432 OPHTHALMOLOGY 



There is scarcely any disease which the general physician or 

 internist is called upon to treat that may not be, and that frequently 

 is not, due to or influenced by eye-strain. The commonest is desig- 

 nated by that silly and meaningless word, migraine. The term has 

 little or no significance nowadays. It is in fact the vulgarization of 

 a misnaming and meaningless designation of a malobserved and 

 trivial symptom, which in the majority of cases is not present, of a 

 widely prevalent and ingravescent disease, with indescribable symp- 

 toms, which may, in extreme cases, wreck life and morbidize the 

 mind, the etiology and pathology of which are unknown, the location 

 or organs affected being also unknown, and of which no treatment 

 avails. It is made to cover the conditions indiscriminatingly called 

 scotoma scintillans, headache, sick headache, gastric and intestinal 

 disorders, insomnia, melancholy, etc.; in a few severe cases such 

 patients have all of the symptoms. One symptom, dermatosis, the 

 French physicians learned long ago, is not recognized by modern der- 

 matologists. Severe skin-disorders are not infrequently an indirect 

 result of eye-strain. Migraine is almost always due to eye-strain, and, 

 except in the rarest worn-out chronic cases, it is almost immedi- 

 ately curable by extinguishing eye-strain. It is the commonest of all 

 affections, the great manurer of the ground for other and terminal 

 diseases, the supporter of quacks and patent medicine syndicates. 

 At least 10 per cent of Americans suffer from it, under one alias or 

 another, recognized or unrecognized. The larger number of these, 

 taught by sad experience, have given up the hope of cure, and they 

 are neighbors of the person who says migraine has no relation to 

 eye-strain, and who does not know that thousands are now being cured 

 by two little pieces of glass. Eye-strain effects have a peculiar tend- 

 ency to periodicities and waves of better and worse. The nervous 

 centres can endure for a time the burdens and irritations laid upon 

 them, but at last give way. This is so of mental states and diseases, 

 and the eye, as psychologists know, is the chief creator of intellect. 

 Hence those diseases or symptoms, when not dependent upon organic 

 disease, like headache, sick headache, fickle appetite, the paroxysmal 

 neuroses, cardiac palpitation or irregularity, chorea, epilepsy, 

 neuralgias, insomnia, colds, etc., which exhibit such waves and troths 

 of exacerbation and depression, may be due to ocular irritation. 



A key to many mysteries of disease might be found in a careful 

 classification of such as have increased with civilization as com- 

 pared with those conditions outside which have been changed during 

 the progress of civilization. Among these changed conditions none can 

 be more noteworthy than the new kind of labor, and the tremendous 

 addition of the amount of it, thrown upon the eye by the printing- 

 press, schools, sewing, clerical, and urban life. No other organ has 

 been subjected to such a change of work and stimulus, and in all 



