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Relax and See
BOOK REVIEWS lessness is perhaps a somewhat too harsh verdict, but the disease itself is a violation of the old principle of "First, do no harm." It is perhaps fitting that this condition should have arisen in America where civilization is inclined to be somewhat wasteful of its re sources, and where the philosophy is rampant that if a little is good, a lot more is wonder ful. We chide our patients for taking twice the prescribed dose. We blast them if they take a lot of harmful and needless medications, and we become very disturbed when they poison themselves from any miscarriage of selftherapy. Yet here we are faced with a confession of having ignored one of the oldest doctrines in medical care and, in an effort to save the lives of many premature infants, have gone hogwild on oxygen therapy without considering the possibility that there might be some spe cific dangers to it. In many ways we may be creating a similar deluge for ourselves with wanton antibiotic therapy, and some of the other newer and as yet ill-defined therapeutic measures which we now have in our hands. It is incumbent upon us all then to profit from the experience of retrolental fibroplasia, and it should give us pause in the management of any new thera peutic tool. (Signed) W. A. MacColl, M.D. Seattle, Washington.
BOOK REVIEWS RELAX AND SEE. By Clara A. Hackett. (With Lawrence Galton.) New York, Harper & Brothers, 1955. 300 pages. Price : $4.00. P. T. Barnum made a comfortable living on the theory that there's a sucker born every minute. It seems evident that even in the United States—which owes its great material wealth, its low death rate, its low maternal mortality rate, its low rate of blindness, and its long span of useful, productive life to the
333
accomplishments of the physical and biologi cal sciences—there is still as great a market for mumbo-jumbo as in the most primitive parts of Africa. Clara Hackett claims that she has brought about vast improvements of vis ual acuity in 90 percent of 2,800 persons who have had such varied conditions as myopia, cataracts, glaucoma, optic-nerve atrophy, conical cornea, and macular degeneration. Al though she states that most of the latter patients, if not all, were at the same time under medical care, by implication she gives credit for any help the patient might have received to her exercises rather than to the medical care which they were getting. One wonders how many of the 40 retinitis pigmentosa cases she reports as improved by her exercises have also been reported as improved by the Filatov treatment-—it is not incon ceivable that some of these persons, grasping at straws, received both kinds of therapy at the same time. Possibly one should not begrudge Harper Brothers and the Bates cult the shekels they extract from the gullible. Yet there is obvious danger here to the eyes of our fellow Ameri cans. One shudders to think of the amblyopias which will be produced by having chil dren follow the Hackett-Galton treatment for strabismus, rather than proper care; and of the preventable blindness that will occur among patients with chorioretinitis and glau coma, if they rely on her exercises rather than on medical advice. According to the pub lisher's jacket blurb, Miss Hackett apparently has so far evaded the application of medical and optometric practice regulations. She calls her treatments "training," her patients "stu dents." It was Bates who developed most of the hocus-pocus Miss Hacket recommends, and she acknowledges her debt. She and Mr. Galton, "medical" columnist for Hearst's Cos mopolitan, are in error when they ascribe to Bates the idea that visual training can im prove sight and when they credit Bates with the "revolutionary idea" that it is the extra-
334
BOOK REVIEWS
ocular muscles which control accommodation, rather than the ciliary muscle. This erroneous concept was held by many physicians until early in the 19th century when Thomas Young observed the action of the ciliary muscle in a bovine eye. Other poorly trained practitioners before Bates held to this con cept, despite the great strides in ophthalmic science in the 19th and 20th centuries. Such laboratory work on accommodation as he did, Bates carried on largely on fish, and even nonmedicai physiologists who have studied accommodation have pointed out the vast difference between the process in fish and mammals. The idea of visual training, of course, ante dates Bates by many years. Most ophthal mologists have been puzzled and have felt frustrated by myopic patients who seem to have a lower degree of visual acuity than is justified by their refractive error. It is recog nized that some persons who have blurred vi sion from various causes fail to use such vi sion as they have to try to interpret the blurred image they see—they give up at once, rather than use the little cues and tricks which others find helpful. Serious students of visual training have followed the scientific method rather than a sectarian approach. The scien tific method involves accurate observation, thorough reporting of all factors which might bear on the results, the setting up of adequate controls so that an hypothesis may truly be tested, and integrity and absence of emotion in recording the findings. Those who have followed the scientific method have developed orthoptics as an aid in the total management of muscle imbalance, inadequate fusion, and the efficient, comfortable use of binocular vision. Although orthoptists have avoided the exaggerated claims of the Bates cult, there is no justification for the assertion in the foreword by Dr. William Gutman, a member of the American Institute of Homeopathy, that the principle of systematic exercise and training has been strangely overlooked in re lation to the visual function. It is significant that Hackett and Galton
ignore the findings of the Johns Hopkins and Washington University investigations of the claims for visual training in myopia. It is true that instead of devoting their years of preparation to a servile study of Bates, oph thalmologists study the function, chemistry, and microscopic anatomy of the normal and abnormal human eye; they learn to observe the function of the inner eye through the retinoscope, ophthalmoscope, slitlamp biomicro scope, and gonioscope. Not always trust ing their own observations, they make photo graphs of what they see and call on other disinterested scientists to check their findings. Possibly, Hackett and Galton see no merit in this kind of approach and therefore attach no value to ophthalmologic investigations of the results of visual training. On the other hand, I feel in studying the Hackett modifica tions of Bates' system—sunning, palming, the long swing, the lazy daisy swing, edging, blinking, and so forth—much as neuropsychiatrists must feel when asked to review works by phrenologists, or astronomers the writings of astrologers. In October, Coronet ran an article by Galton based on the Hackett exer cises, and followed the article with a page of barbed comments, by Oscar Wilde, among which was this reflection on Homo sapiens, "I can believe anything—provided it is in credible." Franklin M. Foote.
