SECT. VII.—ON PERISCYPHISMUS.
When many deep-seated vessels send a copious defluxion to the eyes, we have recourse to the operation called periscyphismus. These cases are attended with such symptoms as these: in the first place you will find the patient’s eyes atrophied and small, weak of sight, the canthi corroded, and the eyelids ulcerated, the hairs falling off, with a discharge of very thin, acrid, and hot tears; there is a deep-seated pain in the head of an acute and violent character, and there is frequent sneezing. Having first shaved the head as aforesaid, and avoiding the place where the temporal muscles play, we make a transverse incision, beginning at the left temple and ending at the other. The incision must have its terminations where there are no muscles, its direction being a little above the forehead, and we must avoid the coronal suture. Leonidas directs the incision to be made along the middle of the forehead. When the bone is laid bare we may keep the parts asunder with tents and plenty of pledgets, and bind the extremities of the division; and, as we formerly stated, bathe with wine and oil. After loosing them, if the inflammation is on the decline, we may scrape the bone until it begin to incarnate, and accomplish the cure by a mode of practice calculated to promote incarnation, using the incarnative powders; among which is that containing of wheaten flour, p. ij; of colophonian rosin, p. j; and that called the cephalic, and those incarnatives prepared from pumice-stone. For, when the skin is thickened by a dense cicatrix, and the mouths of the vessels constricted, the defluxion is prevented from being determined to the eyes as before.
Commentary. See Aëtius (vii, 93); Pseudo Galen (Isagoge); Albucasis (Chirurg. ii, 5); Haly Abbas (Pract. ix, 18.)
It is evident that this operation is neither more nor less than a complete division of the integuments of the head from temple to temple; of course it must even have been more dangerous than the operation treated of in [the last section]. Aëtius, Haly Abbas, and Albucasis describe it in the same terms as our author. The periscyphismus and hypospathismus are briefly noticed in the ‘Isagoge.’
Fabricius ab Aquapendente treats of these operations among those of the ancients, qui ne sont plus en usage (Œ. C. ii, iv); even Tagliacozzi speaks of them as being cruel and dangerous. However, a surgical operation, similar in principle, called the “long issue of the scalp,” is still practised in certain hospitals of Great Britain. See the ‘Transactions of the Provincial Association,’ (vol. xi.)