800 PEECY FRIDEKBEKG 



(mumps 01 the lachrymal gland), with status lymphaticus, and enlarged 

 thymus. Possible connection with protein serialization, acidosis, exudative 

 diathesis, hyperchlorhydria, pylorospasm, and acid stomach. 



Vernal Conjunctivitis, or Spring Catarrh (Saemisch) is similarly, a 

 lymphoid affection of the conjunctiva of the lids and of the circumcorneal 

 area of the ocular conjunctiva. The lymphoid hypertrophy of the pal- 

 pebral conjunctiva often shows progressive tissue changes with toughen- 

 ing to a horny consistency. The papillary hypertrophy around the cornea 

 is on the contrary always gelatinous, never more consistent. The condi- 

 tion is most obstinate, annoying, and shows a marked tendency to relapse 

 at about the same time each year, that is, just after the final disappear- 

 ance of cold winter weather. Constitutional and local treatment of every 

 kind has been tried with practically no effect. Local applications of as- 

 tringents are worse than useless as even very weak solutions cause marked 

 reaction and aggravate the condition, which tends gradually to disappear 

 with the advent of hot summer days and cool fall days. Of late, x-ray and 

 radium treatment and instillations of fibrolysin have been reported to act 

 well, as do adrenalin solutions used locally. Marked pigmentation was 

 noted in many but by no means all of the patients. This and the similarity 

 in some ways to trachoma and other follicular lymphoid conditions of the 

 lids associated with acidotic states and adenoids, and the beneficial effect 

 of adrenalin suggest the therapeutic administration of thyroid gland on 

 the supposition of a relative hypothyroidism due to overacting pituitary 

 and adrenals. 



Vitamins and the Visual Organ 



The importance of vitamin disturbances in disorders of nutrition has 

 an important bearing on the metabolism and function as well as the 

 structures of the eye. The physiology of the vitamin supply has not been 

 worked out, and it is a question whether these substances normally supply 

 a chemical which is itself essential to life or whether they act indirectly to 

 stimulate the endocrin glands in their nutritional functions, and serve as 

 activators of hormones. The latter agency is indicated by the apparent 

 inability of the organism to store vitamins and produce a reserve or to 

 synthetize any one of these important substances from diets which con- 

 tain all the basic organic and inorganic constituents* of fat, carbohydrate, 

 or protein food. The analogy and even partial identity of hormone and 

 vitamin action is indicated by functional and organic ocular disturbances 

 which are found, on the one hand, in typical dyscrinisms of an hereditary 

 character, and again in definite avitaminoses. The interrelation of metab- 

 olism and endocrin supply is indicated in disturbances of fat digestion, 

 in acidotic states, and in faulty calcium metabolism, all of which are 

 generally accompanied by characteristic disturbances of the eye. Calcium 



