150 ENLARGEMENT OT THE LACHRYMAL CARUNCLE. 



growth should be got rid of; and, therefore, the question now 

 arose, what measures were to be taken for the purpose. I shewed 

 the case to my excellent friend, Mr. Youatt, who agreed with me 

 that, of the various modes of operation which appeared appropri- 

 ate, — caustic, excision, ligature — the latter seemed the simplest, 

 and on that account the preferable proceeding, and accordingly, 

 ligature was adopted. I deemed it my duty, however, before 

 operating, once more to warn the Major of the risk we ran of 

 exciting inflammation in the eye, and that, for what the conse- 

 quences of that might be I could not hold myself responsible : at 

 the same time I candidly confessed to him I had no strong reasons 

 to be very apprehensive about the event. 



The horse, after due preparation by regimen and physic, was 

 operated on in August 1836. The tumour, having a narrow neck 

 — growing from a slender pedicle — was easily encircled with a 

 doubled strong silk ligature, which was drawn moderately tight. 

 The second day afterwards, the tumour had acquired a livid hue : 

 the ligature was tightened. The fourth day, the tumour appeared 

 darker coloured and shrunk the ligature was again tightened. 

 The sixth day, tightening of the ligature dissevered the tumour, 

 and it fell off. I ordered another dose of physic, and fomentations 

 and simple astringent collyria, and every thing until the twelfth 

 day seemed going on well ; but on this day there appeared some 

 considerable injection of the conjunctiva, accompanied by a dim 

 lustreless aspect of the cornea. Next day, this dimness had in- 

 creased ; and the day after, the entire cornea had become white 

 and perfectly obscure from interstitial deposit. Blood-letting, both 

 general and local, was practised; strong cathartic medicine was 

 given ; and fomentations were used, in accordance with the apparent 

 exigencies of the case : but all availed nothing ; the eye remained 

 completely obscured, and my worst predictions of the liability of 

 the e3^e to an attack of inflammation from such an operation seemed 

 to be fulfilled. I had no resource left but mercury. I ordered a 

 drachm of calomel to be given in a ball every morning. About the 

 ninth day the gums had become tumid and reddened, and the 

 breath affected with mercurial foctor. The medicine was discon- 

 tinued. The day following the horse cudded his hay ; after mas- 



