The eye in its relation to health

I

A CRITIC is one who is skilled in judging of the merits of a work. He must be a connoisseur ; he must be an adept, before he is able to pass judgment of high value.

In this work many ideas are set forth that are entirely new. Many tests are suggested that may seem strange, and results recorded that appear incredible, but the value of these tests can not be determined without thorough investigation. Viewed from the standpoint of our earlier professional teaching and experience, the position I assume may seem to be wrong ; yet careful investigation as directed in this work will perhaps prove that new methods will produce new results. Some months or even a year and more ought to be spent in the experiments suggested in this work, for many of the changes sought are, at the best, slow, and the conditions with which we deal are at times obstinate and deceptive.

After investigation, I invite criticism. "Truth 7 o THE EYE IN ITS

is mighty and will prevail." This is the one sustaining thought to one who presents anything new to the world; and for appreciative and valuable criticism of this work I turn to those only who are possessed of careful, discriminating, strong, individual judgment, and whose conclusions are always based on a thorough investigation of facts.

However extensive the experience of any oculist may have been, I do not expect from him full concurrence in my opinions as a result of that experience ; and any judgment from that plane I shall deem in a great measure unfair ; but from such a source, after careful consideration of the methods I have suggested, I do expect concurrence, or, at least, fair criticism.

A perfect judgment can not be fairly arrived at by reading only a part of this work, for questions might suggest themselves on one page which would be satisfactorily answered by a continuous and careful perusal of all the pages.

A subject like the present, pointing toward advancement in the field of medicine, is too sacred to be trifled with by casual and inexperienced criticism ; but all honest inquiry regarding my methods I will cheerfully answer, hoping thereby to advance medical science.

I fully realize that many of the following statements may seem incredible; but they can all be practically demonstrated by carefully conducted tests in any suitable clinic, which is the only place in which to decide a question of so important a nature. Under suitable conditions, I shall be pleased to make these tests at any time. There seems to be little, if anything, left to discover concerning the laws of refraction in their application to defective vision. Helmholtz, Donders, Landolt and many others seem to have solved nearly every problem in matters of refraction and the application of glasses for correction of the same. Many ingenious methods have found their way into use for determining, both by objective and subjective examinations, the artificial aids to produce the most perfect vision. The acquisitions in this field are the result of many years of careful investigation, through all of which the tacit assumption has been, that, when the eye was so corrected and the function of vision at once more easily and perfectly performed, all that could be desired had been accomplished. Here is exactly where the greatest error has existed ; and it has lain so deeply hidden that it is not entirely strange that it has remained so long undiscovered. What misled us to the greatest extent was that, when the function of vision was perfectly performed, we rested in the belief that the eye was perfect ; but it did not occur to us that some eyes might be using an excessive amount of nerveio THE EYE IN ITS

impulse to bring about and sustain that perfect vision.

Long years of effort are made by defective eyes to perform the function of vision as perfectly as possible. When necessary, the nerve-centers innervate to their utmost power the various eye muscles, causing a change of shape in the crystalline lens, stretching muscles which were too short and shortening muscles which were too long, to enable the eyes to look in the same direction. These conditions are continued, and more or less sustained, from day to day through a period of many years. Thus, anatomical parts that were manifestly imperfect at birth meet with changes in shape that become more or less established, so that it is impossible at once to discover and correct the same by fitting such glasses as produce the most perfect vision. Such a procedure is often incorrect, inasmuch as it stimulates the maintainance of abnormal conditions that, as soon as possible, ought to be discovered and corrected. When all the facts are carefully considered, we can readily see that we may have more or less firmly fixed conditions, which will only recede gradually and thus permit the eye slowly to assume a normal state.

In a slight measure, the discovery of the action of atropine, hyoscyamine, and similar drugs on the eye, has taught us that the first manifest

RELATION TO HEALTH. ■ n

conditions that present themselves to us in latent hypermetropia are not what they seem. For instance, a spasm in the ciliary muscle often hides a great measure of the defect, making the eye appear more perfect than it really is. Similar hiding power may exist in any of the other ocular muscles and deceive us as to their true conditions. It is for this reason that many people experience great and repeated trouble in their endeavors to have their vision properly corrected. They pass on and on from one professional man to another, receiving from each a correction that proves but temporary ; and yet it is probable that each correction was made scientifically and fulfilled all needs that the eyes manifested at the time of each examination. Every oculist has had his troublesome cases of this kind.

