672 
DEPARTMENT OF SURGERY. 
have been obtained from the use of subconjunctival injections 
of normal salt solutions in the treatment of chronic inflamma¬ 
tory diseases of the coats of the eyeball ; they give very sat¬ 
isfactory results in iritis, irido • eyelitis, corneitis or scleritis, 
although not indicated in the acute state ; but, when the con¬ 
dition becomes chronic the injection of a physiological salt 
solution will often have a good effect upon the disease. The 
exact manner in which the good results are produced is not 
known to a certainty, but in our opinion the salt solution in¬ 
jected into the tissue stimulates the lymph spaces and lymph- 
channels, and in this way increases absorption of the oversup¬ 
ply of lymph in it. The presence of salt solution in tissues 
does not add anything to them in the way of nutrition, but the 
cells, intercellular substance and fibres of a tissue bathed by 
the solution are stimulated to activity, and in this manner allows 
them to perform their normal function. 
The change following a subconjunctival injection might 
also be the result of prevented hypernutrition ; that is, by re¬ 
ducing the amount of nutritious elements carried to the part in¬ 
volved, the lymphatics are enabled to remove foreign substances 
contained in the tissue in much less time than would be re¬ 
quired otherwise, and in this way the pathological conditions 
soon would become less intense and the absorbing system 
allowed to perform its normal function. We therefore notice 
two ways by which we can account for the beneficial results fol¬ 
lowing such injections, ist, by increased activity of the lym¬ 
phatics, and, 2d, by a reduction of nutrition carried to the part 
involved. To tell which of these two is correct is impossible, 
and, in fact, of but little importance ; what is most valuable to 
us is the result, not the manner in which nature accomplishes 
its purpose. 
Such injections should never be used in acute conditions, for 
in such instances the lymph-radicles are already over-stimulated 
or over-taxed by an increased amount of substances in the inter¬ 
stitial spaces of the tissue involved. The proper course to adopt 
in acute cases of this nature is to reduce or prevent the develop¬ 
ment of the inflammatory intensity by external applications; 
and, when this is accomplished, and the tissues that were in¬ 
volved remain abnormal by hypernutrition, or subnormal activ¬ 
ity of the absorbing system, they may then be stimulated by 
these injections. Some of the indications for subconjunctival 
injections of normal salt and antiseptic solution are the follow¬ 
ing chronic conditions : 
