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The Editor's Farewell to Arms
AMERICAN JOURNAL OF OPHTHALMOLOGY Published Monthly
by the Ophthalmic Publishing
Company
EDITORIAL STAFF DERRICK VAIL, Editor-in-Chief
S. RODMAN IRVINE, MAJOR (MC), A.U.S. (on
WILLIAM H. CRISP, Consulting Editor
DONALD J. LYLE
LAWRENCE T. POST, Consulting Editor
IDA MANN
WILLIAM L. BENEDICT
RALPH H. MILLER, MAJOR (MC), A.U.S. (on
FREDERICK C. CORDES
ALGERNON B. REESE
SIR STEWART DUKE-ELDER, BRIG.
M. URIBE TRQNCOSO
EDWIN B. DUNPHY, 243 Charles St., Boston,
F. E. WOODRUFF
HARRY S. GRADLE
ALAN C. WOODS
active duty)
55 East Washington Street, Chicago 2
904 Carew Tower, Cincinnati 2
530 Metropolitan Building, Denver 2
The Eye Hospital, Oxford, England
640 South Kingshighway, Saint Louis 10 The Mayo Clinic, Rochester, Minnesota
active duty)
73 East Seventy-first Street, New York 21
384 Post Street, San Francisco 8 63 Harley Street, London, W.l Mass.
500 West End Avenue, New York 24
824 Metropolitan Building, Saint Louis 3
Johns Hopkins Hospital, Baltimore 5
58 East Washington Street, Chicago 2
EMMA S. BUSS, Manuscript Editor, 121 Woodbine Avenue, Wilmette, Illinois
Directors: LAWRENCE T. POST, President; WILLIAM L. BENEDICT, Vice-President; DONALD
J. LYLE, Secretary and Treasurer; WILLIAM H. CRISP, HARRY S. GRADLE, DERRICK VAIL.
Address original papers, other scientific communications including correspondence, also books for review to Dr. Derrick Vail, 55 East Washington Street, Chicago 2, Illinois; Society Proceedings to Dr. Donald J. Lyle, 904 Carew Tower, Cincinnati 2, Ohio. Manuscripts should be original copies, typed in double space, with wide margins. Exchange copies of medical journals should be sent to Dr. William H. Crisp, 530 Metropolitan Building, Denver, Colorado. Subscriptions, applications for single copies, notices of changes of address, and communications with reference to advertising should be addressed to the Manager of Subscriptions and Advertising, 837 Carew Tower, Cincinnati 2, Ohio. Copy of advertisements must be sent to the manager by the fifteenth of the month preceding its appearance. Author's proofs should be corrected and returned within forty-eight hours to the Manuscript Editor, Miss Emma S. Buss, 121 Woodbine Avenue, Wilmette, Illinois. Twenty-five reprints of each article will be supplied to the author without charge. Additional reprints may be obtained from the printer, the George Banta Publishing Company, 450-458 Ahnaip Street, Menasha, Wisconsin, if ordered at the time proofs are returned. But reprints to contain colored plates must be ordered when the article is accepted. THE EDITOR'S FAREWELL TO ARMS Back on the job after three years of service with the Army, your editor finds himself once more in charge of the destiny of one of the finest and most influential ophthalmic journals in the world. E m e r g ing from another life which was exciting, challenging, and stimulating, he is amazed to find that during these long bitter years of warfare, hardships, and shortages that encircled and gripped every civilian venture, the prestige of the Journal is enhanced, its circulation increased, its scientific contributions growing in quality and quantity, a n d the number of its friends
and collaborators nearly double that of prewar years. This extraordinary phenomenon appears at first sight to be a paradox. When one looks more deeply beneath the surface, however, one sees the cause. It is that of magnificent loyalty and team work of the entire staff under the experienced and wise guiding hands of the former editors, D r . Post and Dr. Crisp. With his usual modesty, D r . Post, in a previous editorial, justly lauded the faithful members of the staff, effacing himself and minimizing his leadership. It is time to get the record straight and pay
proper honors to the former chief-editor,
1268
EDITORIALS
who stepped back into the vacuum without hesitancy at a time when his other responsibilities had increased almost beyond endurance, and 40 hours of work had to be accomplished in 24. Each number of the Journal during the war is a glowing witness to his wisdom and ability and to his burning interest in the welfare of ophthalmology. Each number, too, is a witness to the devotion of the staff under his brilliant direction. No more needs to be said. The record stands for all to see, and all of us are grateful. We are grateful, too, to Dr. Crisp for his work during these years. At a time in his life when with honor and laurels he might have turned over to other hands the arduous task of editing abstracts of ophthalmic literature much of which was difficult of access, he continued on with increased vigor and will, because he was indispensable, and the Journal would have sustained a grievous wound by his resignation. For over a decade his editorials, faithfully appearing in these columns, have guided and helped ophthalmologists the world over. Those of the war years were particularly helpful, for they breathed wisdom and stability at a time when fiery chaos was everywhere. It is good to be back among people such as these. Derrick Vail.
