CHAP. V. Of certain affects of the Eyes, and first of staying up the upper Eye-lid when it is too lax.
OF the diseases which befall the eyes, some possess the whole substance thereof, as the Ophthalmia, a Phlegmon thereof: others are proper and peculiar to some parts thereof,* 1.1 as that which is termed Gutta serena to the optick nerve. Whence Galen made a threefold difference of the diseases of the eyes, as that some happened to the eye by hurting or offending the chief organ thereof; that is, the crystalline humor; others by hindering the animal faculty, the chief causer of sight, from entring into them; and lastly, other some by offending the parts subservient to the prime organ or instrument, Now of all these diseases, the eye hath some of them common with the other parts of the body, such as are an ulcer, wound, Phlegmon, contusion, and the like: other some are peculiar and proper to the eye,* 1.2 such as are the Egilops, Cataracta, Glaucoma, and divers others of this kinde. Some have their upper eye-lid fall down, by reason that the upper skin thereof is relaxed more than is sufficient to cover the eye, the gristle in the mean while not relaxing it self together therewith. Hence proceeds a double trouble; the first, for that the eye can∣not be easily opened; the other, because the hairs of the relaxed eye-lid run in towards the eye,* 1.3 and become troublesom thereto by pricking it. The cause of such relaxation is either a particular palsie of that part, which is frequent in old people, or the defluxion or falling down of a waterish humor, and that not acrid or biting; which appears by this, that those who are thus affected have a rank of hairs growing under the natural rank, by reason of abundance of heaped-up humor, as it is most probable. For thus a wet and marish ground hath the greatest plenty of grass. Now if this same humor were acrid, it would cause an itching, and consequently become troublesom to the patient, and it would also fret in sunder and destroy the roots of the other hairs, so far it is from yielding matter for the preternatural generation of new.* 1.4 It is fit before you do any thing for the cure, that you mark with ink the portion thereof which is superfluous, and therefore to be cut away, left if you should cut off more than is requisite, the eye-lid should remain turned up, and so cause another kinde of affect, which the ancients have called Ectropion. Then the eye being covered, take and lift up with your fingers the middle part of the skin of the eye-lid, not taking hold of the gristle beneath it, and then cut it athwart, taking away just so much as shall be necessary to make it as it were natural; lastly, join the lips of the wound together with a simple future of three or four stitches, that so it may be cicatrized; for the cicatri∣zation restrains the eye-lid from falling down so loosly, at least some part thereof being ta∣ken away. There ought to be some measure and heed taken in the amputation, otherwise you must necessarily run into the one or other inconvenience, as if too much be cut a way, then the eye will not be covered; if too little, then you have done nothing, and the patient is troubled to no purpose. If there shall be many hairs grown preternaturally, you shall pluck them away with an instrument made for the same purpose; then their roots shall be burned with a gentle cautery, the eye being left untoucht, for a scar presently arising will hinder them from growing again.