The Eye in its Relation to Health ================================= By Chalmer Prentice, M.D. Chicago, A.C. McClurg & Company, 1895 Transcription (c) A. Wik, 2004 +-------------+ | Chapter VII | pages 79-128 +-------------+ 79 A SHORT muscle on examination by diffu- sion tests may present itself in four differ- ent ways. First. It may be wholly manifest, in which case any and all tests will give like results. Second. It may be partly manifest and partly latent to the test. Third. It may be absolutely latent with no man- ifest defects. Fourth. Spasm may cause the eye to manifest the reverse of the anatomical condition, in which case the eye will deviate in a direction opposite to that of the short muscle. This is the dangerous condition that I have elsewhere pointed out. The first four of the following cases are given as illustrations of the four forms of eye-strain, respectively. Case. I. Presented by the president of the Johnston Optical Co., of Detroit. Left eye turned upward 20 deg. above the right. While reading, writing or looking intently at any near point, the inferior muscle of the left eye drew it down to a level with the other; but when not so employed or while looking off into the distance 80 or holding ordinary conversation, the nerve-cen- ters would invariably relax their effort and the eye would turn upward fully 20 deg. into a posi- tion of perfect rest; so, the greater part of the time there was no strain in this case, no constant waste of nerve-force, no unremitting source of brain irritation; consequently this person suf- fered little or no disturbance of the nerve-cen- ters. He was calm, quiet, and generally free from ailment. No correction was made as the person felt no necessity for it. The following cases were treated by repres- sion. They are selected for the purpose of set- ting forth some of the most prominent features of the treatment in which tenotomy and muscle advancement are often necessary. Sometimes the desired results are arrived at without an oper- ation, the repression being effected entirely by glasses. When prominent symptoms of a disease have been subdued, we are naturally led to believe that our work in repression is more or less com- plete; but it has so often proved incomplete on later examinations, that it is never safe to draw such conclusions. This will be clearly illustrated in the following case from Dr. Stanley of Brant- ford, Ont. In any particular case treated by repression alone, the only satisfaction we can have is to know that we have proceeded suffi- 81 ciently far to establish a more perfect and hap- pier condition of previously disturbed functions. Case 2. Partly manifest; D. A., age forty; Dr. Stanley of Brantford, Ont., says this case has been under his observation for upwards of four years; that from the first it was a very active and marked case of diabetes mellitus, and, toward the latter end of this period, neither diet nor medical remedies seemed to make any impression in less- ening the gravity of reducing the prominent symptoms. I saw the case first on October 10, 1889. Specific gravity, 1.052; thirst unquench- able; voided twenty pints of water in twenty-four hours; sleep broken and restless; obliged to get up four or five times during the night; anxiety and general nervous symptoms very depressing; skin dry and scaly. No hyperopia was found by dropping a two grain solution of atropine into the eyes twice a day for one week; then increasing to four grains to the ounce, it was used for three days, and on examining the eyes again I still found no indica- tion of hypermetropia. Vision without the glasses was twenty-twentieths or normal. I prescribved a +1 D glass for outdoor use, which gave twenty- fiftieths of vision at twenty feet. For house, reading, writing and all close purposes, I pre- scribed a +4 D, which was 1 D more than an absolute suspension of accommodation at thirteen 5 82 inches. This rendered the patient artificially myopic. At the expiration of three months, through the 1 D glasses at twenty feet, vision was twenty-twentieths. On removing the glasses, vision was also normal, but on returning them to the eyes again, the vision through the glasses was now reduced to twenty-thirtieths, but in half an hour it was again twenty-twentieths or normal. I now increased the power of both pairs of glasses .75 of a dioptre, which again gave twenty- fiftieths of vision at a distance, and the glasses for near use about the same amount of artificial myopia that the first pair of reading glasses gave. At the expiration of six months more, vision under the 1.75 D, at twenty feet, was normal. On removing these glasses, it now required some five minutes for normal vision to take place, indi- cating that the reduction of ciliary innervation was become somewhat fixed. The glasses were continued, as well as the above modus operandi, for a period of one year, since which time the patient has been wearing +2.75 for all general purposes. With these glasses vision is twenty- twentieths at all distances, but for the purpose of resting the accommodation, a +5 D is frequently resorted to for long and continued close work. This ciliary repression was carried on during the treatment of the long muscles, which was as follows: 83 Created horizontal diplopia; found the supe- rior and inferior rectus muscles balanced. Ver- tical diplopia disclosed 3 deg. of convergence. Sufficient prism to make up for the convergence produced no change in symptoms. On the sup- position that the manifestation was correct, which it proved to be, and that an unknown quantity of latent defect might be in the same direction, I gradually increased the prism, base out, until, within and hour, under 30 deg. of prism, the intol- erable thirst had entirely disappeared; the feet, which had been constantly cold, became warm; from a sallow paleness the complexion became flushed and ruddy; the pulse was reduced from 110 to 76. The prisms were now removed. On the 11th, the tests were repeated with similar results as on the previous day. On October 12 the patient could diverge for 12 deg. of prism, base in. These were kept on the patient in this position for nearly two hours. All distressing symptoms were very much aggravated until the patient exhibited great uneasiness and alarm. The hands and feet were cold, the complexion very pale, while the pulse mounted to 130. The prisms were removed, and an unusually uncom- fortable night followed. On the 13th, 30 deg. of prism were again accommodated for, and worn for two hours. A general relief followed. At this time, the 30 deg. proving somewhat tire- 84 some to the eyes, I reduced the prism to 20 deg., which the patient continued to wear for one week. The thirst did not return, the nights were some- what more comfortable, the quantity of water re- duced to ten pints, while the circulation and warmth in the extremities were considerably en- hanced. On now adding 20 deg. more of prism temporarily, a perspiration appeared on the fore- head and other parts of the body, the first the patient could remember having had for nearly four years. Partial tenotomy was now performed on each internal rectus muscle, leaving but a few of the outer fibres. I now had a 4 deg. of manifest divergence, but the symptoms were not so mate- rially relieved as they had been under the prisms; he could still accommodate for 40 deg., base out. Twenty degrees were constantly worn, base out, for two weeks following this, at which time I made a complete division of both internal tendons, not detaching them from the capsule. Under diplopia I now had 16 deg. of manifest exophoria. Vision was single to within a distance of about fourteen inches, but diplopia existed for all dis- tances nearer. The repression in the external muscles was now considerable; the