Page:Evisceration.djvu/8

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ative material which prevented the usual collapse, and enclosed a cavity which gradually filled with granulations and finally resulted in a stump which was fuller and more mobile than that following enucleation. Following the lead of this inquiry I was led from theoretical considerations, after cauterizing with carbolic acid, to pack the cavity of the eviscerated globe with pulverized iodoform.

The method which has been employed is to dry out the globe and, after pouring from a paper funnel into the cavity of the globe as much of the powder as it will contain, to tamp it with cotton on a cotton holder, making room for more of the iodoform, which also is to be lightly packed into the cavity. If packed too tightly the escape of the serum is impeded, and in that event, either forced to infiltrate into the orbit or extrude the plug of iodoform. Pursuing this process it has been observed in more than a dozen cases that the sclera remains partly distended by the iodoform, which may remain in position for several days or even weeks, in some cases.

In one case of recent injury in which I eviscerated, cauterized and packed with iodoform, on the following day no pain had been experienced and exceptionally no swelling had resulted. The patient was to notify me if he had any trouble. On the fifth day my assistant called and found that he had removed the bandage and taken a trip into the country. He subsequently objected to having the bandage reapplied, and was digging wells in another week. In his case a small plug of iodoform remained for three weeks and was finally crowded out by the encroaching granulations. An excellent stump possessing good excursion was the result. After three months, considerable shrinkage has occurred, but there is still a fair degree of prominence and good motion. In no