and Carcinoma of the Eye. 301 



could not be prevailed on to submit to have the eye sunk, 

 was kept easy by \vearing a bandage round his head, not 

 unlike to the spring truss that is used for an inguinal her- 

 nia. The bolster of the instrument made a pressure on the 

 outside ol'the eyelids, which kept them constantly closed 

 and hindered the eye from moving. In consequence of 

 this, the projection gave no pain ; and, by the aid of the 

 other eye, the paiient was enabled to work at a common 

 handicraft business without inconvenience. 



The more direct way of affording relief in the staphyloma 

 is by removing the whole of the^projecting substance; in 

 consequence of which the humours of the eye are discharg- 

 ed, and the posterior part of its tunics collapse, so as to 

 form a kind of button at the bottom of the orbit. On this: 

 button, when the wound is healed, an artificial enamelled 

 eye is capable of resting; by which the uniform appear- 

 ance of the face may be restored. Authors are not agreed 

 on the best mode of performing the operation. HcTster 

 St. Yves, and others, have proposed to pass a double lioa- 

 ture through the middle of the tumor, and then to separate 

 the threads, and tie the tumor on each side, so that the 

 compression made by the ligature mav cause it to mortify 

 and slough off. But this is so painful, and so indirect a 

 mode of accomplishing the object, that I believe it has not 

 been practised for many years. Scarpa, in more modern 

 times, has recommended 'to us to remove a small portion 

 only of the projecting cornea (agreeable to a mode first pro- 

 posed by Celsus in his book De Medicina, lib. vii. cap. 7*), 

 and to force out the crystalline and vitreous humours' 

 through the opening ; after which, he says, the wound will 

 close, and the tunics of the eye collapse to a small size 

 without occasioning any considerable degree either of pain 

 or inflammation. This mode of performing the operation 

 appears to nie, however, to be liable to considerable objec- 

 tions. If the opening in the cornea be not larger than the 

 size of the crystalline humour (which not unfi^quently, in 

 cases of the staphyloma, is without disease), this hum'o'ur, 

 in passing through the aperture, is very liable to bruise the 

 ins, and to bring on pain and inflammation, that are both 

 violent and tedious; and if, on the contrary, the opening 

 be so large as to allow the crystalline and vitreous humours 



• The words of Celsus are, " in summa parte eju? ad lenticul,-? mao-nitudi- 

 neni exsciiidcre, Scarpa proposes to make an opening- " two th-ee or 

 four lines in dumeter, according to the size of the staphyloma :" but 'the 

 largest of these dimensions being only one third of an inch, is barel v sufficient 

 to allow the crystalline to come through it , without forcibly compressing the 



to 



