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Eyes and Industry
126
BOOK REVIEWS
the cell type changing very definitely with the chronicity of the illness. A reported "count within normal limits" is misleading. The inoculation of spinal and other fluids into laboratory animals produces a nonrelated entity (J. Path. & Bact., 33:463, 1930) differing entirely from the original disease. X-ray therapy may be of some value early in the disease, but is apparently of no help in the chronic phase. The purpose of this communication is to endeavor to show that the etiology of the syndrome of deafness and interstitial keratitis is viral. Once having recognized this etiology the treatment becomes important particularly in avoiding certain procedures. The patients seem to fare much better when the treatment is less dramatic and not ex perimental. (Signed) Emanuel Rosen, Newark, New Jersey REPLY TO DR. ROSEN
Editor, American Journal of Ophthalmology: Thank you for forwarding Dr. Emanuel Rosen's letter. I find it quite interesting from several viewpoints. Initially, I might state that the patient was treated and the case re port prepared for publication prior to the publication of Dr. Rosen's articles. I fail to see, however, that the course of treatment would have been altered, since no original therapy has been offered by Dr. Rosen. That the etiologic factor might possibly be viral in character is by no means new since Cogan (Arch. Ophth., 33:144-149, 1945) before 1945 was working along such lines. Our animal studies were undertaken after consultation with the department of pathology of the Cleveland Clinic and the virus laboratory of Western Reserve Uni versity. It was felt that by such investigation a factor might possibly be isolated against which more specific therapeutic measures could be directed. The patient was treated with all of the antibiotics and supportive measures known at that time, in addition to X-ray therapy to
the head. The authors of the only cases presented in the literature at that time, Co gan, and Mogan and Baumgartner (West. J. Surg., 42:628, 1934) were consulted con cerning treatment of the case. In addition, the patient was presented at joint staff meet ings of the neurology and neurosurgical de partments. His case was followed by the members of the E.N.T., eye, medical and X-ray departments. In 1934, Mogan and Baumgartner reported such a case which they felt was markedly relieved by cervical sympathectomy. In summary, we had a young man with advanced keratitis and rapid loss of hearing. One would have expected his course to fol low that of practically all of the cases to total deafness, the remarkable exception be ing Mogan and Baumgartner's case. In view of the unsatisfactory response to other therapeutic measures, it was decided that the problem should be presented to the patient and his family. This was done, and it was stressed that the procedure might very possibly not relieve the symptoms and that it had been tried in only one case. Un der those conditions the cervical sympathec tomy was performed. Whether the return of hearing was initiated or aided by the op eration is indeterminable, but we have all been encouraged thereby, and also by his subsequent course. (Signed) R. A. Donald, Fresno, California
BOOK REVIEWS By Hedwig S. Kuhn, M.D. St. Louis, C. V. Mosby Company, 1950. 378 pages, 151 illustrations. Price: $8.50. Dr. Kuhn has collected in this book a comprehensive statistical and medical re port of the literature on file with the Joint Committee of Industrial Ophthalmology. To this literature she has added her own ob servations and opinions. The first four chapters pertaining to vis ual testing, skills, standards, and corrective EYES AND INDUSTRY.
127
BOOK REVIEWS programs are idealistic but do form a definite program of progress toward which the safety engineer and the ophthalmologist may work. Chapter five was contributed by Dr. Al bert C. Snell and is written in his own inimitable style. This chapter covers eye injuries caused by solid bodies in minute detail and should be required reading and practice by all ophthalmologists doing in dustrial work. Chapter six concerns radiation injuries and is an excellent summary of all data pub lished to date concerning this serious and painful form of injury. Chapter seven deals with chemical eye injuries and here the author has allowed her enthusiasm over a new drug to bias her opinion. The implication in this chapter is that hydrosulfosol has the uncanny magic of rapidly curing any and all types of chemical burns. On page 231, strict ad herence to the basic principle of denuding is advised as the first step; yet under pro cedure on page 232, this important step is notably missing. Chemical burns, after all, do have individual characteristics and their treatment should be more individualized than the author has indicated. Eye protection and illumination are well covered in chapters eight and nine and these two chapters provide an excellent handbook for guidance in approaching these problems. Dr. Kuhn is to be commended on her treatment of the problem of the blind in industry. It certainly is a step toward render ing obsolete the criticism of Dr. Meyer Wiener that "more has been written about the problem of the blind and less done about it than any other subject." Under the headings of miscellaneous and appendix there is a wealth of information touching all of the subjects of interest to the industrial ophthalmologist. Of particular value in this book are the complete lists of references on every subject, compiled at no small effort. The possessor of this book practically has a Cumulative
Index at his hand in so far as industrial ophthalmology is concerned. A well-done index completes this fine book. Ralph S. McLaughlin.
