An ophthalmic retrospect / by Freeland Fergus.

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

Licence: In copyright

Credit: An ophthalmic retrospect / by Freeland Fergus. Source: Wellcome Collection.

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    It has specially sounded the death knell of treatment with strong caustic solutions, for it has been proved beyond possibility of reasonable doubt that a strong caustic solution, without killing the micro-organisms, destroys the protecting epithelium and allows the parasite to have a firmer hold. It has thus become established once and for all that an oil immersion lens is as essential an instrument for diagnosis in an ophthalmic clinic as is an ophthalmoscope, and should be used as freely. Biological pathology has there¬ fore come to play the chief role, not merely in affording us a method of accurate diagnosis, but also an invaluable aid in judging of the effects of treatment. As for treatment, I now personally rely entirely upon irrigation with normal saline in dealing with all forms of catarrhal conjunctivitis, the one exception being that I use zinc sulphate for the special form due to Morax organism. A pint of saline should be passed through the conjunctival sac at least once in four hours. By so doing the discharges are thoroughly removed, and the condition rapidly improves. Never again will I employ the strong nitrate of silver in specific purulent conjunctivitis. I have never seen good result from it, but very often an immense amount of harm. Some two years ago I read a very large number of essays on the subject of ophthalmia neonatorum, and was not surprised to find that one maternity clinic gave statistics of several thousand births in which not a single case of ophthalmia neonatorum had occurred, and in which no other precaution than thorough irrigation of the eyes with saline had been adopted. The prophylaxis, then, consists in washing, and not in the drug, which is held in the solution. Of recent years there has been the introduction into practice of certain substances which are known as organic salts of silver. Their use has been chiefly advocated by a Frenchman of the name of Darrier, and their introduction was heralded as a new epoch in ophthalmology. When I got his book I confess I was sceptical, for the simple reason that it contained mere statements of opinions concerning matters which might quite well have been put to an exact test. It seemed to me that in that work biological pathology had been thrown to the winds, and that we had returned to the crudest days of the worst empiricism. For¬ tunate^, I had working with me Dr. Muir Kelly, who was able to put the various salts recommended to accurate tests. I confess that in my own hands they had never given me much in the shape of results. I found that when solutions
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