of the hands, feet, and limbs ; when eruptions are present upon
the skin, and vesicles, or pustules, upon  the eye; when there
is much flatulence of the stomach and bowels; and large quan-
tities of sulphur  are expelled from the system, through the skin,
bowels, and kidneys.   Peters.
   From cases supplied by  Tietze, Knorre, Fleischmann,
Segin,  Elwert, andNEGiDi, EiiCKERThas arranged the follow-
ing clinical indications for the use of Sulphur.
   When the eyelids are more or less swollen, especially in the
morning;  the meibomian glands red and swollen; the edges
of the lids inflamed, thick, knotty, ulcerated, and covered with
thick and hardened matter.
   When the conjunctiva is injected, showing a convolution of
fine red vessels, which run to the edge of the cornea, and is red-
dened and swollen. The outer angle of the eye red and swollen.
   When the cornea is surrounded by a pale-red circle, with
lymph  effused between its layers ; when it is dim, traversed by
red blood-vessels, vascular at its upper half, with specks, ulcers,
and pustules upon its surface and  edges.
   When there is a profuse and hot flow of tears on opening
the eye ;  great intolerance  of light, especially of candlelight;
pain  and aching in the eye ; stitches, shooting through the eye
into  the brain;  double vision; inability to see small  objects,
while large ones seem enveloped in a mist.

                     Attending  Disorders.
   Eruption of itching pimples over the whole body ; pustules
about the eyes and ears;  lips swollen and covered with scabs ;
nettle-rash and scald-head. 
138
SCROFULOUS OPHTHALMIA.
  Swelling of the glands of the neck, behind the ears, and on
the nape ; suppuration of the glands of the arm-pit;  distension
of the abdomen; loose and chalky stools; emaciation; general
want of development.

                         Review.
  Of 14 patients, 2 were males, 8 females, and 4 unknown;  10
were between 1 and 9 years old, 4 between 14 and 17.
  The inflammation was generally great in extent and severity;
the cornea  had generally suffered severely;  the eye affection
was  often  accompanied  by a  general  scrofulous  condition,
marked by eruptions upon the head and body, and swellings
of the glands.
  Doses.—The 2d  and 3d triturations were  given in £ grain
doses in 4 cases; one dose sufficed in 3  cases; repeated doses
were required in 1.  The tincture was  given in single doses
in 1 case; in repeated doses in 2.  The  2d dilution, in  single
and repeated doses, each in  1 case.  The 5th dilution  in  re-
peated doses in 1 case.  The 30th dilution in repeated doses in
3 cases.  The 30th dilution in single doses in 1 case.
  Sulphur  alone proved sufficient to cure  the  disease,  in 8
cases; in 5  cases, Aeon., Bell., and  Conium were  given with
but little effect; in 5 cases, Sulphur was required to complete
the cure,  after the previous  use of Calc,  Lycop., Bell., and
Hepar.  After the use of the trituration of  Sulphur aggrava-
tions occasionally occurred, at times of the general inflammation,
at others of the photophobia, but then  a rapid  cure followed
in a few days.
  In 4 cases in which the disease had lasted from 2 to 14 days,
cures were effected in from 2  to 8 days; in 4 other cases,  of
from 1 to 3 years' standing, cures took place in from 1 to 4
weeks.  In cases of many years' standing, from 6 to 10 weeks
were required.

               CLOTAR MiiLLER's TREATMENT.
  Hepar. Sulph. is the principal remedy in all ordinary cases,
but it must often be given for a long time tegether.  In recent
cases, when there is considerable redness, swelling,  and pain, it
will be advisable to give several preceding doses of Aconite or
Bellad. 
HARTMANN'S TREATMENT.
139
  Intolerance of light is generally soon improved  by Bellad.;
still, Conium is the most important remedy in those  cases in
which there is no visible inflammation, either of the eyes or
lids.   Viola  Tricohr  often removes this very  troublesome
symptom.
  In  the severest  forms of this disease,  in  which the pain,
swelling, and ulceration  are very considerable, and the whole
course of the disease  quite acute, the Merc. Sublimatus is the
most reliable remedy.
  If the tears are so  acrid that  they excoriate the cheek,  and
eruptions make their  appearance upon the face, head, or ears,
then Rhus Tox. is the  most important remedy.
  Conium and Cannabis are the best remedies against the scars,
specks, and dimness of the cornea, left by recent attacks;  but
Sulphur,  Calcarea,  or  Silex  are necessary in very  old  and
chronic cases.
                 HARTMANN'S TREATMENT.

  Hartmann says that although the management of such a dis-
ease should be principally conducted with anti-scrofulous medi-
cines, yet  he has frequently  commenced the treatment  with
Euphrasia 3d to 6th dilution, with great benefit to the patient,
especially when there is redness  of the sclerotica, which is tra-
versed by red blood-vessels; specks, vesicles, and ulcers, on the
inflamed cornea, profuse discharge of tears and mucus, which
corrode the surrounding  parts; swelling of the eyelids; sensi-
tiveness of the eyes, and intolerance of light, with spasmodic
contraction of the eyelids;  stinging and  aching pains in the
eyes; profuse discharge  from  the nose.   He knows  that  Eu-
phrasia is not the principal remedy in this disease; but it  will
be found  excellent, provided it  is  chosen in accordance with
the symptoms, and  especially when  the  ophthalmia is compli-
cated with catarrhal symptoms.
  If the inflammation should become very acute, and the pains
intolerable, especially when the eye is dry, with excessive  sen-
sitiveness, then a few  doses of  Aconite should be given.
  Next to Aconite, Belladonna is the best remedy ; but these
two remedies are  not  sufficient to effect a complete  cure; there
will remain a certain  degree of  inflammation, and the intoler-
ance  of light may be particularly distressing  toward  evening, 
140             SCROFULOUS OPHTHALMIA.
and will sometimes increase so as to induce spasmodic closure
of the lids.   Then Hepar. Sulph. 3d, may be given with  great
effect;  the higher attenuations are not as efficient as the lower.
  Before giving Hepar. s., it may be advisable  to give a few
doses of Mercurius solubilis, especially if the swelling and spas-
modic closure of the lids render it impossible  to obtain a cor-
rect view of the state of the eye.  The Mercurius will diminish
the inflammation sufficiently to enable Hepar.  s. to act with
promptitude and decided effect.   When the inflammation runs
very high,  and burnin'g  and corroding tears are discharged
whenever the eye is opened, Mercurius  Cdrrisivus, 2 or 3  times
a 'day,  will act admirably.
  In some  cases, Hepar. s. will effect a partial improvement
only, and some other remedy must be given, after which Hepar.
will again act favorably.  Hartmann then usually gives Sul-
phur and Calcarea.,
  Sometimes all the efforts of art are baffled by the  obstinacy
and virulence of the disease, especially when new ulcers break
out on the cornea as fast as the old ones heal; then  Cannabis,
Mercurius,  Silex, or Sepia, may be used.  But in obstinate
cases, where no other medicine seemed to do the least good,
Arsenicum will finally overcome it,  especially if  given in alter-
nation with Euphrasia.
  Thorer has recommended Rhus, and Hartmann  has given
it with good results in some cases,  especially when scrofulous
and herpetic eruptions on the head and face were present.

