DEPARTMENT OF SURGERY. 
285 
make it so ; but it may be irrigated with a 4 per cent, solution 
of boric acid, or a normal salt solution. The inner canthus can 
never be thoroughly cleaned on account of being connected with 
the nostril by the lachrymal canal, which is a conduit for pus 
cocci; therefore, when operations are performed in this region 
all that is necessary is to wash the parts with soap and water 
and a weak solution of boric acid or a normal salt solution, 
which will reduce the vitality and number of pus organisms. 
The lachrymal canal should be irrigated and thoroughly cleaned, 
which will obviate the accumulation of tears and lessen the 
danger of infection. If the canal is open the passage of the 
lachrymal discharge through it to the nose will convey the pus 
cocci away from the eye, and lessen the danger of infection from 
this source. When the canal cannot be opened, the inner can¬ 
thus may be closed with iodoform to prevent the lachrymal fluid 
from being infected in this manner. 
(A) Operation Upon the Eyeball. —The conjunctiva 
covering the eyeball is a very vascular structure and when 
wounded, either accidentally or surgically, it heals very rapidly ; 
large wounds in it can be successfully treated by a thorough 
cleaning and carefully suturing them. The after-treatment, in 
most cases, requires nothing more than protection ; this can be 
accomplished by closing the eyelid, and applying a hood with 
a compress adjusted over the eye. 
1. Operation for Pterygium .— 
Pterygia are patches of hypertrophi¬ 
ed conjunctiva which extend from 
the nasal canthus to the cornea ; 
they are usually triangular in shape 
with the base at the canthus and the 
apex pointing toward the pupil. The 
instruments needed for the opera¬ 
tion are an eye speculum, sharp- 
pointed knife, pair of dissecting 
pterygium. forceps, pair of scissors, probe, 
needles and sutures. 
Operation .—In most every instance a local anaesthetic is suf¬ 
ficient for the operation, which should be performed in the 
simplest possible manner. It is necessary to save as much of 
the conjunctiva as possible, and to remove all of the diseased 
tissue from the corneal surface, and when possible that of the 
scleral surface also. This, however, cannot always be accom¬ 
plished, especially when the base is very broad. If the ptery- 
