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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    Simple cultures upon Loffler's serum, supplemented oc- casionally by subcultures, supply fairly definite information. One would prefer not to operate, as we found we were doing in Bombay, in the presence of pneumococci or streptococci, orange or citron staphylococci, or diplo-bacilli, or even of numerous white staphylococci. Freeland Fergus^ is of opinion that the Staph, alhiis does not cause suppurations, or even iritis or irido-cyclitis, but if present in considerable quantity, almost invariably gives rise to conjunctivitis after operation. Had there been means and opportunity in Bombay, however, for carrying out bacteriological examinations at a sufficient interval before operating, the knowledge obtained would have been an embarrassment, and would have lessened the useful- ness of the hospital. We would have feared to operate in many cases even with the help of perchloride, and would have kept patients attending for outdoor treatment until many of them would have fallen into the hands of the couching quacks. Bacteriological examination would be appealed to more commonly did surgeons feel perfect confidence in the result. One fears to place implicit trust in a negative result, which may possibly, by some rare chance, be due to faulty technique. There is also the feeling that a few dangerous microbes may escape detection, lying in folds or recesses. Probably, however, such scattered organisms are of little account, for it is recog- nized that a certain dosage is required for the effective lodgment of pyogenic organisms in a wound. However this may be, it was curious that the one complication, presumably infecti\'e, which occurred among our fifty cases bacteriologically ex- amined (see later) was in an eye in which the test gave no warning of danger.! * Brit. Med. Joum., March, 1905. t It was one of our rare cases of occlusion of the pupil from iritis. But the iritis was not very severe ; there was neither much injection of the eye nor much exudation. The closure of the pupil came as a surprise, and was apparently largely due to the treatment being at first very mild. From the conjunctiva after perchloride irrigation only one colony of white staphylococci was grown, while the tube inoculated before irrigation furnished eight colonies of white staphylo- cocci and two small moist pits suggestive of early diplo-bacillary colonies, which, however, did not develop.