weak. In order to improve her health I gave her nourishing food and ferruginous tonics till the 23rd idem, when she was laid on the table for operation. The lens was extracted in the following way :? The pupils having been fully dilated with Liquor Atropiaj Sulph. (4 gr.? ^i) she was anfesthetised. The speculum was then adjusted and a Von Graefe's knife was made to enter the margin of the right cornea on a level with the upper edge of the pupil. The counter-puncture was made at an exactly made to cut opposite point and the knife carried upwards andwas reached. its way out before the corneo-sclerotic junction The incision was thus confined entirely to the cornea. A portion of the iris was then pulled out and snipped off. Von Graefe's cystotome was then introduced and the lenscapsule lacerated. The curve of a curette was then gently pressed against the lower portion of the cornea and slided upwards. The lens slipped out. A piece of muslin wetted in cold water was then laid on the closed lids of both the eyes. Over this a few pledgets of cotton, also wetted, were laid, and the whole secured with a
bandage.
hour 10 minims of Tinct. of opium were given : the changed night and morning. On the 3rd day the lids were opened and the wound was found in a veiy satisfactory condition. On the 7th day a green shade was put before her eyes, and on the 5th of December she left the hospital with a sight sufficient for ordinary purposes. Before the operation she could not go out of her house without the aid of some person, but now she goes about in the bazar with nothing but a stick in her hand. Ilcmarlts.?I took charge of the Srinagar Dispensaiy in October last. As the patient was much out of health and advanced in age, I was unwilling to make her my first " eyecase." But I thought I was not justified in sending her out of the dispensaiy without making an effort to restore her sight. The operation above described, 1 had seen performed several times in the Lahore College Hospital by Dr. J. B. Scriven. It differs from Von Graefe's operation in the following points : 1. The puncture and counter-puncture are made in it lower down than in Von Graefe's operation. 2. The incision is confined entirely to the cornea, whereas in Von Graefe's operation the sclerotic is encroached upon. This operation is fully described in Lawson's " Diseases and Injuries of the Eye," 3rd edition, page 141. The advantages of this operation over Von Graefe's are?(a.) that only a small piece of the central portion of the iris is excised ; (b.) that it very rarely prolapses through the corners of the incision, and (c.) that the danger of cystoid cicatrix, which sometimes happens after Von Graefe's operation (owing to the incision extending to the sclerotic) is avoided. In my next cataract case I shall simplify the operation by giving up the use of the cystotome and lacerating the capsule of the lens with the point of the knife as it traverses the anterior chamber. I request my professional brethren to try this operation and publish the results. After
bandage
SRINAGAR
DISPENSARY,
[Cases reported by Senile Cataract :
GURHWAL.
Assistant-Surgeon Ohdedar]
Extraction
Method;
op
MoHKNDRA Natii
Lens by Lawson's
Cure.
P.inna, a Hindoo female, a^e;l between GO and 70 years, was admitted into the Srinagar Dispensary on the 18th of November 1879. For the last five years she had completely lost the use of her eyes owing to senile cataract. She was very
an
was
Elephantiasis of the Labia Majoka : Removal : Cure. Bhan Mati, a Hindu female, aged 23, was admitted into the Hospital on the 28tli November 187!). She first noticed a slight enlargement of her external labia three years back. They continued to increase in size gradually, with no pain, but only a feeling of drawing down when she stood up or walked about. The labia, on examination, were found to be enormously enlarged and tubcrc dated on the external surface?each labium looked not unlike a hemisphere of the brain. The opposed surfaces were at points ulcerated. She could walk only slowly and with her legs wide apart. Both the groins were affected with Erythema Intertrigo. The very same day she was laid on the operating table. All preliminaries having been arranged, a semi-lunar flap was raised from the outer surface of each labium. The labia were then removed. Altogether seven ligf, ures were required. The flaps, for a certain distance at tlieii upper part, were joined to each other by means of iron /ire sutures, and at their lower part to the contiguous margins of the vagina. The wound was dressed with Carbolic oil and lint. A female catheter was passed into the bladder and secured by means of tape in order that the urine might not irritate the raw surface. The antiseptic dressing was continued and the wound healed kindly. She left the hospital on the 22nd of December. The right labium weighed 1 seer 5? cliittacks, the left 1 seer 2^ cliittacks; they have been sent to the Lahore
Medical College Museum.
