The clinical value of bacteriology / by Freeland Fergus.

  • Fergus, A. Freeland (Andrew Freeland), 1858-1932.
Date:
[1905?]
Catalogue details

Licence: In copyright

Credit: The clinical value of bacteriology / by Freeland Fergus. Source: Wellcome Collection.

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    pathogenic micro-organisms are present. I have not seen a suppuration after an operation involving the opening of the eyeball for a very considerable time. With one exception, to be noted presently, if, on bacteriological examination, evidence of the presence of bacteria is not found, then the case will give you no trouble. As a rule, the conjunctiva will remain almost normally white. The one exception to be noted is that often tolerably acute inflammation follows operation where the patient is rheumatic or gouty, and I always approach such cases with some trepidation. Where you get the Staphylococcus albus, unless it be very abundant, you may operate with safety, but generally in such cases there is a good deal of external catarrhal disturbance after the operation, although I have never yet seen an eye lost from the presence of this parasite. Of course no amount of care will prevent the occurrence of intraocular haemorrhage and the escape of vitreous. They will probably give trouble alike to patients and surgeons till the end of time. Lastly, what new views as to treatment do we obtain from the modern theory as to the infectivity of conjunctivitis, and even of blepharitis, for of late many cases of this disease have been shown to be due to the diplo-bacillus of Morax ? All treatment must be viewed under two aspects, the prophylactic and the curative. In general medicine, prophylaxis has made enormous strides, with the result that several of the specific fevers are now almost never seen; even tuberculosis has decreased very much since the malady was definitely recognised as infectious. In the prophylaxis of a patient who has an inflammation of the conjunctiva, two points must be attended to—(a) If only one eye is affected, then care should be taken that the other eye is not involved; (b) those in attendance on the patient must be warned of their danger. As regards actual treatment, little if any progress has been made. No doubt many of the older remedies which were so much in vogue in the year 1879, when I entered the Glasgow Eye Infirmary as a student, have fallen into disuse, and new ones have taken their place. The question is, are these new preparations of greater utility than those which they have supplanted ? I think not. The whole attitude of mind of a certain French school which is sometimes copied in this country reminds me forcibly of the history of a series of patents to diminish the consumption of coal in steamers. The first improvement was to save some 50 per cent, of the fuel. This was immediately followed by another to save another 25 per cent. Four or five years later an enterprising engineer made an improvement to save an additional 30, and so on till the steamer at last must have been making coal at a very considerable rate. It seems to me that there is something analogous to this in so-called modern ophthalmic therapeutics. A few years ago somebody invented protargol, which is, as every-