An ophthalmic retrospect / F. Fergus.

  • Fergus, A. Freeland (Andrew Freeland), 1858-1932.
Date:
[1909]
Catalogue details

Licence: In copyright

Credit: An ophthalmic retrospect / F. Fergus. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    12/20 (page 10)
    But other changes have necessarily followed on this developinent which we owe to modern biological pathology. 1 he j)atient is no longer kept lying straight and stifi’on his back for days together with the view of preventing inflam- mation. >^o lunger is a s[)eeial diet considered to have anytliing to do with the liealing of an aseptic wound. W ithin reasonable limits he may have his ordinary food, and ^above all, it has abolislual what used to be fre(juent in Glasgow, and which I never saw done anywhere el.se, a preliminary iridectomy. Iiitis is not due to the pressure of the lens on the iris: it is due, and invai'iably so, to micro- organic invasion. Therefore, as two operations expo.se the eye twice to the risk of septic infection, the preliminary iridectomy seems to me a piece of grossly bad surgery, e.xcept when performed for the purpo.se of maturation. Betore 1 pa.ss from the di.scussion of the changes which have taken place in cataract extraction, I would like to mention that the Bresident of this Society, my friend, Jfr. Cluckie, has (juite recently obtained e.xcellen't results by what T think may tairly be called a form of snl)-conjunetival extraction. The operation as described by him to me seems a good one. It is done .so as to insure primai'y and immediate union of the conjunctiva, which, if it take place, the deeper structures can, as it were, heal up at their leisure, amply protected by the united conjunctiva from all risk of septic invasion. May I crave 5'our further indulgence briefl}’ to discu.ss two other matters, namely, the treatment of conjunctival inflam- matory affections and corneal ulceration ( The treatment of the former has undergone a radical change sitice it has become a recognised doctrine that all acute conjunctivitis is but the expression of the pre.sence of micro-organic life. That was a doctiine wholly unknown in my student days. It was well establi.shed that two forms of acute conjunctivitis were distinctly contagious, namely, granular ophthalmia and the purulent conjuncti\ itis which we now for the most part associate with the action of the gonococcus. But it never occurred to anyone in these days to consider that almost all inflamniatory conjunctivitis was highly contagious. Time and again I have looked up the te.xt-books of that ])eriod to find it attributed to such causes as the incidence of cold, bad ventilation, too much indulgence in tobacco and alcohol; luivcr a word was .said as to the proximate cause being the presence, of germs. The pathology which we learned was equally obscure ; it was of course entirely hi.stological. Films