On the use of the ophthalmoscope as a help to diagnosis in diseases of the nervous system / by John Ogle.

Ogle, John W. (John William), 1824-1905.

Date:: 1860

Credit: On the use of the ophthalmoscope as a help to diagnosis in diseases of the nervous system / by John Ogle. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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$June 9, 1860. retina. There was no increased sensibility to the (stimulus of light.” Such are the cases which I thought it would bej of interest and serviceable to bring forward as demonstrating the use of the ophthalmoscope in affections of the nervous system, hope I may, at a later opportunity, be permitted to adduce still others, and again perhaps to refer to the abo re as beinj still under observation. I will make no further comment on the results of the ophthalmoscopic examination in the above instances, so far as they are for any important deduction, excepting to draw special attention to the great sensitiveness of the retina (as the acute pain showed) in Case No. 4, that viz. in which there was paralysis cf the third cranial nerve on the right side. This symptom in such a case appears to be of great interest, and I do not recol ect. to have noticed it in any previous instance of this affection. In conclusion, I would observe that no doubt in some cases the application of the ophthalmoscope may be instrumental in diagnosing (a matter so difficult, but so necessary) between giddiness and other symptoms proceeding from actual organic change, and the same symptoms arising from disturbance in other distinct parts, as in the digestive organs, and, therefore, strictly sympathetic in character. Again, it ,may prove useful as a means of diagnosis, when it is doubtful (especially in children, parturient women, etc.,) whether such and such symptoms are owing to repletion or to defective and even sinking powers, just as the state of the fontanelles is looked upon as being a useful guide in such doubtful instances. Might not the entire subject be greatly furthered; and much light thrown upon it, by judicious experiments [on some of the lower animals; different conditions of the cerebral capillary system being artificially produced for [he sake of contrasting different conditions of the vessels of the choroid and retina ? 13, Upper Brook-street. ON A CONVENIENT NEEDLE FOR THE READY application op metallic sutures IN THE OPERATIONS OF CLEPT PALATE, VESICO-VAGINAL EISTT7L2E, Etc. By P. c. PRICE, Esq. 1 Surgeon to the Great Northern Hospital, etc. ° 316 engaged “ the rrai°™tion of de- arlsmS flom rest of development-such, for instance, as the deficiency of the soft portions of the roof of the mouth in what is commonly known as cleft or split palate ; or in the reparation of breeches of structure, as those resulting in permanent lesions of the female bladder, vagina and rectum, have often doubtless experienced the necessity of such mechanical instruments as would enable an easy per formance of an operation. Improvements in such necessitous instruments have by degrees been added to the operator's armamentarium; but still every addition seems to show the further necessity that exists for yet more useful mechanical aids. Since the introduction of metallic sutures (so ablv and forcibly recommended by Dr. Marion Sims) for the more efficient closure of the structures of the bladder, vagina etc the want of a suitable means of appliance has been ’more than ever needed. The ordinary curved needle set in a handle, and drUled with a smgle hole near its point is found inconvenient, for great difficulty is experienced in disengaging the metallic thread with which it is armed. To obviate* this °mconv”nience among other contrivances, was invented by, I believe a German, a needle with a moveable point, but still further perfection and simplicity was needed. A short while since Mr. Startm, in the columns of this Sournal, suggested the use of a tubular needle, which was a decided improvement and one that was quickly recognised. Still, however there seemed room for a more complete instrument to enable a free and ready application of the wire suture in cases rendered rf thelesion^tc14 °f management by reason of the position •While lately witnessing one of Mr. Baker Brown's skilful operations for vesico-vagmal fistula, I was struck with the inconvenience that resulted from the method of applying the ShLukTtUle ^Ch> m *lus instance, required a/extapair of hands to arm the needle after its insertion through the needleSUT d'7 mea*1S °{ the ordinalT grooved or tubular fn fho T dl?,pense with what I considered an impediment ^Jh ,e(1 usually scientific and clever operations, I have devised the needle figured below. It consists of a tubular needle, such as at first suggested, I believe, by Mr. Startm, set in a wooden handle, but irnrne- rf the C°,Imected therewith by a rod of metal, which is out °y0S? Plane common to both the needle and its handle. Wdth / a npper surface of the handle is a steel slide of the sliders backwd movement. At the front end button n. patch-spring, regulated by a small screw- The slide ■. ?lnunS the needle is thus accomplished :— louartt’ ‘Tb8 T°™g Tge °f an “ch “ ™ and one end of th teAa'™ aS f“ 0111° the handle as it will go ; one end of the metafile thread to be used is then inserted into aLg th?tube^i it“nTa ‘“T* its breech’ U Pushed wire that projects at P°int ; tbe P“di™ of spring, anS XteMeisereaTyCfof uT ^ * tbe Catcb' necessarf, ttaough^e^ip^o/th asfmutcl1 of the needle as is wire is made to uroiect . A6 stlcture to be closed, the shown by the dotted line tipth* tbe P°'.nt °f the “istrument (as has been much approved of by Mr. Spencer Wells Surgeons who are in the habit of performing certaffi nl *” opeiations on the perineum, etc. In cleft-nalate a* ^\a,stlc U1 operations about the genito-urinary part?,^this imeffie fc be found very advantageous, and will at once rendm TJ11 passing of metafile threads through the Ltaffis of flie soft Jess compficated proceeding. It has been my good loitune to have assisted for many years my friend Mr Fer- gusson m nearly all his numerous operations for split pklate; SHXf Pa'ate °p^> woudd^ave been Green-street, Grosvenor-square. Mi^re^ His bhth-day, as a mark of theh “ In the Crimea there were 28 deaths out nf « „ ■ amputations of the elbow-ioint and „f a, “ 33 primary articulations, 24 were fatal J Our of as 31- s0,c™dary dis- kuee there were 62 deaths.’ The same 00™“^““ °f the m M^eipeau's hands only$

On the use of the ophthalmoscope as a help to diagnosis in diseases of the nervous system / by John Ogle.

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