Pallucci on lachrymal fistula

Be warned. Reading this may make your eyes water!

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Montage of three illustrations from a book by Palluci (1762)

Like many medical and surgical books (historic or modern), the illustrations and descriptions here may be gruesome to behold. Don't worry, however, if you are blinking away the tears, since tears are very important. They prevent the cornea at the front of the eye from drying, stop the eye sticking to the inner eyelids and prevent friction. They wash away dust and, as they said in the nineteenth century, weeping relieves the head of congestions!

One of the College's rare books is a first edition of Pallucci's Methodus Curandae Fistulae Lacrymalis, and concerns the re-routing of tears in the eighteenth century.

It was published in Vienna in 1762 by Johann Thomas Trattner and we are impressed when we note that a whole book (117 pages plus three engraved plates and descriptive captions) could be devoted to one particular crying disorder. The book is a report on the invention of a new method for the treatment of lachrymal fistula. A lachrymal fistula is the small opening left behind when an abscess in the upper part of the tear-duct bursts, near the root of the nose. Less commonly it can result from a wound to the lachrymal gland. Medically, explained in its simplest terms, a fistula is a tube connecting things that ought not to be connected and such tubes need to be closed in some way. The author proposes inserting a canula into the lachrymal duct, passing a fine gold thread from the sac towards the nasal fossa through the nasal duct, and introducing a simple corrosive to clear the obstruction. We know that later surgeons sometimes used beer for the corrosive substance.

Top right in our pictorial montage we see a detail from plate 3 showing 'from life' a case of lachrymal fistula in a young boy of 13 who presented himself before Pallucci in 1757. The main part of the image shows an older man looking undisturbed by his surgery to correct a similar condition. Inset to the lower left is the book's frontispiece.

Natalis Guiseppe Pallucci (1719-1797) was a Florentine surgeon who studied medicine in Italy, practised in Paris and eventually settled in Vienna where he was appointed as the Imperial Surgeon. He was famous mainly as a lithotomist and for operating on cataract although he did not agree with the usual extraction method of dealing with cataract and instead invented an instrument to enable the depression operation consisting of a trocular canula. (See his Description d’un nouvel instrument a abaisser la cataract avec tout le succes possible, Paris 1750, a copy of which may also be found in the College Library).