156 DISEASE OF THE LACHRYMAL PASSAGES, 



August 4:th, 1841. — Having provided myself with three wax 

 bougies of the smallest size made use of by surgeons, I had the 

 horse cast, and his head extended and placed in a convenient 

 posture for operation upon the eye. An assistant firmly main- 

 tained the eyelids apart, while I, choosing the inferior puncture — 

 it being the larger and having the more direct passage — for 

 operation, readily introduced into it a bougie, but had pushed it 

 no farther than into the lachrymal sac before it bent and became 

 useless. Withdrawing this, I passed a second bougie, which, by 

 dexterous manipulation and some force, I succeeded in insinuating 

 into the duct, through which it readily passed onward to the ex- 

 tent of seven inches ; then, on further force being used, it bent, as 

 the first had done, and was in consequence withdrawn. The 

 act of withdrawal I found to require more force than the introduc- 

 tion, in consequence of the cohesion between the membrane and 

 bougie, arising from the latter having become softened ; and the 

 result was that, just as the operation was concluded, about one- 

 eighth of an inch of the end of the bougie broke off and remained 

 within the puncture : however, it easily became extracted with a 

 pair of dissecting forceps. Still, such an accident, Avhicli might 

 have proved serious, was enough to make me resolve in my mind 

 not again to use the common bougie, but to have a whalebone probe 

 manufactured for the purpose. For this time, therefore, I released 

 my patient. 



5th. — The eye shews a slight inflammatory appearance from 

 what was done yesterday ; but the flow of tears over the face is 

 diminished, leading me to believe that the bougie has done some 

 good. At the exit of the duct within the nostril there is a little 

 coagulum resting. 



6th. — Tears still running over the cheek, and, having provided 

 myself with a whalebone probe of sufficient length — thirteen 

 inches — and the requisite size, I determined, this morning, to 

 renew my attempts to permeate the duct. I also had, this time, 

 by me, a pewter syringe, with a nozzle sufficiently pointed and 

 fine to enter the puncta. I first introduced the whalebone probe, 

 as on a former occasion I had the bougie, which passed readily 

 enough into the lachrymal sac, but required withdrawing for a 



