The Cure of Imperfect Sight by Treatment Without Glasses: Illustrated

The Cure of Imperfect Sight by Treatment Without Glasses

Illustrated

By William Horatio Bates

THE FUNDAMENTAL PRINCIPLE

Do you read imperfectly? Can you observe then that when you look at the first word, or the first letter, of a sentence you do not see best where you are looking; that you see other words, or other letters, just as well as or better than the one you are looking at? Do you observe also that the harder you try to see the worse you see?

Now close your eyes and rest them, remembering some color, like black or white, that you can remember perfectly. Keep them closed until they feel rested, or until the feeling of strain has been completely relieved. Now open them and look at the first word or letter of a sentence for a fraction of a second. If you have been able to relax, partially or completely, you will have a flash of improved or clear vision, and the area seen best will be smaller.

After opening the eyes for this fraction of a second, close them again quickly, still remembering the color, and keep them closed until they again feel rested. Then again open them for a fraction of a second. Continue this alternate resting of the eyes and flashing of the letters for a time, and you may soon find that you can keep your eyes open longer than a fraction of a second without losing the improved vision.

If your trouble is with distant instead of near vision, use the same method with distant letters.

In this way you can demonstrate for yourself the fundamental principle of the cure of imperfect sight by treatment without glasses.

If you fail, ask someone with perfect sight to help you.

FERDINAND VON ARLT

(1812-1887)

Distinguished Austrian ophthalmologist, Professor of Diseases of the Eye at Vienna who believed for a time that accommodation was produced by an elongation of the visual axis, but finally. accepted the conclusions of Cramer and Helmholtz.

The Cure of Imperfect Sight

by Treatment Without

Glasses

By

W. H. BATES, M.D.

CENTRAL FIXATION PUBLISHING CO.

NEW YORK CITY

Copyright, 1920

By W. H. BATES, M.D.

PRESS OF THOS. B. BROOKS, INC.

NEW YORK

On a tomb in the Church of Santa Maria Maggiore in Florence was found an inscription which read: Here lies Salvino degli Armati, Inventor of Spectacles. May God pardon him his sins.

Nuova Enciclopedia Italiana, Sixth Edition.

TO THE MEMORY

OF THE

PIONEERS OF OPHTHALMOLOGY

THIS BOOK IS GRATEFULLY DEDICATED

PREFACE

This book aims to be a collection of facts and not of theories, and insofar as it is, I do not fear successful contradiction. When explanations have been offered it has been done with considerable trepidation, because I have never been able to formulate a theory that would withstand the test of the facts either in my possession at the time, or accumulated later. The same is true of the theories of every other man, for a theory is only a guess, and you cannot guess or imagine the truth. No one has ever satisfactorily answered the question, Why ? as most scientific men are well aware, and I did not feel that I could do better than others who had tried and failed. One cannot even draw conclusions safely from facts, because a conclusion is very much like a theory, and may be disproved or modified by facts accumulated later. In the science of ophthalmology, theories, often stated as facts, have served to obscure the truth and throttle investigation for more than a hundred years. The explanations of the phenomena of sight put forward by Young, von Graefe, Helmholtz and Donders have caused us to ignore or explain away a multitude of facts which otherwise would have led to the discovery of the truth about errors of refraction and the consequent prevention of an incalculable amount of human misery.

In presenting my experimental work to the public, I desire to acknowledge my indebtedness to Mrs. E. C. Lierman, whose co-operation during four years of arduous labor and prolonged failure made it possible to carry the work to a successful issue. I would be glad, further, to acknowledge my debt to others who aided me with suggestions, or more direct assistance, but am unable to do so, as they have requested me not to mention their names in this connection.

As there has been a considerable demand for the book from the laity, an effort has been made to present the subject in such a way as to be intelligible to persons unfamiliar with ophthalmology.

