[84] Rough diagram of Bowman's operation, showing the grooved director in the punctum, and the knife in the groove just before it slits up the canaliculus. [85] Diagram of operations for convergent squint--A A, line of sub-conjunctival incision; B B, line of Dieffenbach's operation; C, wire speculum. [86] _The Radical Cure of Extreme Divergent Strabismus._ J. Vose Solomon, F.R.C.S., 1864. [87] _Ophthalmic Hospital Reports_, vol. iv. part ii. p. 197. [88] _Biennial Retrospect_ for 1865-66. Syd. Soc. pp. 363-4. For a thorough discussion of the merits of this operation, see papers by Von Graefe in _Brit. Med. Jour._ for 1867, vol. i. pp. 379, 446, 499, 657, 765. [89] _Ophthalmic Hospital Reports_, vol. i. p. 224. [90] Streatfeild on Corelysis. _Ophthalmic Hospital Reports_, vol. ii. p. 309. [91] _a_ iris; _b_ lens; _c_ cornea. The hook is seen applied to the adhesion between lens and iris. [92] The staphyloma with the needles inserted, the lids held asunder by a spring speculum. The elliptical dotted line shows the amount to be removed; the vertical one, the position of the preliminary incision with the Beer's knife. [93] Resulting stump after the stitches are inserted. [94] _Ophthalmic Hospital Reports_, vol. iv. part 1. CHAPTER VI. OPERATIONS ON THE NOSE AND LIPS. RHINOPLASTIC OPERATIONS.--The operations for the restoration or repair of lost or mutilated noses are so various, and the minuteness of detail necessary for full description of them so great, that a complete account in a manual such as this is impossible; a brief notice of some of the most important varieties of the operation is all that can be given. _Principles._--1. It is necessary in every case that a suitable edge be prepared on which to fix the flap of skin, however obtained. To be suitable, this edge, should be (_a_) made in healthy skin, not in old or weak cicatrices; hence no trace of the original disease should be left; (_b_) it should be made thoroughly raw, by the removal of an appreciable amount of its edge; it should be pared, not merely scraped. 2. It is useless to attempt to restore a nose unless the patient is in good general health, well nourished, and perfectly free from all remains of disease in the nose or its neighbourhood. The flaps which are to form the new nose may be obtained either from (1.) the cheeks; (2.) the forehead; (3.) a distant part either of the patient or of another person. (1.) _From the Cheeks._--When the cheeks are healthy, and specially if they are tolerably full and lax, the flaps from the cheeks produce much the most satisfactory result. As performed by Mr. Syme, the operation consists in the shaping of two equal flaps (A, A) from the skin of the cheek at each side, having the attachment above. A site for each flap is formed by the careful paring away of the whole thickness of the edge of the cavity of the lost organ (see Fig. XVII.) [Illustration: FIG. XVII.[95]]