Cases of hernia : with remarks / by James Spence.

  • Spence, James, 1812-1882.
Date:
[1845]
Catalogue details

Licence: Public Domain Mark

Credit: Cases of hernia : with remarks / by James Spence. 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.

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    with that of one eye, an operation is scarcely necessary when only one eye is affected with cataract. In young persons, however, it is of much importance to possess the vision of both eyes; on account of the greater exertion of them required, and the liability to be deprived of the sight of the other eye by injury or disease, when one is affected with cataract. It is therefore proper in such cases to restore the sight where one eye has become blind from cataract, just as we would operate on the left eye of an individual, after having restored the sight of the right. By operating on these cases without delay, the sensibility of the eye has not become impaired by disease; and I have generally found operations on young subjects more successful than those performed on patients more advanced in life. Besides, the deformity which the blind condition of one eye occasions is obviated, which, espe- cially in females, is of very great consequence. But the risk of a collapsed eye by an unsuccessful extraction should be avoided. There is an antiquated, though still popular, notion that a certain degree of maturity or ripeness of the cataract is necessary, before an operation can be performed. This notion, though wrong in theory, arrives at a correct conclusion; for, though not impracticable, it is improper to operate till the cataract is so far advanced as to deprive the individual of useful vision. Hence, partial or imperfect cataracts, by which the sight is not much im- peded, do not require operation ; and the phrase, “ unripe for an operation,” is better understood by the common people than any more lengthened and scientific explanation ; and it is, in one sense, a correct enough expression. § 3. Should both Eyes, if affected with Cataract, be operated on at the same time ? If the patient is in a favourable state of health for it, and if the operations are to be performed with the needle, both eyes may be operated on at the same time with propriety and success. By adopting this course, the patient is subjected to only one period of anxiety and of confinement, which are circumstances of impor- tance to all, but more especially to those who are delicate or much advanced in life. If, however, the patient does not seem from his constitution to be in a very favourable state for an operation,—if the weakening effects of after treatment upon a feeble frame be dreaded,—or if the operation to be performed is that of extraction, only one eye should be operated on at first, and the other some time afterwards. This mode of procedure subjects the patient to less risk, and we obtain the benefit of the experience afforded by the progress of his case, to guide us in the treatment of the second operation. Moreover, the treatment to which the patient is subjected after the first operation, generally forms a very excellent preparation for