THE NEW OPHTHALMOLOGY AND ITS RELATION TO 

 GENERAL MEDICINE, BIOLOGY, AND SOCIOLOGY 



BY GEORGE MILBRY GOULD 



[George Milbry Gould, Physician, Philadelphia, Pa. b. 1848, Auburn, Maine. 

 B.A. Ohio Wesleyan University, 1873; A.M. ibid. ; M.D. Jefferson Medical 

 College, 1888. Fellow of the College of Physicians, Philadelphia; Member 

 of the American Ophthalmological Society; American Academy of Medicine; 

 American Medical Association. Author of a series of medical dictionaries; 

 Borderland Studies; Diseases of the Eye; Meaning and Method of Life; An 

 Autumn Singer; Biographic Clinics, 4 vols.; and many other works.] 



THE distinction between what may be called the old ophthalmo- 

 logy and the new is one of almost unique clearness, as compared with 

 that of other departments of medicine or science. Especially in 

 medical practice, the modern status has usually grown out of the 

 older and oldest by infinitesimal increments and gradual modifi- 

 cations. In opthalmology it is not so, and this fact explains why 

 there are such profound differences of opinion as regards the claims 

 of the new. Although both are usually practiced by the same men, 

 they may be, and often are, as distinct in origin, theory, and practice, 

 as, e. g., are otology and ophthalmology. 



The " old ophthalmology " was, and is, concerned with inflamma- 

 tory and surgical diseases alone, remaining ignorant of and indifferent 

 to such relations as might exist between the eye and the general 

 system, except as regards those minor and few diseases which arise 

 in the body and then affect the eye. Ocular inflammations, ocular 

 operations, and the ocular results of systemic disease these were 

 the limits of its interests. Even in recent text-books on medical 

 ophthalmology, there is no thought of any other relations of general 

 medicine and ophthalmology than those morbid ocular ones originat- 

 ing outside. That the eye is the starting-point of systemic disease 

 was unsuspected. In the latest, greatest, best, and most official 

 text-book on general medical practice, that of Allbutt, there is not 

 a word, from the first page to the last, which hints at the ocular 

 origin of any systemic disease, not even of headache. In the text- 

 books of general medicine by Continental authors there is the same 

 official ignoring of the claims of the new ophthalmology. In America 

 also most of the text-books either ignore entirely, or, what is worse, 

 list the remote causes of one or two systemic symptoms as possibly 

 due to the eye, but so mechanically and inattentively as to turn the 

 student aside more effectively than the silence of the utter ignorers. 

 The "praise" is very "faint" indeed, with which they condemn. 

 The new ophthalmology finds its objects of study and interest 

 precisely in these systemic results of ocular conditions. I do not mean 