SOME RELATIONS BETWEEN AUDITION. By J. Donald
VISION
AND
Harris, Ph.D. Springfield, 111. Charles C Thomas, 1950. Clothbound, 56 pages, including bibliog raphy. Price: $1.50. The eyes and ears both collect and sort out impinging stimuli, and though they are derived from different germ layers and handle quite different spectra, the functional organization of the auditory and visual nerv ous systems is similar. In both organs, sen sitivity is almost at theoretical limits. Nei ther ever produces true zero sensation. In the absence of an external stimulus the eye reports idioretinal gray, and external signals register over the background of this sen sation. Both organs can briefly tolerate an enor mous variation in intensity. Visual adapta tion has its counterpart in auditory fatigue. In both vision and audition, the Weber frac tion varies with the intensity of the stimulus. For both senses duration approaches zero with infinite intensity. The critical flutter frequencies of noise may be compared with their analogue in vision. Pitch discrimination shows a smooth de crease from high to low frequencies, but hue discrimination is best at 485, 575, and 625 millimicrons, as might be expected with three color receptors present—each with a differ ent brightness distribution. The auditory system does not show the diversity of nervous action found in the retina and optic nerve; and in comparison to the retina, the histology of the cochlea is simple. This scholarly and stimulating dissertation indicates that certain general principles char acterize the organization of the whole sensorium. James E. Lebensohn.
BOOK REVIEWS
the cell type changing very definitely with the chronicity of the illness. A reported "count within normal limits" is misleading. The inoculation of spinal and other fluids into laboratory animals produces a nonrelated entity (J. Path. & Bact., 33:463, 1930) differing entirely from the original disease. X-ray therapy may be of some value early in the disease, but is apparently of no help in the chronic phase. The purpose of this communication is to endeavor to show that the etiology of the syndrome of deafness and interstitial keratitis is viral. Once having recognized this etiology the treatment becomes important particularly in avoiding certain procedures. The patients seem to fare much better when the treatment is less dramatic and not ex perimental. (Signed) Emanuel Rosen, Newark, New Jersey REPLY TO DR. ROSEN
Editor, American Journal of Ophthalmology: Thank you for forwarding Dr. Emanuel Rosen's letter. I find it quite interesting from several viewpoints. Initially, I might state that the patient was treated and the case re port prepared for publication prior to the publication of Dr. Rosen's articles. I fail to see, however, that the course of treatment would have been altered, since no original therapy has been offered by Dr. Rosen. That the etiologic factor might possibly be viral in character is by no means new since Cogan (Arch. Ophth., 33:144-149, 1945) before 1945 was working along such lines. Our animal studies were undertaken after consultation with the department of pathology of the Cleveland Clinic and the virus laboratory of Western Reserve Uni versity. It was felt that by such investigation a factor might possibly be isolated against which more specific therapeutic measures could be directed. The patient was treated with all of the antibiotics and supportive measures known at that time, in addition to X-ray therapy to
the head. The authors of the only cases presented in the literature at that time, Co gan, and Mogan and Baumgartner (West. J. Surg., 42:628, 1934) were consulted con cerning treatment of the case. In addition, the patient was presented at joint staff meet ings of the neurology and neurosurgical de partments. His case was followed by the members of the E.N.T., eye, medical and X-ray departments. In 1934, Mogan and Baumgartner reported such a case which they felt was markedly relieved by cervical sympathectomy. In summary, we had a young man with advanced keratitis and rapid loss of hearing. One would have expected his course to fol low that of practically all of the cases to total deafness, the remarkable exception be ing Mogan and Baumgartner's case. In view of the unsatisfactory response to other therapeutic measures, it was decided that the problem should be presented to the patient and his family. This was done, and it was stressed that the procedure might very possibly not relieve the symptoms and that it had been tried in only one case. Un der those conditions the cervical sympathec tomy was performed. Whether the return of hearing was initiated or aided by the op eration is indeterminable, but we have all been encouraged thereby, and also by his subsequent course. (Signed) R. A. Donald, Fresno, California
BOOK REVIEWS By Hedwig S. Kuhn, M.D. St. Louis, C. V. Mosby Company, 1950. 378 pages, 151 illustrations. Price: $8.50. Dr. Kuhn has collected in this book a comprehensive statistical and medical re port of the literature on file with the Joint Committee of Industrial Ophthalmology. To this literature she has added her own ob servations and opinions. The first four chapters pertaining to vis ual testing, skills, standards, and corrective EYES AND INDUSTRY.
