OPHTHALMY. 
eye, foas to make the tranfparent cornea feem quite funk, 
revent ey mpletely fhut. Chemofis 
is the term ufually applied to thisfort of cafe. 
The fevere acute ophthalmy generally affects only the _— 
part of the eye-ball ; but fometimes the interior of the 
1s alone affected, or, at all events, more fo than the ace 
a a red appearance ; 
d the aqueous humour is occafionally re 
i thefe apogee 
there m miey be a 
the eye, eipecilly betwixt the choroid and {clerotic coats. 
Hence may arife the termination of the internal ophthalmy 
in amaurolis, fo common when the cafe does not end in fup- 
puration. 
The fevere acute ea ae halmy ay the moft rigorous 
Tardinefs in pro- 
condition in which fuppuration, or an extravafation of lymph 
des the eyes is threatened ; while, in other inftances, the 
aAGie from the exceffive weaknefs produced i in the veflels of 
the conjunGiva. Both general and topical blood-letting 
fhould therefore be fpeedily aaa Leeches fhould be 
applied to the piel of the eye-lids, efpecially, fays 
Scarpa, about the inner sahae on the vena angularis, 
where it joins = oS deep orbitar, oe tranf{verfe vein 
of the a See Saggio di Offervaz. &c. 
Mr. Ware aear a ee ee being put a. or very n 
the eye-lids, as they have fometimes caufed a cpaideatls 
{welling of thofe parts, and increafed inftead of leflening 
the irritation. Ino oT . o this Jeera recommends 
of the 
mode of bleeding, in cafes of ophthalmy, perhaps produc- 
tive of was be enefit than any other, and this probably on 
account of its acting at once both as a general and topical ap- 
plication ; ie plan uilged tois that of opening the tempo- 
ral arte 
There ne is another methed of bleeding, which deferves to 
be particularly noticed, as having frequently proved fupe- 
riorly efficacious. The vifible blood-veffels on that part of 
the conjunctiva, ‘which covers the infide of the eye-lids, are 
much more numerous than thofe which are obfervable on the 
white of theeye. Hence, in ophthalmy, the itflammation 
feems greateft on the infide of the eye- ids, where the blood. 
veffels are often not only much increafed in number, _ are 
alfo extremely full and turgid. Sometimes alfo the 
infide of a paper particularly of the lower sue is fo 
much enlar s to be conftantly n both 
thefe cafes great eae has aed derived aa tearifying the 
inner furface of thefe parts with a lancet, by which means a 
ean quantity of blog, 
io punciures made in the outfide of the {welled part, near 
its edge, will let aut a quantity of blends water, and ma- 
terially leffen the iweliing. hen the tumefaction of the 
everted eye-lids is very serena great and {peedy relief 
has often been piven, by cutti: a piece of the infide of 
thofe a s with a pair of cured all. Ware on Oph- 
thalmy, 39: 4 
General ene though copious, and affifted by th 
topical application of leeches, does not always prove a 
quate to the removal of the high degree of inflammation at- 
tendant on chemo tis expedient to employ additional 
eans, in order to give exit to the blood effufed in the cel- 
lular fubftance, between the conjuntiva and {clerotica, and 
raifing the of thefe membranes fo much above the level 
of the cornea. With this view Scarpa recommends making 
acircular incifion in the conjun@iva near the margin of the 
ign {ciflars. Asa lancet, however, 
is perhaps preferable for the ope- 
ration, and fear iReations might ful ce both for the difcharge 
of the extravafated blood, and of that diftending the ea 
of the conjunctiva itfelf. But, according to Mr. War 
there cannot be an eafier, nor a more effectual remedy i in 
chemofis, than zther. A few drops are to be poured into 
the palm of the hand, and diffufed over it, which may be im- 
mediately done by prefling the other hand againft it. The 
hand is then to be applied to the eye, and kept fo clofe to 
it that the {pirit, as it evaporates, may infinuate itfelf into the 
part affe€ted, and bring about the abforption of the extra- 
vafated blood. Ina few inftances of chemofis, in which the 
{welling and inflammation have been confiderable, Mr. “Ware 
oque cum aque pure 3{s in 
tunc exprimatur fuccus, et boslistar paululum ad oculos et 
ad palpebras fzepe in die 
After general on topical eee ko alas ie ae of 
the moft gentle kind fhou niftered ; phof- 
phorata, pulp of oe Ree Tapers eee mag- 
nefie fulphas, are the moft proper. When the ftomach is 
affected, Scarpa alfo pes: an emetic, as being of fin- 
ails fervice i in cafes of ophthalmy. 
eeding and other evacuations have been practifed, 
the ome moit ufeful meafure is the application of a blifter to 
the nape of the neck. Scarpa ebferves that the integuments 
this fituation, and behind the ears, fympat ize more 
Mr. Ware, 
m ‘ne 
o be applied to the temples, direétly over the orifices 
by the leeches ; and I have found that the fooner the blifter 
has followed the bleeding, the more efficacious both 
proved.’’ When the cag has been very violent, and 
refifted the common me r. Ware adds, that the moft 
beneficial effe€&ts have alfo = foaeane: produced by the 
eae of a blifter large enough to cover the eh head. 
“At firlt, » topical emollient applications to the eye are moft 
new m 
beneficial ; fuch as mallows boiled in milk, bread and 
milk po oultices, or Sid oft pulp of a baked apple; all in- 
cluded in fine little muffin bags medies of this defcrip- 
tion fhould be see at leaft every two 8. - 
lie with his head in an elevated pofition. To e eye- 
lids from adhering together in the night time, the {permaceti 
en the os halmy is pel apa with 
a violent pain in the hea are recommends a ftron 
— of poppy heads to ie applied as a fomentation. 
nder the preceding plan of cage diese es pe flage of 
fevere ophthalmy ufually abates in the of a week, 
he burning heat, and dartin is in ae aed and the 
febrile peers Sy the conititution, ali fubfide. The a 
tient is compara eafy, and regains his appetite. 
eye-lids lofe their elie aa ‘wale A difcharge - hic 