thirst was entirely gone and the daily quantity of water reduced to seven pints; gravity 1.035; feet warm; skin moist; cheerfulness came; sleep more con- 85 tinuous and refreshing. The gravity was reduced slowly and was at times variable. On the first of May following, it was 1.020. On the 4th of July, 1890, gravity was 1.016. All tests now failed to find the slightest trace of sugar. Repeated ex- amination at various times through a space of four years have resulted in finding no sugar. Perfect health has prevailed. Patient paid me a visit in September, 1894, having been through a year of tedious work, with some very harassing reverses. Was feeling somewhat depressed and nervous; specific gravity 1.020; no trace of sugar; no other diabetic symptoms. By diplopia, the lateral eye muscles were per- fectly balanced as well as the vertical. By differ- ential test, namely prism base down before one eye, then the other, the patient was able to accommodate for several degrees more of prism on one eye than on the other. I at once began repression in this direction, and in one week the patient was wearing 14 deg. of prism base down before the right, or divided between the two eyes, with a perfectly satisfactory relief from nervousness and depression. The color of the skin was very much improved. To be certain that these changes were due to the above repression with the 14 deg. of prism, I at once reversed it. In the course of two hours the patient was able to fuse for 10 deg. in the 86 opposite direction. The complexion turned pale, the pulse mounted to 96, the hand and feet grew cold, and a very nervous and excited condition ensued; in ten hours the test of the urine showed sugar; gravity 1.038. The patient was very much alarmed. I immediately reversed the prisms. Nevertheless, a restless night was spent. Gravity was 1.030 in the morning, but by evening it had fallen to 1.020. On the following day it was 1.018 with a perfect alleviation of the disturbed con- ditions. I now made a complete division of the superior rectus of the right eye, not detaching it from the capsule. This eye was now thrown below its fellow 6 deg., vision was easy and single with the head slightly elevated. On look- ing upward there was double vision. At the end of three weeks no inconvenience from double vision remained and the patient's condition was in every way satisfactory. A letter was received from the patient seven months after the last operation, all conditions of health being reported perfect. This and many other cases that can be shown prove that, although the prominent symptoms of disease may be entirely relieved, as this diabetes was for a space of over four years, considerable abnormal innervation may still exist. The fact is, our first operations relieved the nerve-centers suffi- 87 ciently to place the diabetes under subjection; but during all this time a considerable abnormal innervation was existing. The exceeding promi- nence of the defect in the lateral muscles was sufficient to hide completely that existing in the vertical direction. It might have been found had it been looked for after the first operations, but the improvement in the general conditions naturally led us to suppose that we had done all that was necessary. I look upon the above as in no way a stubborn case. The abnormal innervations yielded very readily to the repression. The abnormal inner- vation giving rise to tonic spasm is sometimes so stubborn, that it fails to yield at times, even for months. Then suddenly it will relax and advance rapidly into high degrees bringing marked relief. This will be found illustrated clearly in case No. 19. Case 3. Absolutely latent; M. S. M. twenty- nine years old; married ten years; highly intellec- tual; graduated from a collegiate course at the age of eighteen with the highest honors; had always been a bright, vivacious girl, but was of a somewhat excitable nature. Had always been inclined to a constipated habit; at the age of twenty-two began to suffer with occasional pains and local disturbances in the region of the ovaries, and this condition continued to increase until it 88 became an almost constant source of suffering. At the age of twenty-seven other complications set in, neuralgic pains in the upper portion of the spine, also in the dorsal region. She now had a constant desire for water, ices, or cold drinks; was voiding large quantities of water, being obliged to get up two or three times in the night for that purpose. Her case was diagnosed as diabetes depending on chronic ovaritis, and in council a removal of the ovaries was advised. Preparations were made for the operation, but, through dread, it was abandoned. At about the time she visited me, she had again decided to undergo the operation. I found the specific gravity of her water 1.044, eighteen pints in twenty-four hours, perfectly clear and free from color; thirst quite marked; the smell of acetone was very perceptible in the breath; skin dry and scaly. She was excessively nervous and irritable. I created diplopia with prisms which at twenty feet gave no indication of any irregularity in any of the eye muscles; vision was normal at both far and near points. Could converge for 40 deg. of prism, and diverge the optic axes for only 6 deg. At the near point, vertical diplopia gave no evidence of any irregularity in the lateral muscles. While under the converging prisms, base out, her thirst and nervousness were aggravated, so I reversed the prisms to base in; causing the eyes to 89 diverge 6 deg. A perceptible relief followed. Founding my judgment on this test, I now began repression of innervation to the internal muscles, by having her wear 6 deg. of prism, base in, for distance, and when reading 20 deg., base in, in connection with a +3 D glass for suspending the effort of accommodation. The thirst was sub- dued almost at once, and the nervous symptoms markedly relieved. On the following day she was able to wear 8 deg. of prism, base in, without creating much double vision. At the end of one month, by gradual repression, she was able to, tolerate 20 deg. of prism, base in, without creating diplopia. During this repression, the pains in neck, back and ovaries were greatly diminished, and the constipation was entirely relieved from this time on. On removing the glasses I now had a highly manifest case of exophoria. By the finger test, approaching it close between the eyes, I found the right eye less inclined to converge. I made a complete division of the tendon of the external muscle of the right eye on the immediate line of its attachment to the sclerotic, after which there still remained a manifest exophoria of 3 deg. by diffusion test. I continued repression in the same direction, in ten days again arriving at 14 deg. of prism. I now made a complete division of the tendon of the external muscle in the left eye. In 90 neither operation was the tendon detached from the capsule. After the last operation, all symp- toms were materially relieved; the thirst was entirely gone; the amount of water voided was now five pints with a specific gravity ranging from 1.026 to 1.030; the pains in the ovaries, back and neck were gone. The only disagreeable feature to the patient now was that my last oper- ation had turned the eyes inward 10 deg., and for a time all objects were seen double. I now placed on her eyes sufficient prism, base out, to bring about single vision again. I decreased this prism 1 deg. at a time, varying through a period of two weeks, at which time she was able to see objects properly, directly in front of her, but on turning the eyes either to the right or left, they would again appear double. I continued the repression process by putting on 1 deg. of prism, base in, then two, letting her wear each change until fusion