

DISORDERS IN RELATION TO THE EYE 803 



Endocrin Therapy in Ophthalmology 



The largely empiric character of organotherapy in eye disease has as a 

 result that we have many suggestions and implications, with comparatively 

 scanty data of a definite and well authenticated sort, A philosophic, sci- 

 entific attempt to rationalize our methods of treatment, from this point 

 of view, must bear in mind some of the basic factors of immunity, metab- 

 olism, and physiology recounted under the various headings of this sur- 

 vey. Constitutional treatment, either of general or of ocular disease, must 

 recognize a probable endocrin factor not only in diet and drugs, but in 

 heat and cold, rest and exercise, sleep, sun and shade, nay, even in mothers' 

 milk. 1 



As far as specific organ products are concerned, general principles 

 will indicate the importance of correcting disorders of metabolism or of 

 endocrin balance. The choice of the gland or glands, and of activating 

 adjuvants from the dietary or the pharmacopoeia, will be determined 

 largely by physiological chemistry and by a clinical diagnosis which con- 

 siders not only the ocular symptoms but the systemic reaction to special 

 tests of endocrin function. This is the only basis for a rational therapy. 



Clinical observations on organotherapy in particular ocular affections 

 have been concerned with uveitis, glaucoma, and admittedly dyscrinoid 

 eye-states as noted in the preceding chapters. The implications are largely 

 constitutional and causal, rather than local and symptomatic. The lat- 

 ter phase suggests a brief study of the traditional and accepted procedures 

 of ophthalmic medication from the endocrinological point of view. This 

 indicates that many of our valuable ocular remedies act, at least in part, 

 by virtue of their vagotonic or sympathetico-tonic action. 



Ophthalmic Pharmacodynamics. The two main classes of ophthal- 

 miatric alkaloids, the meiotics and the mydriatics, are characterized as 

 much by their selective action on the two branches of the vegetative nerv- 

 ous system, as by their well-known and striking pupillomotor influence 

 and the resultant or accompanying action on ocular hyperemia and inflam- 

 mation, on intra-ocular tension, and so on. 



Heat and cold, local abstraction of blood by leeching or cupping, dark- 

 room cures, sweating and catharsis, as well as systemic alkalinization have 

 been used with good effects in a wide range of ocular diseases on a largely 

 empiric basis of clinical observation. lodids and mercury are, admittedly, 



1 Endocrinology gives us a new and broader view of what was accepted unques- 

 tioningly and fatalistically as Nature's way of healing, a way which, as often as not, 

 killed instead of curing. *We may safely assume that all Nature's telluric influences 

 act on and by the complicated system of the glands of internal secretion. How else 

 can we attempt to explain the systemic effects of such influences as wind, weather, 

 altitude and climate, seasonal incidence ar.d geographic distribution of disease, and 

 so many others? 



