Lectures on the American eclectic system of surgery / by Benjamin L. Hill.

  • Hill, B. L. (Benjamin L.)
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the American eclectic system of surgery / by Benjamin L. Hill. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    Fig. 115. form of lacrymal.fistula or obstruction in the duct of the lacry- MAL GLAND itsclf, producing dryness instead of suffusion of the eye. This part, however, is rarely the object of surgical or medical attention. When it is, it has to be treated on general principles, with due regard to the susceptibility of contiguous parts. In proceeding to the mpre common —Operation for Fistula Lacrymalis, place the patient in a sitting posture, and stand behind him. Have a small sharp pointed scalpel, bistoury, or cataract knife ; and holding it perpendicularly to the eye-brows, direct the point to the infe- rior margin of the internal tendon of the eye-lids (Undo ocuU),— which can be clearly seen by drawing both lids outwards. In this place and direction, press the point of your instrument directly downwards, (as in Fig 115), until a flow of mucous and tears indi- cates that it has entered the lacry- mal sac. As you then raise it out, make a slight outward cut so as to enlarge the opening. A probe, slightly curving forwards and in- wards, is then to be introduced and pushed through when it meets with obstruction. A few drops of l)lood from the nostril will show when it has entered that cavity; sometimes there will be quite a stream. Another sign is that, on withdrawing the probe, the patient can blow ivind out at the eye. The Tube (see Fig. 110, page 594,) or Style, (Fig. HI) according to preference, is then to be inserted; and the wound healed sooner or later, as the case or operators judgment indicates. [See for the Dis- ease and Medical Treatment, page 251.] OPERATIONS ON THE LIDS AND CONJUNCTIVA. Wounds dividing the eye-lids may require sutures (the in- terrupted, using very small needles.) Extraction of the cilia may be necessary for iricliiasis, inver- sion of the lids, or dis'richiasis, the mal-position of the hairs themselves. In the latter case, a touch or two of caustic will often prevent the necessity for repeating the operation.