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Although Lagrange advocated iridectomy in all cases in his first communication, he no longer judges the procedure to be necessary in all instances, reserving it for cases in which for any reason, such as hypertension, prolapse is to be feared.
In bad cases, it may be used with good effect several times during the day, and will be found equally beneficial in cases of prolapse of the rectum. The ice is to be retained in the rectum. These two terms signify one and the same disease; that is, a condition of the system in which the power of voluntary motion is lost.
We have found in a large number of cases in which an iridectomy has been omitted, that the results have been in no way inferior to those in which a piece of iris has been removed, provided always that no subsequent iris prolapse takes place.
This operation opens a large filtration passage for the intra-ocular fluids and the prompt healing of the wound with its mucous covering prevents prolapse of the iris. Under no circumstances must iris be left between the lips of the wound.
The tendency is a degenerative one a prolapse to ancestral methods of reaction, a dissociation or disintegration of the personality, a lack of control over more elementary activities.
Of the different anomalous positions of the uterus, most of which are acquired, the only one that will be mentioned is that of complete prolapse of the uterus. In this instance the organ may hang entirely out of the body and even forbid locomotion. Of 19 cases of hernia of the uterus quoted by Debierre 13 have been observed in the inguinal region, five on the right and seven on the left side.
This unfortunate maiden had been delivered while standing upright, with her elbows on the back of a chair. The child suddenly escaped, bringing with it the uterus, but as the funis ruptured the child fell to the floor. Wagner pictures partial prolapse of the womb in labor.
Upon incision of the prolapse intra-ocular hemorrhage occurred, causing nearly total blindness for two weeks. Vision is clearing fast and it remains yet to be seen what the final results may be. One buphthalmic eye trephined by myself gave good results.
The disease sets in suddenly; the animal trembles, staggers, falls and dies in a convulsion. Blood may be discharged from the nose and with the urine and faeces. In the abdominal form, abdominal pain, diarrhoea, prolapse of the rectum, bloating and doughy swellings in the region of the abdomen occur.
Of the cases with varying degrees of vision from hand movements to six-ninths all but one have either remained the same or shown some improvement. The one exception was an eye having six-ninths vision. A small button hole iridectomy was made; prolapse of the iris into the wound occurred four days later requiring incision.
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