Srinagar,
15th
January
1880.
bandage.
hour 10 minims of Tinct. of opium were given : the changed night and morning. On the 3rd day the lids were opened and the wound was found in a veiy satisfactory condition. On the 7th day a green shade was put before her eyes, and on the 5th of December she left the hospital with a sight sufficient for ordinary purposes. Before the operation she could not go out of her house without the aid of some person, but now she goes about in the bazar with nothing but a stick in her hand. Ilcmarlts.?I took charge of the Srinagar Dispensaiy in October last. As the patient was much out of health and advanced in age, I was unwilling to make her my first " eyecase." But I thought I was not justified in sending her out of the dispensaiy without making an effort to restore her sight. The operation above described, 1 had seen performed several times in the Lahore College Hospital by Dr. J. B. Scriven. It differs from Von Graefe's operation in the following points : 1. The puncture and counter-puncture are made in it lower down than in Von Graefe's operation. 2. The incision is confined entirely to the cornea, whereas in Von Graefe's operation the sclerotic is encroached upon. This operation is fully described in Lawson's " Diseases and Injuries of the Eye," 3rd edition, page 141. The advantages of this operation over Von Graefe's are?(a.) that only a small piece of the central portion of the iris is excised ; (b.) that it very rarely prolapses through the corners of the incision, and (c.) that the danger of cystoid cicatrix, which sometimes happens after Von Graefe's operation (owing to the incision extending to the sclerotic) is avoided. In my next cataract case I shall simplify the operation by giving up the use of the cystotome and lacerating the capsule of the lens with the point of the knife as it traverses the anterior chamber. I request my professional brethren to try this operation and publish the results. After
bandage
SRINAGAR
DISPENSARY,
[Cases reported by Senile Cataract :
GURHWAL.
Assistant-Surgeon Ohdedar]
Extraction
Method;
op
MoHKNDRA Natii
Lens by Lawson's
Cure.
P.inna, a Hindoo female, a^e;l between GO and 70 years, was admitted into the Srinagar Dispensary on the 18th of November 1879. For the last five years she had completely lost the use of her eyes owing to senile cataract. She was very
an
was
Elephantiasis of the Labia Majoka : Removal : Cure. Bhan Mati, a Hindu female, aged 23, was admitted into the Hospital on the 28tli November 187!). She first noticed a slight enlargement of her external labia three years back. They continued to increase in size gradually, with no pain, but only a feeling of drawing down when she stood up or walked about. The labia, on examination, were found to be enormously enlarged and tubcrc dated on the external surface?each labium looked not unlike a hemisphere of the brain. The opposed surfaces were at points ulcerated. She could walk only slowly and with her legs wide apart. Both the groins were affected with Erythema Intertrigo. The very same day she was laid on the operating table. All preliminaries having been arranged, a semi-lunar flap was raised from the outer surface of each labium. The labia were then removed. Altogether seven ligf, ures were required. The flaps, for a certain distance at tlieii upper part, were joined to each other by means of iron /ire sutures, and at their lower part to the contiguous margins of the vagina. The wound was dressed with Carbolic oil and lint. A female catheter was passed into the bladder and secured by means of tape in order that the urine might not irritate the raw surface. The antiseptic dressing was continued and the wound healed kindly. She left the hospital on the 22nd of December. The right labium weighed 1 seer 5? cliittacks, the left 1 seer 2^ cliittacks; they have been sent to the Lahore
Medical College Museum.
Srinagar,
15th
January
1880.
