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.

    4/8 (page 4)
    there may be some free bleeding, but I have not found the angular artery to give trouble, nor have I found it necessary to do more than apply pressure forceps, and that but seldom. Muller’s retractor I have found useful in retarding haemor¬ rhage by its pressure on the parts. So far the results have been most satisfactory, and, in my opinion, fully justify the operation. I do not say that the operation is one to be done in every case, but in mucocele, an atonic condition of the sac, it gives the best results of any treatment which we have tried; and in chronic dacryo-cystitis it is certainly a radical cure. Watering of the eye, or epiphora, is not made worse by the operation, and in our experience it soon ceases to give trouble. My cases have hitherto been all done under a general anaesthetic, as it is a somewhat tedious operation; and I have not had courage to try local anaesthesia, although I under¬ stand it is done thus in some places. I have to thank Dr. Fergus for the opportunity given to me to perform the majority of my cases, and, indeed, for the suggestion at the outset of trying the operation in such cases. The following cases were shown :— Case I.—Miss W. had been subject to dacryo-cystitis for twenty-five years, and when seen on 18th September, 1905, there was a large mucocele on the right side, the upper puncta was blocked, the lower canaliculus slit, but the passage also impervious. After various probings and douch- ings, during which a false passage was discovered, the sac 1 was removed on 4th February, 1906, in the usual manner. The wound healed without drainage by first intention, and the result I am able to show you to-night. Case II.—Mrs. M., aged 37, had suffered from dacryo¬ cystitis of at least twelve months’ duration. Probing and douching having been tried, without lasting effect, the sac was removed on 2nd December, 1905. The wound healed •by first intention. Case III.—D. W., aged 25, had suffered from dacryo¬ cystitis of the left sac for from eighteen months to two years. Pus exuded on pressure, and so the sac was well washed out for some days previous to the operation. Operation (22nd August, 1906).—As the sac failed to appear in the wound on injecting glycerine, a probe was passed down into the nasal duct, the sac defined, seized with forceps, and the probe withdrawn. A small gauze drain was inserted for 1 Sac shown.