Ophthalmic surgery / by Robert Brudenell Carter and William Adams Frost.

  • Robert Brudenell Carter
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Ophthalmic surgery / by Robert Brudenell Carter and William Adams Frost. Source: Wellcome Collection.

    541/582 (page 529)
    5-5 When the tumour is within reach of the finger, the diagnosis is comparatively easy, a subperiosteal node and distension of the frontal sinus beino- the only affections with which it could be confounded ; the former would generally be distinguished by its not being of absolute bony hardness, although when the history justifies a suspicion of its being a syphilitic node, the effect of a course of iodide of potassium might be tried. A woman, aged 51, with a history of syphilis having been acquired five years previously, for which she had undei-gonean incomplete course of mercury and iodide, presented what were thought to be exostoses on the frontal bone on the left side, and on the right malar and temporal bones. The right eye was pushed for- wards, and there was paralysis of all the ocular muscles on that side. She had suffered from deep ul- ceration of the tongue, and serpiginous ulceration on the thigh. Under a course of iodide of potassium the tumours and the displacement of the eye disappeared. When the tumour is situated far 'back, a certain diagnosis is impossible, as the symptoms are common to any slowly growing tumour. The removal of exostoses is often difficult and fre- quently impossible, yet if the tumour is certainly growing the attempt should be made. It is sometimes impossible to cut through the pedicle owing to its hardness. The vitality of these tumours seems to be very low, and several instances have been recorded in which a violent blow, or an abandoned operation, has been followed by its death and detachment. The small size of the pedicle and the leverage afforded by the large size of the tumour sometimes enable the' latter to be severed without much apparent force being required. Such manoeuvres are, however, not free from danger, especially when the attachment is to the roof of the orbit, as a portion