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The Art of Seeing
BOOK NOTICES
419
From the context the reader judges that the author has had defective vision since the age of 16 years, owing pri marily to corneal scars resulting from a punctate keratitis. He apparently went through several stages in his reactions to his ocular disability. At first, there was discouragement, followed by an intense effort to see as clearly as possible, and then an abandonment of such effort, hav ing exhausted the possibilities as pre sented by the ophthalmologists whom he consulted. Many years later, he encoun tered a student of the late Dr. Bates, who taught him to utilize to better purpose the sight that remained to him. The thesis of his book is that the usu al practice of ophthalmologists confines itself to the mechanics of vision and does not concern itself sufficiently with the physiology and psychology of the subject. There is much discussion of these ele ments in seeing, with great detail as to the methods advocated by Dr. Bates to gether with some additions from the au thor's own experience. He dismisses the discussion of the mechanical factors by the statement that he is not qualified to comment upon them, writing merely that he concludes that there is something of truth in the arguments of both the ortho dox ophthalmologists and of Dr. Bates. He believes that those with defective vision defeat their own purpose by an over-effort to see, and much of his ad vice is toward overcoming staring. He also urges training the eye to overcome avoidance of high illumination. He him self is convinced that his ability to see has been greatly increased. This might be true in his case even if his actual ability to read test charts were not proportionately BOOK NOTICES improved. The weakness of the argument T H E ART O F SEEING. By Aldous is the attempt to apply the method uni Huxley. 273 pages. New York and versally. To do so would not only be London, Harper and Brothers Pub absurd in some cases, but dangerous. lishers. 1942. Ophthalmologists rejected the Bates
completed just as planned, it will fill a long-felt need. The ideal hospital for ophthalmic pa tients should be a specialty unit but should not be divorced from the medical, sur gical, and other branches of the profes sion because the full development of each specialty can be attained only in close co operation with general medicine and all other specialties. On the other hand, ophthalmology receives scant attention in the general hospital. The nurses are poorly trained to handle eye cases and are quite uninterested in them. They are not sufficiently dramatic and there is too much detail, much of which seems unim portant to nurses. It is even difficult to keep the ophthalmic dressing-room equip ment in good condition, and in most gen eral hospitals special instruments, such as perimeters and slitlamps, are inacces sible. In many hospitals ophthalmic oper ations must wait on other surgery. In all of these and other particulars the eye pa tient suffers. Hence the value to the pa tient of the change from general to spe cial hospitals. In some hospitals it has been possible to concentrate all ophthal mic cases in a single unit. This, of course, offers the same advantages as the spe cialty hospital; that is, if operating room and clinics are equally concentrated—but usually this arrangement is impossible, and the ophthalmologist must walk long distances to care for his patients. One of the benefits of an eye hospital is the possibility of concentration of var ied pathology, and it is hoped that this will prove of great value in the instruction of ophthalmology in the Saint Louis area. Lawrence T. Post.
