ies, or acrid substance brought in contact with the cornea. pass into the slighter and chronic states; but 106. a. Acute Corneitis may be of various degrees of severity in different persons. In some, there is but little local uneasiness beyond irritation on motion; while in others, of a full habit, or who are laboriously occupied, exposed to heat, or addicted to intoxicating liquors, the inflammation is most intense, and rapidly extends to the sclerotica and whole anterior chamber, with hypopyon. The more severe states usually commence with a pink zone in the sclerotica, around the cornea, which loses its transparency, and becomes minutely inject-excepting that it is more obstinate, and more ed with delicate-coloured vessels, particularly liable to return. It is sometimes unattended at its circumference, and dull, turbid, or cloudy. by redness of the sclerotica, and the pain is not If the inflammation be excited by a foreign body, considerable. It is most common about the ulceration takes place around it. If the disease period of puberty, and is occasionally connectbe not soon arrested, the pink zone assumes a ed with amenorrhoe in the female, and with deeper tint, and extends farther in the sclerot-swollen lymphatic glands. In the more obsti ica; the cornea is rendered more opaque, and nate cases, increased secretion of the aqueous suppurates; and the chambers of the aqueous humour, and consequent enlargement of the humour are involved. When the cornea is anterior chamber, occasionally supervene. penetrated either by ulceration or suppuration, the aqueous humour escapes, the iris and cornea coming in contact. When the wound in the cornea is small, it unites by adhesion, and the aqueous humour is soon reproduced; but when it is large, prolapsus of the iris often results. [Diagnosis.-The distinctive characteristic of corneitis is, opacity of the membrane, from enlargement of the vessels, and interstitial deposition. At first there is a hazy appearance of the cornea, causing dulness of vision; then a gradual loss of transparency, and general cloudiness, with increasing imperfection of sight, objects appearing as if seen through a cloud or mist. And this cloudiness may, as stated by COPLAND, be general or partial. The cornea resembles a piece of ground glass, and the opacity may be so great as entirely to conceal the iris and pupil. The other appearances in the external vessels of the eye have been sufficiently pointed out. 107. b. Sub-acute and chronic Corneitis are common in young persons of a fair complexion and delicate constitution. The cornea loses its transparency, presents a dull gray colour, or becomes hazy, nebulous, or nearly opaque; the opacity commencing at the circumference, and gradually, but unequally extending. The nebulous and opaque spots are sometimes yellowish, as if matter were formed; and the sur- Prognosis.-This affection may be promptly face loses its polish, and seems rough. The cured by proper treatment; the interstitial decircumference of the cornea is minutely inject-posite becomes absorbed, and the sight, conse quently, restored. We sometimes, however, find the iris to assume a darker hue after recovery, giving to the eye a somewhat duller hue than natural. If the treatment is not sufficiently prompt and energetic, the cornea loses its transparency, and becomes changed in various degrees, from leucoma to slight nebula. The iris is dull and dark-coloured, the pupil adherent, and there may be opacity in the opening.] ed with a multitude of very fine vessels, which impart to it a reddish-brown tint, and occasionally elevate it somewhat. The conjunctiva often retains its natural paleness, but the sclerotica is minutely injected, particularly around the cornea. As the brownish-red tint of the circumference of the part increases, the opacity in its centre becomes greater, and vision more affected. There is generally much intolerance of light, notwithstanding the diminished transparency of the cornea, owing to af- 110. d. Treatment.-a. Acute corneitis requires fection of the sclerotica. A partial form of cor- active depletory and other antiphlogistic measneitis, which is generally of very long duration, ures. Cupping behind the ears or on the temis sometimes met with. Inflammation com- ples is always necessary. Purgatives, and afmences in one or two spots at the circumfer-terward calomel with JAMES's powder, and occaence of the cornea, with pain of the eye and sionally with opium, until the mouth is affected, nebulosity, others being affected in succession. are beneficial, especially if the iris be inflamed. Redness is first observed in the sclerotica, in In the more obstinate and chronic cases, cupone or two points; and minute vessels extend ping, or the application of a number of leeches from these into the cloudy spots in the cornea, to the vicinity of the eye, should be repeated more or less of which may become thus affect- oftener than once, and be followed by open blised, or entirely opaque. ters, setons, or issues. Mr. LAWRENCE advises issues to be inserted in the temples. Astringent and stimulating applications, to remove the opacity, are generally injurious. Warm fomentations are more serviceable, particularly with emollient and anodyne substances. Emetics, if