                 ALLOPATHIC TREATMENT.
  Lawrence says that we must first endeavor  to remove the
unhealthy condition of the digestive organs and skin, which is
so prominent a feature in the complaint, and  to invigorate the
constitution.
  The bowels must be completely cleansed from the accumulated
load of ill-digested food and unhealthy secretions; 2  or 3 purg-
ative doses often afford the greatest relief to the sufferings of
the child.  Then Mercurius should  be  given  until the tongue
is clear, and the motions  of natural  consistence  and  color.
Finally, in the state of debility to which the yeung sufferers
are frequently reduced by this painful and obstinate complaint,
tonic  medicines  may be   used.   Mackenzie recommends 
TREATMENT  OF SCROFULOUS OPHTHALMIA.      141
Quinine strongly; he has found no remedy so useful as this;
it  exercises a remarkable power over the constitutional dis-
order which attends scrofulous ophthalmia, and thereby over
the local complaint.  In most instances, its  effects are very re-
markable ;  in  most cases, it acts like a charm; abating com-
monly in a few days, the excessive intolerance of light, and the
profuse lachrymation; promoting  the absorption of the pus-
tules, and hastening the cicatrisation of the ulcers of the cornea.
   Belladonna  has been strongly recommended against  intole-
rance of light and spasmodic closure of the lids; if the dose be
increased until dilatation of the pupil is produced, the  photo-
phobia invariably disappears.
  GENERAL REVIEW OF THE TREATMENT OF SCROFULOUS OPH-
                         THALMIA
  In the preceding chapter, we find 75 cases of scrofulous oph-
thalmia cured by 15 different remedies, in which Sulphur was
given with  decided advantage in  14 cases ;  Calcarea,  in 13;
Merc. Subl., in  10 ; Ehus, in 7;  Arsenicum and Conium, each
in 6 ;  Bellad., in 5; Hepar., in 4; Merc Solub., in 2 ; Aurum,
Caust.,  Euphrasia, Magnes., Acid. Nitric, Pulsat., and Silex,
each in 1 case; while Baryta and Psorin have been merely re-
commended.
  When the disease occurred in  a chronic form, we have found
that Arsen., Aurum, Calc, Conium, Hepar., Magnes., Merc.
Sol., Pulsat., and Sulphur, have  been  relied upon.   In the
more acute attacks, Bellad., Subl., Ehus,.and Sulphur.  In the
slighter  cases, Bellad. and Ehus.  In the more severe attacks,
Arsen., Calc, Hepar.,'Subl., and Sulphur.  When there was
an effusion of pus in the anterior  chamber, (hypopion,) and pro-
lapsus of the iris, Hepar.  Against specks, ulcerations, and vege-
tations of the cornea, Cannabis, Euphras., and Nitric Acid.  In
the  more torpid forms, Hepar.; in  the  erethistic,  or  irritable
varieties,  Sublimate.
   j)oses.—In these we find very great differences of  opinion
and practice.   The lower, or  stronger preparations  of  Bellad.,
Hepar.. Conium, and Ehus, were used, and these were even found
practically,  more preferable to the higher potencies.  Aurum, 
142      TREATMENT OF SCROFULOUS OPHTHALMIA.
 Euphrasia, Merc. Sol. and Subl., Silex, and Sulphur were also
 used in the lower dilutions.  The  30th  dilution of Ars. and
 Calc. was occasionally relied upon, and also of Sulphur, Ehus,
 Hepar., and Causticum.   The high potencies of  Calc, Hepar.)
 and Ehus were employed, but at times without effect.
   The 75 cases were furnished by 34 different physicians, the
 majority of whom are in favor of the lower dilutions, namely,
 Bo'cker used them successfully 13 times; Tietze, 6 times;
 Bicking, in 4  cases; Lobethal  and Hanstein, each in 3
 case ;  Frank, and Frelitz, each in 2 cases: in all, in 31 cases.
 The higher dilutions were relied upon by an anonymous  phy-
 sician in 9 cases; by Thorer in 5;  by Tietze in 4; by Gross
 and Segin, each in 3; by Hermann in 2 ; by  Bicking and
 Haustein, each in 1 case; in all, in 29 cases.
   The local use of the appropriate remedies was employed with
 Aurum, Bellad., Conium, Euphrasia, and Subl. ; the external
 use of  Conium  was found especially useful  against nervous
 photophobia.  Euckert says, that the external and local action
 has been too little brought in play;  when the watery solution
 does not avail, an ointment  may be applied with  benefit.
   The results of the treatment were necessarily very variable,
 although they were often both  rapid and decided  even in the
 most refractory cases. Thus, of 11 cases in which the  disease
 had lasted from 1 to 4 weeks,  cures were effected  in every in-
 stance in from 2 to 6 or 10 days.
   In 4 cases in which it had persisted from 1 to 4 months, 3
 cures were effected in from 4 to 14  days, and in 1 case, at the
 end of 5 weeks.
   In 21 cases, in which the duration was from 1 to 5 years and
longer, 3 cures were accomplished  in from 4 to 20  days;  14
cures in from 1 to 6 weeks ; and 4, in from 8 to 12 weeks.
   In contrast to these results we find in Fischer's Clinical
Guide,  that of 20 cases treated  aUopalhically, 9 had lasted from
4 to 14  days, and 3 of these were cured in from 14 to 18 days;
3,  in from 3 to 4 weeks; 2, in  from 7 to 8 weeks; and 1 at the
end of 8 months.
   Of nine other cases which had lasted  from 4  to 6 weeks, 6
were cured in from  3 to 8  weeks;  and  3, in from 11 to  20
weeks.   In 1 other case of 12 weeks' standing, a  cure was ac- 
TREATMENT OF SCROFULOUS OPHTHALMIA.      143
complished in 4  weeks; and 1  of 3 months' duration, in 3
months.
  In 15 cases out of the 75, it is expressly stated that they had
been treated allopathically for a long time unsuccessfully.
  Hartmann recommends Hepar., after the previous use of
Bellad.;  while Schroen and Hering both recommend  Sul-
phur, and  the latter, Merc. Calcarea is  often indicated after
Sulphur, and Hartmann and Lobacher advise them in alter-
nation.  Calc. is  recommended by Lobethal, as equally use-
ful  as  Nitric Acid "and  Cannabis, against vegetations  of  the
cornea.  Gross recommends  Nitric Acid  after the previous
use of Calcarea.
  In excessive intolerance of light, Schroen  gives  1  dose of
Bellad. between each 2 doses of Hepar.  Hering is afraid to use
Sulphur after Hepar.
  Bicking thinks  Hepar.  most indicated  in  patients  of  the
torpid scrofulous constitution;  also Conium and Calcarea.
Bocker thinks that Sublimate is more useful against the irri-
table than the sluggish forms of inflammation.
  The parts of the  eye involved in the disease, and the kind of
pains which prevailed, and the signs of general scrofula which
were present in the different cases, will  be found most easily
by reference to the following Tables, of which No. I. contains
the disorders of the tissues, and the varieties of the pains ; while
No. II. includes the other more distant affections.
			rABLE II.						
	in *> J-i <	T3	03 u "3 o	i "3 o	u a Pi SB	3	OQ a	3 .c a.	.d P. "3 m
			Calc. Calc. Calc. Calc. Calc. Calc. Calc.						
				Con.	Hep.		M.Subl.	Rhus. Rhus.	Sulph.
									
Inflam. & Swelling ab't Eyes				Con.	Hep.			Rhus. Rhus.	
	Ars. Ars. Ars.	Bell.				M. Sol. M. Sol. M. Sol. M. Sol.	M.Subl.		Sulph.
									
				Con.				Rhus.	
									
		Bell.	Calc. Calc. Calc. Calc. Calc. Calc. Calc. Calc. Calc. Calc.		Hep.				Sulph.
									Sulph.
									
					Hep. Hep.		M.Subl.	Rhus.	
									
								Rhus.	
									
									
									Sulph.
				Con.					
Irritability and Obstinacy...	Ars.								
						M. Sol.			
 
				TABLE		I.										
		a& 3 d u •<	a 3 3 <	OS ->> u a P		o! to M oS o "3 o	S 3 3 05	a 3 a o	OS OS I. a. 3 w	u Pi a	i a S3		1 s	2	3 «	a "3 03
... a 11		Ars.			Bella. Bella.			Con. Con. Con. Con.		Hep. ...		M. Sol.	Sub.		Rhus.	Sulph.
						Calc.										
		Ars.				Calc. Calc.				Hep.						
		Ars. Ars. Ars.			Bella.	Calc.		Con. Con. Con.		Hep. Hep. Hep.		M. Sol.	Sub. Sub.			Sulph.
Edg Mei Oon,																Sulph.
		Ars. Ars.						Con. ' Con."					Sub. Sub. Sub.			Sulph. Sulph.
	Swollen—...........................................	Ars. Ars.			'Bella.'	Calc"				"Hep!' Hep.						Sulph.
													Sub. Sub.			Sulph.
					Bella.			Con. Con. Con.								Sulph.
		Ars. Ars. Ars.				Calc.									........	
Pup Con Ant Scle Oar Into									Euph.	Hep.	Mag.			Ac. Nit.		Sulph.
				Bary.			Caust.			Hep. Hep.					Rhus.	
	' " Lymph.................................	Ars. Ars.				Calc.				Hep. Hep. "Hep;' Hep. Hep.			Sub. "Sub." Sub.			Sulph. Sulph. Sulph.
						Calc.		Con.								
		Ars. Ars. Ars. Ars. Ars. Ars. Ars. Ars. Ars. Ars. Ars.														Sulph.
			Aur.		Bella. Bella.	Calc.		Con.	Euph.	Hep. Hep. Hep. "Hep'.' Hep.						
																
																Sulph.
Tea^	re, Hot..........................................................					"Caic!'		' Con."' Con.				si" Sol'.			Rhus.'	Sulph.
					Bella. Bella.	Calc.										Sulph.
																
						Calc. Calc.		Con. Con.		Hep.						
																Sulph.
												lii. Soi				1 . ...
																

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TREATMENT  OF RHEUMATIC OPHTHALMIA.      145
                 RHEUMATIC OPHTHALMIA.
   See page 49.
   (a.) RUckert  says that in this dangerous form of eye-in-
 flammation, the homoeopathic literature has several very inter-
 esting cases of cure to present.
   The following remedies have been  used most frequently,
 namely, Aeon., Bryon., Clematis, Coloc, Natrum, Mer., Puis.,
 Merc. Sol., Rhus, Spigelia, and Sulphur.
                         ACONITE.
   Kreussler says  that Aconite deserves  particular attention
 in rheumatic  ophthalmia; it often  effects  cures unaided  by
 any other remedy.
   {b.) It is a  decidedly  homoeopathic remedy to rheumatism,
 (see Treatise  on  Apoplexy, p. 67.)  It causes  pains, especi-
 ally in the bones  and joints.  Vogt.  Painful sensations in the
 bones and joints, which disappear after the breaking out of a
 profuse sweat, and abundant flow of urine. Sobernheim.  It
 acts decidedly on the fibrous system ; causes the most violent
 pains in the  bones and joints.   Harnisch.  General painfull-
 ness of all the joints.  Kuttner.  (Peters.)
                        BRYONIA.
   (a.)  Dudgeon says it is  an efficient remedy in rheumatic
 ophthalmia, when the sclerotica, and  membranes of the aque-
 ous humor are involved.
   (6.) Hering says it is useful after Pulsatilla when the pains
 have  lessened, but the redness remains; also when the  eyes
 burn  or smart as  if sand  were in  them, aggravated in the
 evening and at night; when the lids are swollen, and the pain
 shoots into the head, when they are opened.
   {c.) Bryonia resembles Colchicum in its action ;  it acts princi-
 pally upon the serous and fibrous tissues, and upon the liver,
 and is perhaps most serviceable in the  rheumatisms of bilious
persons, who are also subject to derangement of  the  stomach,
 nausea, and diarrhoea.   Peters.
                        clematis.
   (a.) Hartmann says  it is the most important remedy, and
its place can be supplied by no other, when the  aching in the
                   10 
146       treatment of rheumatic ophthalmia.

eyes, intolerance of light, and lachrymation are especially in-
creased in the open air;  when the eyelids stick together in the
morning, with great heat in them, and the iris is inflamed.
  (5.)  It  is allied to Rhus and  Corrosive  Sublimate in its
action, causing  an  efflorescence upon the skin and  a vesicular
eruption; and  curing chronic  headache when seated in the
fibrous tissue of the scalp, secondary syphilis, venereal ulcers,
and bone pains, also fungus excrescences, and various  chronic
humid exanthems.   Peters.

