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Related post: cotton held over the eye to jirevent it. Inflammation followed
with closure of the pupil, vision being equal to perception of
light. Only one other patient h.ad any loss of vitreous, occur-
ring as the speculum was removed ; this one recovered with
good vision. One case, intended to be a simple extraction, was
iridectomized on account of the iris falling before the knife and
being wounded in making the incision. Vision ^ fj. Buy Primidone
During the after-treatment several slight accidents, such
as injuring the eye by the hand or striking it against ob-
jects, have happened, but none have been followed by
serious results.
In two cases there has been suppuration, besides the one
above stated, following discission. One was one of my first cases.
No antiseptic precautions were employed. Suppuration began
on the fifth day. The pupil was finally blocked by thick inflam-
matory membrane. It was afterward incised with DeWecker's
iris scissors, but the vision thus gained was soon lost by closing
of the pupil made. The other was in a case of simple extraction,
and began twenty-one days after the operation — after the pa-
tient was allowed out of the house. All sight for a time was
lost, but the vitreous, to which the suppuration was confined,
under atropine and constant hot, moist applications, cleared up.
Vision = f§ at the last examination without further operative
procedures. After the suppurative process had ceased, a Buy Primidone Online point
of iris was observed adherent to one corner of the corneal
wound. Whether a small portion of the wound failed to unite
thoroughly, giving entrance later to some pyogenic micrococci
or not, can not be stated positively, but such was my opinion.
To recapitulate, I have operated in all fifty-one times.
Forty-four of these have been successful in restoring use-
ful vision. Seven patients have not recovered vision. Of
these seven, two, although the operation was successfully
done, were not expected to regain any vision, on account of
other eye troubles. Two others had eyes with fluid vitreous,
and it was very doubtful if the blindness was due to the cata-
racts alone. However, these operations as performed would
not have been successful if there had been vision in the eyes.
Three cases were lost through causes directly connected
with the operation and treatment, and which possibly might
have been prevented — viz., one of dislocation of the lens.
one of suppuration, and one due to the effects of the ether
passing away too quickly. Of the fifty-one, eight were done
without iridectomy, of which none were Generic Primidone unsuccessful, and
forty-three with iridectomy, including all the complicated
cases and all the losses. Four per cent, of cocaine in a satu-
rated solution of boric acid was used in nearly all cases.
A UNIQUE FRACTURE OF THE PATELLA.
By C. R. PARKE, M. D.,
SORANTON, PA.
The case that I \vish to speak of is of interest to me
in that I had never seen anything of the kind before, and,
after seeing it, I was unable to find a similar fracture spoken
of in any of the works I was able to consult.
On February 16, 1893, I was called to see M. S., ITungarian
miner, aged twenty-two, single. On December 13, 1892, while
at work in the mines losiding coal into a little mine car, a car
from another breast came down the track, and his right leg was
caught between the two cars as they came together. The im-
mediate result of the accident was severe pain and inability to
walk. There was a severe contusion about the knee joint,
though the skin was not broken.
Extensive swelling immediately followed, and, upon the ar-
rival of a local surgeon, a diagnosis of " contusion and sprain
of right knee" was made. The treatment consisted of lini-
ments and lotions. The man improved so that he went about
the house, but was verj' lame and had but slight control over
the right leg.
Upon making ray examination on February IGtli, I found
the general appearance of the right knee similar to the left,
the only difference being that the right patella was not as
prominent as the left and seemed slightly lower on the leg. Pa-
tient was able to extend leg (by muscular force) very imperfectly.
Upon placing my hands upon the knee, I found the ligamentum
patellfe lax. The patella seemed complete in its entire circum-
ference, but three fourths of an inch above the superior border
I found the inferior border of another patella, which also
seemed entire in its circumference, with the exception of the
inferior border, which was nearly straight across. The surface
of this second patella was flat, however, not convex, as was the
lower one.
These two patella: seemed bound together by some kind of
ligamentous union. Upon grasping either of them firmly, I was
able to get my fingers under sufliciently to make out that they
were but about half the thickness of the normal patella. I
then realized the nature of the trouble. The patella had been
caught by its external and internal edges between the little
mine oars, and had been cracked throughout nearly its entire
circumference (the exception being jnst at the attachment of

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