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The Eyes of the Aviator
American Journal of Ophthalmology Series 3, Vol. 2, No. 6
June, 1919
PUBLISHED MONTHLY BY THE OPHTHALMIC PUBLISHING COMPANY EDITORIAL STAFF ADOLF ALT, CASEY A. WOOD, 7 W. Madison St., Chicago, 111. Metropolitan Bldg., St. Louis, Mo. HARRY V. WURDEMANN, M. URIBE-TRONCOSO, Cobb Bldg., Seattle, Washington. 143 W. 92nd St., New York City. MEYER WIENER, EDWARD JACKSON, Editor, Carleton Bldg., St. Louis, Mo. 318 Majestic Bldg., Denver, Colo. CLARENCE LOEB, Associate Editor, 25 E. Washington St., Chicago, 111. Original papers and books for review may be sent to any member of the editorial staff. Reports of society proceedings, correspondence, and other scientific communications should be addressed to the Editor. Proof should be corrected and returned within forty-eight hours to the printer. Reprints may be obtained from the printers, Tucker-Kenworthy Co., 501 S. La Salle St., Chicago, 111., if ordered at the time proofs arc returned. Subscriptions, applications for single copies, communications with reference to advertising or other business, should be addressed to H. A. FOX, Manager, 7 West Madison St., Chicago, 111. T H E EYES OF T H E AVIATOR. If aviation had been achieved thru an evolutionary transition extending over countless generations, like that from the fish to the bird, it would have been attended with the perfecting of physical organization by the weeding out of countless defects, little noticed and of trifling importance while we walk on the earth, but fatal when we attempt to mount into the air. Among such defects, previously little thought of, are some of the eye and vision, t h a t ' rise to tragic prominence with attempts at flying. To speak of the air service as "the eyes of the modern army" is to keep as near the truth as figurative statement ever can. Blind Samson, the sport of his enemies, might well represent an army of today without its aviators. And if, by sacrifice of his own existence Samson could inflict terrible punishment upon the enemy, still it was only "schrecklichkeit," not military efficiency. If salt that has lost its savor is useless, what is to be said of the eye that
does not see things that safety requires should be seen ? A scotoma, never appreciated as a defect in the field of vision, may hide an enemy until time for effective defense is passed. Color perception only slightly subnormal might make the observer fatally slow to pierce a disguise. A minor defect of motor coordination and balance may be of no importance while a man stands with his feet on the earth, yet it means disaster when attempting a difficult landing. The experience of war has led to the relaxation of visual requirements in many branches of the service. But for air service it teaches that they should be made, if possible, more exacting, and should be rigidly enforced. No material relaxation of them is possible without an increase in the proportion of fatalities, which makes those inflicted by the enemy look small in comparison. The Major in the regular army whose son has a slight macular lesion, and minute relative scotoma with disturbance of muscle balance, never be-
EDITORIALS
fore noticed, cannot understand why his boy may not gratify his laudable ambition to become a flier. The Congressman, who does not know the difference between the accommodation of the eye, and that of obtaining a small loan from his bank, does not understand why the government should be put to the expense of a physiologic laboratory like that at Mineola. Yet the Major would be inconsolable for the death of his son in the smash of a bad landing; and the Congressman would declaim most eloquently against the sacrifice of $50,000 airplanes to say nothing of the expense of the training and lives of needed officers thru the temporary disabilities produced by altitude or training in stunt flying necessary for attack or defense in the air. There is great need for scientific men to acquaint themselves with the facts regarding the physical requirements for safe and successful aviation; and then to exert themselves actively in producing a public opinion that will support rigid requirements for the aviator, and scientific study of all the difficulties he has to meet and overcome. The book on Air Service Medical, elsewhere noticed in this number, should be read and studied by every oculist who wishes to keep in touch with the newest and most suggestive phases of medical thought; and at the same time get a new point of view for the functions and diseases with which he has to deal in his daily practice, and fit himself to perform his educational duty toward the public. E. J. RELATIVE SCARCITY OF TRACHOMA ON T H E PACIFIC COAST. Rarely does a writer remark upon the paucity of clinical material; rather is-it true that he selects a subject for which he has gathered as many cases as possible. This writer has been struck with the fewness of trachoma patients whose home is in the Pacific Northwest. This
455
is the more remarkable because our population is easily eighty per cent transplanted from other sections of America, with a great mixture of the foreign element from all parts of the world. Of the latter there are face elements prone to this disease;—the Swedes and Norwegians, those from the Levant, Southern Europe and the Japanese. Odds and ends of peoples are found; even the Spanish-speaking Jews from the Marmora seacoast of Turkey, and as a contrast occasionally an Eskimo. The coast Indian tribes are not at all afflicted with trachoma, while those east of the Cascade Mountains, and particularly those east of the Rockies, have quite a high percentage of sore eyes from this disease. The writer finds quite a contrast in the last 10 years of his practice to the two decades spent in the Great Lakes Regions, as regards the prevalence of trachoma in private practice. His recent experience in Army Service corroborates the opinion that the affliction is not only not endemic in the Northwest, but that practically all cases here are imported, few arise de novo, or few contagions result. W e must then ascribe the relative immunity of our inhabitants to the climate, to the absence of dust and flies; —due to the cool, equable and moist climate as well as to the character of the soil, which is mostly a loam upon gravel or hard pan, there being little fine sand or clay to form dust. Then, too, our people live largely out of doors, even during our winter weather. Conditions are different over the mountains where the intense heat of the summer with its dust and dirt and the rigors of the winter, with the fouler air of house living, give local causes of ocular irritation. Now are these not provocative causes for trachoma? Certainly the refractive conditions with the eye strain are not different here, neither are the other alleged causes of the disease. Thus the writer comes to the conclusion regarding trachoma that the moderate climate of the Northwest Pacific slope is
