210 ANTHROPOLOGY. 



5, Operations on the Eye. 



Few parts of the body are exposed to such manifold evils as the eye. 

 Great progress has been made by modern surgery in tlie treatment of tliis 

 organ, and if in some cases its aid be ineffectual, in others every desirable 

 result has been accomplished. 



1. Affections of the Lachrymal Apparatus. A defective condition 

 of the puncta lachrymalia and lachrymal canals and nasal duct is shown by 

 a constant overflow of tears. Various operations have been made use of 

 to restore the flow of the lachrymal secretion through these natural chan- 

 nels. Anel invented a syringe {pi. 140, fig. 50) the fine point of which is 

 introduced into the puncta, and an injection of lukewarm water forced 

 through. This syringe (from j to 1 oz. cnpacity) is made either of silver 

 ,or.of glass; the exceedingly fine tubes, of gold, silver, or steel. Fig. 54 

 represents a peculiar jet piece as used by Laforest. 



Operations frequently become necessary for obstruction of the nasal 

 duct, caused by accumulation of matter, contraction of the parietes, or 

 even by the entire absence of the bony canal. In fistula lachrymalis it 

 becomes necessary to open the lachrymal sac for the purpose of restoring 

 the function of the duct. For this purpose is used a small scalpel (Rutdor- 

 fer's fistula scalpel), the point of which is introduced deep enough into the 

 part affected to overcome any slight resistance (p/. 139, fig. 8 a); the inci- 

 sion is then to be widened, and the fistula opened, if present. A blunt 

 probe is next to be pushed into the nasal duct [fig. 8 />, and pi. 140, fig. 53); 

 should this meet with any obstruction, so as absolutely to bar its passage, a 

 sharp probe is to be employed to pierce through this obstruction, and so to 

 open the duct. 



The restoration of the nasal duct is much preferable to the formation of 

 an artificial one ; cases do occur, however, where the latter is alone possible. 

 After the lachrymal sac is opened, a trochar {fig. 56, BelTs trochar) is intro- 

 duced through the lachrymal bone, and turned round until it j)enetrates the 

 nasal cavity. After inflammation has subsided, a stjde of silver or a piece 

 of catgut bougie may be introduced into the aperture. 



PI. 139, fig. 7, after Scarpa, illustrates the position of the lachrymal sac. 



Among diseases of the eyelids requiring an operation, we find entropion 

 or permanent inversion of the eyelids, and with it the turning in of the eye- 

 lashes. By means of an anatomical forceps, or an entropial forceps {pi. 140, 

 fig. 48), a fold of the skin of the eyelids is taken up sufficiently large to 

 bring the edge of the lid and the cilia in their normal position ; this fold is 

 then to be cut off with a pair of scissors, and the edges brought together. 

 The inversion will usually be counteracted by the resulting cicatrix. 



It sometimes becomes necessary to cut off the whole eyelid with the roots 

 of the cilia. A thin plate of bone or silver is introduced beneath the eye- 

 lid, and the border then cut off. The knife used by Jüngken in this opera- 

 tion is represented in fig. 47. 



2. Of Cataract. By this is understood an opacity of the crystalline 

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