210 ANTHROPOLOGY. 
5. OPERATIONS ON THE HYE. 
Few parts of the body are exposed to such manifold evils as the eye. 
Great progress has been made by modern surgery in the treatment of this 
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 (pl. 140, jig. 50) the fine point of which is 
introduced into the puncta, and an injection of lukewarm water forced 
through. This syringe (from 7 to 1 oz. capacity) is made either of silver 
or of glass; the exceedingly fine tubes, of gold, silver, of steel. Mig. 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 ( pl. 139, jig. 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 (jig. 8 6, and pl. 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, Bell’s trochar) is intro- 
duced through the lachrymal bone, and turned round until it penetrates the 
nasal cavity. After inflammation has subsided, a style of silver or a piece 
of catgut bougie may be introduced into the aperture. 
Pl. 189, 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 (pl. 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 Jiingken in this opera- 
tion is represented in jig. 47. 
2. Or Cataract. By this is understood an opacity of the crystalline 
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