An operation for the radical cure of stricture of the lachrymal duct : with description of a stricturotome / by Charles Hermon Thomas.

  • Thomas, Charles Hermon.
Date:
[1911]
Catalogue details

Licence: In copyright

Credit: An operation for the radical cure of stricture of the lachrymal duct : with description of a stricturotome / by Charles Hermon Thomas. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    to ordinary probes, and which allow only the passage of an Anel's probe, will be found permeable to the conical tip of this instrument. The tip being engaged in the stricture, gentle, continuous pressure is to be made, and the blade carried through and beyond the contraction. It cannot be too strongly insisted upon that exploration of strictures in this locality is to be conducted with ex- treme deliberation and patience; all instruments should be introduced by coaxing, and never by force. More than one sitting may be necessary. The blade being now caused to engage within the stricture, incision is made completely dividing the tissues at the strictured point, even to the bone, and in at least two different directions. The instrument should then be moved laterally in all directions, to make sure that no narrowing remains ; and before withdrawal it should be carried within the nasal fossa as an exploring instru- ment, to learn if any other stricture be present, which, if found, should also be incised. By far the most com- mon seat of stricture of these passages is at the junction of the sac and duct ; only occasionally will a stricture be found at the nasal extremity of the duct. A little bleeding at the nose and at the inner canthus is the only external indication that an operation has been performed. The whole operation is singularly free from pain, and with cocaine the pain becomes quite insignifi- cant. Stilling, and those who have used his instrument, describe more or less considerable haemorrhage from the nose and ecchymosis of the lower lid as the ordinary results of operation, due, no doubt, to the somewhat extensive and unnecessary cutting of healthy structures, which unavoidably attends the use of such a knife as his, but which conditions do not exist in the operation as here described, the incision being limited to the parts affected.