had taken place. This I continued until she was able to accommo- date for 8 deg., base in, which was in about three months from the last operation. On now remov- ing the prisms, easy single vision was possible directly in front and to both sides sufficiently far to be perfectly practicable. Six months after the last operation, every trace of sugar had disappeared from the secretions, the quantity was normal, and not a trace of ovaritis 91 or spinal irritation was left. The general health was admirable. It is true this patient was obliged to suffer considerable inconvenience and annoyance during the treatment. The double vision was unpleasant and perhaps alarming to the patient and friends, but the result far more than counter-balanced all these trivial annoyances. A dangerous capital operation was avoided, and health and happiness restored. One year after this patient left my scare, she gave birth to a healthy eight pound boy. Three years from this time, although her health had remained perfect, she returned for an examination. Artificial diplopia, both vertical and horizontal, disclosed a perfect balance in all the muscles. At this examination, finding no functional derange- ments, I made no further effort by repression to discover if abnormal innervation still existed. Case 4. Reverse manifestation; woman, thirty- six years old; married twelve years; no children; when a girl suffered from headaches, with pain in the back of the neck and between the shoulders; since the age of twenty-two had gradually increas- ing sensitiveness and pain in both ovaries, the left being the worst; habitual constipation; at the age of thirty kidneys began secreting larger amounts of water than normal; at this period a gradually increasing thirst set in; no sugar was 92 ever discovered in the secretions. An operation for the removal of the ovaries was seriously advised. The patient was determined to die rather than submit to it. Six months before she visited me, an aggra- vating cough set in. At the time of her first visit, on the twenty-second of November, 1892, the amount of water passed was twenty-four pints in twenty-four hours; specific gravity 1.002; thirst insatiable; no sugar. By diffusion test the supe- rior and inferior muscles were apparently balanced, the external and internal muscles turned the eyes inward 4 deg. I corrected this by placing 4 deg. of prism, base out, on the patient. In an hour the prism test again showed 2 deg. more of conver- gence. I corrected this; in half an hour, under 6 deg. of prism, base out, there were 2 deg. more of manifest convergence. Instead of balancing this with prisms, I overcorrected by 24 deg. Within an hour all distressing symptoms were very much aggravated, specially the pain and thirst. I con- cluded from this that the manifest convergence was due to spasm and that the prism was increas- ing it. I now removed the glasses. After twenty minutes the patient was able to accommodate for 4 deg. of prism, base in, in half an hour 2 deg. more were tolerated, increasing the divergence of the eyes. The thirst and pain were somewhat relieved. I now put on the patient 10 deg. of 93 prism, base in, and sent her home for the night. This gave double vision for any distance beyond ten feet. November twenty-third. At noon the patient was able to see objects single under the 10 deg. prisms. I now tested with prisms at the near point, 12 inches, at which distance 12 deg. more of divergence were manifested, which made in all 22 deg. at the near point. I now suspended accommodation with a +3 D glass, and overcor- rected the entire amount of divergence manifested at the near point by putting on 28 deg. of prism, directing the patient to continue reading as long as possible. In a quarter of an hour the mouth had become moist, the thirst had entirely disap- peared, and the pain in the ovaries was gone. The distance prisms were increased to 12 deg. and the repression kept up at both far and near points for three days. The improved conditions contin- ued. This decided the patient to undergo what- ever temporary inconveniences were necessary to this treatment. On the twenty-sixth of November I made a complete division of the tendon of the external muscle, not separating it from the cap- sule. Three days later a division of the opposite tendon was made. The result was 16 deg. of manifest convergence. Double vision existed at all points beyond twenty inches. Vision was now made single by 8 deg. of prism, base out. This 94 was reduced almost daily. At the expiration of ten days, vision without glasses was single, directly in front, but double on looking either to the right or left. Repression was continued with prisms, base in, increasing them one degree at a time, through a period of three months, when 14 deg. of prism were worn, base in, with single vision for all distances. The amount of water was now reduced to five and one-fourth pints in twenty-four hours. The most rapid reduction was during the first few days of treatment. The only ovarian difficulty now left was, that, when the patient was lying on her back, she could not straighten her left limb without producing a slight pain in the left ovary. Sufficient divergence had taken place, so that I now advanced or shortened the internal muscle of the right eye sufficiently to give 12 deg. of con- vergence again. Repression was continued. At the end of three months, vision was single with- out glasses. This convergence would have cor- rected itself in time without the use of prisms but not so quickly. I have seen the patient occasionally through the space of nearly two years, and not a trace of the old difficulty has ever returned in that time. Ignorant criticism of this class of cases, where diplopia or double vision has been created for the purpose of reversing or repressing an 95 abnormal nerve-impulse, has proved very injuri- ous to a large class of sufferers, in many in- stances costing life; a criticism that is conscien- tious, no doubt, as many see no deeper into the necessities of the eyes than that their muscles should bear a perfect balance physically; but such critics do not seem to know that physical balance is often sustained by an alarming degree of unbalance or inequality of nerve currents, that is destroying the equilibrium of the brain centers, and fast robbing them of vital forces that should be expended in other directions. As it is the abnormal impulse alone that is sapping life of its forces, that is disturbing the brain, we must look sufficiently deep to discover this disturbing force, and, when necessary, temporarily sacrifice the apparent muscular balance, which, under proper care, rights itself in from a few days to a few months. Discontinuance of the treatment in obedience to this criticism has often resulted fatally to the patient in a very few days. The great danger lies in the eyes remaining in that abnor- mally balanced condition that is threatening life. The following cases, Nos. 4, 6 and 7, are illus- trative of this statement: Case 5. June, 1890, Mr. McL., of Windsor, Ont., aged forty-six, was voiding eighteen pints of water in twenty-four hours; specific gravity 1.044; thirst intense, with symptoms of portal congestion; 96 an appearance of excessive jaundice; very ner- vous; pulse 115; chronic diarrhoea. After deter- mining that the external muscles were short, and that considerable strain existed in the ciliary mus- cles, I began repression by relaxing one of the external muscles, and putting on heavy fogs at once (+ 5 D). In three days time the eighteen pints of water were reduced to six; the thirst was entirely relieved; the jaundice color of the com- plexion had cleared; much relief was experienced as to the portal congestion; and the diarrhoea was relieved as well as the indigestion. The