G. M. Gould
1903 BMJ (Clinical Research Edition)  
breakfast, the anorexia of such children, is also indicative of the same morbid cause. 'Extreme sensitiveness to noise an aspect of the symptom of insomnia that has been noticed. Complaint 'of the"nervousness" of patients, young or old, the6 fidgetiness," etc., of the waste; and rush of op moldelln-nervous life, fills the newspapers and magazineoi Much of itis due to eyestrain. As high a proportion as 50 per cent. or over of modern school children are pronounced aakkward or subnormal in
more » ... 'and mental qualities. had ta-en as much morphine as Mrs. Browning. -t is indeed true that opium was a blessing to De Quincey, as he said it was. Before stopping' I wish to allude to facial eyestrain expression. Observant oculists notice it when some patients enter the room. It is not always present, just as ocular symptoms may be absent in the worst cases. I should say that the, expression of the eyes and face is characteristically morbidized in 50 per cent. of such patients, especially older ones. In children with eyestrain, anaemia, anorexia,. and night terrors, it is, 'owever, usually to be detected. is not a result of heterophoria, the latent or the permanent tdrrinin of the eye outward, such as De Quincey and Wagner had. That is a different matter, and eauses a different ex-pression It is an almost inde cribable haunting, signal, as Tn BunL.r DZi JoPE 75 7 exhausted and hopeless suffering, a sort of haggard, sunken look, telling a tale of pained, tired, and useless effort. In the later photographs of Darwin, of Carlyle, of Mrs. Carlyle, and of Whittier it is evident, and suggestions of it 'exist in those of others. (It was this look that first suggested to me many years ago that Carlyle was an eyestrain sufferer.) It is plainly present in the pictures of Beethoven, Tennyson, Mrs. Browning, etc. The " Bachelder eye" of Webster, Whittier, etc., I suspect was a result of the intensity'and victory of the effort to compensate for the eyestrain present. Old painters sometimes reproduced the eyestrain expression more or less perfectly in their pictures of mediaeval saints and ascetics. Lastly, I cannot forbear allusion to the influence eyestrain sequels have had on the growth during the last century of European spas and health resorts, springs and waters, sanatoriums, cures, establishments, etc. The histories of the search for health at these places by Wagner, Nietzsche, Darwin, Parkman, and Huxley bring vividly before the mind directly. and as much by indirection, that these resorts came into being largely, if not principally, in a pitiful attempt to cure eyestrain. Pleasure places and fashion resorts, one realizes often' grew out Iof the superstition. The hunt for diet doctors and water doctors was so intense that its ludicrousness is almost as crying as its unavailing resultlessness, and both are only; equalled by the pathos of it all. Hydropathy, its gulls and its gullies, are still dismnally echoing in the twentieth century. The peculiar kinds of diseases and of patients on which fatten a'hundred forms of quackery, Eddyism, osteopathy, absent healing, and all the nauseating rubbish of several million maudlin American cranks and scamps, are also in big part due to an attempt to treat astigmatism by ignoring it, or by means of that potent article of the materia medica vulgarly named" tommy-rot." intercurrent Diseases.-Several of the patients for example, De Quincey and Nietzsche-seemed extremely subject to influenza or colds; and especially Mrs. Carlyle. When not suffering from headache she was always suffering from colds or .influenza-" eight influenzas annually," said Miss Martineau. They afflicted her all her life, most exasperatingly and most wearingly. I have not copied near all the excerpts which prove the continuousness and severity of these seizures. It is gratifying to be able to quote a great medical authority that such attacks of colds and influenzas may be due to micro-organisms, or local conditions in the air passages. but these maladies, as we now know, both depend to some extent on a special predisposition in the sufferer, having its root in the nervous system, and both leave their stamp on that system and gradually undermine it. Now here is a truth, or a glimpse of it, that deserves most careful pondering by the profession. In Mrs. Carlyle's case it is noteworthy that these colds and influenzas did notcoexist usuallywith headache and sick headache; thatthey came on in a most unaccountable manner, without explainable reason, usually in winter, and remained long, and most remarkable that they ceased at the time of the great change in 57 or 62. Wet and foggy, or not, driving, sailing, or not, shp is at this time " perfectly astonished with the impunity, etc. ' Allof Mrs. Carlyle's sick headaches were caused by eyestrain, afact beyond all question. As little doubt can there be that -no cause can more directly and infallibly upset and morbidize the nervous, mental, and nutritional mechanisms. It thus supplied the"nervous system " with precisely the predisposiig condition Sir James Crichton-Browne gives as the cause o£ colds and influenzas. The inference is very suggestive that Mrs. Carlyle's influenzal attacks were the reflex' results of eyestrain. The smile of incredulity with which the all-wise may receive the thought has nothing to do with its truth or falsity. In private practice the fact of the interconnexion of nasal and ocular diseases has often been noted. Illustrative cases have been published. The details of one such are of exceptional interest. A healthy, clear-headed, intellectual man was given two pairs of spectacles for his myopic astigmatism, a stronger or higher correction for use at the theatre, driving, etc., a weaker correction for reading and daily or constant use. For a year his wife and daughter observed, without telling him, that whenever e e wore the strong, or accommodation-exciting glasses, he " caught cold," with coryza,lhoarseness, etc., which at once disappeared when the weaker lenses were used. He used the stronger ones but few times a year. When certain of the strange eoincidence his wife told her husbnnd. In the past ten years the cold has been produced in this .way -a I u.idred or more times. Yow, if his wcaker glasses 'get SnEB.,26, .1903.] 1. -
doi:10.1136/bmj.2.2230.757 fatcat:qaglpafmorggvgd2ctrgii37y4