BLINDNESS FROM ONCHOCERCA Trachoma is still the world's greatest cause of blindness. But as a common disease it has receded from many civilized areas, and it has shown itself more and more susceptible to various forms of treatment. There is another cause of blindness which is estimated to affect more than a million persons throughout the world, and yet which is hardly known by name to most ophthalmologists. This
1269
disease, onchocerciasis, although its caustive agent is well understood, is essentially incapable of treatment by any known remedy. Furthermore, the possibility that this disease may ultimately affect civilized populations to which it is at present unfamiliar is by no means to be excluded. Human ocular onchocerciasis is widely endemic in many African areas of the British Colonial Empire, and has been found widespread in southern Mexico and Guatemala. It is due to infestation with the microfilarias of a threadworm, Onchocerca, which invade almost all parts of the eye and lead slowly to complete blindness from corneal opacities, cataract, chorioretinal degeneration, and optic atrophy. An investigation of its incidence in the Gold Coast of equatorial Africa has recently been made by Harold Ridley, of the Royal Army Medical Service (British Journal of Ophthalmology, Monograph Supplement X, 1945) who laments that lack of realization of the importance of the disease was demonstrated by absence of mention at a discussion held in London in 1944, on "Important diseases affecting West African troops." In Africa, research has attributed the disease to a filaria named "Onchocerca volvulus"; while in Guatemala the responsible parasite is called "Onchocerca caecutiens" ("the blinding filaria"). The two organisms are presumably identical, and there is a probability that the disease was primarily African and was originally imported to the Americas with the slave trade. The disease is carried by the fly Simulium, which breeds in running water at altitudes from sea level to 4,500 feet. Simulium is an intermediate host. Man is the true host of this filaria, since he carries the organism during its sexual stage. Much work on the subject has been done by Pacheco-Luna of Guatemala. At the Cleveland Pan-American Congress, Pacheco-Luna showed some remarkable
by the Ophthalmic Publishing
Company
EDITORIAL STAFF DERRICK VAIL, Editor-in-Chief
S. RODMAN IRVINE, MAJOR (MC), A.U.S. (on
WILLIAM H. CRISP, Consulting Editor
DONALD J. LYLE
LAWRENCE T. POST, Consulting Editor
IDA MANN
WILLIAM L. BENEDICT
RALPH H. MILLER, MAJOR (MC), A.U.S. (on
FREDERICK C. CORDES
ALGERNON B. REESE
SIR STEWART DUKE-ELDER, BRIG.
M. URIBE TRQNCOSO
EDWIN B. DUNPHY, 243 Charles St., Boston,
F. E. WOODRUFF
HARRY S. GRADLE
ALAN C. WOODS
active duty)
55 East Washington Street, Chicago 2
904 Carew Tower, Cincinnati 2
530 Metropolitan Building, Denver 2
The Eye Hospital, Oxford, England
640 South Kingshighway, Saint Louis 10 The Mayo Clinic, Rochester, Minnesota
active duty)
73 East Seventy-first Street, New York 21
384 Post Street, San Francisco 8 63 Harley Street, London, W.l Mass.
500 West End Avenue, New York 24
824 Metropolitan Building, Saint Louis 3
Johns Hopkins Hospital, Baltimore 5
58 East Washington Street, Chicago 2
EMMA S. BUSS, Manuscript Editor, 121 Woodbine Avenue, Wilmette, Illinois
Directors: LAWRENCE T. POST, President; WILLIAM L. BENEDICT, Vice-President; DONALD
