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.

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    dilatation of an urethral stricture would be to that of the life- long retention of an instrument in the urethra. On its first introduction, it shared the common fate of all novelties : it was either rejected in toto by those who either could, or, what is worse, would not recognise its advantages j or, on the other hand, its value was, I believe, overrated by those who adopted it. I have myself pursued it from its very first appearance, but must admit that, whilst I have found it easy and efficient in many instances, in others it has proved difficult and un- satisfactory in its application. In these latter cases, I find the best treatment is to make a small opening with a history directly into the lacrymal sac, and hence dilate the nasal duct by periodic probing, leaving the superior lacrymal passages altogether intact. I know, however, of no class of affections that tax the surgeon^s patience and ingenuity greater, than these lacrymal strictures. Some will not yield per- manently to any plan of treatment hitherto suggested. As an extreme measure, the lacrymal sac has been destroyed by caustics or the actual cautery — a procedure which, however apparently illogical in theory, has proved successful in practice. There are two very common conditions of the puncta lacry- Eversion •n 111'- 1 1 and cloau malia, which may, u overlooked, ongmate long-protracted of the and ineffectual treatment. We may find them everted, turned away from the surface of the eyeball, or skinned over by chronic inflammation (especially in old people). In either case the puncta no longer fulfil their physiological function—that of receiving the tears as they distil down over the surface of the eyeball. Hence arise watering of the eye, chronic con- junctivitis, and even ectropion — all three effects acting and reacting on each other, so as to form an accumulated fund of discomfort to the patient. Such cases, after having been treated ad infinitum by all varieties of lotions and ointments, I have over and over again seen at once cured by slitting up the canaliculus. Effects had previously been mistaken for causes. A great variety of operations has in modern times been devised for the cure of in- and e-version of the eyelids, but none appear to me to present any striking novelty or