A practical treatise on the diseases of the eye / by William Mackenzie ; to which is prefixed an anatomical introduction explanatory of a horizontal section of the human eyeball by Thomas Wharton Jones.

Date:: 1840

Credit: A practical treatise on the diseases of the eye / by William Mackenzie ; to which is prefixed an anatomical introduction explanatory of a horizontal section of the human eyeball by Thomas Wharton Jones. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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$^ '.the openings; and these gradually contracted, until one after the other closed. ; lln four months, the patient was perfeetly cured. A most remarkable instance of successful extirpation of a maxil- ' llary fungus occurred in tlie practice of Dr Thomas White of Man- j tchester.'’Indeed, the hones of the orbit appear to have suffered more iin this case than in any other on record. J Case 83 The patient was a female. In two years’ time, the tumour, situated \ i'betwixt the left zygomatie process and the nose, put on a frightfid appearance ; i ithaving grown to such a bulk that it pressed the nostrils to one side, so as to stop !the passage of the air through them, and thrust the eye out of its orbit, so that i[:it lay on the left temple. Though thus distorted, the eye still j)crformed its offiee. H j. The swelling occupied the greater part of the left side of the face, extending from 4 \ the lower part of the upper jaw, to the top of the forehead, anil from the farthest sj part of the left temple to the external eanthus of the eye. U])on handling the tumour. Dr White tound an unusual and unequal bony hardness. It was of a t i dusky livid colour, with varicose veins on the surface, and there was a soft tubercle projecting near the nose, where nature had endeavoured in vain to relieve herself. Dr White began the operation with a semi-circular incision below the dislocated i'l 'Cye, in order to preserve that organ, and as much as possible of the orbicular h muscle; then carrying the incision round the external and inferior part of the iit tumour, he ascended to the place where he began, taking care not to injure the left wing of the nose. After taking away the external part of the tumour, which I ‘ was separated in the middle by an imperfect suppuration, there appeared a large I' quantity of a matter like rotten cheese, in part covered by a bony substance, i so carious as to be easily broken through. Abundance of this matter was 1s«cooped away, with a great many fragments of rotten bones. Upon cleansing '.the wound with a sponge. Dr White found the left bone of the nose, and the zygomatic process, carious, and removed them. He says there were no remains 5 of the bones composing the orbit. The ojitic nerve was denuded as far as the dura I imater; this membrane and the pulsation of the vessels of the brain were apparent ■ to the eye and touch. The superior maxillary bone, in the sinus of whieh the idisease had had its origin, was surprisingly distended, and in some places carious. I The alveolar process was probably in this state, as Dr White mentions that he removed it. He then applied the aetual cautery to the rest of the bones, taking care not to injure the eye and neighbouring parts, which were sound. The ])atient drew her breath through the wound, and was so incommoded by the fietid matter (lowing into her throat, that she was obliged for several weeks to lie on her face, to j)revent suftbeation. Notwithstanding her miserable condi- tion, nature at length assisted, laudable pus appeared, sound flesh was generated, and the patient recovered. The eye returned to its place, and she enjoyed the perfect sight of it. The only inconvenience that remained, was a constant dis- charge of mucus from the inner eanthus of the eye.'-^* Mr Howship has illustrated, by a beautiful engraving, the great extent to wbicb the bones, forming the parietes of the antrum, may be dilated by this disease. Case 84.—The patient, whose skull he has represented, a woman about 30 years of age, was received into the Westminster Hospital, with an extraordinary I swelling upon the right side of the face, producing great distortion of counte- nance, but not attended with any discoloration of the skin. The basis of the tu- mour extended uj)wards to the eye, whieh was almost closed, and reaehed below to the chin ; the adjacent angle of the mouth being much depressed, and thrown t out of its line, and the nose pressed aside towards the left cheek. In the most ( prominent part, the tumour projected about 4 inches beyond the general line of * ' the bones of the face. On the inside of the mouth, the tumour was very large, ' having extended itself across the palate, nearly to the opposite teeth. The tu- t :imour was confined entirely to the bones about the upper jaw ; it was apparently 5 .fleshy, and where it extended across the roof of the mouth, it was of a florid red ; colour. The teeth of the upper jaw, thrown out of their natural situation, formed ' an angle with the remaining jiart of the alveolar circle. All those teeth involved$