the digestive organs be loaded; and diaphoretics, assisted by warm pediluvia, if the skin be dry and fever present, are also useful. B. The scrofulous variety, especially its more chronic states, is benefited most by sarsapa 108. Although the severe and acute grades of corneitis often run into suppuration or ulceration, the slighter or more chronic states do not terminate in this manner, excepting in subacute cases, where partial or circumscribed points of suppuration may occur. The more severe grades are attended by much pain in the eye, temples, and forehead, with tension of the organ, white tongue, and febrile disturbance, particularly at an early stage; and they often rilla, sulphate of quinine, decoction of bark with liquor potassæ, the compound myrrh mixture, the iodide of potassium, and by small doses of the bichloride of mercury in tincture of bark. As this variety often continues many months, perseverance in the use of these means, and changes from the one to the other, a dry, warm air, and change of air, with attention to the state of the digestive organs, and a carefully regulated diet, are most requisite. [The influence of mercury in checking the inflammation and restoring the transparency of the part is often strikingly manifested, and, after suitable depletory measures, should never be neglected; and especially is this article indicated where the iris participates in the affection. In feeble constitutions, even local depletion may not be borne well; here tonics, as iron, quinine, and the different preparations of iodine, as the iodide of iron, are the articles on which most dependance is to be placed. A nutritious diet of animal food will often prove advantageous, especially in the scrofulous variety.] III. INFLAMMATION OF THE INTERNAL PARTS OF THE EYE. SYN-Internal Ophthalmia, Ophthalmitis Interna, Auct. var. 111. DEFIN.-Inflammation of one or more of the internal tissues of the eye, occurring either primarily, or consecutively of external disease, and attended by impaired vision, and frequently by constitutional disorder. the latter, and spread over this cavity to the cornea, and either adhesion of the iris to the cornea or hypopyon be produced. Primary inflammation of this membrane presents the usual phenomena of inflamed serous surfaces, viz., effusion of albuminous or coagulating lymph, or of a serous fluid, and very rarely of pus, the first of these sometimes becoming organized into morbid adhesions. 115. A. Symptoms.-The anterior chamber is cloudy, the iris becomes dull and dark, its surface assumes a reddish-brown tinge, the reddish tint being most evident in light eyes, and the pupil is somewhat contracted. The cornea loses its transparency, becomes nebulous or mottled, sometimes with an ulcer in its surface. There is but little external redness, excepting a pink zone around the cornea. An effusion of whitish or yellowish matter takes place in the anterior chamber, and the patient complains of pain and aching in the eye and forehead, of fulness or tightness in the organ, and of intolerance of light, especially early in the complaint; these symptoms subsiding at more advanced periods. Its progress in children is not rapid. Mr. WARDROP Considers the opacity to be seated in the internal surface of the cornea, and that it arises from a number of round specks, which give a mottled appearance to this part, particularly in adults. He also believes the effusion into the chamber, which has been generally considered pus, to be albuminous, and similar to that which causes adhesions, but not coagulable.* 112. In diseases of the internal eye, artificial dilatation of the pupil is necessary, both to the investigation of their nature and extent, and to 116. B. Hypopyont-or the presence of a yeltheir treatment. Mr. LAWRENCE has given a lowish matter in the anterior chamber, resemlearned account of the agents by which dilata-bling, and usually called, pus, and attending or tion may be accomplished. Various narcotic vegetables possess this power, but belladonna in the highest degree. The tincture, extract, decoction, infusion, or powder of this plant may be employed for this purpose, either internally, or dropped into the eye, or rubbed on the brow or temple. Hyoscyamus is the next powerful substance. An aqueous solution of the extracts of either may be rubbed or placed upon the eyelids, or parts in the vicinity, and washed off after remaining for about an hour; or it may be dropped into the eye, when a speedy and certain effect is desired. i. INFLAMMATION OF THE ANTERIOR CHAMBER. SYN. - Inflammation of the Capsule of the Aqueous Humour, WARDROP; Aquo-Capsulitis, MACKENZIE; Kerato-iritis, Rosas; Inflammation of the Anterior Chamber, Law RENCE. 113. CHARACT.-Diffused muddiness, or mottled appearance of the cornea, dimness of vision, fulness and tension of the eye, dulness of the iris, slightly contracted pupil, headache, white tongue, and fever. 