1911 BMJ (Clinical Research Edition)  
IT has beeni suggested to me several times tllat I shouLld publislh a description of the simple way in wlhiclh I remove an eye. It is as follows: The only instrtuments required are: An eye spectilul, a l)air of toothed fixation forceps, a smrall pair of bluntpointed scissors (straight or curved oI1 the flat), and a clirved nieedle threaded with fine iodized catgut. The l)atieft is anaesthetized. Unless the sutrgeonl be aimbidextrous, to remove the right eyeball he stands at tlhe head of the
more » ... e, anid to remove the left at the patient's left side. The speculum is inserted. The eyeball is grasped from above downwards with the fixation forceps rather more than one-third of ani inelh behind the ouLter margin of the cornea, a firm hol(d beilng talen of all the struictuLres down to the sclerotic and incluiding the tendon of insertion of the external rectus. This tendon is inserted inlto the globe 4 in. from the corniea. The hiold with the forceps is to be retained until the eyeball is removed. A firmii slip witlh the scissors, pressina their niose w-ell against the globe, divides the conjunctiva, Tenon's capsule, and gellerally miiost of the tendinouss fibres of the muscle. With additional snips the tendon is completely divided. One blade of the scissors is3 n:w puslhed well hlome under the conjunctiva, first above and then below the cornea, and that membrane is divided around and as close itp to the cornea as possible. No more conjunctiva thlani is necessary should Le removed in order that a plentiful lining mlay be left to the socket. By rotating the eyeball as far inwards as possible the optic nerve is brougciht close utp to the outer canthus, and is easily divided either ilear to or far back from the eyeball as circumstances nmay require. The eyeball can now be lifted well ouit betweei ii tlle lids, held apart by the speculum, with the forcels)s w l-hicil are still retaining their original lhold, and the variouS m11Uscles easily divided by the aid of sight at tlheiu insertions into the globe. The whole of this process frequentlv does -not occupy inore than onie minute. The bleeding is sta-uLnelied. The cut edges of the conjunctiva and s3ubjacent struictures are inow suturedl, beginnina at the inner side. After pulling the cut edges well out between tlhe d lids ith the forceps, the first stitch is inserted and tied. Bv keeping the thIread sufficiently taut with the left h Iiand the cut edges of the conjunctiva are Lept outside the-li(ds and the subsequent passages of the needle are greatlv facilitated. By passiiig the needle twice tlhrough tlle last loop before pulling it tiglht the end of the sututre is securled. The speculuin is now reemovedl. CatefuLl suituring prevents the formation of the troublesome button of granilation tissue v-luicli otlherwise forml-s. Mrod ificatiowq* 1. Tlle order of procedure nmay be reversc( I by (lividing tlhe internal rectus tendon first. 2. If it be desired to sew the cut tendoils of tlhe lateral straialht imiuscles togetlher alid those of the stuperior and infeLior straiglht niiuseles, to facilitate the process. each of tlie tendolns shouild be caught by a fine pair of catel forceps before division. TaIE fourteenithi Iinternation1al Antialcoliolic Conigress w-ill be leldk at Milan in 1913. THE twelnty-secoi(i congress of French-speaki-hg alienists and( nieurologists will be lheld at Ttiuis in April. 1912 (lst to 7tll). The following quLestions are proposed for discussioni: (1) Instinctive perversionis; (2) nervouis and miiental disorders associate(d w-ith imialaria; (3) assistance for Illiatics in tile colonies. THE total nulLmber of students of imiediciine in the several ntiniiversities of Switzerlan(d duiring the wiuter session of 1910-11 was 1,849. Of these 656 were Swiss, of whom 45 were,rwomen. Of the foreign stuldents 488 w%vere mnen and 705 womien. They were distributed as follows: Geneva, 584, of whoml 92 were Swiss, inclulding 4 w^omen; 492 were foreigners, of whoom 291 were women; Zilrichl. 432, of whom 160 w^ere womzen: Bern, 551, of wh]omz 156 werewoiiilen; Laulsanne, 299, of whom 126 were wom1en; BHasel, 183, of whloml 8 were womenv SEVENTY-NINTH ANNNUAL MEETING OF THE, titish pt ItR 5 CIt 10M
doi:10.1136/bmj.2.2654.1249-a fatcat:u7st3y5tirb2tkrxiiyvw3ha6u