Lectures on the operative surgery of the eye or, an historical and critical inquiry into the methods recommended for the cure of cataract, for the formation of an artificial pupil, &c. &c. &c. : containing a new method of operating for cataract by extraction ... being the substance of that part of the author's course of lectures on the principles and practice of surgery which relates to the operations on that organ / by G. J. Guthrie.

  • Guthrie, G. J. (George James), 1785-1856.
Date:
1827
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the operative surgery of the eye or, an historical and critical inquiry into the methods recommended for the cure of cataract, for the formation of an artificial pupil, &c. &c. &c. : containing a new method of operating for cataract by extraction ... being the substance of that part of the author's course of lectures on the principles and practice of surgery which relates to the operations on that organ / by G. J. Guthrie. Source: Wellcome Collection.

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

    47/612 (page 9)
    Complete inversion of the lid, or entropium, is, however, a consequence of chronic inflammation, and may therefore take place at every age, in every habit, and in every situation of life; but naturally prevails most among the poor, from want of cleanliness. In the lower lid it may occur before the in- flammation has completely passed into the chronic state, in consequence of the swelling of the conjunctiva, and the oedema of the integuments, causing the edge of the lid, which is confined by its attachments, to roll inwards. Mr. Ware* has conceived, that when trichiasis affects the upper lid, it must be owing to a relaxation of the levator palpebral superioris, and a contraction of the superior part of the orbicularis; whereas, in the case of a trichiasis affecting the lower lid, it can only arise from a relaxation of the skin and a contraction of the inferior part of the orbicu- laris. And as in these two cases the causes of the disorder are very different, they will in consequence require a very different treatment. But later observation has disproved these opinions of Mr. Ware, the proper operation being in both cases alike in principle, and nearly so in execution; whilst a relaxation of the lid, without inflammation of the con- junctiva, has been found incompetent to its formation. Mr. Crampton has not only pointed out the principal cause of the disease, viz. the contraction of the angles of the lids; but has nearly indicated the proper method of cure. He first demonstrated, that the levator palpebral superioris was not inserted into the upper or convex margin of the tarsal cartilage, as was previously supposed, but into the parts connected with it and the conjunctivaf; in consequence of which he * Ware on the Ophthalmy, 2d edit, page 93. f Crampton's Essay on the Entropeon, page 28. He says, That it is not inserted upon either margin I ascertained by the following dissection : I raised the conjunctiva of the upper eyelid: beginning at the inferior margin of the tarsus, and continuing my dissection beyond its superior or semicircular edge, I found that the tendon of the levator remained attached to the conjunctiva upon one side, and to the in- tegument of the eyelid upon the other. The levator palpebrae, there-