patient was able to walk but a few rods when I first saw him. By the end of one week he was able to walk two miles without experiencing any inconvenience. On the tenth day the specific gravity was 1.032 and the patient had so gained in strength that he was able to walk four miles without fatigue. This was the last visit he made; for, in his weak mental state, he was led to be- lieve that the changes he had experienced could not be the result of anything that had been done to the eyes. By advice, that which I had done was undone; the glasses were removed, and superseded by a prescription of opium and atro- pine. The condition of the patient grew rapidly worse, and on the twenty-eighth day after I last saw him he died. Case 6. August 15, 1890; Mr. R., of De- 97 troit; age thirty-five; clerk in clothing store; had suffered for past two years from excessive melancholia; he was nervous, irritable and his nights restless; was habitually constipated; six months before visiting me, he began to notice considerable difficulty in walking, especially in the dark, with a gradual and partial loss of feel- ing in the lower limbs; symptoms of motor- ataxy developed rapidly. On his first visit he was unable to turn around quickly, while walk- ing, without great danger of falling; was unable to stand with his eyes closed; complexion pale, feet and hands cold. I began repression with prisms and plus spherical glasses. During the first day, considerable warmth was restored to the extremities and a ruddier color to the skin. At the end of three weeks he had so improved that he was able to stand, without falling, while his eyes were closed. There was some improve- ment in the walk; he was now able to turn around with much less clumsiness. The im- provement in this case was very considerable for the space of two months, at which time Mr. R. felt able to return to his duties in the clothing store, which had been abandoned for three months previous to the treatment. The repression glasses were somewhat dis- agreeable, and during my absence in the East, Mr. R. was induced to abandon them and try a 7 98 treatment that consisted of suspension. From this time his condition grew worse, and at the end of three months he put a period to his existence by shooting himself. Case No. 7. F. G. age thirty-five; bright, intelligent and for several years actively engaged in business; suffered occasionally from ver- tigo and extreme nervousness. A few weeks previous to coming to me, on returning to his home one evening he was seized with dizziness, temporary partial loss of vision, and was pros- trated for several weeks, being confined to bed. It was now first discovered that he was suffering from diabetes. His devoted brother, who had been a patient under this treatment, went to visit him, and by slow stages and resting, brought him to me. I found his specific gravity 1.050; four- teen pints of water in twenty-four hours; thirst intense; pulse 105; unable to walk but a few rods, and that with great exhaustion. Repression rapidly subdued his thirst; reduced his gravity in two months to 1.024; his pulse to 75. In three months he had gained fourteen pounds in weight and enjoyed a walk of two or three miles. He returned to his home two thousand miles away. Ciliary repression was continued by a high grade of fogging. During a space of four months very bright and encouraging letters concerning his health were received. Riding, driving and fish- 99 ing excursions were indulged in with great pleasure. He wrote a letter telling he had been able to dance eight round dances in a night. This, of course, I at once advised against. A few days after this he had the misfortune to have all his glasses broken, and neglected for three weeks to have them replaced, at the end of which time he was suddenly taken ill again. Hurried corre- spondence by his sister followed, asking for glasses. Then came a telegram that he was much worse, and the following day another announcing his death. This and the two pre- vious cases are three only of many similar ones that I have known. The uplifting and sustain- ing power of repression is as clearly demonstrated in these, as in that class of cases that have resulted favorably. I do not assume that cases Nos. 5, 6 and 7, which resulted fatally, would have been cured had they continued treatment; but as far as the treatment was carried, the evidence was most markedly in its favor. Where defect exist in several of the muscles, the defect is sometimes so prominent in one as to hide completely the defects in the others, which only manifest themselves to us after a correction of the first. The reasons for this will be discussed at more length after clinics Case 8. J. A. age twenty-four; farmer; had 100 suffered from epileptic seizures since sixteen years of age, which gradually increased in fre- quency until they were of daily occurrence; the mental faculties were very much impaired; the power of speech was affected to the extent that it was very difficult to understand the patient; the right upper and lower extremities were partially paralyzed, so that his walk consisted of a dragging, halty gait, while the right hand and arm were used but little, and clumsily; constipated habit, and complexion pale. Vertical and horizontal diplopia disclosed no muscle defect; convergence was 45 deg.; diver- gence 2 deg. After a careful examination lasting three days, I began repression with prism, base down, before the left eye, which, when forced to 8 deg., led to an improvement in the color of the skin and the action of the heart, diminishing its activity from 95 to 75 beats per minute, with a feeling of warmth and tingling to the right hand and foot. Several tests were made by removing the prism and reversing its position, in which case the above symptoms increased. From these indications, I now crowded the prism to 14 deg., base down, before the left eye. Twice I was obliged to reduce the prism 2 or 3 deg. to prevent diplopia, from the spasms that would ensue. The epileptic seizures were now reduced to one-third in number, also much in severity. I now made a 101 complete division of the superior rectus muscle of the left eye. The cut eye assumed a normal position. The opposite eye turned upward 18 deg. It required 12 deg. of prism to bring about fusion. I began reducing this, degree by degree, but the opposite eye was very slow and obstinate in getting back into line. At the end of six weeks, not having accomplished this, but still retaining single vision with prisms, I again exam- ined the lateral muscles with the same result as at first, 2 deg. of divergence and 45 deg. of conver- gence with this difference; vertical diplopia now indicated 5 deg. of convergence. I now added prism, base out, to correct this, and exceeded the correction by putting on the patient 24 deg. of prism, which were worn for three hours in my office, during which time the face became pale, the hand and foot cold, followed by a fit of con- siderable severity which lasted five minutes. This decided me that the present manifest convergence was due to spasm; so, on the following day, I began repression at the near point, suspending accommodation with a fog, or +4 D glass, and 20 deg. of prism, base in, diverging the eyes. In two hours 4 deg. of prism, base in, could be tol- erated with single distant vision. I added a +1D glass reducing the distant vision to twenty-fiftieths. At the end of ten days the patient was wearing 12 deg. of prism, base in; the vertical displace- 102 ment that resulted from the operation had corrected itself; the eye had come down into line while I was diverging the eyes and repressing the REVERSE MANIFEST defect in the lateral muscles. From this time on all conditions improved rapidly. The power of speech returned; no