In inflammation of the eye, the irritation generally extends also to the lids, as the conjunctiva or external membrane of the eyeball is, as we have already shown, reflected over the inner surface of the eyelids.

External applications may consist of either cold or tepid water, or milk and water, or a mucilage made by pouring water on quince seeds. The room should be darkened, and the patient kept as quiet as possible. Care also should be taken that matter from the diseased eye should not be transmitted to those of the attendant, as a similar inflammation would be the result. In simple inflammation of the eye, a lotion may be used, two or three times a day, composed of one grain Sulph.-zinc to a tablespoonful of water.

The prominent remedies in Ophthalmia are Bell., Arn., Euphrasia, Acon., and Merc. These remedies may be indicated in almost every variety of the disease. In treating this disease, we shall for the sake of clearness, speak of it under the following heads.

a. Catarrhal Ophthalmia.

b. Rheumatic and Arthritic Ophthalmia.

c. Scrofulous Ophthalmia. a Syphilitic Ophthalmia.

a. Catarrhal Ophthalmia.

This is generally the result of a cold, frequently affects both eyes, and may be attended with cough and fever. The redness gradually extends over the whole conjunctiva, at first there is profuse discharge of tears, then more or less secretion of mucus. The eye is sensitive to the light; pressure in the eyes with burning, shooting pains, and sensation as if sand were lodged between the lids, are also present

Aconite is an important remedy in the commencement of the treatment, either alone or in alternation with Belladonna or Chamomilla.

Chamomilla is servicable when there is slight catarrhal fever, sensation of pain on opening and closing the lids, which are often closed with mucus.

Belladonna is an invaluable remedy, where there is congestion to the head, great redness and dryness of the eyes, and sensitiveness to light. It is particularly indi-cated where there is a profuse watery discharge from the nose, accompanied with the usual catarrhal symp-toms.

The indications of Euphrasia are similar to those of Belladonna, with the exception that with the former there may be a profuse discharge of tears and mucus, which is not characteristic of Belladonna. The Eu-phrasia is also more particularly indicated where the inflammation is violent and extensive, or where little ulcers may have formed around the cornea.

Ignatia will be of service where there is but little ap-parent inflammation, but severe aching pain in the balls, accompanied with great sensitiveness to light, and pro-fuse lachrymation and coryza.

Dose

Dissolve two drops, or twelve globules, in a glass half full of water, and give a teaspoonful every two hours, increasing the in-tervals as the symptoms improve.

A disposition to catarrhal ophthalmia on every change of the weather, can frequently be relieved by a few doses of Sulph., Calc, or Nux-v.

In the first stage of the disease, four drops of Arnica may be placed in a cup of water, with which the eye may be bathed.

b. Rheumatic and Arthritic Ophthalmia.

This variety of ophthalmia is generally connected with rheumatic and gouty difficulties, and is attended with severe pain. There are sticking, tearing or boring pains in the eyeballs, orbits, and not unfrequently in the temples, aggravated by change of weather. Great redness of the eye, sensitiveness to light, and sometimes profuse lachrymation are also present. This is a highly dangerous variety of ophthalmia, as the inflammation is liable to extend to the internal membranes, and create ulceration of the cornea, and frequently loss of sight.

The prominent remedies, are Acon., Bell., Spig., Col., Euph, also Puls., Bry., Rhus. Sulphur, Calc., Hep., Caust., Mere., may also be consulted.

Treatment

In the commencement of the difficulty, if the inflammation should be slight, and the disease evidently of a rheumatic character, Bryonia and Pulsatilla may be given in alternation, and if there should be considerable fever present, and the pain be more severe, Rhus and Aconite may be alternated in the same way.

As a general thing, where the usual inflammatory phenomena are present, Aconite should commence the treatment, either in alternation, or followed by Bella-donna, if there should be indications of congestion to the brain, violent pain about the eyes and profuse lachrymation.

Belladonna is particularly useful, when beside the symptoms already mentioned, there are severe aching pains over the eyes, with pain in the balls as if they would be torn out or pressed into the head; sparks and flashes before the eyes; intolerance of light, confusion of sight, etc.

Euphrasia is a valuable remedy where the pain is severe, the inflammation extending to the cornea, or if ulcers have formed there, and the pupil become contracted.

Spigelia is suitable when the eyeballs feel swollen and exhibit a number of enlarged vessels; the pain is violent, sticking, boring, and digging, and proceeds from the interior of the eye; on opening the eyes objects seem to float in fire.

