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Muscle Operations
224
BOOK NOTICES
This fifth edition is very little like those of these have already been published in which have appeared in the German lan- this journal; and others will be brought guage; if it were not for the old familiar before our readers in subsequent issues. The volume is better illustrated than its illustrations it would be hard to recognize this as Fuch's text-book, then too, the predecessors. There are 23 cuts and diaillustrations have been amplified. Recent grams in the text, and 19 insert plates changes from the former American edi- and one in colors. The introduction of tions are in particular the chapters of illustrations adds substantially to the Glaucoma, The Retina, Disturbances of value of almost any clinical report. It is Motility, and the sections on Refraction a poor picture, indeed, that does not tell and Operations. Many of the newer . more about a clinical case than the text methods, descriptions and even theories that would occupy an equal space. But are included in this fifth edition, "Largely there is as much to be learned of exmade on the editor's own responsibility." pression thru pictures, as of expression The familiar appeal to the general thru phrases and sentences. Again the reader is urged to have these practitioner in the preface is hardly applicable. Neither this nor any of the edi- transactions in his library if possible. tions of the work were ever quite adapted The early volumes may not be obtainable, to the common variety of doctor, or even but the, current volumes can readily be to the beginner in ophthalmology. This procured thru the Secretary of the SoE. J. is a book that is of primary use to the ciety. practicing ophthalmologist, and to him largely as a store house of information. CORRESPONDENCE. The beginner would be appalled by the MUSCLE OPERATIONS. vastness of the subject and even by the To the Editor:— size of the book, which now reaches one thousand and sixty-seven pages. He Allow me to send you a few reflections should first read text-books of less pre- suggested by the two letters dealing with tensions. operations for squint, in the November The reviewer's advice to the progres- number of the AMERICAN JOURNAL OF sive oculist is, to buy this edition and OPHTHALMOLOGY, pp. 806-807. shelve the older ones. H. V. W. A discussion between two medical men is never a disagreement between two persons, but between two opinions; a third TRANSACTIONS OF T H E AMER- person may therefore intervene, especially I C A N OPHTHALMOLOGICAL if he hopes to demonstrate that the diverS O C I E T Y . Volume 16. Fifty- gence originates merely in an insufficient fourth Annual Meeting, 1918. 8vo, precision of the words used, and that the 412 pages, 23 Ms., 1 col. plate, 19 two colleagues are not speaking exactly other plates. Published by the So- of the same thing. ciety, Thomas B. Holloway, SecreIn the present case the word that lacks tary, Philadelphia. precision is "operation." If Dr. Loeb had This volume contains the papers, discus- written: "The position that all cases of sions, and proceedings of the last annual convergent strabismus should be tenolmeeting of the society, with sketches of omiscd is not a tenable one," I am certwo of its deceased members; and the can- tain that Dr. O'Connor would have been didates' theses of the nine associate mem- entirely satisfied. He might perhaps even bers elected at the annual meeting. have emphasized on the sentence, saying The latter occupy over 160 pages; and —as I say myself, after such personal exadd greatly to the scientific value of the perience I may have gained, and esvolume. They abundantly justify the pecially after all I have seen of my practice of requiring candidates to show father's work for so many years—"The their ability to contribute to the proceed- position that hardly any case of conings of the society. The requirement that vergent strabismus should be tenotomised, they should do so has stimulated the pro- is the only tenable." If, on the contrary, duction of some valuable papers. Some Dr. Loeb was speaking of advancement,
CORRESPONDENCE
our two colleagues agree again, since Dr. O'Connor writes: "Few of us who operate, do so until we have eliminated the cases that are cured by glasses and visual training." In fact, I doubt that this latter was the meaning of the word operation in Dr. Loeb's mind, for he would not have said that some operations result in strabismus of the opposite character, this being an inconvenience special to tenotomy. Dr. Loeb advocates the nonoperative treatment, which gives him 40% correct positions of the eyes: the percentage is very good and does much credit to the author's skill and patience. He will, however, admit that the difficulty increases with the degree of the squint and the amblyopia of the deviated eye. Again, the amblyopia gets worse as time passes away, and the contractility of the externi gets weaker and weaker; this is a fact well known to any one who takes the trouble of measuring the excursion of the eyes. If, then, a method—be it an operative one—enables us to reduce considerably the angle of squint, and, on the other hand, if by increasing the power of the externi, without impairing the strength of the interni, it gives the eyes a far better mobility, without any risk of divergent squint, there is no doubt that in the hands of so skillful an orthoptist as Dr. Loeb, such a method may give a still better percentage of correct positions. It may additionally enable to secure binocular vision, even if that has not been asked for, and, with the patient sati.-fy also the oculist. The muscular advancement is the method I mean. With all its advantages it may be performed on ver, y v.ing children, when the amblyopia is not inveterate and the chances of subsequently restoring binocular vision are the very best possible. Of course, there is no question of operating all cases before having thoroly tried the nonoperative treatment; in case of failure it is the best preparation to the postoperative training of the binocular vision. In short, I believe that if in the pending discussion the word operation means tenotomy, Dr. O'Connor will agree with
225
Dr. Loeb, and if it means advancement, Dr. Loeb cannot but agree with Dr. O'Connor. Begging both our colleagues pardon for my intervention—our readers for my hesitating English—I am, Respectfully yours, Paris, France.
