Page:EB1911 - Volume 10.djvu/112

 local application is the yellow oxide of mercury used as an ointment.

Phlyctenular conjunctivitis, and the corneal complications with which it is so often associated, constitute a large proportion (from to ) of all eye affections with which the surgeon has to deal.

Granular Conjunctivitis.—This disease, which also goes by the name of trachoma, is characterized by an inflammatory infiltration of the adenoid tissue of the conjunctiva. The inflammation is accompanied by the formation of so-called granules, and at the same time by a hyperplasia of the papillae. The changes further lead in the course of time to cicatricial transformations, so that a gradual and progressive atrophy of the conjunctiva results. The disease takes its origin most frequently in the conjunctival fold of the upper lid, but eventually as a rule involves the cornea and the deeper tissues of the lid, particularly the tarsus.

The etiology of trachoma is unknown. Though a perfectly distinctive affection when fully established, the differential diagnosis from other forms of conjunctivitis, particularly those associated with much follicular enlargement or which have begun as purulent inflammation, may be difficult. Trachoma is mostly chronic. When occurring in an acute form it is more amenable to treatment and less likely to end in cicatricial changes. Fully half the cases of trachoma which occur are complicated by pannus, which is the name given to the affection when it has spread to the cornea. Pannus is a superficial vascularized infiltration of the cornea. The veiling which it produces causes more or less defect of sight.

Various methods of treatment are in use for trachoma. Expression by means of roller-forceps or repeated grattage are amongst the more effective means of surgical treatment, while local applications of copper sulphate or of alum are certainly useful in suitable cases.

Diphtheritic conjunctivitis is characterized by an infiltration into the conjunctival tissues which, owing to great coagulability, rapidly interferes with the nutrition of the invaded area and thus leads to necrosis of the diphtheritic membrane. Conjunctival diphtheria may or may not be associated with diphtheria of the throat. It is essentially a disease of early childhood, not more than 10% of all cases occurring after the age of four. The cornea is exposed to great risk, more particularly during the first few days, and may be lost by necrosis. Subsequent ulceration is not uncommon, but may often be arrested before complete destruction has taken place. The disease is generally confined to one eye, and complicated by swelling of the preauricular glands of that side. It may prove fatal. In true conjunctival diphtheria the exciting cause is the Klebs-Löffler bacillus. The inflammation occurs in very varying degrees of severity. The secretion is at first thin and scant, afterwards purulent and more copious. In severe cases there is great chemosis with much tense swelling of the lids, which are often of an ashy-grey colour. A streptococcus infection produces somewhat similar and often quite as disastrous results.

The treatment must be both general with antitoxin and local with antiseptics. Of rarer forms of conjunctivitis may be mentioned Parinaud’s conjunctivitis and the so-called spring catarrh.

Non-inflammatory Conjunctival Affections.—These are of less importance than conjunctivitis, either on account of their comparative infrequency or because of their harmlessness. The following conditions may be shortly referred to.

Amyloid degeneration, in which waxy-looking masses grow from the palpebral conjunctiva of both lids, often attaining very considerable dimensions. The condition is not uncommon in China and elsewhere in the East.

Essential Shrinking of the Conjunctiva.—This is the result of pemphigus, in which the disease has attacked the conjunctiva and led to its atrophy.

Pterygium is a hypertrophic thickening of the conjunctiva of triangular shape firmly attached by its apex to the superficial layers of the cornea. It is a common condition in warm climates owing to exposure to sun and dust, and often calls for operative interference.

Tumours of the Conjunctiva.—These may be malignant or benign, also syphilitic and tubercular.

EYEMOUTH, a police burgh of Berwickshire, Scotland. Pop. (1901) 2436. It is situated at the mouth of the Eye, 7 m. N.N.W. of Berwick-on-Tweed by the North British railway via Burnmouth. Its public buildings are the town hall, library and masonic hall. The main industry is the fishing and allied trades. The harbour was enlarged in 1887, and the bay is easily accessible and affords good anchorage. Owing to the rugged character of the coast and its numerous ravines and caves the whole district was once infested with smugglers. The promontory of St Abb’s Head is 3 m. to the N.W.

EYLAU (Preussisch-Eylau), a town of Germany, in east Prussia, on the Pasmar, 23 m. S. by E. of Königsberg by rail on the line Pillau-Prostken. It has an Evangelical church, a teachers’ seminary, a hospital, foundries and saw mills. Pop. 3200. Eylau was founded in 1336 by Arnolf von Eilenstein, a knight of the Teutonic Order. It is famous as the scene of a battle between the army of Napoleon and the Russians and Prussians commanded by General Bennigsen, fought on the 8th of February 1807.

The battle was preceded by a severe general engagement on the 7th. The head of Napoleon’s column (cavalry and infantry), advancing from the south-west, found itself opposed at the outlet of the Grünhöfchen defile by a strong Russian rearguard which held the (frozen) lakes on either side of the Eylau road, and attacked at once, dislodging the enemy after a sharp conflict. The French turned both wings of the enemy, and Bagration, who commanded the Russian rearguard, retired through Eylau to the main army, which was now arrayed for battle east of Eylau. Barclay de Tolly made a strenuous resistance in Eylau itself, and in the churchyard, and these localities changed hands several times before remaining finally in possession of the French. It is very doubtful whether Napoleon actually ordered this attack upon Eylau, and it is suggested that the French soldiers were encouraged to a premature assault by the hope of obtaining quarters in the village. There is, however, no reason to suppose that this attack was prejudicial to Napoleon’s chance of success, for his own army was intended to pin the enemy in front, while the outlying “masses of manœuvre” closed upon his flanks and rear (see ). In this case the vigour of the “general advanced guard” was superfluous, for Bennigsen stood to fight of his own free will.

The foremost line of the French bivouacs extended, from Rothenen to Freiheit, but a large proportion of the army spent the night in quarters farther back. The Russian army on the other hand spent the night bivouacked in order of battle, the right at Schloditten and the left at Serpallen. The cold was extreme, 2° F. being registered in the early morning, and food was scarce in both armies. The ground was covered at the time of battle with deep snow, and all the lakes and marshes were frozen, so that troops of all arms could pass everywhere, so far as the snow permitted. Two of Napoleon’s corps (Davout and Ney) were still absent, and Ney did not receive his orders until the morning of the 8th. His task was to descend upon the Russian right, and also to prevent a Prussian corps under Lestocq from coming on to the battlefield. Davout’s corps advancing from the south-east on Mollwitten was destined for the attack of Bennigsen’s left wing about Serpallen and Klein Sausgarten. In the meantime Napoleon with his forces at and about Eylau made the preparations for the frontal attack. His infantry extended from the windmill, through Eylau, to Rothenen, and the artillery was deployed along the whole front; behind each infantry corps and on the wings stood the cavalry. The Guard was in second line south of Eylau, and an army reserve stood near the Waschkeiten lake. Bennigsen’s army was drawn up in line from Schloditten to Klein Sausgarten, the front likewise covered by guns, in which arm he was numerically much superior. A detachment occupied Serpallen.

The battle opened in a dense snowstorm. About 8