DISEASES OF THE EYELIDS. 257 



INFLAMMATION OF THE EYELIDS. 



The eyelids suffer more or less in all severe inflammations of the 

 eye, whether external or internal, but inasmuch as the disease some- 

 times starts in the lids and at other times is exclusively confined to 

 them, it deserves independent mention. 



Among the causes may be named : Exposure to drafts of cold air, 

 or to cold rain or snow storms; the bites or stings of mosquitoes, flies, 

 and other insects; snake bites, pricks with thorns, blows of whip or 

 club; accidental bruises against the stall or ground, especially during 

 the violent struggles of colic, enteritis, phrenitis (staggers), and Avhen 

 thrown for operations. It is also a result of infecting inoculations, as 

 of erysipelas, anthrax, boil, etc., and is noted by Leblanc as espe- 

 cially prevalent among horses kept on low marshy pastures. Finally, 

 the introduction of sand, dust, chaff, beards of barley and seeds of 

 the finest grasses, and the contact with irritant chemical powders, 

 liquids, and gases (ammonia from manure or factory, chlorine, 

 strong sulphur fumes, smoke, and other products of combustion, etc.) 

 may start the inflammation. The eyelids often undergo extreme 

 inflammatory and dropsical swelling in urticaria (nettlerash, sur- 

 feit) and in the general inflammatory dropsy knoAvn as purpura 

 hemorrhagica. 



The affection will, therefore, readily divide itself into (1) inflam- 

 mations due to constitutional causes; (2) those due to direct injury, 

 mechanical or chemical; and (3) such as are due to inoculation w^ith 

 infecting material. 



(1) Inflammations due to constitutional causes are distinguished 

 by the absence of any local wound, and the history of a low, damp 

 l^asture, exposure, indigestion from unwholesome food, or the pres- 

 ence elsewhere on the limbs or body of the general doughy swellings 

 of purpura hemorrhagica. The lids are swollen and thickened; it 

 may be slightly or it may be so extremely that the eyeball can not be 

 seen. If the lid can be everted to show its mucous membrane, that 

 is seen to be of a deep-red color, especially along the branching lines 

 of the blood vessels. The part is hot and painful, and a profuse flow 

 of tears and mucus escapes on the side of the face, causing irritation 

 and loss of the hair. If improvement follows, this discharge becomes 

 more tenacious, and tends to cause adhesion to the edges of the upper 

 and lower lids and to mat together the eyelashes in bundles. This 

 gradually decreases to the natural amount, and the redness and con- 

 gested appearance of the eye disappears, but swelling, thickening, 

 and stiffness of the lids may continue for a length of time. There 

 may be more or less fever according to the violence of the inflamma- 

 tion, but so long as there is no serious disease of the interior of the 

 eye or of other vital organ this is usually moderate. 

 H. Doc. 795. .50-2 -17 