DR. MARC LANDOLT.
OPHTHALMIC JURISPRUDENCE. BY THOMAS HALL SIIASTID, M.D.,LL.B. SUPERIOR, WIS.
Recent Law Decisions of Special Interest to Ophthalmologists. PEOPLE v. GRIFFITH. (Supreme Court of Illinois, June 21, 1917, 117 N. W , 195.) A. B. Griffith, convicted in the Municipal Court of Chicago of practicing optometry without a license, brought the record by writ of error to the Supreme Court. The essential question involved was whether or not the Optometry Act of Illinois was valid, i. e., constitutional. Held: It was not. The judgment was therefore reversed. Reasons: (1) The act exempted from examination those who had practiced three years, entirely regardless of moral character, temperate habits, age, skill, knowledge, or competency to practice optometry. (2) It prescribed no subjects for examination. The importance of this decision is very great. MARTIN
V.
COMMONWEALTH.
(Su-
preme Court of Appeals of Virginia, Sept. 20, 1917, 93 S. E. 623.) J. Harry Martin, convicted of practicing medicine in the City of Roanoke, Va., without first having procured a certificate from the Board of Medical Examiners of Virginia, brought a writ of error to the Supreme Court of Appeals of Virginia. Dr. Martin was a nonitinerant optician, who displayed on the front door and window of his place of business the following legends, "Dr. J. Harry Martin, Incorporated, Eyes Exclusively" and "Dr. J. Harry Martin, Incorporated, Optometrist." The conviction was had on section 12 of the Medical Practice Act of Virginia, which runs as follows: "Any person shall be regarded as practicing medicine within the meaning of this act
BOOK NOTICES
This fifth edition is very little like those of these have already been published in which have appeared in the German lan- this journal; and others will be brought guage; if it were not for the old familiar before our readers in subsequent issues. The volume is better illustrated than its illustrations it would be hard to recognize this as Fuch's text-book, then too, the predecessors. There are 23 cuts and diaillustrations have been amplified. Recent grams in the text, and 19 insert plates changes from the former American edi- and one in colors. The introduction of tions are in particular the chapters of illustrations adds substantially to the Glaucoma, The Retina, Disturbances of value of almost any clinical report. It is Motility, and the sections on Refraction a poor picture, indeed, that does not tell and Operations. Many of the newer . more about a clinical case than the text methods, descriptions and even theories that would occupy an equal space. But are included in this fifth edition, "Largely there is as much to be learned of exmade on the editor's own responsibility." pression thru pictures, as of expression The familiar appeal to the general thru phrases and sentences. Again the reader is urged to have these practitioner in the preface is hardly applicable. Neither this nor any of the edi- transactions in his library if possible. tions of the work were ever quite adapted The early volumes may not be obtainable, to the common variety of doctor, or even but the, current volumes can readily be to the beginner in ophthalmology. This procured thru the Secretary of the SoE. J. is a book that is of primary use to the ciety. practicing ophthalmologist, and to him largely as a store house of information. CORRESPONDENCE. The beginner would be appalled by the MUSCLE OPERATIONS. vastness of the subject and even by the To the Editor:— size of the book, which now reaches one thousand and sixty-seven pages. He Allow me to send you a few reflections should first read text-books of less pre- suggested by the two letters dealing with tensions. operations for squint, in the November The reviewer's advice to the progres- number of the AMERICAN JOURNAL OF sive oculist is, to buy this edition and OPHTHALMOLOGY, pp. 806-807. shelve the older ones. H. V. W. A discussion between two medical men is never a disagreement between two persons, but between two opinions; a third TRANSACTIONS OF T H E AMER- person may therefore intervene, especially I C A N OPHTHALMOLOGICAL if he hopes to demonstrate that the diverS O C I E T Y . Volume 16. Fifty- gence originates merely in an insufficient fourth Annual Meeting, 1918. 