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Show 68 or TUMOURS or run mums. 0F TUMOURS OF THE EYELIDS. Having forcibly turned out the inside A ration is performed. .ur/r.‘ -‘_. -W. _. 7., s. of the diseased eyelid, the inner membrane of the eyelid, and the ciliary cartilage are to be cut across by the point of a lancet. If the inversion of the eyelid has arisen from the a}. leged cause, it will be immediately relieved. 0F TUMOURS OF THE EYELIDS. "scarf-1."- a... - w .. 5-." THERE are tumours of the eyelids which the patient is very willing to have taken off, and which should be taken‘ofi because they push in the tunica conjunctiva, and pressing upon the eyeball, in the motions of the eyelid, they inflame it. These are small incysted tumours grmving in the place of the meibomean glands, and it is natural to suppose that ll2135M mom they are the enlarged glands. But we must observe, that there are tumours of the eyelids which ought not to be cut. These are small tumours with a broad base, and of a dark red colour. Sometimes they have the appearance of a small boil, being white on the most prominent part: yet this is not passe. On the contrary, the tumour we have to cut out is colourless, only in as much as sometimes by exciting the eye there may be some general inflammation. These incysted tumours of the eyelids, it is needless to at tempt to remove either by local remedies, or by attention to general remedies, they must be cut out, or: the patient can take away the tumour; if we should operate by making our first incision on the outward skin. If the conjunctiva seems intimately united to the tumour upon our everting the eyelid, we have to proceed thus: As in all operations on the eye, the patient is firmly seated, and an assistant standing behind him supports the head against his breast. 1. The assistant must invert the eyelid, by catching the eyelashes and margin of the eyelid with his finger and thumb, and turning his fingers, so that the fore~fin~ ger pushes forth the tumour and everts the eyelid. 2. The surgeon now draws his lancet pointed scalpel across the tumour, so as to divide the tunica conjunctiva in a direction parallel to the edge of the eyelid. 3. Having by scratching a little separated the membrane, so that the tumour is thrust out, he has to push a hook or small tenaculum into it, and then to dissect it away altogether. But it~ the conjunctiva be not diseased or very firmly unit~ ed to the tumour, we had better operate without everting the eyelid, and this is possible without leaving~ an observable scar on the eyelid. 1. The surgeon fixes the eyelid by pressing the two angles down by the points of the fore and middle fingers, and having stretched the outer skin of the eyelid over the tumour, he draws his knife directly over the tumour and parallel to the edge of the eyciids, consequently separating the fibres of the Orbicularis, not cutting them across. 2. Having exposed the outward half of the tumour he pushes the fine tenaculum round under it, and then dissecting it a little more, he applies the curved scissors, and cuts it 03‘ from the tunica conjunctiva. The orbicularis muscle holds the lips of the wound together, without our assistance, and then it is only required that we bind lightly on the eye a cloth wet with cold solution. ‘ [[urdeolum. In this tumour of the eyelid we should do very little, Lin» '4 less it be to move the bowels. r -Iwe'w'! W? 5""!"1'if-"Qfi‘gmr-v6-g -4~ -, A ‘w must submit to the inconvenience; I must add, however, that there is more pain and bleeding than would be imagined to be the consequence of so trifling an operation. The first thing to be examined is, whether or not the tumour be so united to the inner membrane of the eyelid as to force us to cut through the eyelid altogether, before we 5'3 "'hen, however-,the little swelling advances, this white speck bursts and discharges a little fluid, and then a slough is seen within, which is by and byc pushed out, and the sore closes. to promote which, fermentation and poultiees are used. When tumours grow within the socket, they are to be early extirpated, for though they should be of a harmle ss nature, yet their increase, simply by pushing the eyeball forward, and |