302 0?i the Staphijlorndt Ht/dr ophthalmia, 



to be discharsed, without doing violence to the iris, though 

 the pain and inflainmalion consequent on the operation 

 may not be considerable, yet the place of the evacuated 

 humours will be supplied by a watery humour, which will 

 speedily distend the tunics of the eye to their former size, 

 •will do away the pnssil)iiity of inserting an artificial eye, 

 and will hazard the return of all the old symptoms. Scarpa, 

 aware of these circumstances, mentions expressly, that he 

 has been obliged to irritate the wound three or four differ- 

 ent times, after the operaiion, in order to bring on a suffi- 

 cient decree of inflammation to cause the eye to collapse. 

 Influenced by these considerations, I have never performed 

 the operation according to this method; and having uni- 

 formly succeeded in a considerable number of cases, during 

 a practice of more than thirty years, by performing it in the 

 following manner, I trust that I am justified in recom- 

 mending my mode of operating to the attention of this 

 Society. 



The operator will find it more convenient to stand behind 

 the patient than before him ; and the patient should be 

 placed on a chair sufficiently low to allow the operator to 

 carry his hand with ease over the patient's head. A large 

 crooked needle, armed with a strong thread, should then 

 be passed through the opaque projecting cornea, and, after 

 separating the needle from the thread, a knot should be 

 tied in the latter, at a small distance from the eye, in order 

 to hinder the thread from slipping. The operator having 

 thus obtained by means of the thread a secure hold of the 

 eye, a knife siniilar to that which is used to divide the cor- 

 nea in extracting the cataract, or, if this be not at hand, a 

 lonff sharp- pointed lancet, should be pushed through the 

 sclerotic coat, about a quarter of an inch from its connec- 

 tion with the cornea, and be carried quickly but accurately 

 round the cornea, as nearly parallel to it as can be accom- 

 plished. Sometimes, as soon as a puncture is made through 

 the sclerotica, so large a portion of the vitreous humour 

 escapes, as to cause the cornea to become flaccid ; in con- 

 st-quence of which the operator may find it difficult to com- 

 jilete the incision round this tunic with either the lancet or 

 the knife; and in this case a curved blunt-pointed scissars 

 will be found useful to finish the operation. The only ob- 

 jection to the use of the scissars is drawn from the addi- 

 tional pain which it is supposed to give; but the duration 

 of the operation is so short, that the difference between the 

 pain produced by the instruments is scarcely worthy to be 

 named. The haemorrhage that succeeds is seldom consi- 



iJerable^ 