8vo, precision of the words used, and that the 412 pages, 23 Ms., 1 col. plate, 19 two colleagues are not speaking exactly other plates. Published by the So- of the same thing. ciety, Thomas B. Holloway, SecreIn the present case the word that lacks tary, Philadelphia. precision is "operation." If Dr. Loeb had This volume contains the papers, discus- written: "The position that all cases of sions, and proceedings of the last annual convergent strabismus should be tenolmeeting of the society, with sketches of omiscd is not a tenable one," I am certwo of its deceased members; and the can- tain that Dr. O'Connor would have been didates' theses of the nine associate mem- entirely satisfied. He might perhaps even bers elected at the annual meeting. have emphasized on the sentence, saying The latter occupy over 160 pages; and —as I say myself, after such personal exadd greatly to the scientific value of the perience I may have gained, and esvolume. They abundantly justify the pecially after all I have seen of my practice of requiring candidates to show father's work for so many years—"The their ability to contribute to the proceed- position that hardly any case of conings of the society. The requirement that vergent strabismus should be tenotomised, they should do so has stimulated the pro- is the only tenable." If, on the contrary, duction of some valuable papers. Some Dr. Loeb was speaking of advancement,
CORRESPONDENCE
our two colleagues agree again, since Dr. O'Connor writes: "Few of us who operate, do so until we have eliminated the cases that are cured by glasses and visual training." In fact, I doubt that this latter was the meaning of the word operation in Dr. Loeb's mind, for he would not have said that some operations result in strabismus of the opposite character, this being an inconvenience special to tenotomy. Dr. Loeb advocates the nonoperative treatment, which gives him 40% correct positions of the eyes: the percentage is very good and does much credit to the author's skill and patience. He will, however, admit that the difficulty increases with the degree of the squint and the amblyopia of the deviated eye. Again, the amblyopia gets worse as time passes away, and the contractility of the externi gets weaker and weaker; this is a fact well known to any one who takes the trouble of measuring the excursion of the eyes. If, then, a method—be it an operative one—enables us to reduce considerably the angle of squint, and, on the other hand, if by increasing the power of the externi, without impairing the strength of the interni, it gives the eyes a far better mobility, without any risk of divergent squint, there is no doubt that in the hands of so skillful an orthoptist as Dr. Loeb, such a method may give a still better percentage of correct positions. It may additionally enable to secure binocular vision, even if that has not been asked for, and, with the patient sati.-fy also the oculist. The muscular advancement is the method I mean. With all its advantages it may be performed on ver, y v.ing children, when the amblyopia is not inveterate and the chances of subsequently restoring binocular vision are the very best possible. Of course, there is no question of operating all cases before having thoroly tried the nonoperative treatment; in case of failure it is the best preparation to the postoperative training of the binocular vision. In short, I believe that if in the pending discussion the word operation means tenotomy, Dr. O'Connor will agree with
225
Dr. Loeb, and if it means advancement, Dr. Loeb cannot but agree with Dr. O'Connor. Begging both our colleagues pardon for my intervention—our readers for my hesitating English—I am, Respectfully yours, Paris, France.
DR. MARC LANDOLT.
OPHTHALMIC JURISPRUDENCE. BY THOMAS HALL SIIASTID, M.D.,LL.B. SUPERIOR, WIS.
Recent Law Decisions of Special Interest to Ophthalmologists. PEOPLE v. GRIFFITH. (Supreme Court of Illinois, June 21, 1917, 117 N. W , 195.) A. B. Griffith, convicted in the Municipal Court of Chicago of practicing optometry without a license, brought the record by writ of error to the Supreme Court. The essential question involved was whether or not the Optometry Act of Illinois was valid, i. e., constitutional. Held: It was not. The judgment was therefore reversed. Reasons: (1) The act exempted from examination those who had practiced three years, entirely regardless of moral character, temperate habits, age, skill, knowledge, or competency to practice optometry. (2) It prescribed no subjects for examination. The importance of this decision is very great. MARTIN
V.
COMMONWEALTH.
(Su-
preme Court of Appeals of Virginia, Sept. 20, 1917, 93 S. E. 623.) J. Harry Martin, convicted of practicing medicine in the City of Roanoke, Va., without first having procured a certificate from the Board of Medical Examiners of Virginia, brought a writ of error to the Supreme Court of Appeals of Virginia. Dr. Martin was a nonitinerant optician, who displayed on the front door and window of his place of business the following legends, "Dr. J. Harry Martin, Incorporated, Eyes Exclusively" and "Dr. J. Harry Martin, Incorporated, Optometrist." The conviction was had on section 12 of the Medical Practice Act of Virginia, which runs as follows: "Any person shall be regarded as practicing medicine within the meaning of this act