754 PEECY FEIDENBERG 



climate, heat and cold, inheritance, race geographic conditions, seasons 

 and sunshine, mothers 7 milk and materies morbi, act largely, in the last 

 analysis, through a previously unrecognized link in the chain of cause and 

 effect, the glands of internal secretion. 



Ophthalmology and Endocrinology 



A priori one might expect endocrin implications in ophthalmology 

 from two standpoints. If the glands of internal secretion have a proven 

 influence on structure, development, physiology, immunity, emotion type, 

 and temperament, surely there must be some indications, normal or mor- 

 bid in an organ which is so peculiarly suited to clinical observation and 

 to the study from day to day of symptoms, disease processes, and reactions 

 to drugs and treatment, and one which indicates in so many ways its inter- 

 relations with systemic conditions and disturbances. Endocrinology sug- 

 gests ophthalmic applications. 



The eye presents such significant and characteristic peculiarities and 

 individualities depending on race, age, sex, life epoch, skull and orbit 

 form, emotion, neurovascular fluctuations, that ophthalmology suggests 

 endocrin influences. 



Of all organs of special sense the eye shows most strikingly a, con- 

 nection with the endocrin system and dependence on the double system 

 of vegetative control of vagus and sympathetic. This is shown in details 

 of structure and biomorphology, function in health and disease, and 

 perhaps most dramatically and pregnantly in its response to organo- 

 therapy or in the striking reactions to alkaloids and drugs which in ad- 

 dition to their local action referable to either of the dominant branches 

 of the vegetative nervous system have a definite selective action on one 

 or the other gland of internal secretion. In this sense the organ of taste, 

 like that of smell, is of relatively negligible significance, residing as 

 they do in an almost structureless area which is merely a specialized 

 mucous membrane which has hardly the structure or the other criteria 

 (developmental, neurological, metabolic) of an independent organ. The 

 sense of hearing, too, is akin to the eye in its phylogeny as a mechanism 

 mediating the perception of distant objects which may let loose neuro- 

 muscular reactions in the organism. The ear, however, as far as it has 

 hitherto been made the subject of histological and clinical study appears 

 to lack altogether those typical reactions of sympathetic irritation which 

 make of the eye an organ sui ycneris for the expression of the emotions 

 as it is primarily the medium by which those emotions are aroused and, 

 perhaps, harmlessly discharged or canalized by an action which suggests 

 the safety valve in effect if not in detail. In this last connection the re- 

 action of the pupil to sensory and psychical stimuli is significant, as is 