June, 1919
PUBLISHED MONTHLY BY THE OPHTHALMIC PUBLISHING COMPANY EDITORIAL STAFF ADOLF ALT, CASEY A. WOOD, 7 W. Madison St., Chicago, 111. Metropolitan Bldg., St. Louis, Mo. HARRY V. WURDEMANN, M. URIBE-TRONCOSO, Cobb Bldg., Seattle, Washington. 143 W. 92nd St., New York City. MEYER WIENER, EDWARD JACKSON, Editor, Carleton Bldg., St. Louis, Mo. 318 Majestic Bldg., Denver, Colo. CLARENCE LOEB, Associate Editor, 25 E. Washington St., Chicago, 111. Original papers and books for review may be sent to any member of the editorial staff. Reports of society proceedings, correspondence, and other scientific communications should be addressed to the Editor. Proof should be corrected and returned within forty-eight hours to the printer. Reprints may be obtained from the printers, Tucker-Kenworthy Co., 501 S. La Salle St., Chicago, 111., if ordered at the time proofs arc returned. Subscriptions, applications for single copies, communications with reference to advertising or other business, should be addressed to H. A. FOX, Manager, 7 West Madison St., Chicago, 111. T H E EYES OF T H E AVIATOR. If aviation had been achieved thru an evolutionary transition extending over countless generations, like that from the fish to the bird, it would have been attended with the perfecting of physical organization by the weeding out of countless defects, little noticed and of trifling importance while we walk on the earth, but fatal when we attempt to mount into the air. Among such defects, previously little thought of, are some of the eye and vision, t h a t ' rise to tragic prominence with attempts at flying. To speak of the air service as "the eyes of the modern army" is to keep as near the truth as figurative statement ever can. Blind Samson, the sport of his enemies, might well represent an army of today without its aviators. And if, by sacrifice of his own existence Samson could inflict terrible punishment upon the enemy, still it was only "schrecklichkeit," not military efficiency. If salt that has lost its savor is useless, what is to be said of the eye that
does not see things that safety requires should be seen ? A scotoma, never appreciated as a defect in the field of vision, may hide an enemy until time for effective defense is passed. Color perception only slightly subnormal might make the observer fatally slow to pierce a disguise. A minor defect of motor coordination and balance may be of no importance while a man stands with his feet on the earth, yet it means disaster when attempting a difficult landing. The experience of war has led to the relaxation of visual requirements in many branches of the service. But for air service it teaches that they should be made, if possible, more exacting, and should be rigidly enforced. No material relaxation of them is possible without an increase in the proportion of fatalities, which makes those inflicted by the enemy look small in comparison. The Major in the regular army whose son has a slight macular lesion, and minute relative scotoma with disturbance of muscle balance, never be-
EDITORIALS
fore noticed, cannot understand why his boy may not gratify his laudable ambition to become a flier. The Congressman, who does not know the difference between the accommodation of the eye, and that of obtaining a small loan from his bank, does not understand why the government should be put to the expense of a physiologic laboratory like that at Mineola. Yet the Major would be inconsolable for the death of his son in the smash of a bad landing; and the Congressman would declaim most eloquently against the sacrifice of $50,000 airplanes to say nothing of the expense of the training and lives of needed officers thru the temporary disabilities produced by altitude or training in stunt flying necessary for attack or defense in the air. There is great need for scientific men to acquaint themselves with the facts regarding the physical requirements for safe and successful aviation; and then to exert themselves actively in producing a public opinion that will support rigid requirements for the aviator, and scientific study of all the difficulties he has to meet and overcome. The book on Air Service Medical, elsewhere noticed in this number, should be read and studied by every oculist who wishes to keep in touch with the newest and most suggestive phases of medical thought; and at the same time get a new point of view for the functions and diseases with which he has to deal in his daily practice, and fit himself to perform his educational duty toward the public. E. J. RELATIVE SCARCITY OF TRACHOMA ON T H E PACIFIC COAST. Rarely does a writer remark upon the paucity of clinical material; rather is-it true that he selects a subject for which he has gathered as many cases as possible. This writer has been struck with the fewness of trachoma patients whose home is in the Pacific Northwest. This
455
is the more remarkable because our population is easily eighty per cent transplanted from other sections of America, with a great mixture of the foreign element from all parts of the world. Of the latter there are face elements prone to this disease;—the Swedes and Norwegians, those from the Levant, Southern Europe and the Japanese. Odds and ends of peoples are found; even the Spanish-speaking Jews from the Marmora seacoast of Turkey, and as a contrast occasionally an Eskimo. The coast Indian tribes are not at all afflicted with trachoma, while those east of the Cascade Mountains, and particularly those east of the Rockies, have quite a high percentage of sore eyes from this disease. The writer finds quite a contrast in the last 10 years of his practice to the two decades spent in the Great Lakes Regions, as regards the prevalence of trachoma in private practice. His recent experience in Army Service corroborates the opinion that the affliction is not only not endemic in the Northwest, but that practically all cases here are imported, few arise de novo, or few contagions result. W e must then ascribe the relative immunity of our inhabitants to the climate, to the absence of dust and flies; —due to the cool, equable and moist climate as well as to the character of the soil, which is mostly a loam upon gravel or hard pan, there being little fine sand or clay to form dust. Then, too, our people live largely out of doors, even during our winter weather. Conditions are different over the mountains where the intense heat of the summer with its dust and dirt and the rigors of the winter, with the fouler air of house living, give local causes of ocular irritation. Now are these not provocative causes for trachoma? Certainly the refractive conditions with the eye strain are not different here, neither are the other alleged causes of the disease. Thus the writer comes to the conclusion regarding trachoma that the moderate climate of the Northwest Pacific slope is