A treatise on the principles and practice of ophthalmic medicine and surgery / by T. Wharton Jones.

  • Jones, Thomas Wharton, 1808-1891.
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the principles and practice of ophthalmic medicine and surgery / by T. Wharton Jones. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    785/888 (page 707)
    10th.—Fistula of the lacrymal sac. After the evacuation of an abscess of the lacryrnal sac j y bursting or incision, if the lining membrane still con- 'fi mue unhealthy, and the nasal duct obstructed, the open- jg into the sac, though it contracts, may not entirely close, nit remain in a fistulous state with callous edges. The fistulous opening in the skin may correspond with : i Lat of the sac, or the communication between tho two oenings may be through a sinus. There may be more tan one opening in the skin with a corresponding num- er of sinuses. Sinuses of this description are to be distinguished from □uses in the same situation not coninrunicating with e sac (p. 697). Sinuses thus arising wo have seen, >wever, sometimes penetrate inwards by ulceration of e wall of the sac. True fistula of the lacrymal sac is to be closed only ter restoration of the passages to a healthy state, if that possible; if not, the palliative treatment described dow must be had recourse to. 11th.—Exploration of the puncta and canaliculi. The instrument employed is a slender gold probe, com- mly called Anel's probe. The first steps in the ope- tion are the same as in that of the introduction of the Luat-pointed pin into the puncta described bolow. i Lower canalicule.—Having entered the probe, held htly between the thumb and forefinger, into the punc- m, and pushed it downwards to the dilated bottom of e vertical part of the canaliculo, that is, to the depth of out one-tenth of an inch, withdraw it a little and ango the vertical direction of the probe downwards for lorizontal one inwards, or rather for one deviating from i horizontal inwards, so as to be slightly oblique from low upwards, which is the direction of the second part the canalicule. At the same time that the direction of ) probo is thus altered, the inner part of the lower elid is to be stretched, by the finger holding it, to- .rds the temple, and pressed slightly more downwards, order as much as possiblo to undo the curvature of the ralicule. Upper canalicule.—Having pushed tho probe upwards z z 2 1