420
BOOK NOTICES
theories in their entirety, largely because of the incompatibility of the mechanical assumptions with proved facts. If Dr. Bates had confined himself to encourag ing and training the use of defective eyes, some of his suggestions might have been accepted, but his program was so encum bered with deductions that most ophthal mologists and physicists believe to be in correct that all of his ideas were rejected. The reader of this book is convinced of the author's sincerity, but cannot help being apprehensive lest the introduction of unsound ideas counterbalance any good that might be accomplished by the book. Lawrence T. Post. OFTALMOSCOPIA CLINICA, MAN UAL PRACTICO PARA MEDICOS Y E S T U D I A N T E S (Clinical ophthalmoscopy, practical manual for phy sicians and students). By Tomas R. Yanes, Instructor in Ophthalmology, Medical Faculty, University of Havana. Paper covers, 500 pages, 14 color plates, 221 illustrations in the text. Biblioteca Medica de Autores Cubanos, Havana, Cuba, 1943. Price $6.00 (Cu ban). This is an able presentation of the sub ject, by a Cuban author who has become fairly familiar to American ophthalmolo gists during his visits to the United States, and whom we respect for his ability to present clearly and forcefully any subject upon which he speaks. Yanes and his publisher are not quite agreed as to the purpose of the book. The former positively states that it has been prepared exclusively for the practicing physician, to whom it aims to teach the use of the ophthalmoscope, "an instru ment as indispensable as the stethoscope, the sphygmomanometer, and the percus sion hammer." The publisher's announce
ment, on the other hand, offers the book "to the medical student, to the general physician, to· medical specialists, to neu rologists, to internists, and to ophthal mologists." Many authors must have ap plied to their publishers the familiar say ing: "Preserve us from our friends!" The book is based upon a course given by Yanes to Cuban physicians other than ophthalmologists, in connection with the Eighth (Cuban) National Medical Con gress. Self-instruction in ophthalmoscopy is entirely possible, although no doubt rare. So clearly and interestingly arranged are the earlier chapters of the present volume, that from its teaching the physi cian entirely ignorant of ophthalmoscopy could learn the use of the instrument and acquire familiarity with the appearance of the normal eye, as well as with some of the more frequent variations from the normal. In a later edition the author might find it advisable, from this point of view, to add a few more explicit details as to the exact direction of the patient's gaze, and what the beginner should first look for when he starts to examine the eye with the ophthalmoscope. The later chapters of the book hardly bear the stamp of being addressed to the beginner, but suggest an attempt by the author to cover the whole field of ophthal moscopy, to an extent which would cer tainly be embarrassing to a novice. The volume is profusely illustrated, Some of the black and white illustrations are excellent. The best illustrations are a series of color plates, 13 in number, per fectly reproduced from Oeller's Atlas. The great bulk of the illustrations are re productions, sometimes not very clearly printed, from black and white photo graphs of the fundus. These include a number of conditions, some of them rare, of which photographs were furnished to the author by workers in the United States and other countries. For the ex-
419
From the context the reader judges that the author has had defective vision since the age of 16 years, owing pri marily to corneal scars resulting from a punctate keratitis. He apparently went through several stages in his reactions to his ocular disability. At first, there was discouragement, followed by an intense effort to see as clearly as possible, and then an abandonment of such effort, hav ing exhausted the possibilities as pre sented by the ophthalmologists whom he consulted. Many years later, he encoun tered a student of the late Dr. Bates, who taught him to utilize to better purpose the sight that remained to him. The thesis of his book is that the usu al practice of ophthalmologists confines itself to the mechanics of vision and does not concern itself sufficiently with the physiology and psychology of the subject. There is much discussion of these ele ments in seeing, with great detail as to the methods advocated by Dr. Bates to gether with some additions from the au thor's own experience. He dismisses the discussion of the mechanical factors by the statement that he is not qualified to comment upon them, writing merely that he concludes that there is something of truth in the arguments of both the ortho dox ophthalmologists and of Dr. Bates. He believes that those with defective vision defeat their own purpose by an over-effort to see, and much of his ad vice is toward overcoming staring. He also urges training the eye to overcome avoidance of high illumination. He him self is convinced that his ability to see has been greatly increased. This might be true in his case even if his actual ability to read test charts were not proportionately BOOK NOTICES improved. The weakness of the argument T H E ART O F SEEING. By Aldous is the attempt to apply the method uni Huxley. 273 pages. New York and versally. To do so would not only be London, Harper and Brothers Pub absurd in some cases, but dangerous. lishers. 1942. Ophthalmologists rejected the Bates
completed just as planned, it will fill a long-felt need. The ideal hospital for ophthalmic pa tients should be a specialty unit but should not be divorced from the medical, sur gical, and other branches of the profes sion because the full development of each specialty can be attained only in close co operation with general medicine and all other specialties. On the other hand, ophthalmology receives scant attention in the general hospital. The nurses are poorly trained to handle eye cases and are quite uninterested in them. They are not sufficiently dramatic and there is too much detail, much of which seems unim portant to nurses. It is even difficult to keep the ophthalmic dressing-room equip ment in good condition, and in most gen eral hospitals special instruments, such as perimeters and slitlamps, are inacces sible. In many hospitals ophthalmic oper ations must wait on other surgery. In all of these and other particulars the eye pa tient suffers. Hence the value to the pa tient of the change from general to spe cial hospitals. In some hospitals it has been possible to concentrate all ophthal mic cases in a single unit. This, of course, offers the same advantages as the spe cialty hospital; that is, if operating room and clinics are equally concentrated—but usually this arrangement is impossible, and the ophthalmologist must walk long distances to care for his patients. One of the benefits of an eye hospital is the possibility of concentration of var ied pathology, and it is hoped that this will prove of great value in the instruction of ophthalmology in the Saint Louis area. Lawrence T. Post.
