The progress of ophthalmic surgery : from the invention of the ophthalmoscope (in 1851) up to the present time : being an oration delivered before the North London Medical Society on February 11, 1863 / by John Zachariah Laurence.

  • Laurence, John Zachariah, 1828?-1870.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: The progress of ophthalmic surgery : from the invention of the ophthalmoscope (in 1851) up to the present time : being an oration delivered before the North London Medical Society on February 11, 1863 / by John Zachariah Laurence. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    6/26 (page 4)
    latter, wliicli alone appeared to me capable of affording a clear retrospective contrast of the Past and Present of Oplithalmic Science. appendages. Not mucli advance lias been made in the surgery of the ocular appendages. The most striking is undoubtedly a slight, but important, modification Mr. Bowman has intro- duced into the treatment of the various obstructions the ^tricTiI?es. l^crymal passages are liable to. These obstructions or stric- tures involve principally either the canaliculus or the nasal duct. In the former case, the method of slitting up the minute canal, and subsequently dilating it by fine probes, was very closely foreshadowed by Jiinken.* In the latter ease, the idea of dilating a stricture of the nasal duct from the punc- tum lacrymale through the canaliculus was too obvious, to long escape the attention of surgeons. Accordingly, we find Anel, Travers, and Jacob advocating this practice; but it never found favour. Mackenzie characterises it as ' painful, dangerous, and ineffectual; apt to end in incurable atony of the puncta, by causing them to split or ulcerate.' It was reserved for Mr. Bowman to point out that all these dis- advantages depended on the anatomical fact that the punc- tum lacrymale, analogous to the meatus urinarius, was one of the, if not the, narrowest parts of the entire track of the canal, and that, if we opened this up by a cutting instrument, we were at once placed in a position of readily introducing probes of sufficiently useful size, and of thus dilating the nasal duct from the punctum without the disadvantages inci- dental to the older practice. This method of treatment has found much favom' both at home and abroad, and possesses great advantages over the old style, which I now only regard as a last resource, after every other plan of treatment has failed. The treatment of lacrvmal strictures by the modern method is as superior to that, by the style, as the periodical * He removed a portion of tlie eyelid and strictured canaliculus together, and kept the new punctum laciymale (nearer tlio inner canthus) dilated till cicatrisation took place. — Vide his ' Lehrc von den Augen Xraukheiten,' p. 628. Berlin, 1832.