Fig. 1.1
Code of Hammurabi (2250 BC)
Fig. 1.2
Ebers Papyrus (1500 BC)
Fig. 1.3
Hippocrates (460–377 BC)
The Greeks made significant contributions in the early days. Most diseases of the lacrimal system were referred to as “fistules.” Celcus (25 BC–50 AD) advocated cautery and burning of the system to cure “fistules”! [2] Claude Galen (129–200 AD), a century after Celcus, advocated the use of hot iron to achieve charring of the “fistules” and hence a cure! He believed that puncta evacuates as well as secretes into the eye! [2] However, the most remarkable contribution of Galen (Fig. 1.4) has been his description of causes of epiphora. He documented as follows [2]
Fig. 1.4
Claude Galen (129–200 AD)
A canal goes from the eyes to the palate and empties there the secretion formed in the eye. Watering may have three causes; either this canal is blocked, or the secretion is excessive or a scar at the nasal canthus. The latter most is incurable.
Medieval Times and Renaissance
The medieval times as well as the Renaissance were unfortunately a bit laid back as far as the scientific progress related to lacrimal system was concerned. The Arabians chipped in with Rhazes (854–925 AD) evaluating the lacrimal passage further down into the nose and later Avicenna (980–1037 AD) (Fig. 1.5) advocating application of Mongo bean pastes for lacrimal fistulas. Leonardo da Vinci’s (1453–1519) and later William Harvey’s (1578–1657) embryologic work were notable during these times.
Fig. 1.5
Avicenna (980–1037 AD)
Modern Dacryology
Major Contributors of Early Days
George Ernst Stahl (1660–1734)
Stahl was a German physician (Fig. 1.6), who established nasolacrimal duct obstruction as a cause of dacryocystitis. He also suggested probing using a violin thread!
Fig. 1.6
George Ernst Stahl (1660–1734)
Dominique Anel (1679–1730)
Giovanni Battista Morgagni (1682–1771)
Morgagni was an Italian anatomist (Fig. 1.7) and among the earliest to give a description of lacrimal drainage system. He concluded that there were no valves in this system and the flow was bidirectional! He published his account in the treatise “Adversaria Anatomica Omnia” in 1718.
Fig. 1.7
Giovanni Battista Morgagni (1682–1771)
Lorenz Heister (1683–1758)
Heister was the first to classify lacrimal disorders in 1753. He divided the disorders into four chapters namely: A tearing eye, tumefaction of the lacrimal system, an ulcer of the lacrimal system, and lacrimal fistule. The treatise published in 1753 was named “Chirurgische Wahrnemungen” [5].
John Louis Petit (1664–1741)
Petit explained the flow of tears in the lacrimal system and devised a grooved probe for exploration [6].
Sir William Bowman (1816–1892)
Joseph Hasner (1819–1892)
Hasner was an Austrian Ophthalmologist who contributed immensely toward lacrimal physiology, mechanics of flow of tears, and devised surgical procedures for treatment of lacrimal fistules. The distal most valve of the lacrimal drainage pathway is named after him.
Influencial Treatise That Paved the Way Early on
Descriptio Anatomica Oculi Humani
This treatise was published in Gottingen in 1755 by the famous German anatomist Johann Gottfried Zinn (1727–1759) (Fig. 1.9). He was among the earliest to describe complete anatomical course of the lacrimal drainage pathway.
Fig. 1.9
Johann Gottfried Zinn (1727–1759)
Observations on That Disorder of Corner of the Eye Commonly Called Fistula Lacrimalis
Published by Percival Pott (1714–1788), an English surgeon (Fig. 1.10) and one of the founders of orthopedics, this work of his was one of the earliest texts on lacrimal disorders.
Fig. 1.10
Percival Pott (1714–1788)
Chirurgische Wahrnemungen
This treatise was published in 1753 by Lorenz Heister (1683–1758) and was the first to classify lacrimal disorders into four separate subdivisions. Some of the surgical instruments and their design he published are legendary (Fig. 1.11).
Fig. 1.11
Surgical instruments of Lorenz Hiester (1683–1758)
Organic Lacrimalis Pretiumque Externum Oculi Humanos Description Anatomica
This treatise was published in 1797 in Leipzig by Johann Christian Rosenmüller (1771–1820) (Fig. 1.12). In comparison to Zinn’s work, this was very specific treatise only on lacrimal system with advance anatomical details.
Fig. 1.12
Johann Christian Rosenmüller (1771–1820)
Comprehensive Text on Lacrimal Disorders
Johann Adam Schmidt (1759–1809) was the first to bring out an influential treatise on lacrimal system in German and was published on copper plates!
History of Dacryocystectomy (DCT)
The earliest ways of dealing with lacrimal sac infections have been to burn or char it down with help of molten lead or iron [1, 2], which is practically destroying the lacrimal sac. The first refined way of surgical dacryocystectomy can be traced back to John Thomas Woolhouse in 1724 [8]. Johannes Platner (1694–1747) practiced Woolhouse’s technique and described DCT with trephination of lacrimal sac and cautery [8]. Most of these surgeries were incomplete and obviously unintentional because of incomplete knowledge of anatomical details. The modern DCT was described by Rudolph Berlin (1833–1897) (Fig. 1.13) in 1868 and he documented [8, 9] as follows:
