Treatise on the diseases of the eye : including the anatomy of the organ / by Carl Stellwag von Carion ; tr. from the 3rd German ed. and ed. by Charles E. Hackley and D.B. St. John Roosa ; with an appendix by the editors.

Karl Stellwag von Carion

Date:: 1870

Credit: Treatise on the diseases of the eye : including the anatomy of the organ / by Carl Stellwag von Carion ; tr. from the 3rd German ed. and ed. by Charles E. Hackley and D.B. St. John Roosa ; with an appendix by the editors. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

759/810 page 737

$4. To remove the ptosis of the upper lid,—which often remains after paralysis of the ocular motor-nerve, hut often, also, occurs alone,—the following proceeding has been lately recommended. First, at the distance of a few millimeters from the edge of the upper lid, a transverse incision is made through the integument of the lid, down to the orbicular muscle, and the integument of the lid is separated from the latter toward the edge of the orbit, throughout its entire width. When the orbicularis has been exposed to a sufficient width, four to five lines of it, corresponding to the gaping wound, is to be excised with curved scissors, after it has been drawn out with toothed forceps. Then three stitches, at a suitable distance from each other, are so to be passed through the remaining muscular bundle and the edges of the wound, that the armed needle is entered near the free edge of the lid, under the ciliary portion of the muscle and out at the wound, then under the muscle at the upper part of the wound, and through the skin near the edge, and tied. Thus a sub- cutaneous shortening of the upper lid will be attained, the action of the orbicularis weakened, and the action of the levator seconded by the retraction of the lid. If this be not enough, if the upper lid be markedly elongated, it will be well to cut out a crescentic piece of the integument having the first transverse incision as its base, and then apply the sutures. A pressure-bandage is then applied for from twelve to twenty-four hours to favor union by the first intention. (Graefe.) Authorities.—Graefe, A. f. 0. I. 1. S. 7, 9-23, 52-81, 433, I. 2. S. 312, et seq.; II. 1. S. 282, 284, II. 2. S. 299, III. 1. S. 182-189, 326-386, III. 2. S. 409, VII. 2. S. 24-35, IX. 2. S. 57-62, XII. 2. S. 198, 202, 26 V277 ; klin. Monatbl. 1863. S. 3, 4, 1864. S. 2-22 ; Verhandlgn. der Heidelberg, ophth. Versammlung. 1859. S. 22.—Turck, Zeitschr. d. Wien. Aerzte. 1865. S. 522-532.—Stellwag. ibid. 1854. II. S. 491-504, Ophth. II. S. 1194-1200.—Schuft, [now Waldau] Zur Lehre v. d. Wirk- ung u. Labmung der Augeumuskeln. Berlin.—Alf. Graefe, A. f. 0. VII. 2. S. 109 ; kl. Analyse Motilitatsstorgn. etc. Berlin 1S53. S. 17-37, 97-191.— Mt,jd, A. f. O. VIII. 2. S. 368-387.— Bonders, Anoin. d. Ace. u. Rofr. Wien 1866. S. 502. [Accommodation and Refraction of the Eye. London, p. 599]. Leidesdorf, Wien. med. Jahrb. 1864. 4. Text, S. 112-113.— Ducheh, ibid. Jahresb. S. 28-42.—Benedikt, Wochenbl. d. Wien. Aerzte. 1863. S. 351, A. f. O. X. 1. S. 97-103, et seq.—B. Schulz, Wien. med. Wochenschrift. 1862. S. 243.—Javal, kl. Monatbl. 1864, S. 404.— Pagenstecher u. Samisch, kl. Beobachtungen. II. Wiesbaden 1862. S. 38—Hirschmann, ibid. III. S. 89, 98.—Bering, verbal communication.—[Beard and Rockwell, Medical use of Electricity, New York, 1867, p. 50.] 47$