What the President needs is a good bleeding

I so love 19th century medicine.

The first doctor to reach President Abraham Lincoln after he was shot in a Washington theater rushed to his ceremonial box and found him paralyzed, comatose and leaning against his wife. Dr. Charles Leale ordered brandy and water to be brought immediately.

Brandy -- good for what ails ya! Like massive head trauma!

Ophthalmology 100 years ago

I was interested to follow the story of Mrs. Patmore, the house chef in "Downton Abbey," (which, if you're not watching, you really should be). Toward the end of season 1, Mrs. Patmore was losing her vision to cataracts, to the point where she was making dangerous mistakes in the kitchen. Rather than fire her, her employer sent her to London for surgery, and she eventually returned able to see. What exactly was the procedure for dealing with cataracts in 1914?

I checked in with the closest available source: my father, an ophthalmologist. He informs me that cataract surgery was regularly done back then, but it was a pretty barbaric procedure compared to how it's handled today. There were no implants to replace the lenses, so doctors simply removed the clouded lenses and fitted the patient with thick glasses. Even this was usually an improvement over advanced cataracts, which blocked out most light. But the procedure of removing a lens from an eye was very dangerous: there were no sutures available for stitching up the eye post-operatively, patients had to remain perfectly still for weeks afterwards to allow the eye to heal (held in place by sandbags), and the chances of infections and other complications were very high. Nonetheless, Mrs. Patmore's prognosis was certainly possible, although if she's walking around without glasses in season 2, that will be a bit surprising.

Meanwhile, as a followup, where did lens implants come from? According to my father, it had to do with World War II ball turret gunners on bomber aircraft. It was common for the gunners to be hit by shards of the plastic from which the ball turrets were made, and occasionally these shards would wind up in the eyes of the gunners. Doctors at the time found that the eye was remarkably tolerant of the plastic shards and few infections developed. It was later theorized that such plastic could be molded into a replacement lens for cataract patients.