fits have occurred since, with the exception of occa- sional petit-mal. At the end of one month, 20 deg., base in, were tolerated with single vision. I now advanced the internal rectus of the right eye. When last heard from, the patient had passed one year of perfect health, during which time the ciliary had been kept under a repression of a +2 D glass for general purposes, with reading glasses +3 D stronger. Had this patient abandoned treatment after the first operation, which I had to use persua- sion to prevent his doing, he undoubtedly would have suffered the inconvenience of double vision for a considerable length of time, as the result of a want of correction in the second defect. Case 9. Paralysis. Mr. E., aged sixty-five, passed an active business life up to sixty years of age, when he first began to experience restless nights with little sleep; a growing irritability with occasional attacks of dizziness; several months of each year were spent at health resorts and watering places with some little improvement at first; but, on returning to business, the dis- 103 turbed conditions would return after two or three weeks. For one year a dull pain was constant about the base of the brain. On January 15, 1872, while sitting at breakfast, he was stricken with apoplexy and was unconscious for twenty- four hours. The next day on returning to con- ciousness, it was discovered that he had partially lost the power of speech and the use of the right upper and lower extremities. After three weeks he was able to limp about with the help of an as- sistant. The vertigo was excessive; there was a constant dread of some impending evil; the memory and reasoning faculties were much im- paired. With varying conditions of health, the paralysis still remaining, he visited me in 1892 when his condition was rapidly growing worse. In this weakened and depressed condition, as is usually the case, the irregularities in the ocular apparatus were very manifest. A short under muscle in the right eye and inner muscle in the left were found, with one dioptre of manifest hyperopia. Repression in all three muscles was begun at once. At the end of the second day there was a marked change for the better; the internal rectus now was detached. Immediately after this operation, the patient noted a percepti- ble improvement in the return of a natural feeling to the paralyzed side; no inconvenience resulted; his speech was very much improved. The re- 104 pression was continued, and in two weeks from this, he was wearing with perfect ease and single vision, 14 deg. of prism, base down, before the right eye. The impediment in the speech was now entirely gone, also the spells of dizziness; the feeling of fright passed away, and in one month from the first, his visits were made without the necessity of having an attendant with him; and were continued for the space of two months. From this time on, his circulation was good; his bowels, which had been previously constipated, were now regular; he acknowledged that he felt better than he had felt for ten years. During the space of over one year he has attended, with- out the slightest inconvenience, to whatever busi- ness he has had to do; he eats and sleeps well, and says that he enjoys every moment of his life. Case 10. Consumption. In 1873, in company with my father and Dr. Goodrich, of Bellevue, Ohio, I visited Mrs. S. on a farm in Huron coun- ty; she had suffered for a year and a half with consumption; in the six months previous to my seeing her, she had had two hemorrhages; the afternoon fever and night sweats had been very persistent for seven months. Little or nothing was hoped for in her case; her principal treat- ment had been hypophosphites and cod liver oil, alternated each week with large doses of rich 105 cream. Incidentally, during this visit, Mrs. S. asked if her left eye, which was very much turned inward, could be straightened. I told her I thought so, and a few days later it was operated upon. An over-correction of several degrees re- sulted from the operation; of course this was not sought for, but it established a repressive strain. I paid two visits after the operation, after which I did not see the patient, as she moved to Hazelton, Pa. Two years passed, when one day the hus- band of Mrs. S. walked into my office. He talked with me some five minutes without refer- ring to his wife, who I felt confident was long since dead. He said, "You don't ask me about Mrs. S." I said, "I did not wish to distress you. I suppose she is no longer with you?" He said "That's just where you are mistaken; she is perfectly well and hearty and weighs nearly two hundred pounds." He reported that a few months after I last saw her, her cough ceased and her health began rapidly to improve. This case was not operated on with the expectation of influencing the diseased condition of the lungs, but later experience has caused it to be recalled to my memory as a result possibly due to the radical change in the nerve-centers resulting from the repression established by the operation. Case 11. Woman; age twenty-two; consump- tion; constipated habit; complexion pale; pulse 106 85 in the morning, in the afternoon and evening 120, with a hectic fever which had existed about ten months; bright red spots about the size of a penny on both cheeks; nights restless, and for the past six weeks night sweats were profuse; lower lobe of left lung congested and dull on percus- sion; cough quite severe; no hemorrhage. Ex- amined this case in the morning; pulse 85. Repression was made with prisms by turning left eye up 12 deg. In thirty minutes the pulse was reduced to 64. To this prism was added ciliary repression reducing distant vision to twenty-fif- tieths. The next morning better conditions were reported for the previous afternoon and night; pulse was now 76. Repression was now made at the near point by forcing the eyes outward 24 deg., and fogging with a +5 D spherical. Patient looked at pictures in a book for half an hour; had great difficulty to avoid going to sleep while sitting in the chair; pulse reduced to 64; a healthy, red glow, covered the entire face, ears and neck; the hands and feet grew warm. Pa- tient now wore away +3 D spherical, 14 deg. of prism, base down, before the left eye, combined with 18 deg., base in. Repression was being made in three directions. From this time on, there was no more hectic fever, flush, or night sweats; at the end of two weeks from the first visit, the cough had entirely ceased; the only symptom that 107 remained was dullness on percussion of the lower lobe of the left lung. At the end of one month eight pounds had been gained. At this period a very serious interference with the treatment occurred. The patient's sister was taken ill. She watched by her bedside constantly for eight days, when the sister died. This, of course, told heav- ily against any further advancement in the case, but none of the old symptoms returned. On the day of the funeral, from over-exhaustion and grief, the nerve-centers were so disturbed, that I was obliged to reduce my prism 6 deg. in various direction to still maintain fusion. After she had had a few days' rest I increased the prism to its former standard. Two weeks after burying her sister, she was wearing 18 deg., base in. I now advanced the right internal muscle, leaving 10 deg. of convergence, which in ten days had entirely disappeared. I now advanced the infe- rior rectus of the left eye, bringing it 6 deg. below its mate. A slight vertical diplopia existed after this operation, but in three weeks it had entirely disappeared. At the expiration of six months the patient had gained twelve pounds and her health in every way was perfect. Case 12. Male; age twenty-five; acute con- sumption; was constipated; an‘mic; had