The inferior turbinate on the affected side was hypertrophied for nearly
its whole length and was in contact with the septum for some distance at
the anterior extremity, being of a deep red color and very sensitive to
touch. I told her that I believed it would be necessary to remove the
turbinate with the saw and advised its removal as soon as possible,
giving it as my opinion that it would be necessary to do the operation
before the condition of the eye could be relieved. The patient admitted
the force of my argument, but was inclined to wait a while until she
could get her courage up a little higher. Meanwhile she wanted the canal
dilated and begged me to do it. Visiting New York, I supplied myself
with a canaliculus syringe and a set of Bowman’s probes, and on my
return announced myself ready to commence treatment. I proceeded to
insulate the probes in the manner alluded to for needles in nasal work,
scraping the points bright for about a quarter of an inch.
Before introducing the probe I washed the sac out thoroughly with a
fifty per cent. solution of enzymol, and then, connecting the probe
electrode with the negative cord of a galvanic battery by means of an
artery forceps, introduced it (No. 2,—a No. 1 would not pass in the
ordinary manner with considerable pressure) into the canal, and turned
on the current until the meter registered two milliamperes. Using just
enough pressure to guide the electrode, it gradually found its way along
the canal, and in less than five minutes it had entered the nasal cavity
without causing the loss of a drop of blood. In three days I passed a
No. 4 in the same manner, and four days later a No. 6 passed easily.
Three days after this a No. 7 was passed, and that size was passed three
or four times afterwards at intervals three or four days. After the
first passage of the No. 7, all of the solution used for the purpose of
cleansing the sac passed through into the nasal cavity directly from the
syringe, and there was no further collection of pus in the sac during a
week in which the syringe was not used.
The point I wanted to bring out, however, is that after the second
treatment by electricity, the color of the mucous membrane covering the
turbinate began to grow paler, and at the end of the treatments the
entire body had contracted sufficiently to permit free and easy drainage
and natural respiration.
I am led, by this, to the thought that it may be good treatment in many
cases of hypertrophy of the inferior turbinate, and possibly the others
as well, to use the insulated probe electrodes in the lachrymal canal
with the weak current, not exceeding one or two milliamperes. The
careful use of this method may prove it to be a valuable addition to the
present means of treating a class of cases that are troublesome to the
patient and the doctor.
THE PATHOGENIC AND THERAPEUTIC ACTION OF RHUS TOX. UPON THE EYE.
BY CHARLES DEADY, M. D.
Public-domain text, read in full here on John Shaqi.
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