                       COLOCYNTH,
  {a.) Acts with peculiar  power upon the nerves and other
portions of the very lowest parts of the bowels, and neighbor-
ino- organs, such as the kidneys,  lumbar plexus of nerves, etc.;
and is especially homoeopathic in  affections of the  eye and
head, which arise in connection with, or  from sympathy with
these parts, both neuralgic and inflammatory.
  CASE 137.—A man,  aged  34, had suffered for 8 days with
pain in the right  eye, returning periodically every morning ;
the conjunctiva was red, the edges of the lids irritated,  the eye
watered and seemed smaller, with the sensation as if it would
fall out when the  patient stooped.   The attack commenced
with piercing pain in the forehead  over the eye ; followed by
rending pain extending from the  eye into the right  temple,
aggravated by coughing, shaking the head, looking  at a bright
light, and by touch.  There was a discharge  of purulent nasal
mucus ; obstruction of the nose and loss of smell;  the patient
was chilly, irritable, and weak.  The paroxysms lasted until 2
p. m., with entire relief during the evening and night.
  Treatment—The attack was cured in  4 days, by Colocynth
3, 1  dose every night and morning.— Genl. Horn. Journ. Vol.
34, p. 323.  Haustein.

                  NATRUM MURIATICUM.
  See Treatise on Headaches,  p. 55.
  The use of common table-salt, as a medicine, was for a long
time confined to the homceopathists; now it is used in the
dominant  school as a tonic and nutrient remedy; it is sup-
posed to improve the_ blood, to diminish the quantity of serum
quite  decidedly, thus rendering it thicker;  also to  increase 
PULSATILLA.                    147
the quantity of blood-globules quite decidedly;  augments the
fibrin in a slight degree, and lessens the quantity of albumen
in an equal proportion* finally, it  also increases the quantity
of iron and fat in the blood.  It increases the appetite, but its
most certain  and frequent effect is increase of strength, while
the heat of the body is more readily generated and exposure to
cold is better borne.  M. Plouviez increased in weight under
its use to the amount of 13£ lbs. Troy in about 2 months, and
repeatedly became  so plethoric with fullness about  the head,
that he felt himself obliged to be bled.  Hence it is regarded
as an antipathic remedy to debility, emaeiation, anasmia, chlo-
rosis, and  scrofula.  Latterly it has been used as a  substitute
for  Bark,  Quinine, and  Arsenic  in  the  treatment of fever
and ague;  it succeeds in  about 60 per  cent,  of  all cases.
Peters.
   CASE 138.—A man, aged 29, had suffered occasionally for
several years  with  rheumatic catarrhal  ophthalmia.   The eye
seemed dim,  pus collected  at the  angles, there  was  profuse
lachrymation,  slight redness of the conjunctiva of the ball, and
some swelling of that of the lids;  the pupils were somewhat
contracted, the iris  discolored; exposure to  light  caused a vio-
lent piercing  in both temples-;  there was  a constant  appear-
ance  of gauze before the eyes,  and feeling as if it must  be
wiped away;  change of light caused  violent pain;  objects
disappeared while reading and writing; he  could not see  dis-
tant objects at all;  at 10 paces every thing  looked like large
black bodies.
   Treatment—1 dose of 8 globules of Natrum Mur. 30,  was
given daily Tor 4 weeks;  then Natrum 30  and 12, in alterna-
tion,  every 2 days;  the  patient  was cured in 4 months.
LORBACH.

                       PULSATILLA
acts decidedly upon both the mucous membranes and  fibrous
tissues, and hence has a relation both to catarrhal and rheu-
matic affections ; it also has a specific relation to the eye.
  Hering says after the severity of the inflammation has been
lessened by Aconite, but violent pains still remain, and are
cutting, boring, or  piercing, the  eye being  intolerant of light,
all the symptoms being increased in the afternoon and evening; 
148      TREATMENT OF RHEUMATIC OPHTHALMIA.
 when there  have been frequent relapses, and the patient is in-
 clined to weep, then Pulsatilla will be found useful.
    CASE 139.—A lad, aged 13,  suffered with ophthalmia at-
 tended with considerable pain about the eye;  the sclerotica
 was traversed by fine, red vessels, which formed a rose-red cir-
 cle around the cornea; there was but slight conjunctivitis, and
 some  iritis;  also oedema of the upper lids and profuse secretion
 of mucus.
    Treatment—Pulsat. 30, 2 doses; in 48 hours the whole dis-
 ease was  removed except a  slight conjunctivitis.   Puis, is-
 supposed to be specific in similar cases.   Link.


                    MERCURIUS SOLUBILIS.
    Mercury is the remedy par  excellence in all rheumatic affec-
 tions of the eye in which the iris is involved.   In most cases
 it would be  unsafe to trust entirely to any other remedy.
    CASE 140.—A healthy,, blooming girl, aged 19, had suffered
 with  her  eyes for  12  days.  Both  eyes had been  attacked
 simultaneously, but the right  one had improved  rapidly, so
 that the pupil was only a little too widely dilated and the iris
 too little sensitive to light.  The sight was gone, however, in
 the left eye.
    The sclerotica was inflamed, as was evident from the pecu-
 liar redness around the cornea and  beneath  the conjunctiva.
 The centre of the cornea  was transparent and free from ulcer-
 ation, but its circumference was dim and grayish like ground
 glass;  the pupil was  contracted, irregularr  and immovable \
 the color of the iris had a greenish tinge, the pupillary edge
 was swollen, and there was a delicate gray exudation of lymph
 within the circumference of the  pupil, {iritis;) there was also
 a small deposit  of yellow pus at the bottom of the anterior
 chamber, (hypopion.)  Daylight could be distinguished from
/ darkness with the diseased eye, but every thing seemed changed
 into a gray mist;  there  was  no intolerance of light, some
 lachrymation, no great pain  by day, but violent,  rending, tear-
 ing pains sat in in the eye and  its neighborhood, in the temples,
 forehead and cheeks, every evening and night.
    Treatment—One  grain Merc. Sol. 3, was given  daily for 2
 weeks ; in a few days, the pains had ceased, and there was only 
RHUS.
149
a slight redness about the cornea; but the eye was dim ;  still
the pupil was clear, and no longer irregular; the iris blue and
sensitive; the dimness and pus had disappeared, and sight was
restored.  A perfect cure  soon followed.—Genl. Horn. Journ.
Vol. 19, p. 68.   Knorre.
  CASE 141.—A sickly, psoric woman had suffered for several
weeks with rheumatic ophthalmia;  the sclerotica and conjunc-
tiva of the right eye were inflamed;  the rosy redness of the
former  was visible through the latter;  the conjunctiva re-
sembled a dense  net-work of blood-vessels;  there was  an
ulcer upon the cornea of the size of a  mustard-seed,  with
broad, whitish-gray and opaque edges; there were rending and
boring pains in the eyes and its neighborhood, especially in the
frontal bones, with aggravation in the evening  and at night.
Shaking chills  sat in when the aggravations lessened ;  lachry-
mation, photophobia, especially for candlelight, imperfect vision,
as if looking through mist; rending pains in the ear and  teeth
of the right side.
  Treatment—Merc.  Sol. ^th, 6 doses, one per day, effected a
perfect cure  in 14 days, marked by cessation of the inflamma-
tion, and cicatrization of the ulcer.  Knorre.

                          Review.
  The striking features in the above cases are:  the presence of
rending and boring pains, increased at night, and seated in the
bones about the eye;  the inflammation of  the  sclerotica, with
bright rosy-redness visible through the conjunctiva; and the
well-marked Iritis.
  The doses were Merc. 1-12 gr., and Merc 3.

                          RHUS.
  (a.) In an epidemic of catarrhal-rheumatic ophthalmia, Schel-
ling found Rhus the principal remedy; next in order, Arseni-
cum was found most useful, especially when the patient had a
pale, delicate skin, tendency to bloating, considerable debility,
with inclination to fainting.
  When there  was a tendency to scabious affections, Sulphur
proved useful;  to  rhachitic or scrofulous disorders, Calcarea;
to herpetic and impetiginous eruptions, Lycopodium. 
150       TREATMENT OF RHEUMATIC OPHTHALMIA.

