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EYESTRAIN AND ITS REFLEXES DEPENDENT UPON LOW ERRORS OF REFRACTION.
755
hamper Dr. Symons in any way, I hoped he discretion in sending cases for examination. I am entirely at variance with your correspondent as to excluding the press from the ordinary meetings of the committee. The health of our city is so good that we have nothing to keep dark, but if his advice were followed there would not be the same public confidence that this was so. I am, Sirs, yours faithfully, PRESTON KING, M.D. Cantab.
the titles of doctor, surgeon-dentist, veterinary surgeon, &c., hall apply to companies would have the effect of putting an ’end to an audacious and rapidly increasing fraud not only on professional men but on the public.
wishing would
We are, Sirs, yours faithfully,
WILLIAMS, President. BAKER,
HERBERT
A. W. W.
M.D.
Dub., F.R.C.S.I.,
Past President Irish Branch B D.A.
to
use
GEO. M. P. MURRAY, F.R.C S.I., Past President Irish Branch B.D A.
EYESTRAIN AND ITS REFLEXES DEPENDENT UPON LOW ERRORS OF REFRACTION. *,* The decision ot the King’sBench Division in Dublin To the Editors of THE LANCET. is exceedingly to be regretted, particularly as further appeal in the Irish courts is impossible.-ED. L. SIRS, -Will you pardon me a few words of reply to your courteous editorial concerning eyestrain, in your issue of Feb. 6th, just at hand ?? The essential point in the conis entirely omitted by your writer and this is that PREVENTION OF INFECTIOUS DISEASE troversy the low errors of refraction are the cause of the reflex troubles which you think I exaggerate as due to eyestrain. This I IN BATH. have emphasised all through my writings and prove every To the Editors of THE LANCET. day in private practice. And not only myself but hundreds SIRS,-The notes under the above heading from your of other American oculists. The very condition of success in Wales and Western Counties correspondent in THE LANCET curing these patients is, we contend, the very thing you There is no more clearly demonstrated of Feb. 27th, p. 614, seem likely to give a wrong impression frankly ignore. of the relations existing between the medical officer of health fallacy, no greater scientific error than that exhibited in your and the sanitary committee of this city. As I am the coun- own quotation from Donders as to the unimportance of errors These small errors of astigcillor to whom allusion is made I hope you will allow me of less than a dioptre. matism are the causes of the troubles of the patients, a for few remarks. space In the first place, I should like to say that the committee reports of whose cases I have published, and of thousands in private practice. The statements as to the care and accuracy as a whole, and especially I myself, fully recognise that in Dr. W. H. Symons we have got a most efficient of most English and continental ophthalmologists are erroneThe low errors, and energetic medical officer of health. Sometimes, how- ous and the editorial demonstrates this. low of which cause , the degrees unsymmetric astigmatism ever, his energy and anxiety for the city’s welfare seem to outrun his discretion, and this, it appeared to me, was migraine, are ignored in the editorial which is, you say, so in the case especially alluded to by your correspondent. made up from the opinions of London oculists. It is a perI inclose you two notices lately sent out by Dr. Symons. fectly simple matter to demonstrate the truth of my conIn the one dealing with measles and whooping cough I took: tention. A good oculist by correcting the low errors (those dioptre) will cure many or most of the migrainous exception to the paragraph on the first page which speaks below a excluded from your oculists’ offices by " a clean bill of a penalty of £5to which a person is liable for exposing, patients himself while iniected in the streets. Your correspondentof health"as regards their eyes. Conversely, if those who the clean bill of health will wear a pair of spectacles -sayI"expressed the opinion that Section 126"of the Public: give Health Act of 1875 "only applied to those diseases which were producing artificially such low errors of astigmatism they scheduled " and not to measles and whooping-cough. I would will have a most convincing migraine very speedily. It not fair to my argument to ignore entirely the low point out to him that this is not a question of opinion at is which repeatedly, emphatically, and all; it is simply a matter of fact : the section does only error of refraction I have said is the cause of the sufferings to At a to ) continuously scheduled diseases. subsequent meeting apply Nor does it seem fair not that referred to, I offered to support Dr. Symons if he. due to ocular conditions. wished to have measles and whooping-cough included in theto present another fundamental argument of both volumes schedule. While, however, he did not advise our doing this, of my " Biographic Clinics": the fact that every one of the he was still of opinion that the clause, which I claimed was 14 patients whose histories are there described suffered eyes, and got immediate relief misleading to the public, should be retained since, among because of near use of hisand writing, when exercising out other reasons, "it was done elsewhere." Two cases had only by stopping reading &c. A thousand demonstrate this doors, quotations to in of which one the motherr of recently come my knowledge - of a child suffering from whooping-cough was afraid off ’, fact. Can it be explained on any other theory than eyebringing her child to the hospital for treatment ; and in the strain ?? Why is there such a strange di:,.inclina’ion of other was afraid of going out to earn her living because off reviewers, critics, and editorial writers to mention this fact the penalties to which she thought, from reading this notice, which is the substance of the mass of quotations of both books ? Respectfully yours, she was rendering herself liable. KEVIN E O’DUFFY, Honorary Secretary.