LIST OF ILLUSTRATIONS

Portrait of Ferdinand von Arlt Frontispiece

1. Patagonians

2. African Pigmies

3. Moros from the Philippines

4. Diagram of the hypermetropic, emmetropic and myopic eyeballs

5. The eye as a camera

6. Mexican Indians

7. Ainus, the aboriginal inhabitants of Japan

8. The usual method of using the retinoscope

9. Diagrams of the images of Purkinje

10. Diagram by which Helmholtz illustrated his theory of accommodation

11. Portrait of Thomas Young

12. Portrait of Hermann Ludwig Ferdinand von Helmholtz

13. Demonstration upon the eye of a rabbit that the inferior oblique muscle is an essential factor in accommodation

14. Demonstration upon the eye of a carp that the superior oblique muscle is essential to accommodation

15. Demonstration upon the eye of a rabbit that the production of refractive errors is dependent upon the action of he external muscles

16. Demonstration upon the eye of a fish that the production of myopic and hypermetropic refraction is dependent upon the action of the extrinsic muscles

17. Production and relief of mixed astigmatism in the eye of a carp

18. Demonstration upon the eyeball of a rabbit that the obliques lengthen the visual axis in myopia

19. Demonstration upon the eye of a carp that the recti shorten the visual axis in hypermetropia

20. Lens pushed out of the axis of vision

21. Rabbit with lens removed

22. Experiment upon the eye of a cat, demonstrating that the fourth nerve, which supplies only the superior oblique muscle, is just as much a nerve of accommodation as the third, and that the superior oblique muscle which it supplies is a muscle of accommodation

23. Pithing a fish preparatory to operating upon its eyes

24. Arrangements for photographing images reflected from he eyeball

25. Arrangements for holding the head of the subject steady while images were being photographed

26. Image of electric filament on the front of the lens.

27. Images of the electric filament reflected simultaneously from the cornea and lens

28. Image of electric filament upon the cornea

29. Image of electric filament on the front of the sclera

30. Images on the side of the sclera

31. Multiple images upon the front of the lens

32. Reflection of the electric filament from the iris

33. Demonstrating that the back of the lens does not change during accommodation.

34. Straining to see at the near-point produces hypermetropia.

35. Myopia produced by unconscious strain to see at the distance is increased by conscious strain

36. Immediate production of myopia and myopic astigmatism in eyes previously normal by strain to see at the distance

37. Myopic astigmatism comes and goes according as the subject looks at distant objects with or without strain. .

38. Patient who has had the lens of the right eye removed for cataract produces changes in the refraction of this eye by strain 

39. A family group strikingly illustrating the effect of the mind upon the vision

40. Myopes who never went to school, or read in the Subway

41. One of the many thousands of patients cured of errors of refraction by the methods presented in this book

42. Palming

43. Patient with atrophy of the optic nerve gets flashes of improved vision after palming

44. Paralysis of the seventh nerve cured by palming

45. Glaucoma cured by palming

46. Woman with normal vision looking directly at the sun

47. Woman aged 37-child aged 4, both looking directly at the sun without discomfort

48. Focussing the rays of the sun upon the eye of a patientby means of a burning glass

49. Specimen of diamond type

50. Photographic type reduction

51. Operating without anaesthetics

52. Neuralgia relieved by palming and the memory of black

53. Voluntary production of squint by strain to see

54. Case of divergent vertical squint cured by eye education

55. Temporary cure of squint by memory of a black period.

56. Face-rest designed by Kallmann, a German optician

THE CURE OF IMPERFECT SIGHT BY

TREATMENT WITHOUT GLASSES

PERFECT SIGHT WITHOUT GLASSES

CHAPTER I. INTRODUCTORY

MOST writers on ophthalmology appear to believe that the last word about problems of refraction has been spoken, and from their viewpoint the last word is a very depressing one. Practically everyone in these days suffers from some form of refractive error. Yet we are told that for these ills, which are not only so inconvenient, but often so distressing and dangerous, there is not only no cure, and no palliatives save those optic crutches known as eyeglasses, but, under modern conditions of life, practically no prevention.

