SURGERY. 
derto allow the elevation of depressed bone, 
or the evacuation of blood or matter. The 
scalp must be divided by an incision down 
to the bone, and the sides of the cut turned 
lip ; these are laid down again, and approxi- 
mated after the operation. Trepanning is 
. not to be performed merely because there 
is a fracture or depression ; but only when 
symptoms exist, showing that the brain is 
suffering from pressure. 
Tinea capitis, or scald-head, is a super- 
ficial ulceration of the scalp, covered by 
thick dry scabs. Cleanliness is t|ie most 
essential part of the treatment. Tlie scabs 
must be removed, the head kept closely 
shaved, and the ulcers dressed with tlie nng. 
picis cum sulphure, or ung. hydr. nitr. or 
lotion of kali sulphuratum. Alterative me- 
dicines must be given at the same time. ' 
Hare4ip is a deformity existing from 
birth, attended frequently with a fissure in 
the jaw and palate. Its cure consists in 
paring the margin of the fissure, and bring- 
ing the edges into contact, where they are 
held by means of pins, and the twisted su- 
ture; which is a thread passed over the 
pins in the form of the figure 8. They thus 
unite by the first intention. It should not 
be performed on very young children, as 
they are less manageable, and are liable to 
convulsions. The removal of the edge of 
the fissure is performed by means of for- 
ceps, by which the lip is held firmly, leav- 
ing out the part which is to be cut off, and 
which the surgeon removes at one stroke of 
the knife. 
The same operation is necessary for can- 
cerous ulcers of the lip, which commence 
in ulcerated, wart-like excresences, and 
spread very destructively. They should 
be removed as soon as we can ascertain 
that they do not yield to our remedies. 
Diseases hf the antrum are inflammation 
and suppuration of that cavity, and fungous 
growth from its surface. The former re- 
quires an opening by tire extractiorr of one 
of the grinders, and the introduction of a 
pointed instrument through the socket. In 
the latter the cavity should be trephined, 
and the fungus removed. 
The mli me tangere, or spreading herpe- 
tic ulcer about the nose, is a very intract- 
able complaint. Alterative medicines should 
be given internally, together with cicuta, 
and even arsenic : ung. hydr. nitr., ung. 
picis., solution of lunar caustic, and of ar- 
senic, as topical applications. 
Fistula laclirymalis arises from obstruc- 
tion of the ductus nasalis, which causes 
a swelling in the corner of the eye, flux of 
the tears over the cheek, and afterwards a 
fistulous opening from the lachrymal bag. 
Its cure, in an early state, is by injecting 
warm water through the puncta, using a 
collyrium of white vitriol, and smearing the 
edges of the eye- lids with ung. hidr. nitr. 
In a more advanced state, an incision into 
the lachrymal bag is required, together with 
a forcible removal of the obstruction, and 
the introduction of a straight silver nail- 
headed style. 
DISEASES OF THE EYELIDS AND EYES. 
Psorophthalmy and lippihido, or inflamma- 
tion of the edges of the eyelids, with itching, 
&c. Ung. hydr. nitr. lowered, rubbed on at 
night with camel-hair pencils ; vitriolic col- 
lyrium, and alterative medicines. 
Purulent ophthalmy. Red, swollen, and 
everted state of the eyelids, w'ith discharge 
of puruleiit matter, particularly in children. 
Inject under the eyelids solutions of cam- , 
phor, or the metallic salts. ' 
Ectropium, or eversion of the eyelids, 
followed by an indurated and callous state 
of the conjunctiva. Remove a portion of 
that membrane. Exactly the reverse of 
this is the trichiasis, or inversion ; where 
the hairs rub against the eyeball, and where 
a portion of the skin of the eyelid must be 
removed. Hm-deolum, or stye, requires an 
emollient poultice, and touching with ar- 
gentum nitratum. 
Ophthalmy, or inflammation of the eye, 
distinguished into the first, which is called 
the acute stage, attended vfith heat, pain, 
fever, &c. and the second, or chronic pe- 
riod, in which there is a weakness of the 
organ. Remedies of the first are ; in slight 
cases, low diet and gentle purging, with 
keeping off the light : afterwards, in the 
chronic state, one of the following collyria. 
Zinc, vitriolat. gr. v. Aqu. Rosa;, | iv. 
R Ceruss. acet. gr. viii. Aq. feniculi vi. 
Spt. vin. camph, gtt. x. In more severe 
cases, general and local bleeding ; blistei s 
to the temples, behind the ears, and to the 
nape of the neck ; warm emollient applica- 
tions to the eye, total darkness, and the an- 
tiphlogistic regimen in every respect. Akhere 
the chronic state has commenced, astrin- 
gent collyria, or the tinct. thebaica, drop- 
ped once or twice a day between the eye- 
lids. When the complaint is very pro- 
tracted, the state of the constitution in ge- 
neral, or of the digestive organs in particular, 
often is the cause ; hence alterative reme- 
dies, attention to regularity of the bo.wels. 
