The anatomy and diseases of the lachrymal passages / by W. Spencer Watson.

  • Watson, W. Spencer (William Spencer), 1836-1906.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: The anatomy and diseases of the lachrymal passages / by W. Spencer Watson. 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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    ni to be opened and shut in alternate movements. A sort of pumping action is thus induced, favourable to the downward passage of the lotion. B. Anaesthetics, general and local.—Many of the sur- gical proceedings in these passages are much facilitated by the use of a general anaesthetic, and I am sometimes compelled to employ such anaesthetics in the case of young children and timid adults of either sex; but cocaine properly applied is be- coming every day more useful for slight operations on these parts, which must in many cases be frequently repeated. In operating for the division of the canaliculus, cocaine solution (four per cent.) acts very well. It should be applied at in- tervals of forty seconds, six times, in order to be thoroughly effectual. A much longer time is required for the anaesthetising of the canaliculus than for the same effect on the cornea, or on the other regions of the conjunctiva. For probing the canaliculi the same method is sufficient. When there is acute inflammation of the skin, as in many cases of abscess of the sac, the local effects of cocaine are little or not at all effectual, and the same applies to inflammatory affections of the sac, even when the skin is not involved. The operation of opening the sac seems to give as much pain after cocaine as without its use. Opening the sac through the conjunctival surface is also, I think, as painful after as without the use of this very useful drug. So that in these cases, especially when the patient is a child or delicate adult, a general anaesthetic is desirable, and for this purpose nitrous oxide gas is admirably adapted, and gives the operator quite sufficient time. For probing the sac and duct cocaine gives very good results, if applied in the following way:—(1). A 4 per cent, solution is applied three or four times as directed for the canaliculus opera- tion. (2). A stronger solution (8 per cent.) with 1 per cent, of carbolic acid is then injected into the sac by means of the syringe depicted in fig. 8 (see Section VII., supra). (3). At the same time a plug of cotton-wool, saturated with a 20 per cent, solution of cocaine with 1 per cent, of carbolic acid is passed into the nasal fossa of the same side as that operated on and allowed to remain in the inferior meatus for about three minutes, or until the patient experiences a decided numbing sensation in