Panel ophthalmic practice / by A. Freeland Fergus.

  • Fergus, A. Freeland (Andrew Freeland), 1858-1932.
Date:
[1919?]
Catalogue details

Licence: In copyright

Credit: Panel ophthalmic practice / by A. Freeland Fergus. Source: Wellcome Collection.

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    B there is no legal qualification in ophthalmology, as, say, in dentistry. If a man is to be specially paid as an ophthalmic surgeon there is no reason whatever why care should not be taken to make sure that he has a special and reliable knowledge of what is one of the most scientific departments of the whole of medicine. Yet anybody at present can buy a case of testing lenses and call himself an eye specialist. I have no objection to that. Just as a medical practitioner can practise dentistry, so I think no medical practitioner should be prevented practising ophthalmology. But if a man is going to be paid by the State as a specialist in ophthalmo¬ logy, then I would make quite certain that he has had a special training. This training should begin even in his preliminary educa¬ tion. He ought, at any rate, to know enough of the elements of pure mathematics to be able to read text-books in ophthal¬ mology such as Helmholtz ; in other words, part of his pre¬ liminary school training must give him a sound acquaintance with such subjects as plane trigonometry, logarithmic arith¬ metic, the elements of analytical geometry, and even the elements of the calculus. Certainly if a man is going to teach the subject he must know these things. It ought not to be got up for examination, but should be part of his permanent store of knowledge. Then in addition to his medical curriculum I would put him through a ^special course very much as is done for the D.P.H. or a dental qualification. Three subjects are abso¬ lutely essential for an ophthalmic practitioner—viz., modern surgical pathology, physics—particularly the physics of light and of colour—and physiology. A great deal of modern ophthalmic work is operative. In 1891 I laid down and adhered to a rule with, I think, most beneficial results to my patients. When I first joined an ophthalmic hospital a large number of cataract operations went wrong from acute suppuration. I well remember one that I had in 1891, and I wondered from where the infection had come. I found the Staphylococcus aureus in the discharge from the eye that had gone wrong, and I also found the same parasite in the conjunctival secretion of the other eye, although apparently perfectly healthy ; I was obviously deal¬ ing with an auto-infection. From that day I have never operated on an eye without proper bacteriological investiga¬ tions, for the most part made by myself. About the same time also I introduced into my clinic for purposes of diagnosis the oil immersion lens. I would not allow any man to call himself an ophthalmic surgeon who was not able to make such investigations and who was not in the habit of doing so. I would expect, therefore, that an eye specialist avail¬ able for panel patients should be competent to do this work.