  {b.) Hering says, when Bryonia seems indicated, but does
not help, and there are biting, aching, and sticking pains, with
much lachrymation, and agglutination of the lids, or when they
are swollen, as if from erysipelas, then Rhus is useful.
  (c.) Rhus is most decidedly homoeopathic to erysipelatous,
pemphiginous and vesicular diseases and eruptions; as these
stand in an almost antagonistic relation to rheumatic affections,
it is exceedingly doubtful whether Rhus  is ever truly and ab-
solutely  homoeopathic  to  any decided  rheumatic affection.
Peters.
  From cases furnished by Schelling and Segin, the follow-
ign clinical indications for the use of Rhus have been arranged
by Ruckert.
  Eyelids swollen and closed on account of intolerance of light,
and spasmodic  contractions;  cedematous swelling of both
lids.
  Edges of the  lids reddened,  and the  lashes  stuck together
with mucus; profuse lachrymation of both eyes;  pimples and
red streaks upon the cheeks, excited by  the acrid tears;  con-
junctiva of the left eye covered with a bright, erysipelatous red-
ness ; redness of the conjunctiva of both eyes, which is traversed
with a delicate vascular  net-work ; sclerotica of both eyes vel-
vety and dark-red;  redness  of  the sclerotica and development
of numerous blood-vessels ;  blood-redness of the right eye; a
dense net-work of vessels surrounding the cornea, and forming
a wall  around  its  circumference, '{chemosis;) dimness  of the
cornea, which is covered with  mucus; grayish opacity of the
right cornea, with two whitish and shining specks; commencing
opacity on the left cornea ; dimness and smokiness of the capsule
of the lens ; pupils insensible to  alternations of light and shade ;
great sensitiveness of the eye to  light; change of the color of
the Iris from blue to green, with indistinctness of the pupillary
margin, (Iritis.)  The Iris oblique and somewhat contracted;
excessive soreness of the ball of the  right eye, so that  it will
not bear the slightest-touch;  aching, burning pains in the eyes ;
intermittent inflammation of the  eyes; irritability of temper to-
wards noon, so that the  patient is apt to strike and press his
head against the wall. 
RHUS.
151
                 Accompanying Complaints.
  Dizzy sensation, as if one were drawn backwards or sidewards
while walking; headache often increased by day, and also at
night, which, however, occasionally lessens, but never entirely
ceases ; piercing pains, especially  in the left temple, extending
into the eye;  heat of the head; redness of the face during the
attacks of pains,  but frequent paleness at other times; dirty,
yellow, and pale color of the face,  with some bloating; rushing
and noises in the ears;  white coating of the tongue; insipid
and pasty taste in the mouth ;  dryness of the mouth, without
thirst; slimy state of the mouth;  fullness of the stomach, and
nausea after taking but  little food;  twisting, turning,  and
sense of emptiness in the  stomach, with yawning  and eructa-
tions while fasting; pressing and cutting pains in the abdomen;
dry and painful stools, occasionally alternating with diarrhoea;
frequent urinations,  especially at  night, occurring quickly and
even involuntarily;  then retention of urine, which is dark-red.
  Limbs.—Not slight rending, piercing,  and flying pains in the
limbs, especially in the armpits, shoulders, hips, and thighs of
the left side; excessive tenderness of the first dorsal vertebra,
{spinal tenderness;) constant spasmodic  contraction of the left
thigh, with spasmodic pain in  it, and tension extending from
the knee to the swollen foot.
  An eruption of red pimples and pustules upon the nose and
cheeks becomes' more severe as  the eye affection improves,
and vice versa; violent burning  and rending pain about the
affected eye,  aggravated every night and morning, depriving
the  patient  of  rest  and sleep;  sleep  restless, , disturbed by
dreams and tossing about.
  Fever Symptoms.—Chilliness and cold extremities in the after-
noon ; skin dry and very sensitive to slight changes of temper-
ature ; incessant  chilliness and shuddering, as  if from ~a cold,
moist draught of air, extending from the feet and thighs up-
wards ; irritability and impatience; sudden fits of passion.

                          Review.
  In 3 cases, the patients were of the sanguine temperament
4 were females; 2 were from 2 to 4 years of age ; 2,30 years ;
and 1, 42 years. 
152      TREATMENT OF RHEUMATIC OPHTHALMIA.
   In 3 cases, the attacks arose from cold, and had  lasted from
 2 to 3 weeks ; 2 cases had persisted for 10 weeks; in  3 cases,
 the disease was confined to the right side.
   Doses.—Low dilutions were used in all cases, namely, from
 the 1st to the 5th ; improvement began in from 4 to 6  days.
   Rhus alone effected cures in 4 cases; in 1 case, in a scrofu-
 lous patient, Calcarea was given to complete the cure.


                         SPIGELIA.
   See Treatise on Headaches, page 85.
   (a.) Rummel says that it seems peculiarly suited to rheu-
 matic  and arthritic ophthalmias, and  to possess the  power
 of controlling severe inflammations  of the  eye and/sornea.
 Pains about, and deep in the eyes are removed by it.
   CASE  142.—A patient had  suffered for 14 days with oph-
 thalmia ;  the  eye was greatly reddened;  the crowded vessels
 formed a bluish-red circle deep in the sclerotica, a few lines from
 the  cornea;  the cornea, especially its lower  segment, was so
 much dimmed that the form of the pupil could  not be  clearly
 distinguished, and all objects seemed as if enveloped in mist.
 The eyes  were exceedingly painful, especially when moved or
 turned, somewhat relieved by holding the lids closed;  violent
 aching, which extended  from the bony portions of the orbit to
 the temples;  sensation as if an ulcer would form in  the eye;
 exposure  to light was not exceedingly painful to the eye.
   Treatment—Sulphur 2,  did not afford relief; then Spigelia
 30, 1 drop, was given ; the following night was spent without
 pain, the inflammation had lessened, but on the following even-
 ing,  the pains had increased, with discharge of biting, acrid
 tears.  Spigelia 30, was repeated, with progressing improve-
 ment,  except that the  cornea remained unchanged.  Tinct.
 Euphrasia, 1 drop per dose, removed the dimness of the cornea
 in a  few days.  The painless congestion of the white of the  eye
 disappeared under the use of Nux 24.   Rummel.
  CASE 143.—A man had had violent pain in the right eye,
 2 years ago,  after the cessation of which a ptyrygium com-
 menced to grow until it extended far upon the cornea.  At
present there was a fresh attack of pain as if the  left eye would 
SULPHUR.
153
burst, increased by stooping, and appearing regularly for along
time every morning before rising, lasting until noon, and then
suddenly ceasing.
  Treatment—Nux did not help; Spigelia 30, 2 doses cured
him.  Pulte.

                         SULPHUR.
  CASE  144.—A lad, aged 18, who had had suppressed itch,
and  lost his  right eye  from an attack of  inflammation, was
taken with ophthalmia in the left eye.  Equiform, bright redness
of the sclerotica, formed by minute blood-vessels ;  single vari-
cose bundles  of vessels on the conjunctiva; bluish circle around
and  slight opacity of the  cornea;  contraction and immobility
of the pupils; acrid flow of tears;  intolerance of light; violent
rending pains in the supraorbital and temporal regions, and in
the eye itself, increased at night;  slight fever.
  Treatment—At first  daily, and then bi-daily, drop-doses of
Tinct.  Sulph. were  given; the first dose  relieved the pains
somewhat, and in 3. weeks, the whole disease was removed.
Dietz.
  CASE. 145.—A middle-aged man had suffered for a long «
time periodically with attacks of ophthalmia.
  Symptoms.—The  whole left  eye  seemed enlarged, and  its
coverings  swollen;  the cornea was dim, as if  covered with
fine  dust, and was the seat of a  suppurating ulcer;  the con-
junctiva was blood-red from crowded blood-vessels; intolerance
of light; constant aching pains about the whole circumference
of the orbit, increased to a frightful degree by moving the eyes,
or exposure to sunlight, even when the lids were closed, and
almost driving the patient to despair.  The  pain involved the
whole of  the head and caused entire loss of rest and self-com-
mand.
  Treatment—1 grain of Sulph. 2, removed the whole disorder;
even the ulcer healed in a few days.  Gross.
  CASE  146.—A robust  man, aged 27, had suffered for years
with periodical attacks of ophthalmia.
  Symptoms.—-In a new attack, the left conjunctiva was blood-
red,  as  if  injected;  there were aching, tensing,  burning, and
piercing pains through the left eye ; rending pairis in the left 
 154      treatment of rheumatic  ophthalmia.

