ADDRESS

1894 Journal of the American Medical Association (JAMA)  
One of the great faults of our medical societies is the occupation of the time in reading papers and participating in discussions which, for the most part, are the mere quoting of authorities and presenting of views that are not new. The chairman is, however, a privileged individual in this respect, as he is either expected to present r\l=e'\sum\l=e'\of the present status of our science, or make a few general platitudes that may serve to open the meeting of the Section, and if possible put us
more » ... good humor with ourselves and our profession. It would be fortunate if all of our old straw could be threshed out in this one address, so that the remainder of our time could be profitably spent in the presentation of original observations and participating in discussions that might prove of permanent value to each of us. And yet an occasional review of what has been done by our predecessors often proves of inestimable value, and nothing like an extensive acquaintance with the literature of the subject so effectually prevents the presentation of poorly prepared and incomplete ob¬ servations as " new truths." I have had occasion to remark that it is much easier for me to prepare a paper on some other subject than those pertaining to the eye, and I suspect the reason is because I know less about what has been done in other directions. Because the thing is new to me I am tempted to pre¬ sent it as new to others. A few years since when the treatment of granulated lids by " grattage" was proposed, I was reminded of the treatment recommended by St. Yves1 for a sim¬ ilar condition nearly two hundred years ago. He says : " It is to be noticed that the Spots, the Ulcers, and certain Abscesses of the Cornea Transparent, attended with an Inflammation of the Conjunctiva are more speedily cured by Bleeding of the Eye, than by any other Means. Notwithstanding in some cases it is not proper as Practice evinces. This Bleeding of the Eye is performed in different Manners. Some take a Bundle of Beards of Oat-blades and make a kind of Brush with which they scrape the Conjunctiva and so scarify it: [Grattage]. Others pass a covered lancet between the Globe and the Eye-lid and scarify the Cornea [Sclerotic] with it. Others glide a Crooked Needle under the varicous Vessel's which communi¬ cate with the Spot, Ulcer or .4o.sce.ss and cut the Vessels which creep on the Conjunctiva. This last operation is the surest and least painful." Have we anything better to propose to-day? Since Richard Banister, Master of Surgery, Oculist and Practitioner of Physic, published his little book of twenty-three pages on the preservation of the " Eye-sight" three hundred years ago. in which our illustrious predecessor gave the regime he thought necessary to preserve the sight, together with the chief lotions, syrups and juices that should be applied to eye diseases, we have made wonderful progress ; and yet we must confess there are many points needing elucidation, that will require the most patient study on the part of the anatomist, histologist. physiologist, pathologist and clinical observer. Who will give us a clear and rational description of the course and termination of the intra-cerebral fibers of the optic nerve? Who will explain to us the cause of sympathetic ophthalmia? What are the relative functions of the rods and cones? Who will give us a good working theory of color perception? one that will explain color blindness. Why is it that after the çanaliculus is slit and large probes passed that the tears continue to overflow? What operation for cataract extraction is the best? The last word has not been said on heterophoria and errors of refraction, as we shall doubtless learn before the close of this meeting. These and numerous other important problems require our most careful consid¬ eration. In order to solve these questions we can not be guided entirely by our own experience. Many of them can not be answered by one generation, and need not only the experience of ophthalmologists of the present, as well as the past, but that of the entire profession, including the labors of chemists, physi¬ ologists, physicists and men engaged in every depart¬ ment of scientific research. It will be a most unfor¬ tunate step backward if we, as ophthalmologists should permit ourselves to be segregated from the great body of the medical profession as the oculists have been in ages past, or as the dentists are now. One of the most interesting chapters in Richard Banister's book2 is devoted to the exposure of what he calls " proud quack-salving mountebanks, that would undertake all cures, and perform few." He says further : li In the methodicall practice and cure of blind people, by couching of cataracts, our English oculists haue always had an especiall care, according to arts, to couch them within doores, out of the open aire, to preuent further danger. Yet some of these mountebanks take their patients into open markets, and there,for vain-glories sake,make them see, hurting the patient, only to make the people wonder at their rare skill. Some others make scaffolds, on purpose to execute their skill vpon, as the Frenchmen and the Irishmen did in the Strand, making a trumpet to be blowne before they went about their work." Much of the prejudice (and with justice) against oculists who treated diseases of the eye exclusively, has been handed down almost to our own day. Only a few years ago a most bitter fight was made against 1 A New Treatise of Diseases of the Eyes by M. De St.Yves, translated from the original French by
doi:10.1001/jama.1894.02421140001001 fatcat:fapzpkk635bfhpgfqnezx7ukgi