An  assistant  should  raise  the  upper  lid  as  was  directed
in  the  case  of  extraction,  and  the  operator,  presuming
the  left  eye  to  be  the  one  selected  for  operation,  should
draw  down  the  lower  lid  with  the  fore  and  middle  fingers,
which  should  project  a  little  beyond  the  tarsal  margin ;
the  former  (the  index  finger)  being  situated  towards  the
external  canthus,  and  the  latter  (the  middle  finger)  directed


160

towards  the  lachrymal  caruncle ;  so  that  the  moTemenU
of  the  cjc-ball  upwards  and  inwards  will  be  effectually
controlled  by  the  projection  of  the  fingers  beyond  the
edge  of  the  eye -lid,  and  by  tlie  firm  pressure  of  the  tip  of
the  middle  finger  upon  the  globe  towards  the  inner  can-
thiiA.  In  thiH  way  the  eye  is  prepared  for  the  operation
whether  it  be  intended  to  accomplish  the  reclination  or
the  depression  of  the  opaque  lens.  I  really  think  it  is
better  to  fix  the  eye  by  means  of  the  fingers  than  by  tk
use  of  specula  whenever  the  surgeon's  object  is  the  de-
pression or  reclination  of  the  lens ;  and,  I  am  persuaded
the  eye  may  be  as  securely  fixed  without  as  with  a  spe-
culum, unless,  indeed,  this  instrument  be  used  in  an  im-
properly, and  therefore  inadmissibly,  forcible  manner.
Now,  the  operation  itself  is  divided  into  three  stages:—
the  first,  comprehending  the  punctuation  of  the  tunici;
the  second,  the  guidance  of  the  needle  from  thence  to  iti
arrangement  upon  the  lens ;  and  the  third,  the  displaee-
mcnt  of  the  lens.
