SOME REMARKS ON PERIODIC OPHTHALMIA. 
183 
then is coritributive to weakness and poor health is provocative 
of the disease in the predisposed subject. 
The symptoms vary according to the severity of the attack. 
In some cases there is marked fever and in other slighter cases 
this may be almost altogether wanting, but there is always a 
lack of vigor and energy bespeaking general disorder. The 
local symptoms are in the main those of internal ophthalmia (for 
instance, such as are present in retinitis, choroiditis, irido-cho- 
roiditis, irido-cyclitis, etc., in all of which the conjunctiva may 
participate), with, in many cases, an increased hardness (tension) 
of the eye-ball (glaucoma), from effusion into its cavity. The 
contracted pupil does not expand much in darkness nor even un¬ 
der the action of atropine. Opacity advances from the margin 
(limbus) over a part or whole of the cornea, but so long as it is 
transparent there may be seen the turbid aqueous humor, with or 
without flocculi; the dingy iris, robbed of its clear, bright aspect; 
the slightly clouded lens, and a greenish, yellowish reflection 
from the depth of the eye. (And let me emphasize right here 
the necessity of ascertaining the tension of an eye before instill¬ 
ing atropine—the danger being that of precipitating an attack of 
glaucoma with resulting total blindness, of which more in some 
future paper.) From the fifth to the seventh day the flocculi pre¬ 
cipitates in the lower part of the chamber simulating (or forming 
true) hypopyon, and exposing more clearly to view the iris and 
lens. Absorption commences, so that the eye may be cleared up 
in from ten to fifteen days. The characteristic of the disease is, 
however, its recurrence again and again in the same eye until 
blindness results. The attacks may follow each other at inter¬ 
vals of a month, more or less, but they show no relation to any 
particular phase of the moon, as might be inferred from the fa¬ 
miliar name, but are determined rather by the weather, the 
health, the food, or by some periodicity of the system. From five 
to seven attacks usually result in blindness and then the second 
eye is liable to be attacked until it is also ruined. In the inter¬ 
vals between the attacks some remaining symptoms betray the 
condition, and these become more marked after each successive 
