MEDICINAL TREATMENT 179 
with pure silver nitrate or copper sulphate, or even 
actual cautery, has been recommended, although this 
must only be undertaken during the local anzesthesia 
produced by previous application of cocaine. Other 
minor operations can be performed under the same con- 
ditions, such as removal of the membrana nictitans, or its 
treatment in obstinate catarrhal conjunctivitis. 
Ulcerative Keratitis—Ulceration of the cornea usually 
yields to treatment with the zinc and boric lotion; but, 
should it not do so, hot fomentations containing 5 per 
cent. boric acid should be tried every four hours, and if 
they are successful they are much preferable to cautery. 
Lotions containing lead must never be used in cases of 
injury to the cornea, as lead salts are liable to be perma- 
nently deposited in the substance of the. membrane. If 
there is hernia of Descemet's membrane with threatened 
rupture, it is advisable to apply a few drops of eserine 
solution to the eye (0’05 eserine salicylate to 1o'o of dis- 
tilled water), as this reduces intra-ocular pressure and is 
probably a safer proceeding than that of puncturing the 
membrane at its lower border. The object aimed at is, of 
course, reduction of the pressure of liquids in the anterior 
chamber, and if this can be effected by local applications, 
the actual puncture of the chamber would appear contra- 
indicated, even though carried out below the line of 
vision. 
Atropine, although advocated by some in this condition, 
possesses the property of dilating the pupil and increas- 
ing intra-ocular pressure, therefore is hardly a suitable 
remedy. Other treatment for ulceration consists in dust- 
ing the eye with calomel, or the use of the various other 
lotions already enumerated. ‘Oculets,” containing 
zéo gr. of adrenalin, are very valuable in inflammatory 
conditions of the eye, as they quickly reduce hypereemia. 
Where this type of ophthalmic medication is preferred 
