- Email: [email protected]
An Ophthalmic Council
EDITORIALS
important biochemical and biokinetic reactions? Its behavior under condi tions of inflammation, intraocular ten sion, toxic poisoning, bacterial inva sion, melanosis, sarcoma, sympathetic ophthalmia, traumatism, etc., not to mention the large group of hereditary and congenital variations and malfor mations, gives evidence of a field al most wholly unexplored. Its role in the causation of sympathetic ophthal mia is being watched, with keen in terest. The place which protein therapy should occupy in the treatment of ocu lar infections is a biochemical problem under investigation. While the evi dence in favor of its definite curative properties is convincing, protein ther apy seems to suffer most thru its pop ularity, since no doubt too much is claimed for it. Furthermore, authentic data are lacking to explain satisfac torily the complete mechanism of the protein reaction and the local effects now constantly observed. However, innumerable clinical and experimental reports of results from the injection of antidiphtheritic serum, milk, typhoid vaccine, tuberculin, etc., have stimu lated the search for the most highly potent nonspecific protein (vegetable, animal, or bacterial), and the most ef fective method of injecting it. But biologic specificity depends on chem ical individuality of proteins, and bio logic relationship is equally associated with the presence of chemically similar proteins. Glowing results have been the attraction in this problem, rather than the biochemical proof in explanation of them. Obviously, the opportunity here seems great. The unfolding of biochemical truths in medicine, as they may relate to the eye and perhaps may even be added to, thru the study of them in the eye, is a fascinating idea in process of achieve ment, which most of us anticipate and trust we may live to realize. B E N W I T T KEY.
461
AN OPHTHALMIC COUNCIL. There are many things which con cern ophthalmic practice and many social applications of ophthalmic knowledge, that are important to all people who rive under the conditions of civilization. It is desirable that the part of the medical profession that knows of these things, and is engaged in the practice of ophthalmology, should be able to formulate its knowl edge for public service and command the attention thereto of the general medical profession and the community. A body representative of ophthal mologists, that can carefully consider the matters of especial interest to all engaged in ophthalmic practice and can speak for them in public affairs, is to be desired. Such a body might well be one to which the general public could look for guidance in all matters concerning visual requirements, stand ards and conditions of ocular health. It could be made extremely useful in bringing unity of sentiment and giving definite form to conclusions by oph thalmologists in general regarding such matters. This has already been demonstrated by our British con freres. In Great Britain, after failure to in duce the government to appoint a board of experts to advise with ref erence to visual examinations and vis ual hygiene, the Ophthalmological Society of the United Kingdom and the Section on Ophthalmology of the Roy al Society of Medicine established, in 1920, the Council of British Ophthal mologists; composed of the past and present presidents of these organiza tions, four members chosen annually from each of them, and the master and two representatives of the Oxford Ophthalmological Congress. This body, acting in an advisory capacity, has made important recom mendations ; as to the teaching of oph thalmology to medical students, the es tablishment of special examinations for those intending to take up oph thalmic practice; with regard to visual standards for drivers of vehicles and others; notations of the axes of cylin ders, sight testing by opticians, admin-
462
EDITORIALS
istration of optical benefits, the man agement of contagious eye diseases, and other matters. The Council meets quarterly, controls its own organiza tion and appoints committees to inves tigate special subjects, including ex perts in other branches of science. While its recommendations have not always received the attention they de served, there can be no question that these recommendations and their publication have had an influence for good in some important matters. There is room and need for some such body representing officially the ophthalmic organizations of America. At the recent meeting of the Ameri can Medical Association, a half-dozen questions came before the Section on Ophthalmology that could profitably receive the attention of such a Council. North America has a greater popula tion, more oculists, a larger number of state, provincial and local govern ments to be advised, more problems to be solved, involving visual standards and visual conditions, than has the United Kingdom of Great Britain and Ireland. There are three separate organiza tions representing ophthalmologists; the American Ophthalmological Socie ty, the Section on Ophthalmology of the American Medical Association and the American Academy of Ophthal mology and Oto-Laryngology, that in clude in their membership and influ ence the more active and progressive ophthalmologists of North America. By joint action they have achieved very creditable results, thru the Ameri can Board for Ophthalmic Examina tions and in the Washington Interna tional Congress of Ophthalmology. It would seem easy and proper, thru these existing and already cooperating bodies to create, on lines similar to those of the British Council, a body that can speak with intelligence and authority on a class of problems, in solving which the general medical pro fession and the public could be greatly assisted by such advisors.
