Manual of ophthalmic operations / by F. P. Maynard.

  • Maynard, F. P.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Manual of ophthalmic operations / by F. P. Maynard. 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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    patients, like animals. Yet the author has operated upon several for cataract with success and with distinct benefit to their insanity. By choosing a quiet time, humouring their peculiarities and gaining their confidence, much may be done. General ansesthesia may be necessary in them, but it is better dispensed with if possible, as excitement may follow it and bandages may be torn off, etc. It is advisable to bandage one eye only as the lunatic is more likely to leave it alone then. Apart from actual insanity, many patients exhibit mental traits that are trying to the surgeon. The too willing is as difficult to manage and anticipate as tlie too phlegmatic patient, but the latter does better as a rule. Women make worse eye patients than men, unlike our experience of them in general surgery. Their curiosity and restlessness are greater and lead them into trouble, so that auto-infection is commoner in women —^among Indians at any rate. Deafness complicates matters and may lead to unexpected movements and disasters during operation. Diseases of the ear, nose and throat are important, and should be excluded, or recognized and provided against, or cured before the eye operation is undertaken. Death has occurred after cataract extraction, where there were nasal polypi shutting pus up in the upper meatus. General septicaemia followed and death. Short of this, the eye may become infected from disease in the nose, and some surgeons go so far as to spray the nares of all patients requiring corneal section, either by a mixture of Listerin, and Dobell's solution, or with equal parts of water and peroxide of hydrogen (de Schweinitz). It is unnecessary, except for aesthetic reasons, for patients to have baths before ophthalmic operations. Gifford,* whose commonsense in dealing with the essentials • Jour, of Amer. Med. Assoc., Oct. 3, 1903.