Cataract extraction / by H. Herbert.

  • Herbert, H.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Cataract extraction / by H. Herbert. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    lint, soap, and carbolic lotion, i in 60, was made to suffice for the knife, scissors, speculum, and retractor. This practice was begun at a time when the work was less heavy than it afterwards became, when the assistants were untrained, and when we had only a small supply of instru- ments, and no sterilizer. The one set of instruments was used for the whole morning's work, and I had to be personally responsible for all details of any importance. The method proving reliable and on the whole satisfactory, it was con- tinued. But the few minutes of time wasted between one operation and the next could not be well spared, and on this account other arrangements were being made. The details may, however, be of use to others in circumstances such as ours. Details of Sterilization in the Flame.—To minimize the slow destruction of the iris forceps, and especially of the cysti- tome, by the repeated heating, the points of these instru- ments were allowed to remain in the flame for a period just short of that necessary to make them red hot. A trace of black oxidized metal had to be scraped off them occasionally. Since, as it happened, our tenotomy hooks and curettes had bone handles, these instruments had to be rapidly cooled after heating by being plunged into a bowl of carbolic solution. The irrigator nozzle held in the fixation forceps needed to be heated to a dull red before the first operation of the day, in order to burn away matter in its lumen. It was also cooled by immersion in the fluid to save time. Afterwards, between one operation and the next, the nozzle was not removed from the rubber tube. Only its tip was placed in the flame, the fluid being drawn back from it by a slight sliding movement of the finger and thumb which held the rubber tubing. It was only heated enough to give a hissing sound, when a little fluid was allowed to spurt through it to cool it again. Some of the nozzles used were rather short for this heating of their tips, while still attached to rubber tubmg. The interior of the tubing immediately beyond the metal got roughened after a time, and unless it w^ere cut away, small particles of rubber were apt to be thrown into the eye by the stream of fluid passing through. A few such particles were left in eyes, fixed by blood-clot, but they gave rise to no irritation, and were slowly absorbed. 4
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