It is a well known fact that the human body is not a perfect mechanism. Nature, in the evolution of the human tenement, has been guilty of some maladjustments. She has left, for instance, some troublesome bits of scaffolding, like the vermiform appendix, behind. But nowhere is she supposed to have blundered so badly as in the construction of the eye. With one accord ophthalmologists tell us that the visual organ of man was never intended for the uses to which it is now put. Eons before there were any schools or printing presses, electric lights or moving pictures, its evolution was complete. In those days it served the needs of the human animal perfectly. Man was a hunter, a herdsman, a farmer, a fighter. He needed, we are told, mainly distant vision; and since the eye at rest is adjusted for distant vision, sight is supposed to have been ordinarily as passive as the perception of sound, requiring no muscular action whatever. Near vision, it is assumed, was the exception, necessitating a muscular adjustment of such short duration that it was accomplished without placing any appreciable burden upon the mechanism of accommodation. The fact that primitive woman was a seamstress, an embroiderer, a weaver, an artist in all sorts of fine and beautiful work, appears to have been generally forgotten. Yet women living under primitive conditions have just as good eyesight as the men.

Fig. 1. Patagonians

The sight of this primitive pair and of the following groups of primitive people was tested at the World's Fair in St. Louis and found to be normal. The unaccustomed experience of having their pictures taken, however, has evidently so disturbed them that they were all, probably, myopic when they faced the camera. (see Chapter IX.)

When man learned how to communicate his thoughts to others by means of written and printed forms, there came some undeniably new demands upon the eye, affecting at first only a few people, but gradually including more and more, until now, in the more advanced countries, the great mass of the population is subjected to their influence. A few hundred years ago even princes were not taught to read and write. Now we compel everyone to go to school, whether he wishes to or not, even the babies being sent to kindergarten. A generation or so ago books were scarce and expensive. To-day, by means of libraries of all sorts, stationary and traveling, they have been brought within the reach of practically everyone. The modern newspaper, with its endless columns of badly printed reading matter, was made possible only by the discovery of the art of manufacturing paper from wood, which is a thing of yesterday. The tallow candle has been but lately displaced by the various forms of artificial lighting, which tempt most of us to prolong our vocations and avocations into hours when primitive man was forced to rest, and within the last couple of decades has come the moving picture to complete the supposedly destructive process.

Fig. 2. African Pigmies

They had normal vision when tested, but their expressions show that they could not have had it when photographed.

Was it reasonable to expect that Nature should have provided for all these developments, and produced an organ that could respond to the new demands? It is the accepted belief of ophthalmology to-day that she could not and did not,1 and that, while the processes of civilization depend upon the sense of sight more than upon any other, the visual organ is but imperfectly fitted for its tasks.

There are a great number of facts which seem to justify this conclusion. While primitive man appears to have suffered little from defects of vision, it is safe to say that of persons over twenty-one living under civilized conditions nine out of every ten have imperfect sight, and as the age increases the proportion increases, until at forty it is almost impossible to find a person free from visual defects. Voluminous statistics are available to prove these assertions, but the visual standards of the modern army2 are all the evidence that is required.

In Germany, Austria, France and Italy the vision with glasses determines acceptance or rejection for military service, and in all these countries more than six diopters3 of myopia are allowed, although a person so handicapped cannot, without glasses, see anything clearly at more than six inches from his eyes. In the German Army a recruit for general service is required—or was required under the former government—to have a corrected vision of 6/12 in one eye. That is, he must be able to read with this eye at six metres the line normally read at twelve metres. In other words, he is considered fit for military service if the vision of one eye can be brought up to one-half normal with glasses. The vision in the other eye may be minimal, end in the Landsturm one eye may be blind. Incongruous as the eyeglass seems upon the soldier, military authorities upon the European continent have come to the conclusion that a man with 6/12 vision wearing glasses is more serviceable than a man with 6/24 vision (one-quarter normal) without them.

