Cases of irido-choroiditis, treated by division of the ciliary muscle : with remarks on the relative value of this operation and iridectomy / by Henry Power.
- Power, H. (Henry), 1829-1911.
- Date:
- [1864]
Licence: Public Domain Mark
Credit: Cases of irido-choroiditis, treated by division of the ciliary muscle : with remarks on the relative value of this operation and iridectomy / by Henry Power. 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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![1864.] Quarterly Report on Surgery. 545 VII. On the Ccesarean Operation. By M. Van Aubel. (Presse Med, Beige, Dec. 20th.) M. Van Aubel, in a communication to the Belgian Academy of Medicine, proposes a modification in the performance of this operation, which he believes, oy preventing the entrance of puafand blood into the cavity/of the peritoneum, will materially lessen the danger of peritonitis. First, an incision is to be made along the median line comprising only the skin and /fatty tissue down to the aponeurosis, from which tlfose layers are to be separated by careful dissec- tion to the extent of half-an-jnch. The aponeurosis, with the peritoneum, is next incised, and then the uterus, care being taken during the extraction of the child to maintain the two serous surfaces in contact. This accomplished, the visceral peritoneum is to be dissected to the extent of half-an-iuch, including with it as thin a layer as possible of the muscular substance, the two serous surfaces being kept closely applied to each other during the dissection, in order to prevent effusion of blood into the peritoneum. The wound and uterine cavity are to be cleansed with the greatest care. To the two dissected flaps of the uterus the sutures employed by Gely in wounds of the intestine are to be applied, serous membrane being thus brought into contact with serous membrane. The two lips of the divided/ peritoneum and aponeurosis are to be carefully brought into contact, and the two serous membranes united by means of the glover’s suture. The external wound is to be united by the interrupted suture, and dressed as an ordinary wound. In tin-, way the author believes adhesive inflammation and complete closure of the uterine and peri- toneal cavities may be secured. To the objection that the dissection required renders the operation more difficult, the author replies that with a liitle ad- ditional time all proves easy enough; but at present he only speaks from dissecting-room experience. VIII. On Glaucoma. gL By Dr. Leibreich. No. 152.) (Gaz. des Hop., 1863, In a lecture upon glaucoma, Dr. Leibreich thus expresses himself respecting iridectomy, about which we have had of late so sharp a controversy : “ I say that this procedure cures all forms of glaucoma, and that in this sense it has far surpassed the hopes of Von Graefe, announced at first with much caution; but I do not mean by that to say that by its aid we can cure every case of glaucoma, no matter at what stage the disease may have arrived. On the contrary, the prognosis is very different according to the period of the disease. Iridectomy induces the disappearance, why we know not, of the inflammatory symptoms and of the increased intra-ocular pressure; and the effect of the operation is the more striking in proportion as these symptoms are more marked. Perform it in cases of hyperacute glaucomatous choroiditis, without fearing to add an artificial lesion to an existing ophthalmia, and you will find all the inflammatory symptoms disappearing, and the well-nigh extinct vision returning to its normal state—a result not obtainable by the most energetic employment of every description of antiphlogistic. But you must not hesitate nor wait until the intra-ocular compression, cutting the continuity between the retina and the nerve, works its mischief on the papilla of the optic nerve. There are cases, happily not common, in which the effect of the disease is so violent that this destruction may be produced after some weeks; and in such cases it is of importance to perform the operation, if possible, during the early days, for every day’s delay exerts its effect upon the favourable result. In cases in which the inflammation pursues a slower course, after the operation you find the periodic exacerbations of the disease disappear, the patient](https://iiif.wellcomecollection.org/image/b2243611x_0013.jp2/full/800%2C/0/default.jpg)