The reason why greater uniformity of opinion has not existed concerning treatment through the sight centers, is that our observations have been, confined to more or less manifest defects, and these at best represent but a very small percentage of the disturbing conditions that may exist in the ocular apparatus. Defective eye muscles, which tend to cause the eyes to deviate from a normal position, were tested by various methods tending to destroy the fusion stimulus ; but these methods discover only a very small percentage of the existing abnormal conditions. The great majority of disturbing causes are not to be found in manifest defects of muscle balance. Some of the most serious conditions exist where the muscle balance is apparently perfect, the defect being a fixed abnormal innervation which is sustaining a perfect position of the eyes, and which continues to maintain it under all tests that rely on the artificial disturbance of fusion power (diffusion tests).

Further than this, in a large share of those cases where the deviations are manifest, the eyes are turned in exactly the opposite direction to that in which anatomically short muscles would turn them. For instance, a right eye with a short superior muscle, instead of being drawn upward, might tend downward to a considerable extent by the force of spasm. The nerve-impulse sent to the inferior muscle to enable it to hold the eye down level with its fellow, becomes, through resulting irritation, more than is necessary, and pulls the eye down beyond a balance ; so that the opposite eye will be the higher of the two under the diffusion test, because the abnormal impulse is permanent. It can readily be seen that the usual correction of an eye manifesting this reverse condition would prove injurious instead of beneficial. I have spoken at length elsewhere on this class of cases ; adverse results in them are strong reasons why we have not attained a more general success. Such results have failed to make the treatment impressive, and from the very nature of these cases as set forth in this work, it will be seen how unreliable any and all of such tests are, however complete and perfect their destruction of fusion power may be.

Again, eyes that are capable of prominently manifesting their defects are more or less at rest when not in constant use, whereas absolutely latent eye troubles find no such periods of relief. It is from the latter and the reverse class that the most serious nervous disturbances take their rise. The correction of muscular insufficiency or manifest irregularity must not be confounded with the idea of repressing abnormal innervation. One is not a modification of the other, nor do they bear the slightest resemblance to each other, though both methods of treatment are through the medium of the eyes ; and it would be as foolish to confound them with each other for this reason as it would be to confound various schools of medicine because the remedies are applied through the medium of the mouth.

Eye-strain, or excessive abnormal innervation of the eye muscles, depletes the nerve-centers. It also gives rise to brain irritation of varying degrees. Dispositions are altered by it ; character is forcibly changed ; mental faculties are impelled into channels of work that are anomalous. Into such an altered state these conditions may force a being as to make him appear to the world an entirely different character from what he otherwise would have been. So, if in time these disturbing conditions can be corrected, we may expect to see favorable changes in the physical, mental and moral parts of the individual.

Some very remarkable cures have followed the correction of defects in and about the eyes ; in fact, so wonderful have some of these changes been, that to the novice it seemed absolutely incredible that anything in connection with the eye could have been the real cause of the change; and, naturally, he turned in some other direction to account for the facts which were too stubborn to be denied. Generally what is called "mental-suggestion," in some of its forms, has been settled upon as the cause of these changes. Some persons have more or less belief in the efficacy of suggestion, or they would not turn to it as such a potent cause ; but suggestion as a curative power has been known under various names for ages. Gasner, a priest of Bavaria, was said to have worked some remarkable cures by laying on of hands. Hell, of Austria, claimed a wonderful healing potency in the magnet. Mesmer took his cue from the preceding claimant, and evolved what has been known for a century as mesmerism. About the close of the last century, the French Academy appointed a commission to investigate the principles involved in Mesmer's work. Benjamin Franklin was a member of that commission. The decision arrived at was, that whatever effects were produced were of a temporary character, and due entirely to suggestion. Hypnotism and braidism are simply other names for practically the same influence. There are other methods of more modern birth that owe whatever efficacy they possess to suggestion. I think all careful observers are ready to admit that there is considerable influence in suggestion, both for good and for evil, especially on weak, nervous people. The evil effect will prove the greater and more lasting of the two.

However potent suggestion may be, it has never been an aid to curative results through the medium of the eye ; on the contrary, it has been the most detrimental element in the way of its advancement. Suggestion is more effective in the shape of ridicule than any other form of its administration, for it is easier to depress than to elevate a failing life ; and such we have frequently seen sacrificed to the potent evil influence of suggestion. The strongest evidence of the true value of treatment through the eye is the fact that it has made all of its advancement through a storm of opposition and ridicule, the only argui6 THE EYE IN ITS

ments of the unenlightened. Suggestion cannot be said to have had any influence in lunacy and other states of lost minds that have been influenced and restored by eye treatment. Prisms in a certain position often relieve pain, and when reversed increase it ; yet the suggestion is equally potent in either position.