cold hands and feet; weight one hundred and nine pounds; pulse 90 in the morning, in the evening 108 115; night sweats had been continuous for two months previous to the first visit; a severe cough had existed for five months, and the expectoration was thick mucus; the sputa was not examined microscopically; there had been no hemorrhages; the left lung was dull on percussion and its breath- ing space limited, especially in the lower lobe. The diagnosis of consumption in this case was based on the evidence of the above symptoms without the microscopic examination of the sputa, the occurrence of a hemorrhage, or any apparent disintegration, but all of the other symptoms were well marked. The treatment consisted of repression of the ciliary with +5 D glasses, which were worn most of the time; 2 D were permitted for outdoor pur- poses for limited periods. These gave but twenty one-hundredths of vision; repression also of both external and left inferior rectus muscles. The complexion at once changed from a pale to a pink color; the hands and feet were warmer. At the end of two weeks the patient was wearing 16 deg. of prism, base down, before the left eye, which was repressing the innervation to the infe- rior rectus muscle. A division of the superior muscle of this eye was made at the end of two weeks. The cough ceased at once; constipation was now relieved, and the heart's action reduced to 70. Repression in the ciliary and both exter- 109 nals was continued with glasses for two weeks longer. I now made complete division of the right internal and advanced the left external, by my operation of a single stitch and a ligature plate, thus bringing about 10 deg. of divergence by diffusion test. One month after the last oper- ation there still remained 3 deg. of divergence, while the vertical muscles were balanced. This case was heard from seven months after the last operation. The general health was much improved; none of the old symptoms remained; eighteen pounds in weight had been gained. Case 13 was the mother of the above patient, who accompanied him during his treatment; her age was forty-four; had suffered from chronic bronchitis for five years; was of slight build; an‘mic; had suffered much from headaches and spinal irritation; had cold hands and feet; pulse was normal. Ciliary repression was made with glasses that gave twenty-fiftieths of vision. Re- pression of the right inferior rectus was continued for one month, when she was wearing 22 deg. of prism, base down, before the right eye. Complete division of the tendon of the superior rectus was now made. The cough ceased the first day; the hands and feet were warmer; the general circula- tion was much improved; the headaches and spinal irritation were entirely relieved. This case was also heard from seven months after leaving, 110 when the health was reported good, with a gain of eleven pounds in weight. Case 14. Male; age forty-one; symptoms of consumption fourteen months; pale, very nervous and restless; occasional pains in left lung; lower and middle lobe dull; occasional night sweats; hectic fever in the evening accom- panied by an excessive sensitiveness of the entire right side of the face, also of the cheek inside the mouth; no inflammatory action existed in these parts; cold water had to be drunk with great care to prevent its coming in contact with the right side of the mouth, in which case it gave rise to distressing pain; right side of face could not be touched with a feather or even a hair without giving rise to great distress and alarm. This patient had been advised to have the facial nerves cut out to relieve the painful sensitiveness. The case yielded slowly to repression; at the end of six weeks the left eye had turned upward 15 deg.; at this time +3 D glasses gave twenty- thirtieths of vision. I did not fog the vision to the same extent in this case, because I needed a higher acuity to assist in the repression in a ver- tical direction. There was some general im- provement in all the conditions of the patient up to this time. I now advanced the inferior rectus of the left eye, using my ligature plate, which drew it 6 deg. below its fellow by diffusion test, 111 but double vision did not result. The sensitive- ness in the face and inside of the cheek entirely disappeared within three days. Repression in the ciliary was now increased by fogging the pa- tient to twenty-sixtieths for distant vision, adding +3 D more for reading purposes, so as to sus- pend entirely the action of the ciliary for the time being; the constipation was entirely relieved from this time; the cough ceased, and in five months this patient had gained thirty pounds in weight; pulse 70; appetite and complexion good. Perfectly good health continued for a lit- tle over one year, since which time I have not heard from the patient. Consumption. I have made preliminary ex- aminations and repression tests in one hundred and twelve cases of consumption, and in all with the exception of nine, some of which might have yielded by longer persistence in the tests, I was able to bring about marked changes in the prom- inent symptoms, generally consisting of a reduc- tion of the high action of the heart, change in the color of the skin, increase in the warmth of the hands and feet, where the extremities had been cold. None of these cases were treated further than a few preliminary tests. In such cases there is a great lack of patience to under- go the repression; but this is quite natural to nervous persons, inasmuch as they generally lack 112 confidence in the possibility to affect lung dis- eases through the visual centers. Consumption is most markedly a nervous disease. Its pre- monitory stage is marked by nervous conditions which, emphasized in character, accompany it through all its stages. F.J. McGillicuddy, A.M., M.D., of New York, says, "Tubercular consump- tion is not a local but a constitutional disease, and calls for general treatment. Tubercular bacilli do no and cannot cause consumption in a perfectly healthy individual. They only induce disease in persons with lowered vitality, who thus become susceptible to their influences." I am thoroughly convinced that a large percentage of consumption takes its origin from irritation aris- ing through visual centers, and that many cases, especially in their earlier stages, are amen- able to treatment through the same medium. Case 15. Mr. F.; age sixty; delicate habit; constipated; very nervous; at the age of twenty was attacked with paralysis agitans, or shaking palsy, which lasted through a space of forty years. At the time I saw the patient his trouble was complicated with chronic bronchitis, sciatica and spasmodic stricture of the neck of the blad- der. Repression of the ciliary and inferior mus- cle of the right eye with glasses brought some alleviation of the shaking. A complete division of the superior rectus was made, after which, 113 while my hand was still resting on the forehead, I noticed the shaking suddenly cease. The pa- tient turned pale, was nauseated. He said, "I feel strange; I think my shaking is over.". The spasm at the neck of the bladder also passed away at once, doing away with the necessity of using a catheter which had been required for the past three years in voiding the urine. I heard from this case occasionally for two years. The constipation, sciatica and chronic bronchitis were very much reduced, and there had not been any return of the shaking palsy or of the irritation of the bladder. Case 16. Gen. C. of the United States Vol- unteers; age sixty; dyspeptic; much depressed; in weak and rapidly failing condition; progressive atrophy of the optic nerves had gradually destroyed the vision, until barely enough sight was left to enable him to get about the streets; he could recognize