,
,
’
The other notice I inclose you was sent to all the medical practising here. In it you will see we are reminded that it is illtgal to remove patients suffering from notifiable diseases in public carriage., although Section 127 of the Public Health Act especially provides for what is to be done in the event of patients being so removed. That it is most undesirable for public carriages to be used for this purpose everyone will allow. and luckily here in Bath with our ambulance accommodation it is not necessary, but why tell the profession that what an Act of Parliament especially provides for is illegal ?‘! As I said at the beginning I have great respect for Dr. Symons’s energy and ability, but I cannot support him in the issue of notices that are incorrect and misleading, i-imply from a mistaken desire cf doing good thereby. 11 Bluff"may succeed in other matters, but it is neither politic nor dignified in the administrator of public health. As to the bacteriological examination in suspected
GEORGE M. GOULD.
men
*We publish Dr. Gould’s letter with pleasure, but we remain of the same opinion. It is not correct to suggest that our ophthalmologists are ignorant of the possible constitutional trouble that will follow slight errors of refraction ; while we are certain that the results of these errors have been exaggerated.-ED. L. BILHARZIA HÆMATOBIA.
To tAe Editors of THE LANCET. to Mr. E. H. Worth I desire to state that a patient of mine who is suffering from this disease contracted it in the Komati Poort Valley of the Transvaal, where he was severely wounded in the disaster to Colonel Benson’s tells me that diphtheria, to which your correspoadent also alludes, seeing column. Whilst in the military hospital he that in this case the reporter had found Hoffmann’s bacilli, he took (?) a solution of boric acid, but said ’ that he always which he especially said were not regarded by the felt worse afterwards and lost more blood." I have found "Cambridge school" as pathogenic, I said that, whilst noti that his haematuria has almost disappeared, the lumbar pain .
SiRS,-In reply
hamper Dr. Symons in any way, I hoped he discretion in sending cases for examination. I am entirely at variance with your correspondent as to excluding the press from the ordinary meetings of the committee. The health of our city is so good that we have nothing to keep dark, but if his advice were followed there would not be the same public confidence that this was so. I am, Sirs, yours faithfully, PRESTON KING, M.D. Cantab.
the titles of doctor, surgeon-dentist, veterinary surgeon, &c., hall apply to companies would have the effect of putting an ’end to an audacious and rapidly increasing fraud not only on professional men but on the public.
wishing would
We are, Sirs, yours faithfully,
WILLIAMS, President. BAKER,
HERBERT
A. W. W.
M.D.
Dub., F.R.C.S.I.,
Past President Irish Branch B D.A.
to
use
GEO. M. P. MURRAY, F.R.C S.I., Past President Irish Branch B.D A.
