Ophthalmic Publicity

AMERICAN JOURNAL OF OPHTHALMOLOGY Published

Monthly

by the Ophthalmic

Publishing

Company

EDITORIAL STAFF DERRICK VAIL, Editor-in-Chief

S. RODMAN IRVINE

700 North Michigan Avenue, Chicago 11

9730 Wilshire Boulevard, Beverley Hills, California

WILLIAM H. CRISP, Consulting Editor

530 Metropolitan Building, Denver 2

DONALD J. LYLE

640 South Kingshighway, Saint Louis 10

IDA MANN

The Mayo Clinic, Rochester, Minnesota

WILLIAM A. MANN

904 Carew Tower, Cincinnati 2

LAWRENCE T. POST, Consulting Editor

87 Harley Street, London, W.l.

WILLIAM L. BENEDICT

30 North Michigan Avenue, Chicago 2

FREDERICK C. CORDES

384 Post Street, San Francisco 8

ALGERNON B. REESE

63 Harley Street, London, W.l

PHILLIPS THYGESON

SIR

73 East Seventy-first Street, New York 21

STEWART DUKE-ELDER

524 Sainte Claire Building San Jose, California

EDWIN B. DUNPHY

243 Charles Street, Boston 14

HARRY S. GRADLE

M. URIBE TRONCOSO

F. HERBERT HAESSLER

F. E. WOODRUFF

PARKER HEATH

ALAN

500 West End Avenue, New York 24

Sherman Oaks, California

824 Metropolitan Building, Saint Louis 3

324 East Wisconsin Avenue, Milwaukee 2

C. WOODS

Johns Hopkins Hospital, Baltimore 5

243 Charles Street, Boston 14

KATHERINE FERGUSON CHALKLEY, Manuscript Editor

Lake Geneva, Wisconsin

Directors: LAWRENCE T. POST, President; WILLIAM L. BENEDICT, Vice-President; WILLIAM A. MANN, Secretary and Treasurer; WILLIAM H. CRISP, FREDERICK C. CORDES, DERRICK VAIL.

Address original papers, other scientific communications including correspondence, also books for review to Dr. Derrick Vail, 700 North Michigan Avenue, Chicago 11, Illinois; Society Proceedings to Mrs. Katherine F. Chalkley, Lake Geneva, Wisconsin. Manuscripts should be original copies, typed in double space, with wide margins. Exchange copies of medical journals should be sent to Dr. F. Herbert Haessler, 324 East Wisconsin Avenue, Milwaukee 2, Wisconsin. Subscriptions, application for single copies, notices of changes of address, and communications with reference to advertising should be addressed to the Manager of Subscriptions and Advertising, 700 North Michigan Avenue, Chicago 11, Illinois. Copy of advertisements must be sent to the manager by the fifteenth of the month preceding its appearance. Author's proofs should be corrected and returned within forty-eight hours to the Manuscript Editor, Mrs. Katherine F. Chalkley, Lake Geneva, Wiscons'n. Twenty-five reprints of each article will be sup­ plied to the author without charge. Additional reprints may be obtained from the printer, the George Banta Publishing Company, 450-458 Ahnaip Street, Menasha, Wisconsin, if ordered at the time proofs are returned. But reprints to contain colored plates must be ordered when the article is accepted.

OPHTHALMIC

PUBLICITY

A t the recent meeting of the American Academy of Ophthalmology and Otolaryngology, there were two important contribu­ tions, the public and press reactions to which merit some comment. These t w o contribu­ tions both dealt with procedures which h a d been highly and luridly publicized in the lay press. Both contributions were largely nega­ tive in their conclusions. T h r o u g h the public relations officer of the Academy, t h e repre­ sentatives of the press were authoritatively 99

informed of the negative results. These nega­ tive conclusions, t h e results of long and p a ­ tient investigation, received, with one o r t w o notable exceptions, little o r n o comment in any of t h e newspapers, whereas the gaudy claims of t h e proponents of these forms of therapy, claims based on personal enthusiasm and unsupported by scientific investigation, had previously been heralded far a n d wide across the country by t h e various news agencies. T h e first of these contributions related t o

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EDITORIALS

the corneal-transplant operation. The care­ ful studies of the five speakers in the sym­ posium showed the operation to be one of lim­ ited applicability, of uncertain results, with many contraindications, and was especially contraindicated in patients with vision of 20/100 or better, where there was a greater chance of permanent blindness than of im­ provement of vision. At best, in the over-all statistics, only approximately one third of the patients undergoing this operation had material improvement of vision. It was quite true, however, that in specially selected cases, notably in keratoconus and slight central corneal scarring without undue vascularization, spectacular visual improvement, not pos­ sible by any other means, might be expected in a materially higher percentage of cases. The second contribution dealt with the results of tissue therapy and the administra­ tion of cod-liver oil in patients with pigmen­ tary degeneration of the retina, the so-called Filatov treatment. Here a careful investiga­ tion of the results of this treatment in a large number of patients failed to reveal any evi­ dence supporting the wide claims made by the proponents of this form of therapy. A limited number of the patients showed some slight subjective improvement in the usual level, but in no greater number and of no higher degree than had been reported with the other widely different forms of treat­ ment formerly proposed—vitamin therapy, sympathectomy, estrogenin and androgenin treatment, vasodilators, and reduction of the intraocular pressure. Objective examination of these patients, before and after treatment, showed little or no change in the visual fields or light adaptation. The conclusion appeared inescapable that, so far as this careful inves­ tigation was concerned, there was no evidence at hand to support the extravagant claims which had been so widely made. At first glance it appears surprising that the various news agencies, whose function it is to disseminate "news," and the lay press of the country, which should strive to lay pertinent information before the public in

