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CHAPTER I

The Eye and Ear

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Injuries to the Eye-Inflammatory Conditions- Pink Eye"Nearsightedness and Farsightedness—Deafness—Remedies for Earache.

CINDERS AND OTHER FOREIGN BODIES IN THE EYE.-Foreign bodies are most frequently lodged on the under surface of the upper lid, although the surface of the eyeball and the inner aspect of the lower lid should also be carefully inspected. A drop of a two-per-cent solution of cocaine will render painless the manipulations. The patient should be directed to continue looking downward, and the lashes and edge of the lid are grasped by the forefinger and thumb of the right hand, while a very small pencil is gently pressed against the upper part of the lid, and the lower part is lifted outward and upward against the pencil so that it is turned inside out. The lid may be kept in this position by a little pressure on the lashes, while the cinder, or whatever foreign body it may be, is removed by gently sweeping it off the mucous membrane with a fold of a soft, clean handkerchief.

Hot cinders and pieces of metal may become so deeply lodged in the surface of the eye that it is necessary to dig them out with a needle (which has been

passed through a flame to kill the germs on it) after cocaine solution has been dropped into the eye twice at a minute interval. Such a procedure is, of course, appropriate for an oculist, but when it is impossible to secure medical aid for days it can be attempted without much fear, if done carefully, as more harm will result if the offending body is left in place. It is surprising to see what a hole in the surface of the eye will fill up in a few days. If the foreign body has caused a good deal of irritation before its removal, it is best to drop into the eye a solution of boric acid (ten grains to the ounce of water) four times daily.

"BLACK EYE."-To relieve this condition it is first necessary to reduce the swelling. This can be done by applying to the closed lids, every three minutes, little squares of white cotton or linen, four fold and about as large as a silver dollar, which have laid on a cake of ice until thoroughly cold. This treatment is most effective when pursued almost continuously for twenty-four hours. The cold compresses should not be permitted to overlap the nose, or a violent cold in the head may ensue. The swelling having subsided, the discoloration next occupies our attention. This may be removed speedily by applying, more or less constantly below the lower lid, little pieces of flannel dipped in water as hot as can be borne. The cloths must be changed as often as they cool. Repeat this treatment for a half hour every two hours or so during the day.

STYE. A stye is a boil on the eyelid; it begins at the root of a hair as a hard swelling which may extend to the whole lid. The tip of the swelling takes on a yellowish color, 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

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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

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