By R. Townley Paton, M.D. New York, McGraw-Hill Book Company, Inc., 1955. Cloth bound, bibliography. Price : $28.50. The advent of antibiotics, eye-banks, and improved surgical instruments has changed corneal transplantation from a mystifying, dramatic procedure done by only a few oph thalmologists to a practical ocular operation which can be done by any interested, welltrained eye surgeon. Dr. Paton's timely book will be a great aid to all ophthalmic surgeons KERATOPLASTY.
BOOK REVIEWS RELAX AND SEE. By Clara A. Hackett. (With Lawrence Galton.) New York, Harper & Brothers, 1955. 300 pages. Price : $4.00. P. T. Barnum made a comfortable living on the theory that there's a sucker born every minute. It seems evident that even in the United States—which owes its great material wealth, its low death rate, its low maternal mortality rate, its low rate of blindness, and its long span of useful, productive life to the
333
accomplishments of the physical and biologi cal sciences—there is still as great a market for mumbo-jumbo as in the most primitive parts of Africa. Clara Hackett claims that she has brought about vast improvements of vis ual acuity in 90 percent of 2,800 persons who have had such varied conditions as myopia, cataracts, glaucoma, optic-nerve atrophy, conical cornea, and macular degeneration. Al though she states that most of the latter patients, if not all, were at the same time under medical care, by implication she gives credit for any help the patient might have received to her exercises rather than to the medical care which they were getting. One wonders how many of the 40 retinitis pigmentosa cases she reports as improved by her exercises have also been reported as improved by the Filatov treatment-—it is not incon ceivable that some of these persons, grasping at straws, received both kinds of therapy at the same time. Possibly one should not begrudge Harper Brothers and the Bates cult the shekels they extract from the gullible. Yet there is obvious danger here to the eyes of our fellow Ameri cans. One shudders to think of the amblyopias which will be produced by having chil dren follow the Hackett-Galton treatment for strabismus, rather than proper care; and of the preventable blindness that will occur among patients with chorioretinitis and glau coma, if they rely on her exercises rather than on medical advice. According to the pub lisher's jacket blurb, Miss Hackett apparently has so far evaded the application of medical and optometric practice regulations. She calls her treatments "training," her patients "stu dents." It was Bates who developed most of the hocus-pocus Miss Hacket recommends, and she acknowledges her debt. She and Mr. Galton, "medical" columnist for Hearst's Cos mopolitan, are in error when they ascribe to Bates the idea that visual training can im prove sight and when they credit Bates with the "revolutionary idea" that it is the extra-
334
BOOK REVIEWS
ocular muscles which control accommodation, rather than the ciliary muscle. This erroneous concept was held by many physicians until early in the 19th century when Thomas Young observed the action of the ciliary muscle in a bovine eye. Other poorly trained practitioners before Bates held to this con cept, despite the great strides in ophthalmic science in the 19th and 20th centuries. Such laboratory work on accommodation as he did, Bates carried on largely on fish, and even nonmedicai physiologists who have studied accommodation have pointed out the vast difference between the process in fish and mammals. The idea of visual training, of course, ante dates Bates by many years. Most ophthal mologists have been puzzled and have felt frustrated by myopic patients who seem to have a lower degree of visual acuity than is justified by their refractive error. It is recog nized that some persons who have blurred vi sion from various causes fail to use such vi sion as they have to try to interpret the blurred image they see—they give up at once, rather than use the little cues and tricks which others find helpful. Serious students of visual training have followed the scientific method rather than a sectarian approach. The scien tific method involves accurate observation, thorough reporting of all factors which might bear on the results, the setting up of adequate controls so that an hypothesis may truly be tested, and integrity and absence of emotion in recording the findings. Those who have followed the scientific method have developed orthoptics as an aid in the total management of muscle imbalance, inadequate fusion, and the efficient, comfortable use of binocular vision. Although orthoptists have avoided the exaggerated claims of the Bates cult, there is no justification for the assertion in the foreword by Dr. William Gutman, a member of the American Institute of Homeopathy, that the principle of systematic exercise and training has been strangely overlooked in re lation to the visual function. It is significant that Hackett and Galton
ignore the findings of the Johns Hopkins and Washington University investigations of the claims for visual training in myopia. It is true that instead of devoting their years of preparation to a servile study of Bates, oph thalmologists study the function, chemistry, and microscopic anatomy of the normal and abnormal human eye; they learn to observe the function of the inner eye through the retinoscope, ophthalmoscope, slitlamp biomicro scope, and gonioscope. Not always trust ing their own observations, they make photo graphs of what they see and call on other disinterested scientists to check their findings. Possibly, Hackett and Galton see no merit in this kind of approach and therefore attach no value to ophthalmologic investigations of the results of visual training. On the other hand, I feel in studying the Hackett modifica tions of Bates' system—sunning, palming, the long swing, the lazy daisy swing, edging, blinking, and so forth—much as neuropsychiatrists must feel when asked to review works by phrenologists, or astronomers the writings of astrologers. In October, Coronet ran an article by Galton based on the Hackett exer cises, and followed the article with a page of barbed comments, by Oscar Wilde, among which was this reflection on Homo sapiens, "I can believe anything—provided it is in credible." Franklin M. Foote.
By R. Townley Paton, M.D. New York, McGraw-Hill Book Company, Inc., 1955. Cloth bound, bibliography. Price : $28.50. The advent of antibiotics, eye-banks, and improved surgical instruments has changed corneal transplantation from a mystifying, dramatic procedure done by only a few oph thalmologists to a practical ocular operation which can be done by any interested, welltrained eye surgeon. Dr. Paton's timely book will be a great aid to all ophthalmic surgeons KERATOPLASTY.