Cases of extirpation of the lachrymal sac / by Freeland Fergus and A.L. M'Millan.

  • Fergus, A. Freeland (Andrew Freeland), 1858-1932.
Date:
[1907?]
Catalogue details

Licence: In copyright

Credit: Cases of extirpation of the lachrymal sac / by Freeland Fergus and A.L. M'Millan. Source: Wellcome Collection.

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    Reprinted from the “Glasgow Medical Journal” for May, 1907.] CASES OF EXTIRPATION OF THE LACHRYMAL SAC.1 By Dr. FREELAND FERGUS and Dr. A. L. M'MILLAN. [Dr. Fergus.] Dr. Fergus said that the first occasion on which he had excised a lachrymal sac was seven years ago, when he did it as a preliminary to cataract extraction. The patient had a fully matured cataract in one eye, and an incipient cataract in the other. On the side with the ripe cataract there had been for many years a chronic suppuration of the sac. The patient had already been refused operation, as it was very properly considered that the risk of suppuration was too great to be run, and had been advised to wait till the other eye matured. That, of course, meant an indefinitely prolonged period. Dr. Fergus’s experience had shown him that probing and irrigation were in most cases only palliative, sq he deter¬ mined to try other means. The patient was accordingly put under a general anaesthetic, and the sac was excised. A radical cure was obtained, and the lens was subsequently successfully removed. Dr. Fergus believed that the description of the pathological condition to be found in the text-books was essentially wrong. It was generally stated that the starting-point of suppuration in the sac was a stricture at the junction of the sac with the nasal duct, that the tears accumulated, and hence the suppuration. If this view were true, then the passing of probes might not be irrational. He held, however, that both the stricture and the formation of the abscess were due to infection of the mucous membrane. They were both post hoc. The recent researches of Tartuferi had, in his opinion, thrown a great deal of light on the subject. The wall of the sac was not the simple structure usually described, but contained little 1 Paper read and cases shown at a meeting of the Glasgow Pathological and Clinical Society held on 8th October, 1906.