J. LYLE, Secretary and Treasurer; WILLIAM H. CRISP, HARRY S. GRADLE, DERRICK VAIL.
Address original papers, other scientific communications including correspondence, also books for review to Dr. Derrick Vail, 55 East Washington Street, Chicago 2, Illinois; Society Proceedings to Dr. Donald J. Lyle, 904 Carew Tower, Cincinnati 2, Ohio. Manuscripts should be original copies, typed in double space, with wide margins. Exchange copies of medical journals should be sent to Dr. William H. Crisp, 530 Metropolitan Building, Denver, Colorado. Subscriptions, applications for single copies, notices of changes of address, and communications with reference to advertising should be addressed to the Manager of Subscriptions and Advertising, 837 Carew Tower, Cincinnati 2, Ohio. Copy of advertisements must be sent to the manager by the fifteenth of the month preceding its appearance. Author's proofs should be corrected and returned within forty-eight hours to the Manuscript Editor, Miss Emma S. Buss, 121 Woodbine Avenue, Wilmette, Illinois. Twenty-five reprints of each article will be supplied to the author without charge. Additional reprints may be obtained from the printer, the George Banta Publishing Company, 450-458 Ahnaip Street, Menasha, Wisconsin, if ordered at the time proofs are returned. But reprints to contain colored plates must be ordered when the article is accepted. THE EDITOR'S FAREWELL TO ARMS Back on the job after three years of service with the Army, your editor finds himself once more in charge of the destiny of one of the finest and most influential ophthalmic journals in the world. E m e r g ing from another life which was exciting, challenging, and stimulating, he is amazed to find that during these long bitter years of warfare, hardships, and shortages that encircled and gripped every civilian venture, the prestige of the Journal is enhanced, its circulation increased, its scientific contributions growing in quality and quantity, a n d the number of its friends
and collaborators nearly double that of prewar years. This extraordinary phenomenon appears at first sight to be a paradox. When one looks more deeply beneath the surface, however, one sees the cause. It is that of magnificent loyalty and team work of the entire staff under the experienced and wise guiding hands of the former editors, D r . Post and Dr. Crisp. With his usual modesty, D r . Post, in a previous editorial, justly lauded the faithful members of the staff, effacing himself and minimizing his leadership. It is time to get the record straight and pay
proper honors to the former chief-editor,
1268
EDITORIALS
who stepped back into the vacuum without hesitancy at a time when his other responsibilities had increased almost beyond endurance, and 40 hours of work had to be accomplished in 24. Each number of the Journal during the war is a glowing witness to his wisdom and ability and to his burning interest in the welfare of ophthalmology. Each number, too, is a witness to the devotion of the staff under his brilliant direction. No more needs to be said. The record stands for all to see, and all of us are grateful. We are grateful, too, to Dr. Crisp for his work during these years. At a time in his life when with honor and laurels he might have turned over to other hands the arduous task of editing abstracts of ophthalmic literature much of which was difficult of access, he continued on with increased vigor and will, because he was indispensable, and the Journal would have sustained a grievous wound by his resignation. For over a decade his editorials, faithfully appearing in these columns, have guided and helped ophthalmologists the world over. Those of the war years were particularly helpful, for they breathed wisdom and stability at a time when fiery chaos was everywhere. It is good to be back among people such as these. Derrick Vail.
BLINDNESS FROM ONCHOCERCA Trachoma is still the world's greatest cause of blindness. But as a common disease it has receded from many civilized areas, and it has shown itself more and more susceptible to various forms of treatment. There is another cause of blindness which is estimated to affect more than a million persons throughout the world, and yet which is hardly known by name to most ophthalmologists. This
1269
disease, onchocerciasis, although its caustive agent is well understood, is essentially incapable of treatment by any known remedy. Furthermore, the possibility that this disease may ultimately affect civilized populations to which it is at present unfamiliar is by no means to be excluded. Human ocular onchocerciasis is widely endemic in many African areas of the British Colonial Empire, and has been found widespread in southern Mexico and Guatemala. It is due to infestation with the microfilarias of a threadworm, Onchocerca, which invade almost all parts of the eye and lead slowly to complete blindness from corneal opacities, cataract, chorioretinal degeneration, and optic atrophy. An investigation of its incidence in the Gold Coast of equatorial Africa has recently been made by Harold Ridley, of the Royal Army Medical Service (British Journal of Ophthalmology, Monograph Supplement X, 1945) who laments that lack of realization of the importance of the disease was demonstrated by absence of mention at a discussion held in London in 1944, on "Important diseases affecting West African troops." In Africa, research has attributed the disease to a filaria named "Onchocerca volvulus"; while in Guatemala the responsible parasite is called "Onchocerca caecutiens" ("the blinding filaria"). The two organisms are presumably identical, and there is a probability that the disease was primarily African and was originally imported to the Americas with the slave trade. The disease is carried by the fly Simulium, which breeds in running water at altitudes from sea level to 4,500 feet. Simulium is an intermediate host. Man is the true host of this filaria, since he carries the organism during its sexual stage. Much work on the subject has been done by Pacheco-Luna of Guatemala. At the Cleveland Pan-American Congress, Pacheco-Luna showed some remarkable