DISEASES OF THE EYE, 285 
OBSTRUCTION OF THE LACRIMAL APPARATUS, OR WATERING 
EYE. 
The escape of tears on the side of the cheek is a symptom of exter- 
nal inflammation of the eye, but it may also occur from any disease 
of the lacrimal apparatus which interferes with the normal prog- 
ress of the tears to the nose; hence, in all cases when this symptom 
is not attended with special redness or swelling of the eyelids, it is 
well to examine the lacrimal apparatus. In some instances the orifice 
of the lacrimal duct on the floor of the nasal chamber and close to 
its anterior outlet will be found blocked by a portion of dry muco- 
purulent matter, on the removal of which tears may begin to escape. 
This implies an inflammation of the canal, which may be helped by 
occasional sponging out of the nose with warm water, and the ap- 
plication of the same on the face. Another remedy is to feed warm 
mashes of wheat bran from a nosebag, so that the relaxing effects 
of the water vapor may be secured. 
The two lacrimal openings, situated at the inner angle of the eye, 
may fail to admit the tears by reason of their deviation outward in 
connection with the eversion of the lower lid or by reason of their 
constriction in inflammation of the mucous membrane. The lacrimal 
sac, into which the lacrimal ducts open, may fail to discharge its 
contents by reason of constriction or closure of the duct leading to the 
nose, and it then forms a rounded swelling beneath the inner angle of 
the eye. The duct leading from the sac to the nose may be compressed 
or obliterated by fractures of the bones of the face, and in disease of 
these bones (osteosarcoma, so-called osteoporosis, diseased teeth, 
glanders of the nasal sinuses, abscess of the same cavities). 
The narrowed or obstructed ducts may be made pervious by a fine, 
silver probe passed down to the lacrimal sac, and any existing inflam- 
mation of the passages may be counteracted by the use of steaming 
mashes of wheat bran, by fomentations or wet cloths over the face, 
and even by the use of astringent eyewashes and the injection of 
similar liquids into the lacrimal canal from its nasal opening. The 
ordinary eyewash may be used for this purpose, or it may be injected 
after dilution to half its strength. The fractures and diseases of the 
bones and teeth must be treated according to their special demands 
when, if the canal is still left pervious, it may be again rendered 
useful. 
EXTERNAL OPHTHALMIA, OR CONJUNCTIVITIS. 
In inflammation of the outer parts of the eyeball the exposed vas- 
cular and sensitive mucous membrane (conjunctiva) which covers the 
ball, the eyelids, the haw, and the lacrimal apparatus, is usually the 
most deeply involved, yet adjacent parts are more or less implicated, 
and when disease is concentrated on these contiguous parts it consti- 