127
BOOK REVIEWS programs are idealistic but do form a definite program of progress toward which the safety engineer and the ophthalmologist may work. Chapter five was contributed by Dr. Al bert C. Snell and is written in his own inimitable style. This chapter covers eye injuries caused by solid bodies in minute detail and should be required reading and practice by all ophthalmologists doing in dustrial work. Chapter six concerns radiation injuries and is an excellent summary of all data pub lished to date concerning this serious and painful form of injury. Chapter seven deals with chemical eye injuries and here the author has allowed her enthusiasm over a new drug to bias her opinion. The implication in this chapter is that hydrosulfosol has the uncanny magic of rapidly curing any and all types of chemical burns. On page 231, strict ad herence to the basic principle of denuding is advised as the first step; yet under pro cedure on page 232, this important step is notably missing. Chemical burns, after all, do have individual characteristics and their treatment should be more individualized than the author has indicated. Eye protection and illumination are well covered in chapters eight and nine and these two chapters provide an excellent handbook for guidance in approaching these problems. Dr. Kuhn is to be commended on her treatment of the problem of the blind in industry. It certainly is a step toward render ing obsolete the criticism of Dr. Meyer Wiener that "more has been written about the problem of the blind and less done about it than any other subject." Under the headings of miscellaneous and appendix there is a wealth of information touching all of the subjects of interest to the industrial ophthalmologist. Of particular value in this book are the complete lists of references on every subject, compiled at no small effort. The possessor of this book practically has a Cumulative
Index at his hand in so far as industrial ophthalmology is concerned. A well-done index completes this fine book. Ralph S. McLaughlin.
SOME RELATIONS BETWEEN AUDITION. By J. Donald
VISION
AND
Harris, Ph.D. Springfield, 111. Charles C Thomas, 1950. Clothbound, 56 pages, including bibliog raphy. Price: $1.50. The eyes and ears both collect and sort out impinging stimuli, and though they are derived from different germ layers and handle quite different spectra, the functional organization of the auditory and visual nerv ous systems is similar. In both organs, sen sitivity is almost at theoretical limits. Nei ther ever produces true zero sensation. In the absence of an external stimulus the eye reports idioretinal gray, and external signals register over the background of this sen sation. Both organs can briefly tolerate an enor mous variation in intensity. Visual adapta tion has its counterpart in auditory fatigue. In both vision and audition, the Weber frac tion varies with the intensity of the stimulus. For both senses duration approaches zero with infinite intensity. The critical flutter frequencies of noise may be compared with their analogue in vision. Pitch discrimination shows a smooth de crease from high to low frequencies, but hue discrimination is best at 485, 575, and 625 millimicrons, as might be expected with three color receptors present—each with a differ ent brightness distribution. The auditory system does not show the diversity of nervous action found in the retina and optic nerve; and in comparison to the retina, the histology of the cochlea is simple. This scholarly and stimulating dissertation indicates that certain general principles char acterize the organization of the whole sensorium. James E. Lebensohn.