The Indian operation of couching for cataractElliot, Robert Henry
History
The Indian operation of couching for cataract
Elliot, Robert Henry
Cataract -- Surgery -- India; Ophthalmology -- India -- History
Passing over four centuries, we come to an even more interesting
description of the operation from the pen of Bartisch of Dresden: “The
day being decided upon, on which the operation is to be performed, the
doctor who is obliged to, or who wishes to do it, must abstain from
wine for two days beforehand. The patient must also fast the same day,
and must neither eat much nor little till an hour after the operation.
Given the aforesaid conditions, try and procure a well-lighted room,
in which the patient may have everything necessary for going to bed
and remaining there, as he ought not to be taken to any place far off;
the nearer to bed the better. Set thyself on a bench in the light and
turn thy back to the window. The patient may be seated on a chair, a
stool, or on a box, before thee and near to thee; in any case he is
to be seated lower than thyself. His legs between thine and his hands
on thy thighs. A servant stands behind to hold the patient’s head.
The servant should bend a little, so that the patient may rest his
head against him (Fig. 1). When the patient is blind of one eye
only, the other eye should be bandaged with a cloth and a pad so that
he cannot see. Then take the instrument or the needle in one hand, so
that the right hand will be for the left eye, and _vice versa_. With
the other hand separate with great care the upper lid from the lower,
using the thumb and the first finger, so that thou canst see how to
direct the needle into the eye. When thou wishest to introduce the
needle, the eye must be turned towards the light and looking straight
at thee; also, I should make the patient turn his eye a little towards
his nose, so that thou canst use the instrument better and that thou
wilt not injure the small veins of the eye, but respect them. Direct
the needle straight and with attention over the membrane called the
conjunctiva, straight towards the pupil and uvea, at the distance of
two blades of a knife from the membrane called cornea or from the grey
that is in the eye. Hold the needle quite straight, hold it steady so
that it will not deviate or slip. Hold the needle and press it, and
turn it with the fingers in the eye with great gentleness, according
to the instructions you may gather from the figure, which shows an eye
in which the cataract has been taken away, while the other eye has
not been touched (Fig. 2). Hold the needle firmly while turning
it round, and be careful always to have the point towards the middle
of the eye, that it almost touches the pupil and the uvea; and not to
oscillate by any chance towards one side. When thou feelest that the
needle has penetrated into the eye, that it almost touches the pupil
and the uvea, and when thou hast proved to be really in the eye, hold
the needle securely and move it, letting it slip backwards and forwards
towards the pupil till thou art certain of being in the substance of
the cataract, which thou canst easily be sure of by the movement of the
cataract material.
Public-domain text, read in full here on John Shaqi.
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