SECT. XI.—ON THE SUTURE OF THE UNDER EYELID, AND THE BURNING OF IT BY MEDICINES. The under eyelid is subject to the same complaints from the ciliary hairs as the upper; for, when larger than natural, it is everted; and it is subject likewise to phalangosis and distichiasis. We must, therefore, perform the operation of the suture in the same manner as for the upper eyelid, but in an inverted order, beginning with the _lunated_ incision on account of the obstruction occasioned by the blood, and then making the _veruted_. But the _under-incision_ is to be omitted altogether, because the lower eyelid, by its natural weight, is readily everted. The rest of the treatment to be completed as in the suture of the upper eyelid, except that the extremities of the ligatures are not to be glued to the forehead. If in this case the patient is averse to an operation, and prefers burning by medicines, you have already got a description of this process. * * * * * COMMENTARY. This section requires no commentary. SECT. XII.—ON ECTROPION, OR EVERSION OF THE LOWER EYELID. Ectropion of the under lid is occasioned by the same causes as lagophthalmos of the upper, only that it does not occur naturally, but arises sometimes from relaxation produced by medicines possessed of this property, which have been applied for inflammation; and sometimes the eversion is occasioned by the suture or burning having been improperly performed. Taking, therefore, a needle, armed with a double thread, we perforate the fleshy mass, pushing it through from the left canthus to the right, and then by means of the thread fastened to both of its extremities, we stretch the skin with the needle, and cut down upon it with a scalpel, removing the needle at the same time. Then, if the eyelid resume its proper shape and is turned inwards, this operation will be sufficient. But if the eversion continue after the removal of the flesh, we apply the back of the specillum to the divided eyelid; and on the inside of the eyelid, having made two incisions, beginning at the two angles of the incision formerly made, and terminating in an acute point, and meeting together like the Greek Λ, we remove this substance, so that its acute point may be below at the eye, and the broad above at what is called the tarsus. Afterwards we unite the separated parts with a needle containing a woollen thread, being satisfied with two sutures. But if the ectropion be occasioned by the operation of the suture or burning we make a simple incision along the first cicatrix below the hairs of the tarsi, and having separated its lips, we fill up the wound with pledgets, using the same methods as for lagophthalmos (except fomentations) until the parts which have been stitched unite. * * * * * COMMENTARY. See Aëtius (vii, 74); Celsus (vii, 7); Albucasis (Chirurg. ii, 14); Haly Abbas (Pract. ix, 20.)