Hypertrophy increases to a certain height when cicatrization and
contraction begin. The duration may be years. The more the hypertrophy
the longer the duration and the greater the contraction. (Note here
that treatment should be directed toward combatting the hypertrophy by
establishing circulation).
=Sequelæ.= I merely mention the sequelæ here: pannus, ulceration of the
cornea, trichiasis, dystrichiasis, entropion, ectropion, symblepharon,
xerosis, corneal opacities. For the explanation, pathology and
treatment of these sequelæ not covered in this treatise, see any good
works on diseases of the eye as Weeks, Fuchs or De Schweinitz.
=Treatment of Trachoma.=—In reporting cases of trachoma treated and
cured by osteopathy we should be sure of our diagnosis.
The treatment is antiseptic, hydrotherapeutical, osteopathic and
operative. A saturated solution of boric acid should be used. Argyrol
20% is good if there is much secretion. Nitrate of silver 2% and copper
sulphate are still used in some cases to advantage as claimed by some
physicians. The osteopath should count on careful cleanliness.
Hot compresses over the eyes are often very agreeable.
Operations are often performed for trachoma. The granules are rolled
out with Knapp’s roller forceps, and other methods.
=Grattage= is practiced with some wonderful results. It is done as
follows: Get some fine sand paper and cut it in strips about one-half
inch wide by three or four inches long. Put it in alcohol in a vessel
for ten to fifteen minutes. Pour off all the alcohol except a few drops
that will cling to the vessel by capillary attraction. Touch a match
to the residue. This will burn just enough to make the sand paper
absolutely sterile without burning the latter. Put the patient under
somnoform. Use a small artery forceps to grasp the edge of the eyelid,
roll the lid back over the artery forceps to expose all granulations
clear to the fornix. Use a protector to the eyeball. Now with the
sandpaper quickly scrape or curette away all of the trachoma bodies and
granulations. Repeat the process on the other eye if it is involved.
Wash out well with a saturated solution of boric acid and bandage
the eyes for a few hours. This will cause considerable swelling and
inflammation. Use cold applications and keep the eyes disinfected. I
have seen some very good results from this method.
=Osteopathic.=—Following the sand paper operation a thorough treatment
of the cervical and upper dorsal region would add considerably to the
rapidity of the patient’s recovery and sense of well being. General
tonic treatment is of special benefit in nearly all trachoma cases as
they are subnormal in their general health.
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