friends only by the sound of the voice; could not read; would write from habit but could not see what he wrote; vision was so imperfect in this case that I could utilize but little fusion power in repression. It was three months before I arrived at a conclusion, at which time I made a complete division of the right internal rectus muscle. There was an immediate improve- ment in the general feelings, and in three months from this time the patient had gained twenty- 8 114 eight pounds in weight, and was able to read ordinary newspaper print, which I advised him to do sparingly. One year later distant vision was normal; general health and appearance were excellent. The following case that resulted fatally is evidence by no means adverse to the value of this treatment. The patient was in a very critical state at the time treatment was commenced, and the result verifies the sustaining or supporting power of repression during the time it was con- tinued. Case 17. H. H., age fifty; diabetes mellitus; gravity 1.048; quantity sixteen pints in twenty- four hours; intense thirst; very weak; unable to walk but a few rods; repression with prisms and by fogging vision to the possibility of reading ordinary type not farther than twelve inches, removed the thirst, and in three weeks reduced the specific gravity to 1.030 and the quantity to seven pints in twenty-four hours; heart's action was reduced from 100 to 75. These conditions were maintained with but little change for the space of three months, with the exception that the gravity occasionally fell to nearly normal, 1.022, and again went up to 1.030. The uncertainty of further results and the tediousness of the fogging process, were the cause of the patient's abandon- ing treatment at this point, removing the glasses 115 and resorting to water cure treatment. A week after the glasses were discarded the bad symp- toms had all returned, and in three weeks the patient was dead. Case 18. H. H., girl; age ten; nervous, mis- chievous, playful child; after receiving slight chastisement from her teacher had a severe attack of St. Vitus's dance, which lasted for three months. This was followed by complete paraly- sis of the right side, and of the power of speech; the mental faculties became a perfect blank; the child's attention could not be attracted in any way, she would not even look up on being repeatedly called by her name; parents were obliged to feed her by putting food into her mouth. The left eye was partially blind; this was determined by covering the right, when the child would make and effort to uncover it; but she paid no attention when the left was covered. Under the influence of chloroform administered at three different times, a manifest defect in the superior and internal muscles of the left eye was very apparent. Under the existing conditions, I could only approximate the defects. A com- plete division of the internal rectus was made on this diagnosis. Plus 3 D glasses for repressing any possible ciliary strain were tolerated by the child, but any stronger than these were rejected. In two months she was able to walk, consider- 116 able impediment yet being noticeable in her speech, but her mental faculties were in every way very much improved. In examinations of the eyes, she was now able to answer questions. Repression was commenced by forcing the left eye upward with prism. More improvement in the use of the paralyzed extremities was noticed. A division of the superior rectus of this eye was made. In four weeks from this time, the child was able to walk with a somewhat halting gait, and use the right hand. In eight months from the time I first saw the patient, not a trace of the difficulty was left. The child was now witty, intelligent, active, and desired to return to school. I advised her not to do so. After a lapse of two years I saw this little patient again, and in perfect health which had continued since the treatment. Two years later, making in in all four, I received a letter from her father stating that her general conditions of health were excellent. Case 19. Male; age thirty-five; was a bright and promising youth, quick to learn and more than ordinarily ambitious. He was eccentric, his disposition and habit being so changed at times that they might belong to another person. At the age of twenty-five, he was actively engaged in a successful business, and from this time these changes of disposition grew gradually more 117 marked. His choice of friends and associates was usually fastidious; but every three or four months a period of two or three weeks would in- tervene, in which all his leisure hours would be spent in neighborhoods strange to his former as- sociations, and among people of the coarsest type. These periodical changes of disposition and asso- ciation were as marked and regular as the sprees of a periodic drunkard. Through a general in- creasing nervous debility he, at age of thirty- two, was thoroughly incapacitated for work, and the business passed into the hands of another member of the family. He was now unable to carry on a coherent correspondence. His mem- ory was very much impaired; he was unable to fasten his mind upon either book or newspaper; and, if he tried, a moment afterwards forgot what- ever he may have read. At times he was morose and surly, and would be dangerous to cross. Again, being very sympathetic, he would break down in a child-like way, and from some imagin- ary cause would be moved to tears. Again his ambitious side would return and he would specu- late in ridiculously impossible schemes. Through incompatibility his wife now deserted him; con- sequently his disturbed mental symptoms were rapidly and greatly emphasized, and at the age of thirty-three he was placed in an asylum. From this time his scheming and eccentric ambitions 118 ceased. For the next two years despondency was the marked feature of his condition, occa- sionally alternated by spells of pitiful repining and regret. It was in this condition that he was brought to me by his mother. The only notable local symptoms were a pale complexion and a heart's action of 96. It required fully an hour of care- ful handling on my part before I gained his confidence and secured his attention sufficiently to proceed with an examination; but he gradually grew very much interested, and was no longer disposed to interfere with my tests. Refraction in both eyes at the far point was above normal, twenty-fifteenths. It was perfect at the near point. By diffusion test, far point, prism base down before the left eye, the upper dot or light was 2 deg. to the left. With prism base in the left light was the lower, manifesting a left hyper- phoria of ½ deg. in conjunction with a manifest esophoria of 2 deg. at the far and near points. Two degrees, base down, before either eye created diplopia. Could fuse 1 deg. before either eye, but with my vertical chart, using a 2 deg. prism, base down, before the left, there were two dots 2 deg. apart, while 2 deg., base down, before the right separated the dots or lights 1½ deg. from each other. I now placed before his right eye 1 deg. of prism, base down. After a few minutes vision 119 seemed sharper. This was shortly increased to 2 deg., and within half an hour to 3 deg. Pulse was not materially changed. Even with repeated efforts the next half hour I failed to increase the prism. The countenance was somewhat flushed and a violent headache followed, which was some- thing from which he had never suffered before. The prisms were removed and tests continued the following day. The next day I commenced with 1 deg., base down, before the left, the reverse of the previous day's treatment. In an hour he had accepted 5 degs. of prism in this direction, the complexion was paler and the heart's action had mounted to 124, with an increase of nervous symptoms. I now changed the position of the prisms to the same that it had been during the first day's test, base down before the right eye. In another half hour he was able to fuse for 4 deg. of prism. The pulse was reduced to 86, and the skin became somewhat flushed. Headache again returned and the test was abandoned for the day. As to symptoms, base down before the right diminished somewhat the excitability of the heart and improved the color of the skin, while at the same time it brought on severe headache. With prism in the opposite direction the heart's excitability was much increased, the complexion paler, and the nervousness visibly aggravated. 