Vol. 60, 1909 - University of North Carolina at Chapel Hill

264
THE CHARLOTTE MEDICAL JOURNAL.
replaced with lungs and the aortic stem as the eye is sufficiently clean the lids
divided into systematic and pulmonary should be gently separated and the cornea
trunks as in the amphibia, the part of the examined. Should there be any doubt as
bulbus at the origin of the aorta atrophies to the presence of any ulceration, a drop of
more than the par connected with the pul- fluorescine solution is instilled. If the
monary artery. In reptiles a part of the cornea is as yet unaffected, the lids are
bulbus musculature persists and can be gently inverted without allowing anything
distinguished from the proper ventricular to come in contact with the cornea—the
muscle; our author has also seen it well
marked in an abnormal human heart. In
the hearts of birds and mammals the bulbus
musculature completely disappears,
slightest abrasion being sure to become in-
fected, with disastrous consequences to the
eye—and painted with a two per cent, solu-
tion of silver nitrate by means of a wisp of
but its cavity persists, undergoes a great absorbent cotton wrapped around a glass
expansion, and forms the infundibulum of rod. If the conjunctiva is very brawny
the right ventricle. How far the infundi- and edematous, this painting had better be
bulum is formed by a downward expansion omitted. There is no necessity to neutralof
the bulbus cavity into the right ventricle ize the excess of silver solution; it is sufand
how far it is formed by an upgrowth ficient to mop the conjunctiva with a pledover
the vetricular muscle is difficult at get of wool.
present to decide, but the evidence of mal- The patient is kept in bed and provided
formed hearts points to the former process with some absorbent cotton and a basin of
being the true one. What the exact func- warm boric acid lotion, and instructed to
tion of the infundibulum of the mammalian wipe away the discharge as fast as it is seright
ventricle may be is difficult at present creted. Every hour or two during the day
to say, but its origin, its comparative anat- and at least every four hours during the
omy, and the arrangement of its muscula- night the conjunctival sac is thoroughly
ture make it certain that it has something irrigated with the same lotion from an unto
do with the regulation of the blood sup- dine by the attendant. A little boric acid
ply to the lungs. There are many clinical ointment should be smeared on the lids to
phenomena connected with this part of the prevent them from sticking together,
heart which need further observation and The silver application should also be reexplanation,
peated daily, the strength and frequency of
the application being gradually diminished
Acute Purulent Ophthalmia.— Render- as the case improves.
son in the British Medical Journal reminds
\
i
if the cornea becomes affected, one per i
us that the most frequent cause of purulent
^g,,^ atropine should be histilled everv four .
ophthalmia is the gonococcus, and if early
^^^^^^^ ^„j jf ^i^g discharge is still copious (
treatment is not successfully adopted the
^„^ ^^^ ^^^^^1 ^^1^^^ 1^^, made its appear- ,
loss of the affected eye is an event only too
^,j^g_ ^^^^ p^^ cent, silver nitrate solution .
probable.
should be stippled into the base of the ulcer, 1
If. as IS frequently the case only one eye .
^ut if the discharge has nearlv ceased, (
IS affected, the surgeon should first examine
cauterization with pure carbolic or the gal- I
the apparently sound eye, and should this
vano-cautery will be advisable. If the ulcer i
show no sign of inflammation, take imme- -^ obviously about to perforate, as shown (
diate steps to protect it from contamination.
^^^ ^^^ bulging of De.scemet's membrane, a t
This is best done by the use of a BuUer's
small perforation should be made so as to '^
shield, but until this can be procured or im-
^^^^^ ^^^ aqueous to escape slowlv, and ij
provised the sound eye can be efficiently
^^^^ prewe^n a large perforation with pro- J
protected by means of cyanide gamgee tisj
^f j^is. The later treatment of eyes S
sue secured fixed with a bandage. •„ ^^^^-^^^ perforation of the cornea has taken «
When a Buller s shield is employed, con- '
pj^^^ ^„^ j^f^ ^ prolapsed iris adherent to
,
i
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stant attention must be directed to the strap-
^^^ ^^^^^^^ f^l,g ^^^^-^^ jj^^ scope of this ii.
ping over the side of the nose, and a vent- -^ -^ sufficient to state that unless >^
hole should be made near the outer part of
operative steps to free the iris or make an i
the eyebrow by inserting a small piece of
iridectomy are taken the eye will be lost A
drainage tube ihe shield must not be re- '
^^^^^^ secondary glaucoma.
moved until all discharge from the affected
eye has ceased. The next step is the care- Remarks on Common Types of Sore i'l
ful removal of all discharge from the af- Throat.—Green, in the British Medical ;
fected eye by gentle irrigation with warm Journal, mentions the difficulties that sore li
one per cent, boric acid lotion. The surgeon throats present both as to diagnosis and ll
or attendant should always wear protecting treatment, especially in small children. In ,'
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goggles while engaged in the treatment of
any of these severe ophthalmias. As soon
considering the sore throat of scarlet fever
he enumerates four different conditions of j«