It is common and natural to cling to a belief in things and methods that have long been established, and in which leading men and authors concur; and, if the results of such following are universally perfect, more cannot be desired. But, when they fall far short of satisfaction, we are warranted and even impelled to search outside of established authority for the aid that it fails to give ; otherwise, science and art would never advance.

II

NO part of the living body is constructed in vain. Every minute portion has some particular office to perform. However simple or however complex any one of these parts may be, it is so constructed as to facilitate the work that it has to do. Each distinct part may be looked upon as a little engine which is put in motion by the application of the motive-force that enables it to perform its function. This motive-force is conveyed from the place where it is generated, through conductors called nerves, to the part where the function is performed; and, like the running of an ordinary engine, the character of the function is determined by the character of the motive-force supply. If the proper amount of steam is admitted to perform the function of the engine, the work is properly and evenly done. If too much steam is turned on, the engine runs too rapidly and is likely to do itself injury by over- work. If too little is applied, the running of the engine is very feeble and can be stopped by the slightest interference. If the steam is cut off entirely, the engine stops. Here we have a perfect analogy to all functions in the human or animal body. If the motive-force is just adequate to the necessities of the part, the function will be normal ; but, if the motive-force is in excess, the function will be erratic and unnatural, exhibiting disturbances which will be classified as some disease of the part, which will be of an active nature. If the motive-force is lacking in quantity and regularity, the result will be that the function will be very feebly performed, and some sluggish, indolent condition will follow, which will be classified as an inactive, indolent disease.

These changes, which are similar in all parts, can be easily noted and demonstrated in the action of the heart. In a state of perfect health, the nerve-centers are furnishing and sending to this little engine, impulses of motive-force which give rise to a regular, unvarying beat of about seventy impulses to the minute. Now, if the nerve-centers be excited in any way, the heart's action at once will manifest the change. A cry of fire, a terrific explosion, or the sudden consciousness of some important news of good or bad import, causes an excitement of the nerve-centers in which the supply of nerve-force is temporarily increased, and a larger amount than usual traverses the various nerves throughout the entire system. The heart's action becomes violent and rapid, manifesting the exact amount of change of motive-supply from the nerve-centers to the heart. We note the changes of action particularly in the heart, whereas the fact is, every function in the whole body is equally affected, but the change is not so manifest to our observation ; nevertheless, the alteration of function everywhere in the body is equivalent to the change in the motive-force supply. The nature of the function, whether it be normal or erratic, is a manifestation of the character of the motive-force supply, really giving us a perfect idea of the condition of the nerve-centers from which the force is proceeding. This would naturally lead us to the conclusion that all alterations of function ARE PRIMARILY CENTRAL IN THE NERVOUS SYSTEM.

Every organ in the body has special organic work to perform. Likewise, the various tissues of which the organ is constructed have functions to perform. Every little living cell, be it bone, nerve, muscle or any tissue, has a function to perform called assimilation. A cell of adipose or fat possesses the power to attract to itself carbon, hydrogen, and oxygen, or matter of its own kind, in just the proportions of which the cell is composed, and in quantity just sufficient to maintain the proper size of the cell : surrounding the cell is the cell wall structure, which is doing a separate work by drawing to itself matter of its own kind, but in different proportions to the cell within : again, adjacent to this is a cell of muscle, bone, periosteum or other structure, each attracting differently unto itself elements of its own kind, in just the proportions that each needs : and so on throughout all the various structures of the animal economy. These are all separate little functions.

The blood is simply a carrier of the food from which all the elements of the body derive their sustenance ; but it does not perform the multiple function to select, for the many cells of various kinds, their individual complex requirements. Each individual cell possesses the power to select by its polar forces that which it requires; and these forces are generated and sustained by nerve-impulse.

Each separate and individual part or organ of the animal economy has some special place or center in the nervous system that presides over it; some specific center where is generated the motive-force that performs the function of the part over which it has control ; and the manner in which the part does its work determines for us the condition of its motive center. A very few of these nerve-centers have been located ; yet a sufficient number to assure us that each function has, somewhere in the nerve-centers, a special place that is generating and sending forth that force which does the work.

