Phlegmon. Causes: traumas, skin disease. Symptoms: swelling, redness,
distortion, infiltration, semi-closed lids, scabs, sloughs, abscess.
Tenderness. Itching. In eczema papules, vesicles, weeping eye.
Treatment: antiseptic astringent lotions, almond oil, vaseline, zinc
oxide, salicylic acid, boric acid, starch, xeroform, pyoktannin; for
eczema, mercury oxides, silver nitrate.
Conjunctivitis will be treated later, and under the present head there
will be considered only the phlegmon of the outer structures.
_Causes._ This lesion may come from two distinct causes, traumatism and
skin disease. The traumatisms in _horses_ and _cattle_ are bruises
sustained in rolling, especially during colics, in striking the head
against posts, poles, shafts and other solid bodies, in enduring blows
with horns or clubs, or frictions by the halter or in putting on a
collar. _Dogs_ suffer especially from blows with clubs and kicks from
men or animals. _All_ may suffer from wounds of the lids, and from
extensions of eczema and other skin diseases.
The _symptoms_ consist in swelling, redness, distortion, and often
extensive infiltration of the lid, sometimes eversion with exposure of
the reddened conjunctiva, usually abrasion, contusion, puncture or
laceration, semi-closed eye, the upper eyelid being comparatively
immovable (ptosis), and the formation of scabs, sloughs, or abscess.
There may be extreme tenderness, or, more commonly, intense itching.
Where eczema exists there may be found minute shot like papules at times
surmounted by small vesicles and the skin disease is continuous backward
upon the face. When abscess forms, the rounded swelling and manifest
fluctuation will betray its presence. Usually the eye waters and the
side of the cheek is wet and the hairs matted by a whitish coagulated
lymph and mucus.
_Treatment._ In the early stages without scabs, sloughs, or abscess,
antiseptic astringent lotions are in place. Weak solutions of zinc
sulphate, boric acid and morphine may be kept applied on a light
bandage. Or silver nitrate 1 gram to 1 oz. water may be applied daily
with a fine brush.
When scabs and crusts have formed they may be softened by the
application of almond oil, and then removed. The surface may then be
dusted with a bland antiseptic powder such as: zinc oxide 10 parts,
salicylic acid 1 part; or boric acid and starch equal parts; or
iodoform; or xeroform. Or unctuous applications may be used; zinc oxide
10, salicylic acid 1, vaseline 10; or iodoform 1, vaseline 5. Or a
watery application may be used, such as the silver lotion or that of
pyoktannin 1:1000.
For eczema yellow oxide of mercury 1, to vaseline 10, has an excellent
reputation. It may be alternated with pyoktannin.
When abscess has formed it should be excised in a line parallel to the
free border and the resulting cavity injected with the silver or the
pyoktannin solution.
In all cases the patient must be fastened as for wounds of the lids so
that he cannot rub the eye.
For eczema and other skin diseases the special treatment appropriate to
the disease should not be omitted.