Ulceration of the cornea from the diplobacillus of Morax-Axenfeld / Hanford McKee.

  • McKee, Samuel Hanford, 1875-1943.
Date:
1907
Catalogue details

Licence: In copyright

Credit: Ulceration of the cornea from the diplobacillus of Morax-Axenfeld / Hanford McKee. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    7/8 (page 5)
    other organisms as well, will do if allowed entrance into the corneal tissue. Case 4 is of interest because diplobacillary conjunctivitis is not common among children, and ulceration of the cornea less so. These cases were all treated by instillation of drops of the sulphate of zinc, 1/4 gr. to the ounce, four or five times daily; between times the surface of the cornea and the conjunctival sac were flushed with warm horacic solution and the solution of the sulphate of zinc. At night a little bland ointment, generally horacic ointment, X gr. to the ounce, was smeared along the edges of the lids. When necessary to dilate the pupil a solution of scopolamin H. Br. was used. The “zinc therapy” differs in degree in different clinics. Agri- cola, in his recent paper, describes the routine zinc therapy in Axenfeld’s clinic. To instil ten times daily and oftener one-half * per cent, zinc sulphate solution freely into the lower conjunctival sac and over the surface of the cornea for one-half to one minute, then five times daily for twenty minutes’ irrigation with a 3 Voo solution. Between times and for the night 15 per cent, zinc ichthyol ointment (Peters) on the conjunctival sac and on the lids, also for the severe cases mydriatics and subconjunctival injections. With this treatment the eye generally after 36-48 hours, often after 24 liours, showed marked improvement. In none of his cases, and the majority belonged to the severe type, ha-d zinc therapy failed. I have never found it necessary to push the use of zinc to this extent, and believe the instillation of drops of a weaker solution than one- half per cent, is desirable, not onJy in ulcerative conditions of the cornea, but in conjunctivitis cases as Avell. My experience has been that one-half per cent, solution of zinc sulphate is t(5o painful. Tlie zinc therapy may vary in different clinics, but the value of the sulphate of zinc as a therapeutic measure in diplobacillary infections can not be gainsaid. The widening of bacteriologic methods in ophthalmology and its practical value is in no better way shown than by a study of ulcera- tive conditions of the cornea. It is essential, especially among adult patients, to treat energetically from the very beginning ulcerative processes of the cornea. The speed with which ulcers of the ser- piginous type develop is Avell known; whether the organism present