readable form, exhibit little or no interest in negativev results. On thought, however, the answer appears easy. Negative results are not "news," and the publication of results invalidating already published claims is, at best, only a wet blanket and, at the worst, may precipitate on the heads of the pub­ lishers recriminations and even damage suits. A case in point which well illustrates this is the attitude recently taken by the Curtis Publishing Company. The question of var­ ious eye exercises for myopies had been widely publicized, and indeed apparently en­ dorsed by a number of prominent periodi­ cals. The Curtis Publishing Company had taken no part in this publicity, but neverthe­ less was deeply interested in its possible hu­ manitarian application and its publicity value. Through the agency of the editor-inchief of one of their major publications, they undertook to finance a thorough investiga­ tion of the possible beneficial results of such treatment. As a result of their offer, a joint investigation of this treatment was under­ taken by a group of psychologists and op­ tometrists on the one hand, and the team from the Wilmer Institute staff on the other. The Wilmer Institute team acted only as judges of any results observed. The results of this study, published in full in the medical press, were largely negative. These negative results were duly transmitted to the Curtis Publishing Company who, since they had fi­ nanced the psychology-optometry phase of the investigation, had just right for first publi­ cation after the reports had appeared in the medical journals. However, in as much as the results were negative, the Curtis Publish­ ing Company had no interest in publishing them or commenting upon them. They simply charged off their investment. The publication of the results, from their stand­ point, might only have touched off a contro­ versy, uninteresting to the great body of their readers, and in which they had no in­ clination to participate. Such a specialty as ophthalmology is par-

EDITORIALS ticularly susceptible to the ill results of mis­ leading publicity. The blind have an emotional appeal to the seeing world. Any form of treatment which promises to allevi­ ate or cure blindness is immediately of in­ terest to the general public, any claims sup­ porting such treatment find sympathetic ears, and any agency endorsing the proposed form of therapy finds ready supporters. In short such forms of treatment are interest­ ing and appealing "news," which the public is anxious to read and the press, therefore, correspondingly anxious to publish. While, undoubtedly, in many instances the publiciz­ ing of these unproven forms of therapy is animated by the most altruistic motives, nevertheless in other instances this does not appear to be true. It must regretfully be ad­ mitted that there are a few ophthalmologists who avail themselves of this sentimental ap­ peal for the purpose of self-advertising. Were the news agencies as industrious in circulating the results of investigations which disprove these spectacular forms of treatment, and the lay press as eager to print them as they are to publicize the original claims, it might well have a deterrent effect on the self-advertisers. Although the reaction of the press to negative results is understandable, the ques­ tion may well be asked—does it reflect a healthy interest in the public welfare and is it in line with the humanitarian motives which one would assume underlay the dis­ semination of information relating to these apparent cures? There the answer should be an unequivocal "No." As was pointed out in the discussion of the paper on pigmentary degeneration of the retina, mankind is afflicted with a host of maladies, often congenital or degenerative, about which the conscientious physician can do little or nothing. These unfortunates are constantly seeking for some relief or cure of these conditions for which they can obtain little alleviation from legitimate doctors. They are ripe fruit, ready for the plucking. As the late Sir William Osier once re­

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marked, "People love to be fooled, and the sons and daughters of Circe are still in our midst." When there is a demand, there is usually a supply. The publicization of un­ proven and often utterly fallacious remedies is followed by a deluge of inquiries on the doctors and medical centers for information as to their value. There must then ensue a long period of patient investigation to vali­ date or invalidate these claims. If the claims are validated, as is rarely the case, the fun­ damental investigator receives but scant pub­ lic recognition—the bulk of the glory goes to the proposer or instigator of the treat­ ment, to the man who thought up the dream. If the claims are invalidated, the investigator gets no thanks for his labors, and may often be the subject of attack in one form or an­ other. At the best the whole incident is quickly forgotten. The lay press cannot escape its responsi­ bility. If the press is willing to publish the unfounded and unproven claims of enthusi­ asts and self-advertisers, to give them wide publicity, and often to make them the subject of special articles and Sunday features, it should be equally willing, even anxious, to follow up the subject and give equal pub­ licity to legitimate releases of investigators which disprove the former extravagant claims. If false hopes are aroused in the minds of sufferers from untractable ailments by injudicious publicity, the same agents re­ sponsible for the publicity should do what they can to rectify their error. Only thus can their public duty be discharged. The present policy of exploiting sensational claims and soft-pedaling the results of in­ vestigations which disprove these claims, is playing into the hands of self-advertisers and, in some cases, of charlatans. Alan C. "Woods. ECLIPSE R E T I N I T I S On November 12th there occurred a par­ tial eclipse throughout the greater part of the United States. Along the Eastern Sea-