DISORDERS IN RELATION TO THE EYE 777 



vague condition, and restriction of diet, active exercise, and the waters of 

 Carlsbad, Bath, and other spas, formed a favorite and effective form of 

 treatment. To-day, physiological chemistry would no doubt give a more 

 precise definition of the metabolic disorder, but the treatment would be 

 along the same general lines. 



Intestinal stasis and putrefaction of fecal matter in a congenitally di- 

 lated colon (Hirschspmng's disease) was noted by Schoenberg in a child 

 of four with acute retrobulbar neuritis which promptly cleared up under 

 evacuation of the bowel and colonic irrigations. 



A. Knapp reports a number of cases of sympathetic uveitis in which 

 the intestinal autotoxic factor was indicated by the history of improper 

 diet, overfeeding and constipation. The usual treatment by mercurial 

 injections, sodium salicylate, pilocarpin sweats, did not seem to have very 

 much effect, but the condition improved rapidly under restricted diet 

 and the Dwyer procedure for regulating the chemical metabolism and 

 bacterial flora of the lower intestinal tract. 



In line with these observations we may mention the report of relapsing 

 uveitis and sympathetic ophthalmia cured or greatly improved by para- 

 specific protein sensitization by the injection of Coley's toxins (Verhoeff) 

 or a combination of typhoid, vaccine and autogenous vaccines (Wiener- 

 Bonime) . 



Keratitis, uveitis, and retinal hemorrhages have been seen often after 

 antityphoid inoculation, which de Lapersonne claims is particularly dan- 

 gerous to arthritics, syphilitics, tuberculous, over forty years of age. 



Focal infections, of the teeth, tonsils, intestines in children, of teeth, 

 gall-bladder, appendix, later; in old age, of sinuses, and prostate, are 

 common sources of toxemias which generally affect the uveal tract and, 

 occasionally, the retina. Arteriosclerosis and chronic hypertension are 

 often due to chronic focal infections and to rheumatism (Ophuels), with 

 final grave depression of adrenals, thyroid, and sympathetic, with vago- 

 tonic ocular symptoms and tendency to glaucoma, Pre-senility, constipa- 

 tion, irascibility, high blood pressure and vascular sclerotic changes in 

 choroid and in iris-angle (Fridenberg) predispose to increased intra- 

 ocular tension. 



Teeth. Functional disturbances such as strabismus, ptosis (Han- 

 cock) or reflex ocular neuroses, expressed as asthenopia, accommodative 

 anomalies, complete and partial paralyses, heterophorias, spasm of the 

 orbicularis, with neuralgia, and sensitiveness to light, may be caused on 

 a basis of sympathetic irritation of the exposed vital pulp of a tooth through 

 heat or cold or by direct contact with foreign substances. Uveal disease, 

 especially septic exudative choroiditis, is often due to apical or alveolar 

 abscesses of chronic type, and toxic absorption is the all important 

 factor. Metastasis has never been observed. Rowe claims that dental 

 infections are the commonest cause of both functional disorders and true 