 side  of the  head;  but little  appetite; constipation; fever in
 the evening, with heat through the whole body;  almost con-
 stant  chilliness by day;  mist before  the eyes;  quick, hard
 pulse.
   Treatment— Aconite and  Bellad. caused but little improve-
 ment ;  but 2 doses of Sulphur 30, one every 4 days, cured the
 whole radically in 8 days.   Tietze.
   CASE 147.—In rheumatic ophthalmia, with great redness of
 the sclerotica, decided intolerance  of  light, discharge of acrid
 tears, rending  and  piercing pains in  and about the eye, with
 rheumatic pains in other parts, Bellad.  30, with  alternating
 doses of Sulphur 60,  produced decided good  effects.   Several
 cases were cured by Sulphur alone; others by Nux.  Weber.
   CASE 148.—A  rough and  drunken woman, aged 53, who
 had ceased menstruating for  1 year, had suffered  for 2 years
 with repeated  attacks of inflammation of the right eye.  The
 present attack had lasted 4 weeks.
    Symptoms.—A pale-red edge around the  cornea, more de-
 cided above, where there was an extensive inflammation of the
• sclerotica and conjunctiva.  From thence a  bundle of vessels
 extended half  across the cornea, between which  the  cornea
 appeared like  ground glass, or like gelatin, and was also some-
 what swollen; the conjunctiva of the ball and  the sclerotica
 were not actually inflamed, but only traversed here and there
 by enlarged blood-vessels.  Intolerance of light, lachrymation,
 heat and burning in the eyes, sticking together  of the  lids,
 rending pains  in the eyes and about the face,  and  right side of
 the head, with evening and  night aggravations,  roaring  and
 rushing  sounds in the right ear, with  deafness, periodical
 rending pains in the left ear,  with discharge of purulent serum,
 especially  at  night;  rending  rheumatic pains  in the  right
 shoulder-joint,' so  that she can often not raise the  hand to the
 mouth, or use it at work.
    Treatment—Sulph. 3, grain doses,  one every  morning; in
 7 days, the inflammation had entirely disappeared; the cornea
 was so clear that she could distinguish large objects ;  10 doses
 more effected  a perfect cure in 3 weeks more.  Knorre. 
REVIEW. .
155
                          Review.
  Of the 4 cases, 3 were in males and 1 in a female, of the age
of 18 to 40 or 53 years.  The disease was inclined  to return
periodically;  one patient had already lost an eye, in a similar
attack.  In all cases, the disease was confined to one eye, namely,
twice on the right side and twice on the left.  The redness of
the sclerotica and the characteristic ring about the cornea were
distinctly evident.   The  pains in  and  about the  eye  were
aggravated in the evening and night.
  Doses.—Tinct. Sulph. in 1 case;
          Trit. 1st and 2d in 2 cases ;
          Sulph. 30, and 60, in 1 case.
  Sulphur alone cured 4 cases, in one instance after the pre-
vious ineffectual use of Aeon, and Bellad.  In one case, Bellad.
was alternated with  Sulph.  Even  long-standing cases were
cured in from 1 to 3 weeks.  In 1 case, after repeated doses of
Sulph. 3, a not inconsiderable aggravation preceded  the  cure.


   General Review of the  Treatment of Rheumatic Ophthalmia.
  In 14 cases, Rhus  and Sulph. were each  used  in 4 cases;
Merc, in 2 ; Coloc, Natrum Mur., Puis., and Spigelia, each in 1
case.  In the  more acute forms,  Coloc, Puis., Spigel., Rhus, and
Merc, were relied upon ;  in the chronic cases, Sulph. and Merc;
when there  was  an  intermitting  type, Coloc.  and Rhus;
Aconite, Bryonia, and Clematis were merely recommended.
  When  the  lids were swollen, Bryon.; and  when closed,
Rhus; cedematous  swelling with redness of the edges of the
lids, Rhus; especial  oedema of the  upper lids, Pulsat.;  when
the angles of the eye maturate, Natrum Mur.
  When  the conjunctiva is only slightly  inflamed, Pulsat.;—
bright red, and traversed with a net-work of enlarged vessels,
Merc,  Rhus, Sulph.;  when  there was  a  wall around the
cornea,  (chemosis,) Rhus and Sulph.
  When  the scelorotica was inflamed,  Sulph.; traversed with
small blood-vessels, Puis.;  rose-red,  Merc.; a bluish-red circle
around  the cornea, Spigelia; a rose-red one, Puis.;  red, with
great development of the vessels, Rhus and Sulph. 
156
GENERAL REVIEW.
  When the cornea was surrounded by a pale rim, Sulph.;  by
an opaque, whitish-gray circle, Merc; dim, opaque, and glance-
less, Merc,  Spigel.,  Sulph.;  gelatinous and swollen,  Sulph.;
covered with ulcers, Merc, Sulph.; with commencing  opacity,
Rhus and Sulph.
  When the iris is inflamed, Clematis;   discolored,  Natrum
Mur;  greenish, Merc, Rhus; irregular, Rhus.
  The  pupils  contracted, distorted,  and  immovable, Merc ;
insensible, Rhus.
  When the pupillary margin is indistinct,  Rhus;  swollen,
Merc.; the membranes of the aqueous humor affected, Bryonia.
  The  lens smoky and dim, Rhus.
  Intolerance of light, Natrum m., Puis., Rhus. ;■ lachrymation,
Merc;  acrid tears, Rhus and  Sulph.
  Aching pains were relieved  by Rhus,  Spig., and Pulsat. ;
when  aggravated by motion and sunlight,  Sulph.;  piercing
pains, by Natrum m.;  rending and  boring, by Merc ; in the
bones about the eye, Merc. Sulph.,  and Sulph.;  nocturnal
aggravations, by Merc, Sulph.
  Rhus cured various  accompanying gastric affections;  pains
in the limbs, fever, rending in the shoulder-joint by Sulph.
  Doses.—The  higher dilutions of Natrum, Puis., Spigel., and
occasionally of Sulphur were used.   The lower potencies of
Rhus, Merc, and Sulph., almost always in repeated doses.
  Of the 15 physicians who furnished cases, 7 used the lower
potencies, and  8 the higher.  Repeated doses were used in 14
cases.
  Results.—In  the slighter cases, improvement began in from 4
to 6 days; in  chronic cases, from 2  to  3 weeks; 4  months
were required in 1 case.
  Calcarea was given after Rhus, and Euphrasia after Spigelia
with good effect.
  Kreussler  says Aconite alone will often effect cures ; Bry-
onia is recommended by Dudgeon, especially  in affections of
the sclerotica and membranes of the aqueous humor.   Hering
advises Clematis after Pulsatilla has relieved the pains, but not
removed the redness.   He also gives Pulsat. when Aeon, has
lessened the inflammation,  but  not removed the nocturnal
pains.   And praises Rhus, when Bryonia seems indicated, but
does not help. 
CATARRHAL OPHTHALMIA.
157
             CATARHAL  OPHTHALMIA.
  See pages 27, 29, and 45 to 49.
  According to Klotar Muller, as the inflammation sets in
suddenly, with great  pain  and some fever, it is judicious to
commence with Aconite; it is also useful in the later stages of
catarrhal-rheumatic ophthalmia, when there are insupportable
pains in the whole ball of the eye, or above and  about it, com-
mencing in the evening and aggravated at night.
  Belladonna is especially suitable when the white of the eye
is  much reddened or traversed with large blood-vessels, with
great intolerance of light, discharge of burning tears, or unplea-
sant dryness of the eyes, increase of pain from moving them,
erysipelatous  swelling of  the lids,  violent headache, vertigo,
dimness  of  vision,  or appearance of sparks,  or black, flying
spots before the eyes.
  Euphrasia is the main remedy when the inflammation arises
in consequence of, or in attendance with, catarrh of the nose,
with profuse secretion of mucus, flow of tears, and formation
of small vesicles upon the edge of the cornea.
  Hepar.  sulph.  and Mercurius, when there  is  soreness  and
swelling of  the edges of the lids, with thick, purulent mucus,
nocturnal agglutination, ulcers and  specks upon the white of
the eye and cornea, pimples and scabs about the eyes and ever-
sion of the lids.
  Nux Vomica is indicated, especially when the internal angles
of the  eye are inflamed, with aching as if from sand, or burning
as if from an acrid substance, with profuse lachrymation, great
photophobia,  especially  in the morning, catarrh of the nose
and headache, great irritability and constipation.
  Pulsatilla when there is a pale swelling of the lids or about
the eyes,  with profuse secretion of tears and mucus, agglutina-
tion of the  lids, violent pains in the eyes, and aggravation of
the symptoms especially in the evening and night.
  Spigelia, when  there are insupportable pains  deep in the
sockets of the eyes, especially from motion, sensation as if the
ball of the  eye were too large, boring, piercing, cutting, and
burning pains as if from foreign bodies therein, profuse lachry-
mation, dull, turbid appearance of the eyes, dimness of vision, 
158    ,  treatment  of catarrhal ophthalmia.
loss  of sight when exerting the eyes, intolerance of light and
of vision.
  Against  frequent  and  profuse  lachrymation, Euphrasia,
Crocus, Digitalis, Graphit, Phosphor., and Spigelia.

                         ACONITE.

  Griesselich says  that he has sometimes, in catarrhal oph-
thalmia, seen good effects from Aconite only.

                       ARSENICUM.
  See pages 61 and 62.
  CASE 149.—A woman,  aged  54, had  suffered for  8 days
with catarrhal ophthalmia and coryza.
  Symptoms.—Redness of the sclerotica of the right eye, swell-
ing of the  lids, piercing pain in the ball and internal angle
from moving the eye, or looking at  a  bright light; burning
and  aching as if from sand; tearing pains in  the forehead
extending into the  eye, sensitiveness of the eyes to  touch,
flow of burning tears, gauzy dim-sightedness, intolerance of
light, discharge of burning mucus from the right nostril, dull
confusion of the head in a warm room,  lassitude, chilliness,
thirst, and sleeplessness.
  Treatment.—Arsenicum 6,1 drop night and morning,  effected
a cure in 5  days.  Haustein.

