we not unfrequently see the hand involuntarily laid upon the eyelids,
as if the better to support and defend the eyeball.



[16] Prof. Donders remarks (ibid. p. 28), that, "After injury to the eye,
after operations, and in some forms of internal inflammation,
we attach great value to the uniform support of the closed eyelids,
and we increase this in many instances by the application of a bandage.
In both cases we carefully endeavour to avoid great expiratory pressure,
the disadvantage of which is well known." Mr. Bowman informs me that in
the excessive photophobia, accompanying what is called scrofulous ophthalmia
in children, when the light is so very painful that during weeks or months
it is constantly excluded by the most forcible closure of the lids,
he has often been struck on opening the lids by the paleness of the eye,--
not an unnatural paleness, but an absence of the redness that might have been
expected when the surface is somewhat inflamed, as is then usually the case;
and this paleness he is inclined to attribute to the forcible closure
of the eyelids.

Nevertheless much evidence cannot at present be advanced
to prove that the eye actually suffers injury from the want
of support during violent expiration; but there is some.
It is "a fact that forcible expiratory efforts in violent
coughing or vomiting, and especially in sneezing,
sometimes give rise to ruptures of the little (external) vessels"
of the eye.[17] With respect to the internal vessels,
Dr. Gunning has lately recorded a case of exophthalmos in
consequence of whooping-cough, which in his opinion depended
on the rupture of the deeper vessels; and another analogous