tend to the whole lid.

on a yellowish color,

66

STYE. A stye is a boil on the eyelid; it begins at the root of a hair as a hard swelling which may exThe tip of the swelling takes breaks down and discharges matter" or pus. There are pain and a feeling of tension in the lid, and, very rarely, some fever. When one stye follows another it is well to have the eyes examined by an oculist, as eye-strain is often an inviting cause of the trouble, and this can be corrected by the use of glasses. Otherwise the patient is probably "run down" from chronic constipation and anæmia (poverty of the blood) and other causes, and needs a change of air, tonics, and exercise out of doors. In a depreciated condition, rubbing the lids causes introduction of disease germs.

The immediate treatment, which may cut short the trouble, consists in bathing the eyelid for fifteen minutes at a time, every hour, with a hot solution of boric acid (half a teaspoonful to the cup of water). Then at night the swelling should be painted with collodion, several coats, being careful not to get it in the eye, as it would cause much smarting. If the stye persists in progressing, bathing it in hot water will cause it to discharge pus and terminate much sooner.

TWITCHING OF THE EYELIDS.-This condition may be due to eye-strain, and can be relieved if the eyes are fitted to glasses by an oculist (not an optician). It is frequently an accompaniment of inflammation of the eyes, and when this is cured the

twitching of the lids disappears. When the eyes are otherwise normal the twitching is frequently one of the signs of nerve fag and overwork.

WOUNDS AND BURNS ABOUT THE EYES. -Slight wounds of the inner surface of the eyelids close readily without stitching if the boric-acid solution (ten grains to the ounce of water) is dropped into the eye four times daily. Burns of the inner surface of the lids follow the entrance of hot water, hot ashes, lime, acids, and molten metals. Burns produced by lime are treated by dropping a solution of vinegar (one part of vinegar to four of water) into the eye, while those caused by acids are relieved by similar treatment with limewater or solution of baking soda (half a teaspoonful to the glass of water). If these remedies are not at hand, the essential object is attained by washing the eye with a strong current of water, as from a hose or faucet. If there is much swelling of the lids, and inflammation after the accident, drop boric-acid solution into the eye four times daily. Treatment by cold compresses, as recommended for "black eye," will do much also to quiet the irritation, and the patient should wear dark glasses.

SORE EYES; CONJUNCTIVITIS.-The mucous membrane lining the inner surface of the eyelids also covers the front of the eyeball, although so transparent here that it is not apparent to the observer. Inflammation of this membrane is more commonly limited to that portion covering the inner surfaces of the

lids, but may extend to the eyeball when the eye becomes "bloodshot" and the condition more serious. For the sake of convenience we may speak of a mild form of sore eye, as congestion of the eyelids, and the more severe type, as true conjunctivitis (see p. 32).

CONGESTION OF THE EYELIDS.-This may be caused by smoke or dust in the atmosphere, by other foreign bodies in the eye; frequently by eye-strain, due to far- or near-sightedness, astigmatism, or muscular weakness, which may be corrected by an oculist's (never an optician's) prescription for glasses. Exposure to an excessive glare of light, as in the case of firemen, or, on the other hand, reading constantly and often in a poor light, will induce irritation of the lids. The germs which cause "cold in the head" often find their way into the eyes through the tear ducts, which connect the inner corner of the eyes with the nose, and thus may set up similar trouble in the eyes.

Symptoms. The eyes feel weary and "as if there were sand in them." There may be also smarting, burning, or itching of the lids, and there is disinclination for any prolonged use of the eyes. The lids, when examined, are found to be much deeper red than usual, and slightly swollen, but there is no discharge from the eye, and this fact serves to distinguish this mild type of inflammation from the more severe form.

Treatment. The use of dark glasses and a few drops of zinc-sulphate solution (one grain to the ounce of water) in the eye, three times daily, will often cure

the trouble. If this does not do so within a few days then an oculist should be consulted, and it will frequently be found that glasses are needed to secure freedom from irritation of the eyes. In using" eye-drops the head should be held back, and several drops be squeezed from a medicine dropper into the inner corner of the eye.

CONJUNCTIVITIS; CATARRHAL INFLAMMATION OF THE EYES.-In this disorder there is discharge which sticks the lids together during the night. The inner surface of the lids is much reddened, the blood vessels in the lining membrane are much enlarged, and the lids are slightly swollen. The redness may extend to the eyeball and give it a bloodshot appearance. There is no interference with sight other than momentary blurring caused by the discharge, and occasionally there is very severe pain, as if a cinder had suddenly fallen in the eye. This symptom may occur at night and awaken the patient, and may be the reason for his first consulting a physician.

One eye is commonly attacked twenty-four to thirty-six hours before the other, and even if it is thought that the cause is a cinder, in case of one eye, it can hardly be possible to sustain this belief in the case of the involvement of both eyes. There is a feeling of discomfort about the eyes, and often a burning, and constant watering, the tears containing flakes of white discharge.

When the discharge is a copious, creamy pus or

matter," associated with great swelling of the lids and pain on exposure to light, the cause is usually a germ of a special disease, and the eyesight will very probably be lost unless a skillful physician be immediately secured. Early treatment is, however, of great service, and, until a physician can be obtained, the treatment recommended below should be followed conscientiously; by this means the sight may be saved. This dangerous variety of inflammation of the eyes is not rare in the newborn, and infants having red eyes within a few days of birth should immediately receive proper attention, or blindness for life will be the issue. This is the usual source of that form of blindness with which babies are commonly said to have been born.

All forms of severe inflammation of the lids are contagious, especially the variety last considered, and can be conveyed, by means of the discharge, through the agency of towels, handkerchiefs, soap, wash basins, etc., and produce the same or sometimes different types of inflammation in healthy eyes. Therefore, if the severe form of conjunctivitis breaks out among any large number of people, as in schools, prisons, asylums, and almshouses, isolation of the patients should be enforced.

"PINK EYE."-This is a severe epidemic form of catarrh of the eye, which is caused by a special germ known as the "Koch-Weeks bacillus." The treatment of this is the same as that outlined below. The germ of pneumonia and that of grippe also often cause con