                      BELLADONNA.

*  CASE 150.—A catarrhal ophthalmia in the right eye of a
child, aged  2, was cured in 48 hours, with Bellad. 400.
  Symphms.—The eyelids  were  swollen,  especially  in the
morning, secretion of mucus, sticking of the lids together, red-
ness of the internal portion of the eyeball, sensitiveness of the
eyes to air and light.

                      chamomilla

Is most useful in children when the eyes prick, ache, and^burn
as if heat came out from them, and are  swollen, or stuck to-
gether in the morning, or else are very dry.  Hering. 
EUPHRASIA.                   159
                    DIGITALIS
is  recommended by Knorre in catarrhal  ophthalmia which
has arisen from the sudden suppression of catarrh of the nose,
when the conjunctiva  of the lids and ball are swollen, with
feeling as if sand were between them, and swelling and redness
of the lids; aching and shooting stitches of pain, intolerance of
light, constant lachrymation increased by bright light and cold,
profuse secretion of pus in  the corners of the eye, obstruction
and dryness of the nose

                       EUPHRASIA.
   See page 79.
   CASE 151.—A woman, aged 22,  had suffered with ophthal-
mia for 10 days in consequence of taking cold.
   Symptoms.—The  white of the lids  and  balls  of both eyes
were reddened ; with enlarged and  congested vessels running
as far  as the cornea; there was an  insupportable itching and
pain as if from sand in the eyes;  lachrymation, sensitiveness
to light.  The right eye was worse than the left, and the at-
tending catarrh was also most troublesome in the right nostril.
   Treatment—After taking Euphrasia 3,  a visible and pro-
gressive improvement occurred.  Frank.
   CASE 152.—A young lady, aged 20, a healthy brunette, and
regular in  menstruation, had suffered  for 3 months with catar-
rhal ophthalmia.
   Symptoms.—The  conjunctiva chemotic and reddened;  pro-
fuse lachrymation; discharge  of acrid water from  the nose;
intolerance of light, so that she was  obliged to remain  in  a
dark room;   aching, cutting  pains in  the eyes and  frontal
sinuses; ulceration of the cornea.
   Treatment—Euphrasia 3, internally, and an external applica-
tion of 3 drops in 3 ounces of water, effected a cure in 5 days,
after a not inconsiderable aggravation.  Weigil.
   CASE 153.—A robust woman, with catarrhal ophthalmia,
was cured in 5 days with  Euphrasia 3, after a decided aggra-
vation.
   CASE 154.—A  woman, aged  53, took  1-drop  doses  of
Euphrasia 1, for catarrhal ophthalmia, and was  soon attacked
with the most violent pains in the affected eye; she only fell
asleep toward morning, but then awoke almost well.   Frank. 
160      TREATMENT  OF CATARRHAL  OPHTHALMIA.
                       HEPAR. SULPH.
   CASE 155.—During an epidemic of influenza, many per-
 sons  were  attacked  with catarrhal or influenza-ophthalmia;
 the eyes became violently inflamed, watered profusely, with
 excessive intolerance  of light, swelling and redness of the lids.
   Treatment.—After a few doses of Bellad., Hepar. acted with
 great rapidity and certainty.
   CASE 156.—A young psoric lady had catarrhal ophthalmia
 with the following
   Symptoms.—The eyelids were inflamed, sore, oozing, and as
 if cauterized,  especially at the internal  angles;  their internal
 surface was bright-red and inflamed, with burning, especially
 in the  morning; soreness, biting, and itching, of the lids ;  red-
 ness of  the conjunctiva, which was traversed  with isolated
 large  blood-vessels; intolerance of light; colored and turbid
 halos around  the  candle  in the evening, and aching  pains so
 that the  eyes had to be closed.
   Treatment—Repeated' doses of Hepar.  3, soon effected a cure.
 Knorre.
                   mercurius  solubilis.
   CASE 157.—Merc, and Rhus generally produced rapid re-
 lief in catarrhal ophthalmia, with slight rosy-redness of the
 conjunctiva, especially at  the inner angle of the eye, attended
 with profuse lachrymation and catarrh  of the nose.  Still, re-
 lapses  were apt to occur  unless  proper care and necessary
 warmth were attended to.  Schelling.

                       nux vomica.                    '
   See page 89.
                       PULSATILLA.
  Weber says this remedy is useful  when the sclerotica is but
little or  not at all  reddened, or only has red spots or specks
upon it;  when acrid tears are secreted, and the patient believes
that something has got into his eye, with aching in the eyes as
if from dust, intolerance of light, redness, and swelling of the
eyelids, and evening  aggravations.  He used  Pulsat. 30,  1
dose every 72 hours, and effected cures in a few days, although
Bellad. 30, or Sulphur was required  at times, or Staphysagria
when the lids were especially affected. 
PULSATILLA.
161
  CASE 158.—A delicate,' scrofulous girl, aged 15, had  suf-
fered for 12 days with catarrhal ophthalmia.
  Symptoms.—The inner surface of the  eyelids was reddened
and  swollen;  on  the conjunctiva  there were many enlarged
blood-vessels converging toward the cornea; beneath these,
the sclerotica  was seen  uniformly and intensely  reddened;
there were several vesicles on the cornea of each eye ; the iris
and  pupils  were  natural.  Increased secretion of mucus  and
tears ;  great photophobia ;  piercing pains in the eyes, forehead,
and temples, aggravated toward evening and midnight; scanty
menstruation  every  3  weeks;  had previously  suffered  with
acne.
   Treatment—Blisters  had been used without benefit; after 3
doses of Pulsat. 6, 1 dose each day, the  pains  were relieved,
and  under the continued use of the same remedy every other
day. a cure was soon accomplished.  Diez.
   CASE 159.—A man, aged 30, had been sick 6 or 7 days.
   Symptoms.—Dryness  and burning about the eyes, increased
in the evening; redness and  swelling of the edges of the  lids;
purulent  mucus  in the corners qf the eye, with adhesion; the
conjunctiva was spongy, dull, irregularly reddened and punc-
tated.
   Treatment—Pulsat.  3, one dose every  night and morning,
effected  a cure in 3 weeks; a  similar  attack, 2 years before,
treated allopathically, lasted  3 months.