E. J.
W H Y T H E DOCTOR SHOULD WRITE. T h e average practitioner is usually satisfied to take the path of least re sistance. He studies his cases, and reads what someone else has to say with regard to interesting or rare dis eases, their course and complications, or summarizing the effects of treat ment. He may also be willing to at tend an occasional medical meeting, where he may brush up, to keep abreast with modern medicine. This holds good in ophthalmology. There is too small a percentage of producers in our profession. Many have the idea that some special talent is required. In this respect they should be disillu sioned. What it does mean, however, is more work, and thus in turn, more knowledge. Nor is it necessary that something new be presented. No one can prac tice ophthalmology for any length of time without encountering an occa sional case which presents a different view, either in its anatomic, physiolog ic, pathologic or clinical aspect. The advantage to the reader is in being able to more easily estimate the significance of such a condition from a larger num ber of reports, than from a limited ex perience. Furthermore to write a re port of a case might call attention to important details, which would other wise have escaped observation. T o the younger man who presents such a report the benefit is much the greater and more far reaching. It means that he must thoroly acquaint himself with the literature before pub lication, in order to make sure that the phase which he is presenting is not only unusual to himself, but to the profession as well. This cannot help but build up the knowledge of his spe cialty. Even if the case, or summary of cases, or supposed new idea has previously been set forth, it is not at all unusual, in searching the literature on a given subject, to acquire bits of knowledge hitherto unknown to us, on the same or even some quite dif ferent topic. While we do not mean to insinuate that only those who write are capable, we unhesitatingly state
important biochemical and biokinetic reactions? Its behavior under condi tions of inflammation, intraocular ten sion, toxic poisoning, bacterial inva sion, melanosis, sarcoma, sympathetic ophthalmia, traumatism, etc., not to mention the large group of hereditary and congenital variations and malfor mations, gives evidence of a field al most wholly unexplored. Its role in the causation of sympathetic ophthal mia is being watched, with keen in terest. The place which protein therapy should occupy in the treatment of ocu lar infections is a biochemical problem under investigation. While the evi dence in favor of its definite curative properties is convincing, protein ther apy seems to suffer most thru its pop ularity, since no doubt too much is claimed for it. Furthermore, authentic data are lacking to explain satisfac torily the complete mechanism of the protein reaction and the local effects now constantly observed. However, innumerable clinical and experimental reports of results from the injection of antidiphtheritic serum, milk, typhoid vaccine, tuberculin, etc., have stimu lated the search for the most highly potent nonspecific protein (vegetable, animal, or bacterial), and the most ef fective method of injecting it. But biologic specificity depends on chem ical individuality of proteins, and bio logic relationship is equally associated with the presence of chemically similar proteins. Glowing results have been the attraction in this problem, rather than the biochemical proof in explanation of them. Obviously, the opportunity here seems great. The unfolding of biochemical truths in medicine, as they may relate to the eye and perhaps may even be added to, thru the study of them in the eye, is a fascinating idea in process of achieve ment, which most of us anticipate and trust we may live to realize. B E N W I T T KEY.
