780 O P H P H finally superseded by pistons. "We close tins article with the curious representation (fig. 6) of an opliicleide with pistons manufac tured about 1836 by C. Mahillon of Brussels, then at the beginning of his career. (V. M.) OPHIR ("VEritf), a place famous among the Hebrews for its gold from the time of Solomon, whose Red Sea fleet, in conjunction with the Phoenicians, went to Ophir and brought thence a vast treasure of gold with precious stones and "almug" wood (1 Kings ix. 28, x. 11). It is quite plain from Gen. x. 29 that Ophir belonged to southern Arabia, from which the Phoenicians still derived gold and precious stones in the time of Ezekiel (xxvii. 22). All attempts to place Ophir in India or on the east coast of Africa (Sofala) are at variance with Gen. x. It is true that Indian products were also brought to Solomon (1 Kings x. 22), but these are not said to have come from Ophir, and therefore we cannot even be sure that Ophir was the emporium where the Indian trade and the Western met, as they did in southern Arabia in later times, unless, indeed, the " almug " or " algum " wood is, as has been conjectured, the Indian sandalwood. OPHITES. See GNOSTICS. OPHTHALMOLOGY. The scientific development of the diagnosis and treatment of diseases of the eye belongs to the last hundred years. Helmholtz s invention of the ophthalmoscope is little more than thirty years old. Our knowledge of the refraction and accommodation of the eye has been worked out by Airy, Young, Sanson, Purkinje, Bonders, Sneller, Helmholtz. Many of the major opera tions have been perfected by Von Graefe and his followers in quite recent times. Finally, the important relations of ophthalmology to general medicine have been worked out principally by Hutchinson, Hughlings Jackson, Clifford Allbut, and Gowers within the last few years. Diseases Acute Catarrhal Conjunctivitis begins with a feeling of of the stiffness of the lids, and pain as if from a particle of grit in the eye. The secretion increases, is at first watery, and is afterwards yellow and muco-purulent, collecting at the inner canthus and gumming the eyelids together. The conjunctiva, especially that on the lids, is reddened, and in severe cases may be so swollen as to overlap the cornea. The eye is generally well in a fortnight. The disease is caused by cold winds, and by irritating particles, and in one form is undoubtedly contagious. The eye must be left uncovered, bathed occasionally with an astringent lotion, and at night some ointment should be applied to the edges of the lids to prevent their adhesion and consequent reten tion of the secretion. Chronic conjunctivitis may result from the above, or be due to the irritation of dust. It occurs frequently from overstrain of hypermetropic eyes. The symptoms are similar, but less severe, and require similar treatment with correction of the hypermetropia where present. Purulent Ophthalmia * (ophthalmia of the newly born) is caused by contact of pus from a gonorrheal or leucorrheal discharge or from another eye similarly affected. It is one of the forms of Egyptian ophthalmia. In children both eyes are generally affected ; in adults usually one. The symptoms begin, from one to three days after infection, with a watery discharge, which increases rapidly in amount, and becomes yellow and purulent. The conjunctiva becomes greatly congested and swollen, bleeding readily. The lids are so stiffened with infiltration that they can hardly be separated. When they are slightly opened quantities of pus escape. There is great pain in the eye, fever, and sleeplessness. The cornea is much endangered ; it may be perforated, may slough wholly or in part, and the eyeball may be destroyed. If one eye only is affected the other must 1 The term "ophthalmia " is now limited to conjunct! val inflamma tions. be protected. Locally the greatest cleanliness is necessary, and the discharge must be constantly removed. Once daily the conjunctiva should be touched with a strong solution of nitrate of silver, and in the interval frequently bathed with astringent solutions. Recently, powdered iodoform has been much recommended as a local applica tion. In adults leeching the temple and the continuous application of ice to the eye may be needed. The attend ants must be warned of the danger of conveying infection to their own eyes. Diphtheritic Conjunctivitis is characterized by the forma tion of a yellowish false membrane on the conjunctiva, which becomes thickened and almost solid from infiltration, and by great liability to sloughing of the cornea. It occurs most frequently in North Germany, attacking weakly children during epidemics of ordinary diphtheria, and, like it, often proves fatal by exhaustion. It should be treated by the internal administration of tonics and stimu lants, and by the local use of ice, antiseptic lotions, and the strictest attention to cleanliness. Chronic Granular Conjunctivitis is a contagious disease arising from prolonged overcrowding under bad sanitary conditions. It is thus specially common among the Jewish and Irish poor, and among workhouse children. The mucous membrane of the lids becomes reddened, thickened, and studded over with small firm "granulations," like boiled sago grains. The friction of these bodies produces a vas cular opacity of the cornea (pannus), at first limited to the upper half of the cornea, but in bad cases involving its whole surface. There is considerable pain and discharge, and the eyelids are kept half-shut. There is a peculiar liability to acute exacerbations. The conjunctiva finally shrinks to a dense white scar, which curves the tarsal cartilage inwards, and brings the edge of the lids and the eyelashes to rub on the cornea, and increase its opacity. It must be persistently treated by strong astringent or caustic applications to the conjunctiva. The pannus, as a rule, disappears with the granulations that caused it. If not, a zone of conjunctiva round the cornea may be divided ; or, as a last resort, the eye may be inoculated with pus from a purulent case. All acute exacerbations must be treated by soothing applications. Incurving of the tarsal cartilage and displacement of the lashes need special surgical operations, which are more or less successful. If a case occurs in a school or in barracks it must be at once isolated. Pterygium is a triangular thickening of the exposed part of the conjunctiva, which may or may not be vascular. Its apex is towards the cornea, over which it tends to grow, and thus to interfere with vision ; otherwise it causes no irritation. Pterygium is a disease of middle life and of warm climates. If it cause no deformity or interference with sight it should be left alone. If large it may be dissected up from the apex and cut off, or transplanted into another part of the conjunctiva, where it will shrivel up. The diseases of the cornea are of extreme importance, Diseases from their great frequency and from the fact that a small of tlie lesion may seriously affect the perfect transparency and co nea regularity of curvature so necessary for clear vision. Chronic Interstitial Keratitis attacks young persons, nearly all of whom, as was first pointed out by Hutchin son, can be shown to be the subjects of hereditary syphilis, and who present some or all of the following physio gnomical characters : a depressed bridge of the nose, scars at the angle of the mouth, and notched and peg- shaped central upper incisor teeth. The disease affects both eyes, one generally some time before the other. It begins by the appearance of cloudy spots in the cornea, which spread until the whole cornea has a ground -glass appearance, not uniform throughout but with denser