114. Inflammation of the membrane of the aqueous humour is often consequent upon the varieties of ophthalmia already described; but it is also a primary disease, and is most common in this form among children. It cannot be considered, even when primary, to be confined to the anterior chamber, or to this membrane. The posterior chamber, the cornea, and iris evidently are also affected, more or less. External inflammation involving the cornea may extend to the anterior chamber and to the iris; or inflammation may commence in consequent upon inflammation-accompanies * [Dr. HAYS gives the following case of inflammation of the membrane of the aqueous humour: "ELIZA WILLIAMS, a coloured woman, aged twenty, ap plied at the Pennsylvania Eye Infirmary, April 6, 1826. Her sight had been growing dim for several days, and she suffered slight pain in her eye. On the most minute examination, no change from a healthy state could be perceived, except, perhaps, an extremely faint dulness, situated at the posterior part of the cornea, the cornea itself being evidently unaffected. After some days a small spot became evident, and was shortly followed by two others, differing, both in situation and appearance, from the opacities produced from inflammation of the cornea. They were deep-seated, and evidently produced by the effusion of lymph on the inner surface of the cornea, giving it the appearance of being mottled with white. The margins of these spots were well defined, and the lamina of lymph so thin as not to produce perfect opacity. These spots remained permanent."-(Notes: to Lawrence on the Eye, p. 307, 308.)] + [Eiter-auge of the Germans; from vño, under, and ruo pus.) brane of the chamber and tissues surrounding | rior hemisphere of the crystalline capsule, oft it. Whether the matter in hypopyon be pus or an albuminous fluid, it seems to sink to the bottom of the aqueous humour; but in some instances it appears as if heaped up or in lumps, and in this case a minute admixture of blood sometimes is seen in it. en extending to the choroid and retina, generally accompanies this disease; but the iris is the focus of morbid action, and the situation of the chief lesions. The primary states of the complaint commence in the pupillary edge of the iris, spread to the rest of the iris, to the 117. C. Treatment.—a. Inflammation of the capsule of the lens, and, perhaps, to the choroid anterior chamber is readily controlled by local and retina. The attendant inflammation of the bleedings, purgatives, and calomel, with JAMES's sclerotica may be sympathetic or otherwise repowder, given twice or thrice a day. Mr. lated to it. Iritis has been divided into the WARDROP has strongly advised puncture of the idiopathic, or that occurring primarily in per cornea, to evacuate the aqueous humour, in this sons of a healthy constitution; and the symand some other affections attended by inflam-pathetic, or that affecting those of an arthritic mation of the membrane secreting this humour, diathesis, or supervening in the course of syphafter suitable treatment has been employed; ilitic cachexia. and MACGREGor, Mueller, LANGENBECK, and 121. Causes.-Primary Iritis occurs most BENEDICT Speak favourably of it, as a meas-frequently in persons of an unsound constituure calculated to prevent rupture of the cor- tion-the gouty, rheumatic, and cachectic; and nea in purulent ophthalmia. Mr. LAWRENCE, hence it presents certain modifications hereaf who takes a candid view of the matter, thus ter to be noticed. It rarely occurs in young remarks: "I have tried it in some instances, and healthy persons, although it may supervene but with so little benefit that I have not been in them, upon the other varieties of ophthalmia. induced to persist in the practice; and I have It is excited by the common causes of inflambeen the less inclined to do so in severe inflammation of this organ (◊ 5), especially by over mations, because the ordinary antiphlogistic treatment enables us to control them." of a rheumatic and gouty diathesis. I do not be. lieve that the use of mercury will cause the complaint, if it be given so as to affect the mouth. exertion, and employment of sight on minute or bright objects; by external injuries or oper118. b. Hypopyon, being an attendant rather ations on the eye; and by exposure to cold, than a termination of inflammation beginning wet, and atmospheric vicissitudes. These last in, or extending to, the anterior chamber, re- are the common exciting causes in persons imquires the antiphlogistic treatment recommend-bued with the syphilitic cachexia, and in those ed in the acute forms of ophthalmia. The only question is, whether or not the cornea should be punctured to evacuate the matter | collected behind it. Puncture or incision has 122. A. IDIOPATHIC IRITIS.-a. Symptoms and been advised for this purpose by WARE, RICH- Course.-Iritis presents various grades of sever TER, BENEDICT, LANGENBECK, and WARDROP. ity and periods of duration. It may hence be BEER at one time directed it, but afterward | mild or severe; acute, sub-acute, or chronic. I reprobated it. Dr. MONTEATH and Mr. MAC- shall adopt Mr. MACKENZIE's division of iritis KENZIE recommend its performance in every into three grades.