We may look upon the brain as a series of dynamos that are constantly generating motive-

RELATION TO HEALTH.

force, and sending it out over the various conductors that we call nerves, which convey it to the place where the work is done. This force polarizes the cell structure, which then performs the work of attraction and repulsion.

i. Visual centers. 5. Complicated movements of hand,

2. Taste, smell and sexual feeling arm and leg.

(centrally located). 6. Coarse leg movements.

3. Hearing. 7. Coarse arm and leg movements.

4. Face, tongue and speech. 8. Coarse arm movements.

9. Writing images.

When the liver, kidneys, heart and other organs continue to perform their various offices in a healthy manner, the inference is that the motive-forces are being furnished accordingly ; but, whenever any of these organs begin to perform unnatural offices — generating abnormal secretions such as sugar, uric acid, etc. — we infer that abnormal motive impulses have supervened.

Normal secretions are the outcome of normal FUNCTIONS PERFORMED BY NORMAL IMPULSES.

Abnormal secretions are the outcome of

ABNORMAL FUNCTIONS PERFORMED BY ABNORMAL IMPULSES.

Each class of secretions is dependent on its characteristic motive-force. In other words, when a function becomes abnormal, it is not the part or engine that is at fault, it is always the motive-impulse which is responsible for the erratic work. For, even if the part itself through local irritation or injury, is caused to change its action, it even then does it by first sending the irritation to the presiding nerve-center, which reflects the impulse that causes the change.

When a bone is broken, the first natural, local changes that follow are pain and inflammation, which occur as follows : From the point of irritation caused by the fracture, an impulse is sent to the nerve-centers that preside over the part. They return their characteristic impulses to the place of injury, which at once establishes an inflammatory action at the place of rupture ; and this action involves the manufacture or formation of those products or elements needed to repair or heal the part. These are new, temporary functions. Without this communication from the injury to the nerve-centers and the corresponding return current, the fractured ends would never become reunited nor the injury repaired.

I have in mind a case of a railroad employe who was under my care some twenty-five years ago. Both bones in the lower part of the leg were broken and protruded through the skin. The fractured ends were properly adjusted. In a general way, he was an unhealthy man, with a very weak nervous system. After several days, the patient remarked to me, "I think you are a very good doctor for I have no pain in my leg." I said, "My dear fellow, that is just what does not suit me. I prefer that you should have some pain and inflammation." But it did not follow. For one hundred and forty days, I tried all the various methods known to get up an irritation in the part, after which I first discovered symptoms of the broken ends reuniting themselves. In this case, the delay resulted from the weak condition of the nerve-centers and their inability to respond by sending back to the injured part the proper nerve-impulse to establish the inflammatory action of repair. Never can work or function be performed without the appropriate application of some motive-force to perform it.

However brilliant an inventive genius may be in all other directions, he begins to lose his reason when he searches after perpetual motion, or a piece of machinery so constructed as to possess in itself the power to do the work or perform the function. Such an unfortunate genius generally ends his life in a lunatic asylum. As in mechanics, so in animal life, all effects have a cause.

III

SIGHT is not passive, it is an active function ; and, although we see apparently without effort and without volition, yet every moment of vision is costing its adequate amount of vital energy. True, we cannot say just how much energy is utilized in looking any given length of rime at any particular scene ; but we do know that many nervous persons are very much exhausted by the use of the eyes for a short time in an art gallery, where things of great interest are constantly attracting their attention. Some are more exhausted by one hour of such effort with the eyes than they would be by ten hours of manual labor; consequently the same amount of vital force that would be required for ten hours of labor, may be disposed of in one hour through the medium of the eyes. Now, if there be some defect in the construction of the eyes, the consumption of nerve-force will be much greater ; for example, a short superior muscle in one eye requires many times the amount of nerve-force to perform the function that the centers were ever intended to furnish. The function of sight may be as successfully performed as if the eyes were perfect, but only by an excessive call on the nerve-centers to maintain a balance between the two eyes ; in such cases the vision is sometimes of more than average sharpness. This extravagant waste might find a good parallel in the following : An electric plant is scientifically constructed for the purpose of running fifty arc lights ; each light utilizes a given amount of electric force that is generated at the electric center, and the fifty lights just use up what force the dynamo can easily generate. Now, in the place of one of these arc lights, if we place an electric motor which uses twenty times as much force as the light that it has displaced, the whole electric system will be disturbed, from the fact that the electric motor is utilizing more than its share of the motive-force ; consequently the other forty-nine lights in the circuit will not receive enough to perform their intended functions ; they will sputter, burn irregularly and feebly. We have here a state of affairs in our arc light system which may be likened to that form of nervous debility where the prominent feature is constant exhaustion, due to a lack of sufficient force of nerve-impulse. But in the animal economy, another condition may follow when the "dynamo" is over-taxed ; the nerve-centers may be excited to an irritable condition in which they generate an excessive amount of nerve-force, and then we have an excited or agitated form of nervous derangement ; and, whether it be general or localized, it soon wears out life.