EYESTRAIN AND ITS REFLEXES DEPENDENT UPON LOW ERRORS OF REFRACTION. *,* The decision ot the King’sBench Division in Dublin To the Editors of THE LANCET. is exceedingly to be regretted, particularly as further appeal in the Irish courts is impossible.-ED. L. SIRS, -Will you pardon me a few words of reply to your courteous editorial concerning eyestrain, in your issue of Feb. 6th, just at hand ?? The essential point in the conis entirely omitted by your writer and this is that PREVENTION OF INFECTIOUS DISEASE troversy the low errors of refraction are the cause of the reflex troubles which you think I exaggerate as due to eyestrain. This I IN BATH. have emphasised all through my writings and prove every To the Editors of THE LANCET. day in private practice. And not only myself but hundreds SIRS,-The notes under the above heading from your of other American oculists. The very condition of success in Wales and Western Counties correspondent in THE LANCET curing these patients is, we contend, the very thing you There is no more clearly demonstrated of Feb. 27th, p. 614, seem likely to give a wrong impression frankly ignore. of the relations existing between the medical officer of health fallacy, no greater scientific error than that exhibited in your and the sanitary committee of this city. As I am the coun- own quotation from Donders as to the unimportance of errors These small errors of astigcillor to whom allusion is made I hope you will allow me of less than a dioptre. matism are the causes of the troubles of the patients, a for few remarks. space In the first place, I should like to say that the committee reports of whose cases I have published, and of thousands in private practice. The statements as to the care and accuracy as a whole, and especially I myself, fully recognise that in Dr. W. H. Symons we have got a most efficient of most English and continental ophthalmologists are erroneThe low errors, and energetic medical officer of health. Sometimes, how- ous and the editorial demonstrates this. low of which cause , the degrees unsymmetric astigmatism ever, his energy and anxiety for the city’s welfare seem to outrun his discretion, and this, it appeared to me, was migraine, are ignored in the editorial which is, you say, so in the case especially alluded to by your correspondent. made up from the opinions of London oculists. It is a perI inclose you two notices lately sent out by Dr. Symons. fectly simple matter to demonstrate the truth of my conIn the one dealing with measles and whooping cough I took: tention. A good oculist by correcting the low errors (those dioptre) will cure many or most of the migrainous exception to the paragraph on the first page which speaks below a excluded from your oculists’ offices by " a clean bill of a penalty of £5to which a person is liable for exposing, patients himself while iniected in the streets. Your correspondentof health"as regards their eyes. Conversely, if those who the clean bill of health will wear a pair of spectacles -sayI"expressed the opinion that Section 126"of the Public: give Health Act of 1875 "only applied to those diseases which were producing artificially such low errors of astigmatism they scheduled " and not to measles and whooping-cough. I would will have a most convincing migraine very speedily. It not fair to my argument to ignore entirely the low point out to him that this is not a question of opinion at is which repeatedly, emphatically, and all; it is simply a matter of fact : the section does only error of refraction I have said is the cause of the sufferings to At a to ) continuously scheduled diseases. subsequent meeting apply Nor does it seem fair not that referred to, I offered to support Dr. Symons if he. due to ocular conditions. wished to have measles and whooping-cough included in theto present another fundamental argument of both volumes schedule. While, however, he did not advise our doing this, of my " Biographic Clinics": the fact that every one of the he was still of opinion that the clause, which I claimed was 14 patients whose histories are there described suffered eyes, and got immediate relief misleading to the public, should be retained since, among because of near use of hisand writing, when exercising out other reasons, "it was done elsewhere." Two cases had only by stopping reading &c. A thousand demonstrate this doors, quotations to in of which one the motherr of recently come my knowledge - of a child suffering from whooping-cough was afraid off ’, fact. Can it be explained on any other theory than eyebringing her child to the hospital for treatment ; and in the strain ?? Why is there such a strange di:,.inclina’ion of other was afraid of going out to earn her living because off reviewers, critics, and editorial writers to mention this fact the penalties to which she thought, from reading this notice, which is the substance of the mass of quotations of both books ? Respectfully yours, she was rendering herself liable. KEVIN E O’DUFFY, Honorary Secretary.
,
,
’
The other notice I inclose you was sent to all the medical practising here. In it you will see we are reminded that it is illtgal to remove patients suffering from notifiable diseases in public carriage., although Section 127 of the Public Health Act especially provides for what is to be done in the event of patients being so removed. That it is most undesirable for public carriages to be used for this purpose everyone will allow. and luckily here in Bath with our ambulance accommodation it is not necessary, but why tell the profession that what an Act of Parliament especially provides for is illegal ?‘! As I said at the beginning I have great respect for Dr. Symons’s energy and ability, but I cannot support him in the issue of notices that are incorrect and misleading, i-imply from a mistaken desire cf doing good thereby. 11 Bluff"may succeed in other matters, but it is neither politic nor dignified in the administrator of public health. As to the bacteriological examination in suspected
GEORGE M. GOULD.
men
*We publish Dr. Gould’s letter with pleasure, but we remain of the same opinion. It is not correct to suggest that our ophthalmologists are ignorant of the possible constitutional trouble that will follow slight errors of refraction ; while we are certain that the results of these errors have been exaggerated.-ED. L. BILHARZIA HÆMATOBIA.
To tAe Editors of THE LANCET. to Mr. E. H. Worth I desire to state that a patient of mine who is suffering from this disease contracted it in the Komati Poort Valley of the Transvaal, where he was severely wounded in the disaster to Colonel Benson’s tells me that diphtheria, to which your correspoadent also alludes, seeing column. Whilst in the military hospital he that in this case the reporter had found Hoffmann’s bacilli, he took (?) a solution of boric acid, but said ’ that he always which he especially said were not regarded by the felt worse afterwards and lost more blood." I have found "Cambridge school" as pathogenic, I said that, whilst noti that his haematuria has almost disappeared, the lumbar pain .
SiRS,-In reply