—a. In the first degree the vascase in which the chambers are completely fill-cularity of the sclerotica is barely perceptible, ed, as they consider absorption in such not to and exists only in one or more points, and chiefbe depended upon, and dread the bursting and ly behind the upper lid. The ring of the iris destruction of the eye. SCARPA and LAWRENCE, next the pupil is slightly discoloured; the pupil on the contrary, prefer active antiphlogistic is not materially contracted, but is somewhat treatment, as they consider that the operation irregular, without its usual clean and sharp edge, aggravates the inflammation, and that when the and is hazy; and the motions of the iris are inflammation is removed by judicious and en- limited and slow. Vision is confused and ergetic means, the effusion will be rapidly ab- slightly obscured. There is little or no pain, sorbed. In this opinion I entirely concur. or aversion from light. This state of iritis ii. INFLAMMATION OF THE IRIS. SYN.-Iritis, may exist for many weeks, and yet be comSCHMIDT. pletely removed by suitable treatment. 119. CHARACT.-Fine vessels running in radii to the edge of the cornea; dark discoloration of the iris; contraction, irregularity, and immobility of the pupil; effusion of coagulable lymph into the pupil and posterior chamber, occasionally also into the anterior, causing adhesions of the iris to the capsule of the lens, with dimness of sight, sometimes almost amounting to blindness, pain in the eye, and nocturnal pain about the orbit. 120. This affection was not known until it was ably described by SCHMIDT of Vienna. It may be consecutive of the diseases already noticed; but it often occurs in a primary form, and then generally assumes more or less of the characters of adhesive inflammation, the danger occasioned by it to the organ arising chiefly from this circumstance; for, if neglected or injudiciously treated, the pupil may become completely and irremediably obliterated by effusion of coagulable lymph. Some degree of inflammation of the sclerotica, and of the ante 123. B. The second degree, or that with evident external inflammation of the eye, is much more frequent than the foregoing. A zone of vascularity is observed in the sclerotica around the cornea, the vessels sinking through the sclerotica, and not advancing into the cornea, The iris, particularly its inner or smaller rings, is discoloured, either from injection of its ves sels or the effusion of lymph; and its anterior surface, instead of being smooth and shining, appears dull, puckered, and swollen, especially near the pupillary opening, where it is retracted towards the lens. The pupil is contracted, irregular, motionless, and filled with coagulable lymph, which generally appears like halfboiled white of egg. Epiphora and intolerance of light are considerable, and vision becomes greatly impaired. The pain in the eye is constant, and attended by pain in the orbit and forehead, particularly at night, and by the usual symptoms of inflammatory fever. In conditions of the frame. They are attended by the usual characters of severe vascular action, especially injection of the vessels, extreme contraction of the pupil, effusion of lymph, dulness of the cornea, external redness, loss of sight, violent pain in the eye, and severe headache, with watchfulness, restlessness, and febrile disturbance, terminating, in a few days, in disorganization of the interior tissues, and in irreparable loss of vision. chronic cases the origin of disease is almost imperceptible, and its progress slow. Little or no pain is felt, and the external redness is very slight or unobserved. At last, lymph is effu. sed, vision is impaired, and the complaint is brought under treatment. The sub-acute cases are intermediate between these two extremes. The chronic form may also follow upon an inactive or partially successful treatment of the acute and sub-acute forms, but it usually presents itself in the first grade; the acute most commonly assuming the third, and the sub-acute the second grades. 124. y. The third degree of iritis presents the following characters: The eye externally is much more inflamed than in the foregoing grades; the redness of the conjunctiva being sometimes so great as to mask for a time the red zone of the sclerotica. Both the smaller and larger rings of the iris are discoloured; the anterior surface being swollen, puckered, and bolstered forward so as to approach the cornea, excepting its pupillary edge, which is retracted towards the lens. Red vessels and spots of blood are sometimes seen on the iris, but more frequently in the lymph occupying the very contracted pupil. One or more minute elevations, of a yellowish colour, which are in some cases specks of effused lymph, in others small abscesses, appear on the surface of the iris; and pus discharged from these abscesses, with lymph, blood, and serum, sometimes occupy the anterior chamber. The cornea becomes hazy and turbid, and occasionally dotted with minute brownish spots. There are at first great intolerance of light and lachrymation, and subsequently vision is completely, 127. b. Consequences and Prognosis-a. Change and generally permanently, lost. Flashes of of texture and colour of the iris follow inflammalight in the eye are frequently perceived by the tion which has been violent or of long duration. patient, indicating the extension of inflamma- General adhesion of the iris to the cornea may tion to the choroid and retina. The pain in occur, and lead to staphyloma; or the iris may the organ is constant, great, and sometimes become adherent both to the cornea and to the