In Great Britain it was formerly uncorrected vision that determined acceptance or rejection for military service. This was probably due to the fact that previous to the recent war the British Army was used chiefly for foreign service, at such distances from its base that there might have been difficulty in providing glasses. The standard at the beginning of the war was 6/24 (uncorrected) for the better eye and 6/60 (uncorrected) for the poorer, which was required to be the left. Later, owing to the difficulty of securing enough men with even this moderate degree of visual acuity, recruits were accepted whose vision in the right eye could be brought up to 6/12 by correction, provided the vision of one eye was 6/24 without correction.4

Fig. 3. Moros from the Philippines

With sight ordinarily normal all were probably myopic when photographed except the one at the upper left whose eyes are shut.

Up to 1908 the United States required normal vision in recruits for its military service. In that year Bannister and Shaw made some experiments from which they concluded that a perfectly sharp image of the target was not necessary for good shooting, and that, therefore, a visual acuity of 20/40 (the equivalent in feet of 6/12 in metres), or even 20/70, in the aiming eye only, was sufficient to make an efficient soldier. This conclusion was not accepted without protest, but normal vision had become so rare that it probably seemed to those in authority that there was no use insisting upon it; and the visual standard for admission to the Army was accordingly lowered to 20/40 for the better eye and 20/100 for the poorer, while it was further provided that a recruit might be accepted when unable with the better eye to read all the letters on the 20/40 line, provided he could read some of the letters on the 20/30 line.5

In the first enrollment of troops for the European war it is a matter of common knowledge that these very low standards were found to be too high and were interpreted with great liberality. Later they were lowered so that men might be unconditionally accepted for general military service with a vision of 20/100 in each eye without glasses, provided that the sight of one eye could be brought up to 20/40 with glasses, while for limited service 20/200 in each eye was sufficient, provided the vision of one eye might be brought up to 20/40 with glasses.6 Yet 21.68 per cent of all rejections in the first draft, 13 per cent more than for any other single cause, were for eye defects,7 while under the revised standards these defects still constituted one of three leading causes of rejection. They were responsible for 10.65 per cent of the rejections, while defects of the bones and joints and of the heart and bloodvessels ran, respectively, about two and two and a half per cent higher.8

For more than a hundred years the medical profession has been seeking for some method of checking the ravages of civilization upon the human eye. The Germans, to whom the matter was one of vital military importance, have spent millions of dollars in carrying out the suggestions of experts, but without avail; and it is now admitted by most students of the subject that the methods which were once confidently advocated as reliable safeguards for the eyesight of our children—have accomplished little or nothing. Some take a more cheerful view of the matter, but their conclusions are hardly borne out by the army standards just quoted.

For the prevailing method of treatment, by means of compensating lenses, very little was ever claimed except that these contrivances neutralized the effects of the various conditions for which they were prescribed, as a crutch enables a lame man to walk. It has also been believed that they sometimes checked the progress of these conditions; but every ophthalmologist now knows that their usefulness for this purpose, if any, is very limited. In the case of myopia9 (shortsight), Dr. Sidler-Huguenin of Zurich, in a striking paper recently published,10 expresses the opinion that glasses and all methods now at our command are of but little avail in preventing either the progress of the error of refraction, or the development of the very serious complications with which it is often associated.

These conclusions are based on the study of thousands of cases in Dr. Huguenin's private practice and in the clinic of the University of Zurich, and regarding one group of patients, persons connected with the local educational institutions, he states that the failure took place in spite of the fact that they followed his instructions for years with the greatest energy and pertinacity, sometimes even changing their professions.

I have been studying the refraction of the human eye for more than thirty years, and my observations fully confirm the foregoing conclusions as to the uselessness of all the methods heretofore employed for the prevention and treatment of errors of refraction. I was very early led to suspect, however, that the problem was by no means an unsolvable one.