461
AN OPHTHALMIC COUNCIL. There are many things which con cern ophthalmic practice and many social applications of ophthalmic knowledge, that are important to all people who rive under the conditions of civilization. It is desirable that the part of the medical profession that knows of these things, and is engaged in the practice of ophthalmology, should be able to formulate its knowl edge for public service and command the attention thereto of the general medical profession and the community. A body representative of ophthal mologists, that can carefully consider the matters of especial interest to all engaged in ophthalmic practice and can speak for them in public affairs, is to be desired. Such a body might well be one to which the general public could look for guidance in all matters concerning visual requirements, stand ards and conditions of ocular health. It could be made extremely useful in bringing unity of sentiment and giving definite form to conclusions by oph thalmologists in general regarding such matters. This has already been demonstrated by our British con freres. In Great Britain, after failure to in duce the government to appoint a board of experts to advise with ref erence to visual examinations and vis ual hygiene, the Ophthalmological Society of the United Kingdom and the Section on Ophthalmology of the Roy al Society of Medicine established, in 1920, the Council of British Ophthal mologists; composed of the past and present presidents of these organiza tions, four members chosen annually from each of them, and the master and two representatives of the Oxford Ophthalmological Congress. This body, acting in an advisory capacity, has made important recom mendations ; as to the teaching of oph thalmology to medical students, the es tablishment of special examinations for those intending to take up oph thalmic practice; with regard to visual standards for drivers of vehicles and others; notations of the axes of cylin ders, sight testing by opticians, admin-
462
EDITORIALS
istration of optical benefits, the man agement of contagious eye diseases, and other matters. The Council meets quarterly, controls its own organiza tion and appoints committees to inves tigate special subjects, including ex perts in other branches of science. While its recommendations have not always received the attention they de served, there can be no question that these recommendations and their publication have had an influence for good in some important matters. There is room and need for some such body representing officially the ophthalmic organizations of America. At the recent meeting of the Ameri can Medical Association, a half-dozen questions came before the Section on Ophthalmology that could profitably receive the attention of such a Council. North America has a greater popula tion, more oculists, a larger number of state, provincial and local govern ments to be advised, more problems to be solved, involving visual standards and visual conditions, than has the United Kingdom of Great Britain and Ireland. There are three separate organiza tions representing ophthalmologists; the American Ophthalmological Socie ty, the Section on Ophthalmology of the American Medical Association and the American Academy of Ophthal mology and Oto-Laryngology, that in clude in their membership and influ ence the more active and progressive ophthalmologists of North America. By joint action they have achieved very creditable results, thru the Ameri can Board for Ophthalmic Examina tions and in the Washington Interna tional Congress of Ophthalmology. It would seem easy and proper, thru these existing and already cooperating bodies to create, on lines similar to those of the British Council, a body that can speak with intelligence and authority on a class of problems, in solving which the general medical pro fession and the public could be greatly assisted by such advisors.
E. J.
W H Y T H E DOCTOR SHOULD WRITE. T h e average practitioner is usually satisfied to take the path of least re sistance. He studies his cases, and reads what someone else has to say with regard to interesting or rare dis eases, their course and complications, or summarizing the effects of treat ment. He may also be willing to at tend an occasional medical meeting, where he may brush up, to keep abreast with modern medicine. This holds good in ophthalmology. There is too small a percentage of producers in our profession. Many have the idea that some special talent is required. In this respect they should be disillu sioned. What it does mean, however, is more work, and thus in turn, more knowledge. Nor is it necessary that something new be presented. No one can prac tice ophthalmology for any length of time without encountering an occa sional case which presents a different view, either in its anatomic, physiolog ic, pathologic or clinical aspect. The advantage to the reader is in being able to more easily estimate the significance of such a condition from a larger num ber of reports, than from a limited ex perience. Furthermore to write a re port of a case might call attention to important details, which would other wise have escaped observation. T o the younger man who presents such a report the benefit is much the greater and more far reaching. It means that he must thoroly acquaint himself with the literature before pub lication, in order to make sure that the phase which he is presenting is not only unusual to himself, but to the profession as well. This cannot help but build up the knowledge of his spe cialty. Even if the case, or summary of cases, or supposed new idea has previously been set forth, it is not at all unusual, in searching the literature on a given subject, to acquire bits of knowledge hitherto unknown to us, on the same or even some quite dif ferent topic. While we do not mean to insinuate that only those who write are capable, we unhesitatingly state