420
BOOK NOTICES
theories in their entirety, largely because of the incompatibility of the mechanical assumptions with proved facts. If Dr. Bates had confined himself to encourag ing and training the use of defective eyes, some of his suggestions might have been accepted, but his program was so encum bered with deductions that most ophthal mologists and physicists believe to be in correct that all of his ideas were rejected. The reader of this book is convinced of the author's sincerity, but cannot help being apprehensive lest the introduction of unsound ideas counterbalance any good that might be accomplished by the book. Lawrence T. Post. OFTALMOSCOPIA CLINICA, MAN UAL PRACTICO PARA MEDICOS Y E S T U D I A N T E S (Clinical ophthalmoscopy, practical manual for phy sicians and students). By Tomas R. Yanes, Instructor in Ophthalmology, Medical Faculty, University of Havana. Paper covers, 500 pages, 14 color plates, 221 illustrations in the text. Biblioteca Medica de Autores Cubanos, Havana, Cuba, 1943. Price $6.00 (Cu ban). This is an able presentation of the sub ject, by a Cuban author who has become fairly familiar to American ophthalmolo gists during his visits to the United States, and whom we respect for his ability to present clearly and forcefully any subject upon which he speaks. Yanes and his publisher are not quite agreed as to the purpose of the book. The former positively states that it has been prepared exclusively for the practicing physician, to whom it aims to teach the use of the ophthalmoscope, "an instru ment as indispensable as the stethoscope, the sphygmomanometer, and the percus sion hammer." The publisher's announce
ment, on the other hand, offers the book "to the medical student, to the general physician, to· medical specialists, to neu rologists, to internists, and to ophthal mologists." Many authors must have ap plied to their publishers the familiar say ing: "Preserve us from our friends!" The book is based upon a course given by Yanes to Cuban physicians other than ophthalmologists, in connection with the Eighth (Cuban) National Medical Con gress. Self-instruction in ophthalmoscopy is entirely possible, although no doubt rare. So clearly and interestingly arranged are the earlier chapters of the present volume, that from its teaching the physi cian entirely ignorant of ophthalmoscopy could learn the use of the instrument and acquire familiarity with the appearance of the normal eye, as well as with some of the more frequent variations from the normal. In a later edition the author might find it advisable, from this point of view, to add a few more explicit details as to the exact direction of the patient's gaze, and what the beginner should first look for when he starts to examine the eye with the ophthalmoscope. The later chapters of the book hardly bear the stamp of being addressed to the beginner, but suggest an attempt by the author to cover the whole field of ophthal moscopy, to an extent which would cer tainly be embarrassing to a novice. The volume is profusely illustrated, Some of the black and white illustrations are excellent. The best illustrations are a series of color plates, 13 in number, per fectly reproduced from Oeller's Atlas. The great bulk of the illustrations are re productions, sometimes not very clearly printed, from black and white photo graphs of the fundus. These include a number of conditions, some of them rare, of which photographs were furnished to the author by workers in the United States and other countries. For the ex-