Strictly construed the terms neurasthenia and nervous debility mean a weak or depressed nerve-force supply. They are sometimes carelessly applied (but are not properly applicable) to all nervous derangements ; for we often meet with nervous derangements that consist of an excessive supply of nerve-force, usually accompanied with more or less irritability, all functions in general being emphasized. The enormous assimilation in abnormally fat persons, and the excessive muscular development and activity in a class of phenomenal athletes, whose histories are short and generally end in some rapidly wasting disease, are extreme examples of that form of nervous derangement which consists of an excess of nerve-force supply and which should be called nenrosthenia. The term abnormal -innervation embraces both of these conditions.

Our fast ocean steamers can run nineteen or twenty miles an hour without excessive consumption of fuel ; but when the speed is raised to its highest possibilities, the last two, three or four miles are attained at a very extravagant increase in the fuel, the consumption being far greater in proportion per mile as well as resulting in a great strain throughout the ship. A ship is sometimes unable to sustain the highest tension that can be put upon her by her engines, in which case the good engineer turns off the excess or abnormal quantity of steam, slows her speed to an easy pace, and thus her life in the waters is lengthened many years. Likewise when we learn that some of our functions are being performed at an abnormally high tension requiring an extravagant amount of nerve-force to sustain them, which is rapidly wearing us out, we should suspend this high rate of function and conserve as far as possible our life forces, by removing the cause of the irritation and waste.

The nerve-centers are capable of generating a certain amount of motive-force or nerve-impulse and no more. Whenever the call upon the centers exceeds their ability to respond, the result is a disturbance somewhere. A large amount of motive-force is utilized in the function of vision even when it is performed under the easiest possible circumstances ; but when there are defects in the eye and its appendages, there is a still greater demand for nerve-force to bring about good vision.

Each nerve-center is intimately connected and in delicate sympathy, with all other centers of the nervous system. Any radical change in one center sends its characteristic influence throughout all.

Harmonious and pleasant sounds, picturesque scenes filled with things of beauty, loveliness and goodness, have the most marked influence over the nerve-centers in general and manifest themselves in the form of the body, the grace of movement and the sweetness of expression in the features. Such external influences have a tendency to produce, through the medium of vision, the perfect man and woman ; whereas the one who is reared amid scenes of crime and brutality, coarseness and privation, is so influenced in his whole physical being that, to the experienced eye, their marks are everywhere to be seen.

The reason husband and wife grow to look alike after living years in each other's company is, that they have looked so constantly upon each other's features, have been made glad by the same influences, have enjoyed the same sunshine, have met with the same sorrows and have been so often subjected to the same experiences, that their functions have become similar.

Now what particular portion of the nerve-centers should we expect to have the greatest influence in changing and controlling the general nervous system? Would it be one of the duller centers, or would it be the most acute and sensitive? We would reasonably look to the most sensitive as bearing the highest influence both for good and evil.

Of all the centers in the nervous system, which is the most sensitive, the most highly acute and the most constantly in use?

The answer is, that center in which the most positive impression is made by the lightest and most delicate touch or impact. Various parts of the body, for instance, the fingers, come in contact with a substance ; immediately there is an afferent impulse communicated to the nerve-centers that says, 'this is velvet, fur, wood, metal, hot or cold.' Again, substances of different flavors are taken into the mouth. When they come in contact with the nerves of taste (gustatory nerves) the afferent impulses from this contact convey to the nerve-centers the consciousness of the presence of lemon, orange, vanilla, etc., and the reflex of swallowing or deglutition follows. If the flavor be something which conveys to the nerve-centers a disagreeable or nauseous taste, the opposite reflex follows, and an effort is made to reject the offensive material instead of swallowing it.

The auditory center discriminates in all the delicate sounds known to music, in all the varieties of harmony and discord. The potent influence of music on the feelings of man and beast is well known.

Another sense equally or more delicate, is that of smell. The perfumes emanating from heliotrope, violet and other flowers can neither be weighed, measured nor analyzed, being so delicate and imponderable ; yet, the sense of smell produced by them is of a very positive nature.