                          Review.
   Ten different remedies were used in the treatment of the
above 11 cases; they present little that is characteristic   But
we find that Euphrasia is useful not only in  acute, but also  in
neglected and obstinate cases; Arsenicum and Hepar. are reli-
able remedies in the latter class.
   The lids and angles of the eyes are always most severely
affected;  Nux is most useful when the corners of the eyes are
principally affected.  Euphrasia,  when there is an attending
violent catarrh of the nose ;  Digitalis, when ophthalmia occurs
after suppressed catarrh.  Nux is the most suitable remedy
when there is biting sensation, as if from salt in the eye.
                       11 
162
PURULENT  OPHTHALMIA.
              PURULENT  OPHTHALMIA.
   Egyptian Ophthalmia.—This is  one of the most severe and
 destructive diseases of the eye;  it is originally and  essentially
 an affection of the mucous membrane of the eyelids, with puri-
 form discharge ; it generally, however, extends to the conjunc-
 tiva of the ball, and sometimes, in spite of all the means that
 can be employed, it reaches the  globe itself, producing in the
 cornea  and iris, injurious and  destructive effects  similar  to
 those which take place in the ophthalmia of new-born children.
 Lawrence.
   Vetch, of 636 cases,  had  fifty dismissed with loss  of both
 eyes, and fifty with that  of one.  In a  large boys'  school  in
 Yorkshire, blindness of one or both eyes, or serious injury  to
 the  sight from corneal opacities,  took place  in nearly 20 in-
 stances.  Of 1500 cases at Ancona, 97  lost  one eye,  and 49
 both.  Of  1604 cases treated by Muller, 15 became blind  in
 both eyes,  18 with impaired  vision  of both eyes, and 26
 remained blind in one  eye.   Of 30,000  cases in the Prussian
 army, blindness followed in 1100 ; and in 1810, in the Chelsea
 and Kilmanheim hospitals, there were 2317 soldiers a burthen
 upon the public from  blindness in consequence of purulent
 ophthalmia, those who  had lost  the sight of one eye only, not
 being included.  All had been treated allopathically.
   Symptoms  and Progress.—According to  Lawrence, in the
 first stage  there is redness of the inside of the lids, with a
 coating of  a little  whitish mucus; some watering  of the eye
 and stiffness  of the lids.  This  stage is not often seen by the
 physician, and often is hardly noticed by the patient.   But the
 disease soon extends to the ball  of the eye, followed by high
 vascular action, great redness and  tumefaction of the conjunc-
tiva, and profuse discharge. The redness is uniform and bright,
and there are often red patches of effused blood in or under the
conjunctiva, which is besides  greatly swollen  and raised  into
an  elevation  called chemosis,  often so considerable as not only
to form a wall around, but also to overlap and nearly cover the
cornea.   At this period, the lids swell greatly, so as frequently
 to form two  large, convex, colorless, or slightly-red protube-
 rances, which meet and nearly close the eye, preventing in con-
junction with the chemosis, all satisfactory examination of the 
purulent ophthalmia.              163
cornea.  The abundant purulent discharge not only bathes the
eyes and lids, but crusts the edges of the lids and lashes, and
pours out over the face, and even drops down upon the clothes ;
the quantity of matter discharged is said in some cases to amount
to several ounces.
  As the disease extends to the ball of the eye, the pain is greatly,
increased, becomes  severe and excruciating, is  deep-seated,
and often attended with fullness and  throbbing of the temples
and headache.   There are remissions and aggravations of suf-
fering, which are sometimes periodical;  and the pain often re-
turns, particularly the sensation, as if there were a foreign body
in the eye, even after it has  been removed for a  time by
treatment.
  In the early stage, there is  not much fever,'but when the
inflammation extends to the ball of the eye, general feverishness
ensues.
  Nature.—A peculiar change of structure of the conjunctiva of
the eyelids is the primary and characteristic effect of this contagi-
ous ophthalmia;  this alteration is not the effect of inflammation,
but, on the contrary, is the first manifestation of the disease, and
the cause of inflammation, when the disorder spreads to the ball
of the eye.   The peculiar change of structure in the conjunctiva
of the lids and its morbid swelling are the  principal and  con-
stant phenomena;  hence  antiphlogistic treatment is by no
means so serviceable  as might be  expected, if inflammation
constituted the essential character of the disease.  There is, in-
deed, high inflammation in  the more severe cases,  attended
with chemosis;  but this inflammation may be prevented by
proper treatment, or may be  controlled, and  still the original
complaint will proceed on its course and the change of struc-
ture go on.   AValther says, that an eruption of small vesicles
on the inner  surface  of the  eyelids is always present in  con-
tagious purulent ophthalmia, and hence he considers the dis-
ease not so much an inflammation as  an eruptive disease,  or a
form of impetigo of the conjunctiva.
  This diseased state of the inside of the lids remains for an in
definite period after the inflammatory symptoms have subsided,
and may lead, under occasional excitement, to the reproduction
of the disorder in all its violence.  No case can be  considered
cured until this  state of the conjunctiva shall have been re- 
164
PURULENT  OPHTHALMIA.
 moved ; it may remain dormant under each  of the eyelids for
 months, but in a  state capable  of  infecting  whole companies
 of soldiers  or scholars.  According to Eble  and Muller, the
 first stage of the disease consists in the presence of small serous
 cysts, or phlyctenaB, on the surface of the conjunctiva of the
 lids, soon followed by thickening and granulation of the mucous
 membrane.   When the granulations have just commenced, the
 conjunctiva of the lids appears like red velvet, or as if covered
 with red dust;  in the higher gradations, like thickly-strewn mil-
 let seeds, or rough sand, or the granulations of a healing wound;
 these granulations, or rather vegetations, sometimes equal a large
 lentil, which is their utmost size.  They exist in great numbers,
 arising from the lining of the lids by a broad basis, being rounded
 at their prominent part at first, but  subsequently becoming
 flattened by pressure, against the ball of the eye.  The largest
 are toward  the middle, the smaller toward  the edges of the
 lids and the angles, especially the outer.  Sometimes they lie
 so  close together that they seem to form one mass, but close
 examination will  discover the  fissures,  sometimes tolerably
 deep, which separate them.  This granular  structure is  more
 developed under the upper than the lower lid, the wider sur-
 face of the former  possessing a great extent of mucous glands,
 and being less exposed to the  air and contact  of remedies,
 The principal effects of the disease are:
   1st. Sloughing of the cornea, especially when the swelling of
 the conjunctiva of the ball,  and the chemosis is very great.
  2d. Bursting  of the cornea.  A  paroxysm of excruciating
 pain is suddenly terminated by a sensation of something giving
 way; a little hot fluid runs down the cheek, and great relief is
 experienced. Just before the cornea bursts, it may  exhibit no
 perceptible alteration, and even after this has happened it may
 present so natural  an appearance that the fissure may  be  over-
 looked.  But Vetch has discovered at times, a small line ex-
 tending across the  cornea;  the next day, a slight opacity ap-
 peared along the line, and increased daily, till the greater part
of the cornea was not only opaque, but projected in an irregu-
lar  cone.  In fact, the aqueous humor at first escapes  by a
division of the cornea, nearly as clean as if cut by a  knife, and
it is to the attempts of the  part  to effect a reunion, under the
presence  of disease, that future deformity is owing; as exten- 
PURULENT OPHTHALMIA.               165
sive disorganization of the cornea by suppuration, or ulceration,
is apt to set in.
  3d. Suppuration of the cornea.
  4th. Ulceration of the cornea.
  5th. Interstitial deposits,  forming opacities in every degree,
from the thinnest film to the most dense  leucoma.
  6th. Opacity of the cornea, from cicatrization of ulcers.
  7th. Prolapsus of the Iris.
  8th. Adhesion of the Iris to the cornea.
  9th. Loosening, sponginess, vascularity and thickening of the
mucous membrane covering the cornea, with enlargement  of
its  blood-vessels, and more or less  diminution of its trans-
parency.  This change  occurs in  various degrees from slight
vascularity to pannus.
  10th. Staphyloma, general or partial; and dropsical enlarge-
ment of the ball  of the eye ; or collapse of its tunics.  Law-
rence.
  Prognosis.—According to Lawrence, the  disease is less
manageable in adults than in infants or children; for the affec-
tion is more formidable,  the danger to the eye greater, and the
issue more uncertain.  If the cornea retains its natural trans-
parency, we may hope to arrest the disease, and save the eye,
by prompt and vigorous treatment.  If the cornea be dim, with
deep-seated pain in the eye or head, the inflammation has ex-
tended to the ball of the eye, and the result is doubtful.  After
partial suppuration, considerable ulceration, or  interstitial de-
position, recovery of sight may take place.
   Treatment—Lawrence,  Rust,  and  Muller  place  great
stress upon the use of cold water, with which the eyes may not
only be frequently cleansed, but it may also be applied  with
benefit as a  lotion,  by means of linen rags dipped  in it, and
laid not only over the eyes and lids, but  also over the forehead.
In the severer forms of the  disease, Walther  applied cloths
dipped in cold water, not only to  the eyes and forehead, but
also to the entire head, with the greatest  benefit.  Confinement
to the house does not seem advantageous at any period of the
complaint, while free exposure of the inflamed eye to cool air,
and even exercise, instead of being hurtful, as patients and their
friends  suppose,  has been found decidedly beneficial.   Dr.
Vetch is even disposed  to recommend the trial  of a journey, 
166
PURULENT  ophthalmia.
in the commencement of the disease, if the eye be freely ex-
posed to the air, and the weather favorable, that is, not too ex-
ceedingly hot and sunny.  He says, that when the second stage
has commenced, with chemosis and purulent secretion, he has
never seen any but the  best  effects from change  of place.
" Soldiers who have commenced a march with the disease com-
pletely formed, though exposed to heat, dust, and fatigue, and
not abstaining even from intoxication, are invariably better at
the end of the journey than when they set out."   Lawrence can
adduce innumerable observations to the same effect.  Murray
was so convinced of the beneficial effects of exposure to the air,
that he was induced to march the soldiers about from one place
to another, with a view solely to the good effects which he saw
result from it.
  Warm fluids, fomentations,  poultices,  and steam,  increase
the heat  and augment  the  vascular disturbance ; still, tepid
ablutions are sometimes agreeable and useful.
  The most homoeopathic  remedies are Rhus,  Cantharides,
Tartar Emetic,  Clematis,  Cannabis, Euphorbium, and Meze-
reum.  Of these, Rhus and Hepar. Sulphur are generally the
most useful.  The Hepar. Sulph. 1st, 2d,  or  3d trituration,
should be given  every  night  and morning;   and  the Rhus,
tincture, 1st, 2d, or 3d dilution,  may be given every 2, 4, 6, or
8 hours, according to the severity of the symptoms.
  Euphorbium may be used when there is a severe inflamma-
tion of both lids, with violent itching and irritation, but with
a rather pale swelling and profuse secretion of pus.
  Local applications  are said to be required at an early stage of
the disease.  Lawrence says that a solution  of Alum is the
first and most useful; other allopathic physicians prefer Nitrate
of Silver and Sulphate of Copper, while Briggs has found the
Oil of Turpentine to be the  most effectual means of checking
the profuse discharge in  purulent ophthalmia; he  introduces
a  minute  quantity, on  the  point of  a  camel's-hair pencil,
between the eyelids every morning, the  eye being immediately
afterward  immersed, or  bathed freely with cold water  and a
sponge, until the uneasiness and sense  of heat which ifc pro-
duces in the eye and surrounding parts, is  allayed, which usu-
ally  requires some  minutes.  These  applications are  quite
homoeopathic enough, but a weak solution of Tartar Emetic is 
purulent ophthalmia.
167
 still more so, and in a few cases I have found it the most useful
 one ; it is decidly homoeopathic to pustular, purulent, and sup-
 purative inflammation ;  has a well-earned old- and new-school
 reputation against inflammation in general, and is certainly not
 more irritating than Turpentine and Nitrate of Silver, which
 have been found very useful.
   Still, I prefer, as a general rule, a solution of Kali Chlor., or
 Kali Carb., or Kali Hydriod., to be used several times a day for
 3 days ;  these, although they will not decidedly check the pro-
 fuse purulent discharge, will alter its  character, render it less
 noxious, thick, and  purulent;  and then  a weak solution of
 Alum,  Sulph.-zinc,  or  Nitrate  of Silver, will exert  a much
 more rapid and permanent beneficial  effect, than if they had
 been used without this previous preparation.
   My friend, Dr. W. S. Stewart and myself treated  over 40
 cases of purulent ophthalmia in children, at the Home for the
 Friendless, without the loss of a single eye, although  3  or 4
 cases proved  exceedingly intractable.  Two adults were not
 quite so fortunate, as one lost one eye, and  the  other  had an
 eye partially damaged although a fair amount of vision re-
mained.
  In chronic cases, Sulphur, Hepar. Sulph.,  and Calcarea  have
proved practically useful. 
I 
INDEX.
                                   A
                                                                    PAGE
Adhesion of Eyelids,..........42
Aconite in Simple Ophthalmia,      ........53
    "   "             "      of New-born Children,      .-    -    -   105
    "   "    Burns and Scalds,........3
    "   "    Rheumatic Ophthalmia,.......145
    "   "    Catarrhal        "         .......157
Alumina in Ophthalmia Senilis,    -             .....55
Ammonium in Conjunctivitis,.........56
Antimonium Tartaricum in Purulent and Pustular Ophthalmia,    -    -    57
Argentum Nitricum in Conjunctivitis,.......57
Arnica in Injuries of Eyes,.........60
Arsenicum in Ophthalmia,       .........61
    "     "  Scrofulous Ophthalmia,.......115
          "  Catarrhal      "       ........158
    "     "  Hypopion,.........107
Aurum in Ophthalmia,..........66
   "   " Scrofulous Ophthalmia,........117
Allopathic Treatment of Scrofulous Ophthalmia,.....140