excruciating, with pain in the orbit and eye-capsule of the lens, occasioning anterior flatbrow, increased at night. When attended with extreme pain, especially in syphilitic cases, very serious changes, even abscess of the anterior chamber, disorganization of the vitreous humour, &c., frequently supervene. In these the inflammation is extended more or less to the internal and external tissues of the eye, and general ophthalmitis (§ 153) is the result. tening of the eye. This is, however, very rare. Dropsical enlargement of the anterior chamber, with closed pupil and staphyloma sclerotica, may likewise supervene (LAWRENCE ). — B After acute or sub-acute attacks, the pupillary margin often becomes adherent to the capsule of the lens, either throughout, or in one or more points. When the inflammation has disap125. d. The discoloration of the iris arises from peared, the adhesion still continues, or is revascular injection and effusion, and is of a yel- duced to slender threads, admitting of partial lowish or greenish tint in light eyes, or of a motion. In some cases, adhesions of the iris reddish hue in dark eyes; but it is very fre- are detached, leaving black marks on the capquently dull, muddy, and dark, and the natural sule, which are permanent.-y. An adventitious brilliancy and fibrous arrangement of this part membrane may form in the pupil from organizaare lost. The effused lymph is seen first at the tion of the lymph effused on the surface of the pupillary edge, and afterward on the lesser cir- capsule. Its opacity is greatest in the centre, cle of the iris, causing a villous, rough, eleva- and it may be connected with partial adhesion ted, or irregular surface or outline of the part. of the iris. In rarer instances, the adventiThe lymph may be in distinct masses of very tious substance is seen in one side of the pu various sizes on the anterior of the iris, or at pil, and attached to the edge of the iris (Atresia its pupillary margin; and, in the most acute Iridis incompleta).-8. Closure of the pupil fol cases, it may fill the pupil or anterior chamber, lows effusion into the posterior chamber, and or even the posterior chamber. The colour of the formation of an opaque adventitious subthe effused lymph is sometimes a light yellow-stance, to which the circumference of the puish-brown or ochrey, but a rusty hue is most common. It is occasionally of a light dirty yellowish tint, particularly when it is abundant and fills the anterior chamber. In this case, or when a small abscess in the iris is discharged in this situation, a form of hypopyon is the result. The pupil is contracted, and becomes more and more so in the progress of the complaint. The effusion of lymph and adhesion render it also angular, irregular, and fixed at one or more points, and free in others. It loses its thin, sharp, and well-defined edge, and becomes dull and cloudy, or otherwise discoloured. 126. e. The acute states of iritis are observed in persons of a full habit or robust constitution, after the action of powerful causes, especially if they continue to act, and the case have been neglected at the beginning, and in cachectic pil is fixed (Atresia Iridis perfecta). This adventitious membrane may extend over the anterior capsule, causing adhesion of the uvea to the lens, and enlargement of the anterior chamber-e. Atrophy of the globe may supervene upon copious effusion into both chambers, and deposition of lymph behind the iris in such quantity as to cause bulging of the sclerotica, or to escape through this membrane, and raise the conjunctiva. In this case the fluid is absorbed after the subsidence of the inflammation; but the internal parts of the ball are so altered that they waste and become flaccid, particularly after complete closure of the pupil. The vitreous humour may also be rendered fluid, and the eye soft, without shrinking in size; but this occurs only after acute syphilitic iritis.-5. Impaired vision may be the result of the extension of inflammation to the posterior tunics, although the disease has been arrested by appropriate treatment, and may follow the acute, sub-acute, or chronic states of the disease. The impaired vision may be caused solely by the lesions produced in these tunics, or by these and the changes in the pupil conjoined. 128. c. The Prognosis.-When the disease is recent, and appropriate treatment is adopted, effusion into the texture or on the surface of the iris will be removed by absorption upon the subsidence of the inflammation. Hence we need not dread the result, if the changes be confined to the iris, although the effusion be copious. But when the complaint has continued some time, and is attended by increasing contraction of the pupil and effusion of lymph, with organization of the latter into adhesions and adventitious membranes; or when the consequences described above (§ 127) are present, or inflammation extends to the posterior parts of the globe and retina, or to the cornea with more or less opacity, the greatest danger to vision is to be apprehended. In most cases, a guarded prognosis should be given, for it is often difficult to determine how far the posterior tunics may be affected. Change of colour in the whole iris, with great contraction of the pupil, and an opaque substance in it; intense external redness, severe and deep-seated pain, extinction of sight, and flashes of light in the eye; large effusion behind the iris, and bulging of the sclerotica, and a protruded state of the iris, and adhesion of the pupil, are all hopeless states of the organ. If unfavourable changes have not appeared, recovery may take place, although the complaint has been of three or four weeks' duration, and sight is much impaired. 