THE NEW OPHTHALMOLOGY 435 



world have done their refraction work badly. The logical and patho- 

 logical conclusions of the labors of Bonders, Helmholtz, and others 

 have been practically made only by some American, and one or two 

 European, refractionists. "I sent my patient to the oculist and 

 glasses had no effect on the disease," means utterly nothing. "Is not 

 my oculist a man of the highest renown and ability?" may mean as 

 little. Does this man of renown and ability teach, and in the persons 

 of his patients demonstrate, that so-called "migraine," headache, 

 sick headache, dyspepsia, spinal curvature, insomnia, neurasthenia, 

 anemia, the blues, and the rest of the list, are often, very often, due 

 to eye-strain? Belief in the truth is a prerequisite of ability to cure; 

 and it is absolutely essential to a rigid attention to at least "78 

 reasons why glasses fail to give relief." From 50 to 75 per cent of 

 glasses prescribed in the world are inaccurate and cannot relieve 

 eye-strain. Then it is also true that fully 75 per cent of the adjusting 

 of opticians is so bad that any possible therapeutic result is not 

 obtained. To be entirely frank, one should add an argument which is, 

 indeed, a two-edged sword, but which needs occasional use to keep 

 it from rusting. It is this : Those who deny that migraine and the 

 many other diseases mentioned may be due to eye-strain have not 

 of course cured such patients in their own private practice. That is 

 a self-judgment which is most severe. Those on the other hand who 

 claim that such diseases are curable by ametropic correction, unless 

 utterly unprofessional, must have cured such patients. If they do not 

 cure they would surely be soon found out and their reputations and 

 practices ruined. They seem to prosper ! I heard one astute oculist 

 say that if this absurd skepticism continued a few years longer his 

 fortune would be made. He is very "successful" and is conducting 

 his work in an honorable manner. The enthusiasm and gratitude of 

 a patient permanently relieved of the tragedy of "migraine" or 

 "neurasthenia" are irrepressible. 



A corollary is that refraction is not taught, there is not a single 

 adequate and thoroughgoing school wherein may be taught, or 

 wherein there is any outfitting, or attempt to teach, this most 

 skilled, most infinitely subtle and difficult art and science. Two 

 years at least of study, daily, exclusive study and practice, after 

 the general course in medicine, under expert teachers, and on the part 

 of the best type of student minds, is a too short period to introduce 

 him to the work, and legally to justify him in entering on such spe- 

 cialist practice. An endower and maker of such a school would do 

 the world a far greater service than either Carnegie or Rockefeller 

 have dreamed of doing. 



Again the critic may justly ask: Have none, then, recognized and 

 spoken out this much unrecognized truth? Oh, yes, many and good 

 men have done so. There is a vast body of literature produced by 



