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L'éxtraction totale de la cataracte
CORRESPONDENCE
and he emphasizes the desirability of the ophthalmic physician himself em ploying the sphygmomanometer in conjunction with the ophthalmoscope. He would have the same fullness of de tail in description and explanation of an ophthalmoscopic examination as is usu ally allowed for a histological prepara tion. H e is outspoken in his criticism as to ophthalmoscopic details which he believes have escaped earlier writers. He offers a number of original and in dependent explanations of various phenomena observed in the retinal cir culation. Greatly in love with his subject, it is even possible that the author has over estimated or even misinterpreted the significance of some of the details which he describes. But his thesis is extremely well written, interesting, and likely to stimulate useful thought and investiga tion in a vastly important field of oph thalmology and of general medicine. W. H. Crisp.
689
ability. Certain precautions are neces sary in the selection of suitable cases; and Barraquer himself is quoted as ex cluding the following types of cases: young patients, with an excessively re sistant zonule (it is better not to do this operation before the age of sixty years) ; dislocated or complicated cata racts. It is to be remembered that hard, amber-colored cataracts have a large nucleus, that their extraction requires a larger corneal flap, and that they pass less easily through the pupillary sphinc ter. The surgeon should not attempt this new cataract operation until he has seen a number of such operations per formed. W. H. Crisp,
CORRESPONDENCE
Trachoma and its treatment To the editor: In concluding a most valuable article on the history of trachoma in this L'extraction totale de la cataracte. country, entitled " T h e Indian and the (Complete extraction of cataract). trachoma problem," in the June issue of Dr. de Saint-Martin, Toulouse, this Journal, the author, Dr. L. W e b France. Octavo, paper covers, 56 ster Fox, briefly speaks of the methods pages, numerous illustrations. Pub which he himself employs in the treat lished for the author by "Occi- ment of this malady. H e says: "My tania," Paris and Toulouse, 1929. preference is for the procedure known (Price not given.) as grattage. In this the lid is everted, De Saint-Martin is a wholehearted bringing into view the retrotarsal fold. propagandist of the method of Barra . . . . The granulations are then scarified quer for intracapsular extraction. This by a three-bladed knife, after which the monograph consists partly of addresses area is vigorously scrubbed with a bi given before various French societies. chloride of mercury solution on a tooth It is very well illustrated by drawings brush, and an antiphlogistic lotion ap of the capsulotomy operation, of plied." Smith's operation, and of Barraquer's Concerning the measures thus advo method, and also by some excellent cated there is such a diversity of opin photographs from a cinematograph film ion that it may be worth while to men by Gaumont. The author insists that tion a letter written by the late Profes with the Barraquer method operative sor Speciale Cirincione which appeared accidents are almost nonexistent, un in the Annali di Ottalmologia under favorable results extremely rare, the date of July, 1928. duration of postoperative care decidedly "In Italy," he said, "there are 300,000 shortened, and visual results equal to people who suffer from trachoma. They the best obtained by other methods, and consume but they do not produce. in a larger proportion of the cases. The There are many who, through enforced operation can also be resorted to at idleness, misdirect their energies and an earlier stage in the patient's dis add to the population of the slums and
and he emphasizes the desirability of the ophthalmic physician himself em ploying the sphygmomanometer in conjunction with the ophthalmoscope. He would have the same fullness of de tail in description and explanation of an ophthalmoscopic examination as is usu ally allowed for a histological prepara tion. H e is outspoken in his criticism as to ophthalmoscopic details which he believes have escaped earlier writers. He offers a number of original and in dependent explanations of various phenomena observed in the retinal cir culation. Greatly in love with his subject, it is even possible that the author has over estimated or even misinterpreted the significance of some of the details which he describes. But his thesis is extremely well written, interesting, and likely to stimulate useful thought and investiga tion in a vastly important field of oph thalmology and of general medicine. W. H. Crisp.
689
ability. Certain precautions are neces sary in the selection of suitable cases; and Barraquer himself is quoted as ex cluding the following types of cases: young patients, with an excessively re sistant zonule (it is better not to do this operation before the age of sixty years) ; dislocated or complicated cata racts. It is to be remembered that hard, amber-colored cataracts have a large nucleus, that their extraction requires a larger corneal flap, and that they pass less easily through the pupillary sphinc ter. The surgeon should not attempt this new cataract operation until he has seen a number of such operations per formed. W. H. Crisp,
CORRESPONDENCE
Trachoma and its treatment To the editor: In concluding a most valuable article on the history of trachoma in this L'extraction totale de la cataracte. country, entitled " T h e Indian and the (Complete extraction of cataract). trachoma problem," in the June issue of Dr. de Saint-Martin, Toulouse, this Journal, the author, Dr. L. W e b France. Octavo, paper covers, 56 ster Fox, briefly speaks of the methods pages, numerous illustrations. Pub which he himself employs in the treat lished for the author by "Occi- ment of this malady. H e says: "My tania," Paris and Toulouse, 1929. preference is for the procedure known (Price not given.) as grattage. In this the lid is everted, De Saint-Martin is a wholehearted bringing into view the retrotarsal fold. propagandist of the method of Barra . . . . The granulations are then scarified quer for intracapsular extraction. This by a three-bladed knife, after which the monograph consists partly of addresses area is vigorously scrubbed with a bi given before various French societies. chloride of mercury solution on a tooth It is very well illustrated by drawings brush, and an antiphlogistic lotion ap of the capsulotomy operation, of plied." Smith's operation, and of Barraquer's Concerning the measures thus advo method, and also by some excellent cated there is such a diversity of opin photographs from a cinematograph film ion that it may be worth while to men by Gaumont. The author insists that tion a letter written by the late Profes with the Barraquer method operative sor Speciale Cirincione which appeared accidents are almost nonexistent, un in the Annali di Ottalmologia under favorable results extremely rare, the date of July, 1928. duration of postoperative care decidedly "In Italy," he said, "there are 300,000 shortened, and visual results equal to people who suffer from trachoma. They the best obtained by other methods, and consume but they do not produce. in a larger proportion of the cases. The There are many who, through enforced operation can also be resorted to at idleness, misdirect their energies and an earlier stage in the patient's dis add to the population of the slums and