129. d. The Diagnosis of Iritis cannot be difficult, if the history of the case be considered, and the state of the iris carefully examined. The affection most resembling iritis is inflammation of the capsule of the lens. Nebulous, contracted, and fixed pupil, discoloured iris, adhesions between the iris and capsule, are present in the latter, which, however, often supervenes in the course of iritis, and generally attends its most acute attacks; while, on the other hand, inflammation of the crystalline capsule is attended by some degree of iritis. The one is thus reciprocally consequent upon the other.-Retinitis resembles iritis chiefly in the great contraction of the pupil; but the former is more sudden, its progress more rapid, its attendant headache more violent, and vision more rapidly impaired, than in the latter. 130. e. Treatment.-The indications of cure are, 1st, to subdue the inflammation; 2d, to prevent or arrest the effusion of lymph; 3d, to promote the absorption of what has been effused; and 4th, to preserve the pupil entire. They are to be accomplished by blood-letting, mercurials, belladonna, &c.-Blood-letting, in acute and sub-acute cases; in young, robust, or plethoric persons; when the pain is severe, and febrile disturbance considerable, and the inflammation extending to the internal tunics, must be most promptly and actively practised. It will often be necessary to repeat it, and even to follow it by cupping on the nape of the neck, or behind the ears, or on the temples. In the circumstances now stated, local bleeding can not be confided in alone; but in chronic, subacute, or mild states cupping will be preferable. Leeches may be employed; but they are, unless a great number be applied, much less efficient than cupping. Immediately after the first bleeding, a full dose of calomel and JAMES's powder, with opium, should be given, and repeated at bedtime, and an active cathartic draught (F. 216) in the morning, aided by a terebinthinate enema (F. 150, 151). The spe cific effects of mercury, which are most effectual in fulfilling the second and third indica tions, will be hastened by its combination with an antimonial; and, if the bowels be acted upon daily by a draught containing equal parts of the spirits of turpentine and castor oil, or a larger portion of the former, the specific operation of the calomel will not be prevented, or even delayed, but the beneficial effects on the disease will be ensured. 131. Belladonna is of great benefit in every stage of the complaint, and should be applied as directed above (§ 112), contemporaneously with the exhibition of mercury. Although the pupil be contracted, and effusion or even adhesion has taken place, the specific operation of the latter, and the effects of the former on the iris, will elongate or even entirely detach the adhesions, if they are soft or unorganized. In addition to these, diaphoretics, diuretics, and warm pediluvia are beneficial. The bowels ought to be kept freely open by the substances already noticed. Turpentine may be used for this purpose, or with the view of aiding the ef fects of calomel, or even as a substitute for it, as advised by Mr. CARMICHAEL, who prescribes it in drachm doses, three times a day, suspended in almond emulsion Blisters are of doubtful efficacy. Mr. LAWRENCE decides against them. 132. B. SYMPATHETIC IRITIS-a. Syphinte Iritis, or inflammation of the iris occurring in persons tainted by the syphilitic poison, is, perhaps, the most common variety of this disease. It is a symptom of syphilis in its constitutional stage; and, although sometimes appearing alone, it is more frequently one of several secondary symptoms, especially ulcerations of the throat, eruptions, swellings of the periosteum, pains of the limbs, affection of the nose, &c. It occurs most frequently along with the earlier secondary affections, and sometimes appears before the primary disorder is cured. (LAWRENCE) It rarely occurs as a symptom of syphilis in infants, although secondary syphilis is not infrequent in them. It may be either acute or chronic; it is often associated with inflammation of other internal tissues of the organ, and it is most commonly determined or excited by exposure to cold, exertion of the eye, or external injury. 133. Diagnosis.-The characters and progress of syphilitic iritis are nearly the same as those of the idiopathic form; yet there are certain points of difference, which are frequently observed in the local symptoms, deserving of notice. These are the tubercular disposition, and the reddish-brown discoloration of the lymph effused on the iris; the angular form of the pupil, and its displacement towards the root of the nose; and the violent exacerbations of pain felt chiefly in the brow during the night, and in a slighter degree or |