708 PERCY FRIDENBERG 



and conjunctiva has been observed after application of bluestone for 

 Parinaud's conjunctivitis. 



Styes. High blood sugar and probably lowered sugar tolerance in fur- 

 unculosis (Gettler and St. George). Furuncles, gangrene in diabetes. 

 Good effect heat, calcium sulphid, yeast, from endocrin standpoint. 



Organotherapy. Secretin, thyroid, to activate metabolism rather than 

 anti-diabetic diet. 



Blepharitis and red lids. Persistent and relapsing hyperemia of the 

 lid margin with occasional secondary infection of the hair-follicles of the 

 lashes producing repeated crops of styes has been observed in conjunc- 

 tion with other manifestations of eye-strain in obstinate refraction error, 

 in connection with focal infections (teeth, tonsils, sinuses) and toxemia, 

 as well as in plethoric, constipated individuals with a gouty tendency. 

 The indication of a thyroid lesion in the predisposition, or at least in the 

 etiology, is clear, and this is borne out by the fact that many accompanying 

 symptoms pointed to a pathologically dominant vagotonia, while the most 

 successful therapy with calcium sulphid, bakers' yeast, intestinal lavage 

 and calomel referred to a restoration, stimulation, or substitution of thy- 

 roid activity. 



The skin, as a mirror of the system, is a faithful index of various meta- 

 bolic and endocrin disturbances which appear not only in the integument* 

 of the eye, the lids, but in other ectodermal ocular structures as well, 

 notably the cornea and lens. 



Senility affects not only the lid-skin (pigment, atrophy) but the cornea 

 (gerontoxon) and lens (cataract). Familial occurrence of one or more of 

 these changes at an early age as an expression of dyscrinoid pre-senility 

 is not uncommonly observed in a familial grouping and hereditary in- 

 cidence. Xeroderma pigmentosum, which is essentially an atrophy with 

 pigmentation and epithelial hyperplasia, has been included in the expres- 

 sions of pre-senility on a basis of syphilitic (hereditary) dyscrinism. 

 It is often accompanied by other changes in the superficial tissues of the 

 eye, notably the conjunctiva, such as atrophy, or essential shrinking, lead- 

 ing to entropion, and with telangiectases of the lids and conjunctiva. 

 Other ocular dermatopathies indicating a metabolic or dyscrinoid in- 

 fluence are edema of the lids, chemosis of the conjunctiva, seen frequently 

 after the ingestion of certain foods (strawberries, crab-meat, buckwheat) 

 or medicines (quinin, antipyrin). Urticaria and Quincke's edema often 

 appear on the lids and conjunctiva, at times associated with iritis, mydri- 

 asis and paralysis of accommodation as an expression of a marked meta- 

 bolic constitutional disturbance, markedly hereditary, which is indicated, 

 further, by frequent association with edema of other parts of the body, 

 notably the larynx and pharynx, cheeks and lips, and penis. In this 

 connection we may note also the coincidence of exudative erythema of the 

 lids and conjunctiva with arthritic symptoms, especially in children. 