Colocynth is an invaluable remedy where the pains are seated in the eyeballs, and are of a burning, cutting character, and where there is congestion of the head, intolerance of light, lachrymation, pressing and tearing pain in the whole brain, most violent in the forehead on moving the eyes.

Veratrum. Tearing pain interrupting sleep at night; intolerable headache.

Dose

Two drops, or twelve globules, in a glass half full of water, a teaspoonful every hour or two hours until the pain is relieved; then every four hours.

Sulphur is also of importance near the close of the disease, or to quicken the action of the other remedies. See also, Inflammation of the eyelids and weakness of sight.

Scrofulous Ophthalmia.

This is a common form of ophthalmia, but generally is confined to children. The eyeball is very red and bundles of enlarged vessels run towards the cornea; there is intolerance of light, profuse discharge of corrosive tears, increased secretion of mucus, and an aggravation of symptoms towards morning; the eyelids are generally reddened, and if the cornea is affected, it becomes dim and sometimes ulcerates.

Arsenicum may be given when the pains are of a burning character.

Dose

A powder, or six globules three times a day.

Belladonna. Sensation of pressure in the eyes, worse on turning them up; sensitive to light.

Dose

Same as Arsenicum.

Hepar. Particularly useful in children who have taken calomel and when the lids are red, sore, and painful to the touch, as if bruised.

Dose

A powder, or six globules, morning and night.

China. Pain in the eyes in the evening, with sensation as if there were sand in them. Dose. - Same as China.

Dulcamara. Will be of benefit when cold is the exciting cause.

Dose

Same as Arsenicum.

Mercurius. When the pains are cutting, worse in the evening and in a warm bed; the eyes fill with tears and are sensitive to the light; sight clouded and small pustules on the ball.

Dose

Same as Arsenicum.

Calcarea and Sulphur are both prominent remedies, in chronic cases, when they may be given, a dose of one in the morning, and of the other at night. See also Tuberculosis.

d. Syphilitic Ophthalmia.

This variety of ophthalmia may arise from suppressed gonorrhoea or syphilis, and from a transmission of the matter to the eye. The treatment should commence with Aconite, followed after the fever is somewhat subdued, by Mercury, and this after eight or ten doses have been taken, if decided relief is not obtained, by Nit-ac., Sulph., or Thuja.

A physician should be consulted immediately, as prompt and skilful treatment is necessary to avoid serious consequences.

Administration

Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose; or a powder, or three globules, dry on the tongue. In severe cases a dose in one or two hours, but as the symptoms gradually abate, the intervals may be extended to four or six hours.

In the milder forms of the disease, a dose once in four or six hours will be sufficient. See also page 12.

Diet And Regimen

The patient should be kept perfectly quiet, and the room more or less darkened, to suit the feelings of the patient The diet should be simple, as in fevers.

Inflammation of the Eyelids.

Aconite

Where the eyelids are swollen, hard and red, with heat, burning, and dryness; or where there are burning and tensive pain, pale and shining swelling, intolerance of light, fever, etc. Bell., Hep., or Sulph., are often suitable after this remedy.

Belladonna

Eyelids swollen and red, burning and itching, bleeding on opening them, or with the margins everted, or paralytic heaviness of the lids.

Calcarea

Incisive, burning or smarting pain, especially when reading, with red, hard and large swelling, copious secretion of humor, and nocturnal agglutination.

Euphrasia

Ulceration and itching of the margin of the eyelids, redness and swelling and agglutination by night; coryza and pain in the head.

Hepar-8

Redness of the eyelids, with pain as from ulceration, or as from a bruise when touched; nocturnal agglutination. Often after Aconite or Mercury.

Mercury

Eyelids hard, with swelling, difficulty in opening them, ulcers on the margin, pustules on the conjunctiva, scabs round the eyes, pain and itching, or absence of pain.

Pulsatilla

Inflammatory redness of the conjunctiva, secretion of mucus, appearance of styes, nocturnal agglutination.

Sulphur

Redness of the eyelid, with burning pains, discharge of humor; ulceration of the margin, pustules and ulcers around the orbits. It may be followed or alternated with benefit by Calcarea.

Administration

In acute cases the remedy may be taken once in from three to six hours; in chronic cases once or twice a day. One drop or six globules may be mixed with a tumbler of water, and a tablespoonful taken at a dose; or a powder, or six globules, may be taken dry on the tongue. See also page 12.