(3)
the blades of the lithotrite, or found in the urine ; but these cannot in any case be con-
sidered as a correct index of the size of the stone; for, living a mile away from the hos-
pital, I could not always superintend the collection of the fragments myself : moreover,
they were often buried in adhesive mucus or pus and very difficult to extricate, so that I
feel certain a great deal was lost. The actual number of times that this operation was
performed, on the five recorded cases, was twenty-eight.
Eye diseases .—These form a very large portion of our cases. Thus, among the
in-patients under the head of Cœcitas, we have 50, and under
Ophthalmia 23 admissions during the year, in all 73 ; among the out-patients, under the
same heads, 741,—in all 814. Thus eye cases of some kind or other form the largest
number of cases of disease of any single organ except the lungs. Their importance
therefore is great, not only on account of their number, but because the modern improve-
ments in ophthalmic surgery have opened a field of benefit to them, which in former
years was unknown. Of the 50 cases of Cœcitas, 25 were operated on for cataract. A
good many of the cases, however, were not cases of simple cataract, but of cataract com-
plicated with glaucoma or amaurosis. On such I operated sometimes, without hope of
benefit, at the wish of the patient. The operation which I have in every case performed
for extraction, since my return from England, has been the new one adopted by Bowman
and Crichett in London. It was in attending the practice of these two excellent oculists
that I became convinced of the superiority of this operation over the old flap extraction.
The details of the operation are given in full in the Ophthalmic Hospital Reports, volume
iv., page 315 et seq ., so that it will suffice here to state that a section of the cornea
is first made of not more than one-third its circumference, instead of half as in the old
operation. A portion of iris is then removed corresponding in length to the corneal
section ; next the anterior capsule of the lens is lacerated ; and lastly the lens itself
drawn out by means of a scoop introduced behind it. The main advantages of this
operation are, 1 st, that the section of a third of the circumference of the cornea has not
the tendency to open that the old section of half has ; on the contrary, coughing, vomit-
ing, or other straining efforts tend rather to close it ; hence chloroform can be used with
safety and the complete relaxation of the patient insured : 2 nd, that, a portion of the iris
being removed, corresponding to the length of the Corneal section, prolapse of the iris
cannot occur, this accident being one of the most fruitful causes of failure in the old
operation : 3 rd, the great care and complete quietude afterwards, so essential in the old
operation, are not necessary in the new.
One case occurred of this disorder on the face. It was of special interest to me,
Herpes Zoster of the Face. being the first of the kind I had met with in this country ; and
I have not seen any mention of it by Indian authors. Herpes Zoster, when it attacks
the face, affects the fifth nerve, and is limited accurately by the mesialline. Such cases
are worth recording, because they are liable to be mistaken for Erysipelas, and because,
in many of them, the cornea becomes disorganised, and blindness is the result. The dis-
ease is accurately described and several cases given by Mr. Jonathan Hutchinson in the
Ophthalmic Hospital Reports, vol. v., page 191, and one is re-
presented in Hebra's Work* published by the new Sydenham
Society. An abstract of my case is given as an appendix to this report.
Amongst the out-patients, a very considerable number have applied for relief on
account of optical defects of the eye, Myopia, Pressbyopia, &c.
These have been relieved by the proper selection of spectacles.
This I have been enabled to effect by means of a set of trial lenses which I brought out
from home ; the patients, in most instances, paying for the spectacles, which were procured,
at a trifling cost, from England.
Our capital operations were 66*; 9 of the cases died, 8 being lithotomy, and
one amputation of the leg. Some of the operations were of
considerable interest ; two of Syme's amputation at the ankle
joint by Dr. Brown, the first of these that have been successful at
this hospital ; also an amputation at the shoulder joint by Dr.
Eye diseases.
* Plate VIII.
Optical defects of the eye.
Capital operations.
* See foot-note in the nu-
merical part of this report.