                                   B

Bruises of Eyelids,...........1
        " Eyeball,        ..........43
Burns and Scalds,  -    -    -........2
             "    Cases of..........3-4
Blepharitis,............5
Blear Eye,       -'...........H
Baryta in Ophthalmia,........--66
Belladonna in Simple Ophthalmia,........66
    "       " Scrofulous   "     -.......117
            " Catarrhal    "        ........158
Berberis Vulgaris in Gouty Ophthalmia,.......70
Borax in Entropium,       -••.........^0
Bovista,.............-    7°.
Bryonia in Rheumatic Ophthalmia,        ......70, 145


                                    c

Conjunctivitis,..........           27
Catarrhal Inflammation of Lids,........29
         Ophthalmia,..........I56
Corneitis,.........                  £*
Calcarea in Simple Ophthalmia,.........70
    "    "  Scrofulous   ".........119 
170
INDEX.
                                                                     PAGE
  Calcarea in Fistula Lachrymalis,......-    - 109
  Cannabis in Affections of Cornea,       .......121
  Calendula in Injuries of Eyes,.......-    -  72
  Causticum in Chronic Ophthalmia,.....-    -    72
           "  Scrofulous    "       ......-    -121
  Chamomilla in Simple      "........74
             " Catarrhal    "       ........158
  China  in  Ophthalmia,..........76
  Conium in Simple Ophthalmia,........-  78
      "   " Scrofulous    "       ........122
  Crocus in Ophthalmia,     ....'...--78
  Clematis in Rheumatic Ophthalmia,    -    -    -     -     -    -    -   145
  Colocynth in     "        "        ........ 146
  Chemosis,............   155
 Clotar Muller's Treatment of Catarrhal Ophthalmia,     .... 157


                                    D

 Dropsical Swelling of Eyelids,.........9
     "       "          "     Cases of     ......      9
 Dulcamara in Chemosis,........         -  79
 Digitalis in Catarrhal Ophthalmia,      -    -    -     - ,       -     -    158

                                   E

 Emphysema of Lids............10
 Encysted Tumors of Lids,.........26
 Eversion of the Lids, {Ectropium,)........34
 Euphrasia in Ophthalmia,.........79
     "     " Scrofulous Ophthalmia,      -    -    -     -    -    -    -125
     "     " Catarrhal     "........158
 Egyptian Ophthalmia,..........161

                                   F

 Falling Down of the Lids, (Ptosis,)........41
 Fistula Lachrymalis,..........108

                                   G
 Granular Lids and Vascular Cornea,.......29
 Graphite in Ophthalmia,.........82
 General Review of Treatment of Simple Ophthalmia,
                            " Scrofulous   "       ....    141

                                   H
 Hepar. Sulphur in Ophthalmia,........82
   "      "    " Catarrhal Ophthalmia,     -   ».....159
   "      "    " Scrofulous     "       -  .  -    .    .    .    .    - 125
   "      "    " Hypopion,     -.......107
Hypopion,............106
Hartmann's Treatment of Scrofulous Ophthalmia,       -     -    -    -    139

                                   I

Inflammations of External Surface of Eyelids,......5
                   "               "  Treatment of,     -    -    -     6
             Secondary of Lids,   -                    ....   8
             of the Edges of the Lids,.......10
                   Angles  "           .......I? 
INDEX.
171
                                                                    PAGE
Inflammations of Meibomian Glands,.......22
      «      « white of the Eyes,  -         ......45
      "      " Sclerotica,.........49
      "      " Cornea,   .    -     -    -......51
Ignatia in Ophthalmia,..........85
Iodine «     "...........85
Iritis,  ----.........155
Intolerance of Light,...........156

                                   K
Kali Bichromicum in Ophthalmia,......   -    -    - 85
  "  Hydriod.    "      "       ........86
Kreosote          "      "         ........86

                                   L
Loss of Eyelashes, (Madarosis,).........17
Lachesis in Ophthalmia,      .........87
     "   "  Fistula Lachrymalis,........109
Ledum  "     <;                 ........87
Lycopodium   "              .........87
     "    .  of New-born Children,     -......105

                                  M
Meibomian Glands, Inflammation of,........22
     "        "   Enlargement of,.......23
Milium,............- 2-4
Mercurius in Ophthalmia,.........88
     "     " Hypopion,    -   -    -.......108
     "  Solubilis in Scrofulous Ophthalmia,   -.....130
     "  Corrosivus      "           ".......131
     "  Solubilis in Rheumatic       ".......148
     "      "      Catarrhal      ".......160
Magnesia Carb. in Scrofulous                ......130
Muller's Treatment of Scrofulous    "          ......139

                                   N
Nsevus Maternus,...........-26
Nux Vomica in Ophthalmia, -                   .....89
  ""----.........9
Natrum in Fistula Lachrymalis,........109
   "    "  Rheumatic Ophthalmia,........146
Nitric Acid in Scrofulous Ophthalmia,.......133

                                   o
Open State of the Lids,     -.........40
Ophthalmia Neonatorum,     -........103

                                   P

Psor-ophthalmia,     "".".*'"                  -     -    -  11
Polypi and Fungi of Angles of Lids,.......19
Ptosis,     -    -    -    -   "........41
Phosphorus in Ophthalmia,......         -    -     90
Pulsatilla   "      "     ...    -......90
     "       " Catarrhal Ophthalmia,   -     -.....160
     "       " Scrofulous     "          .......133
     «       " Rheumatic    "        .......147
Psorin      "     "        "      .........138
Purulent Ophthalmia,   -----                   -    -    161 
172                            INDEX.

                                  K
PAGE
Rheumatic Ophthalmia,........          ilq
Rhus in Rheumatic Ophthalmia,       .......X*J
Rhus Toxicodendron in Ophthalmia,.....         "100
  «         "       " Scrofulous Ophthalmia,      -    -    -    -    ' ***
  «         «       « Ophthalmia of New-born Children,    -    -    -   106
Review of the Action of Arsenicum,  -......65, 116
         «      «      Belladonna,        .....69, 119
   "    General, of Treatment of Simple Ophthalmia,     -    -    -    -101
   «      «    "      "     " Scrofulous     "      ..-    -   141
   «      «    «      "     " Rheumatic     ".....I55
   "    of the Action of Calcarea,........120
   "     "      "    "   Conium,    -------- 124
   "     »      "    "   Hepar. Sulphur,......129
   «     «      "    "   Rhus,       ........I35
   «     "      "    "   Sulphur,........I38

                                   S

Syphilitic Affection of Eyelids,........I3
Styes,  (Hordeola;,)...........20
Sc'irrhoid Induration of  Eyelids,       -......^b
Sepia in Ophthalmia,..........93
Staphysagria in  "..........94
Sulphur in      "        -    -  #........9&
     "    "   Scrofulous Ophthalmia,.......A«5b
     "   "    Ophthalmia of New-born Children,   -    -    -    -    - 106
    "    "    Rheumatic Ophthalmia,       ......153
     "    "    Hypopion,       .........1°8
     "    "    Fistula Lachrymalis,.......108
Scrofulous Ophthalmia,     -........110~Jf«
Silex in Scrofulous Ophthalmia,........136
Spigelia in Rheumatic   "          ......        -15-

                                   T

Turning in of Eyelashes,  (Triciasis,)........14
Thickening of Edges of Lids, (ptosis,).......1?
Tumors of the Eyelids,..........23
Tarsal Tumors of Lids,..........25
Turning in of     "    (Entropium,).......38
Tinea  Ciliaris,...........H
Tabular Review,..........143» lii

                                   Y  (

Vesicular Tumors of Lids,      -     -___,-.;„ ft  '-^^ "     "    "    "   24



 Wounds of Eyelids,   -     -  l^f  -    -    -    ' ) ' )   '    '    '   $ 
 
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