Every ophthalmologist of any experience knows that the theory of the incurability of errors of refraction does not fit the observed facts. Not infrequently such cases recover spontaneously, or change from one form to another. It has long been the custom either to ignore these troublesome facts, or to explain them away, and fortunately for those who consider it necessary to bolster up the old theories at all costs, the role attributed to the lens in accommodation offers, in the majority of cases, a plausible method of explanation. According to this theory, which most of us learned at school, the eye changes its focus for vision at different distances by altering the curvature of the lens; and in seeking for an explanation for the inconstancy of the theoretically constant error of refraction the theorists hit upon the very ingenious idea of attributing to the lens a capacity for changing its curvature, not only for the purpose of normal accommodation, but to cover up or to produce accommodative errors. In hypermetropia11—commonly but improperly called farsight, although the patient with such a defect can see clearly neither at the distance nor the nearpoint—the eyeball is too short from the front backward, and all rays of light, both the convergent ones coming from near objects, and the parallel ones coming from distant objects, are focussed behind the retina, instead of upon it. In myopia it is too long, and while the divergent rays from near objects come to a point upon the retina, the parallel ones from distant objects do not reach it. Both these conditions are supposed to be permanent, the one congenital, the other acquired. When, therefore, persons who at one time appear to have hypermetropia, or myopia, appear at other times not to have them, or to have them in lesser degrees, it is not permissible to suppose that there has been a change in the shape of the eyeball. Therefore, in the case of the disappearance or lessening of hypermetropia, we are asked to believe that the eye, in the act of vision, both at the near-point and at the distance, increases the curvature of the lens sufficiently to compensate, in whole or in part, for the flatness of the eyeball. In myopia, on the contrary, we are told that the eye actually goes out of its way to produce the condition, or to make an existing condition worse. In other words, the so-called ciliary muscle, believed to control the shape of the lens, is credited with a capacity for getting into a more or less continuous state of contraction, thus keeping the lens continuously in a state of convexity which, according to the theory, it ought to assume only for vision at the nearpoint. These curious performances may seem unnatural to the lay mind; but ophthalmologists believe the tendency to indulge in them to be so ingrained in the constitution of the organ of vision that, in the fitting of glasses, it is customary to instill atropine—the drops with which everyone who has ever visited an oculist is familiar—into the eye, for the purpose of paralyzing the ciliary muscle and thus, by preventing any change of curvature in the lens, bringing out latent hypermetropia and getting rid of apparent myopia.

Fig. 4. Diagram of the Hypermetropic, Emmetropic and Myopic Eyeballs

H, hypermetropia; E, emmetropia; M, myopia; Ax, optic axis. Note that in hypermetropia and myopia the rays, instead of coming to a focus, form a round spot upon the retina.

The interference of the lens, however, is believed to account for only moderate degrees of variation in errors of refraction, and that only during the earlier years of life. For the higher ones, or those that occur after fortyfive years of age, when the lens is supposed to have lost its elasticity to a greater or less degree, no plausible explanation has ever been devised. The disappearance of astigmatism,12 or changes in its character, present an even more baffling problem. Due in most cases to an unsymmetrical change in the curvature of the cornea, and resulting in failure to bring the light rays to a focus at any point, the eye is supposed to possess only a limited power of overcoming this condition; and yet astigmatism comes and goes with as much facility as do other errors of refraction. It is well known, too, that it can be produced voluntarily. Some persons can produce as much as three diopters. I myself can produce one and a half.

Examining 30,000 pairs of eyes a year at the New York Eye and Ear Infirmary and other institutions, I observed many cases in which errors of refraction either recovered spontaneously, or changed their form, and I was unable either to ignore them, or to satisfy myself with the orthodox explanations, even where such explanations were available. It seemed to me that if a statement is a truth it must always be a truth. There can be no exceptions. If errors of refraction are incurable, they should not recover, or change their form, spontaneously.

Fig. 5. The Eye As a