The Eye Douche is a small elastic bottle fitted with a nozzle and flexible tube, ending in a rose, through which, by means of a valve, the water is drawn from a vessel and driven in a fine spray over the eye held open to receive it (see fig. 70). The syringe in fig. 70 is very useful for a variety of purposes.
Eye-Drops.—Little bottles are sold by chemists for this purpose, with a tubular stopper; at one end of the stopper is a fine jet, the other is closed by a piece of indian rubber stretched over it; on pressing this a drop escapes from the jet. In dropping astringents into the eye the patient should put his head well back; while the surgeon raises one lid from the eye, drops in the lotion, and then raises the other and drops it in again, and tells the patient to move his eyelids about a little to force the lotion over the whole conjunctiva.
Fig. 71.—Syringe for sending a continuous current into the nose or ear, &c.
Syringing the Ears is best performed by a syringe having a long nozzle to direct the current of soap and water down the meatus on to the wax. Figure 71 consists of a syringe with double opening and air chamber; when in action it supplies a continuous gentle current, which breaks up the concretions more speedily and with less discomfort to the patient than the intermitting jet of a common syringe; but an important part of the apparatus is the long slender nozzle to direct the stream well into the meatus. The instrument-makers supply a little spout or shoot to hang under the ear, to turn off the water into a basin clear of the neck. If time permit, the patient should keep the ear charged with olive oil for a few days before syringing, that the wax may be softened. After the wax is removed, the irritation of the canal is best allayed by a little glycerine or olive oil put into the meatus, and covered by a pledget of cotton wool, large enough to fill the concha and too large to enter the passage, where it may be lost sight of.
Ice-Cold Injection.—In obstinate epistaxis the nares are sometimes plugged, but, before proceeding to this painful mode of treatment, a simpler plan should first be tried; namely, the injection of ice-cold water into the nostril along which the blood flows. The stream should be directed upwards that the water may first dislodge the clots entangled in the meatuses, and then flow over the bleeding surface. This is best done by employing a clyster or douche bottle (see fig. 71), one tube of which lies in a vessel of ice-cold water (containing solution of gallic acid or other styptic if desired, though cold water alone usually suffices), the other tube, having a long narrow nozzle, is passed up the nostril and directed upwards among the spongy bones. With this apparatus the water is injected steadily for half an hour, before being abandoned as unsuccessful. The patient is kept still, sitting upright in a cool room. If these means fail to check the flow of blood, the nares may then be plugged.
Plugging the Nares.
Apparatus.—1. A flexible catheter, No. 7, or Belloc’s sound.
2. Whipcord.
3. Lint.