120 On the following day I chose that position which improved the heart's action and the color of the skin. Four degrees, base down, before the right was all he could fuse under. He was allowed to wear this home the remainder of the day. His night's rest was slightly improved. During the next test, he was able to fuse for 6 deg. of prism. The glasses were comfortable during the day, and the vision remained single until just before bedtime, when headache again set in. On awaking in the morning, he was unable to fuse for his 6 deg. of prism, and after having spent a restless night he returned to my office without the glasses. His eyes now manifested the reverse of every previous condition; the right eye appeared to be the lower of the two. This I suspected to be due to spasm, owing to a bad night's rest. I proceeded, degree by degree, to coax the eyes to fuse under prism, base down, before the right. I was unable to succeed with more than 3 deg., which I left on the patient. On awaking in the morning he was able to fuse for the 3 deg., and came to my office wearing the glasses. He now succeeded in fusing for 7 deg. early in the morning. He wore the prisms all day with comfort and some little improvement in feelings, his heart's action being reduced to 80. On the following morning his eyes would not fuse for 7 deg., but by my orders he kept the 121 glasses on until he arrived at the office. I did not remove them, but suspended the ciliary accom- modation with a +3 D spherical glass. Fusion at the near point took place at once. After read- ing a short time and having the sphericals removed, he was able to fuse for all distances. These glasses were continued during the day. The night's rest was much improved. When he put on the glasses after awaking in the morning vision was double, but after half an hour fusion had taken place. Complexion was decidedly bet- ter and the heart's action the same, 80. At pres- ent, prism could not be increased above 7 deg. I now suspended accommodation with +3 D spherical glasses, and at the near point was able to increase my prism 3 deg. more. After he had looked at pictures for half an hour, the pulse was reduced to 76, and the face was quite flushed, with some little nausea. The following day the same was repeated without the nausea. I now increased the glasses to +5 D. Buzzing in the ears shortly followed this, dizziness, nausea and profuse perspiration; pulse reduced to 70. I now suspected that the ciliary had suddenly relaxed its tonic innervation and on examination, found his vision normal with a +1.50 spherical glass in connection with the 7 deg. of prism, base down, before the right eye. He now manifested 3 deg. of exophoria, instead of 2 deg. of esophoria which 122 had showed on the first examination. At the near point the exophoria was 18 deg., whereas the first examination gave 2 deg. in the opposite direction. The correlation that had existed under abnormal conditions was now practically broken down, and a partial manifestation of the actual state of the muscles presented itself. Plus 2 D spherical glasses and 7 deg. prisms were worn until bed time, which was an hour earlier than usual, and he slept ten continuous hours, the longest period of rest that he could remember for many years. On the following morning his eyes accepted the 7 deg. of prism but rejected the spherical glasses; everything seeming exceedingly foggy and dim through them. The ciliary spasm had returned. The long night's rest had recuperated the nerve- centers, and they refused to yield to the same conditions that had controlled them on the pre- vious day. I now increased to 10 deg. of prism, base down, before the right, a +5 D spherical, and 18 deg. of prism, base in, because of the fact that, in the relaxed condition of the previous day, he had manifested this amount of exophoria at the near point. Under this combination, even at the near point, some considerable difficulty was experienced in inducing the eyes to fuse. After they had fused, reading was continued for half an hour, when the nausea and profuse perspiration again set in. The patient was induced to tolerate 123 the glasses and these discomforts for half an hour longer, when the pulse had fallen to 62. The patient now returned home with three pairs of glasses, 7 deg., base down, before the right eye, 18 deg, base in, with +2 D spherical glasses. Nine hours of continuous sleep followed. In the morning his eyes fused under the 7 deg., base down, but again rejected both other pairs. It would be needless to detail this case further. The process of discovering the abnormal innerva- tions that had maintained a perfect correlation in the action of the two eyes, had now revealed the defects, while the mental condition of the patient showed marked signs of improvement. Changes in the manifestation of the eye defects continued from day to day to reveal and again hide them- selves until, at the end of one month, the patient was wearing before the right eye 20 deg. of prism, base down, and 20 deg. of prism, base in. I now made a complete detachment of the superior tendon of the right eye, dropping the eye 6 deg. be- low its mate. At this time I had the patient wear- ing 20 deg. of prism, base in, with +2.50 spherical glasses, which gave normal vision. The complexion from now remained good, and the pulse was never found above 72. Two weeks after the first operation the left external tendon was completely detached, producing 8 deg. of esophoria by diffu- sion test, but lights fused without prism. Repres- 124 sion with prisms, base in, was continued for three weeks, when 16 deg. could again be tolerated without double vision. I now completely detached the external tendon of the right eye. Under diffusion test, there were now 16 deg. of conver- gence and an inability to maintain single vision farther than fifteen inches. Plus 2.50 D spheri- cals were continued with 6 deg. of prism, base out, to bring about fusion for distance. This was reduced slowly from day to day and, in three months from the last operation, no double vision existed. The patient's mental condition was now en- tirely relieved. He seemed happy, would smile, laugh at anything funny, and seemed fond of tell- ing witty anecdotes. The only abnormal condi- tion that now existed was that, on looking to the extreme right or left, double vision would occur. I deemed it advisable to keep the distance vision at twenty-fortieths, thus continuing a slight ciliary repression. I have occasionally seen this patient during the space of two years. His mental condition has continued very satisfactory; none of the eccen- tricities of his earlier life have recurred; his whole character seems changed; he is of a quiet, happy disposition, and attends to whatever business he has to do without worry. One year after the first operation a perfect 125 balance existed in all ocular muscles under diffu- sion tests. He fused for 4 deg. of prism, base down, before either eye, 6 deg. base in, and 45 deg., base out. A new and perfect correlation had been established. Case 20. Mrs. H., Joliet, Ill. This patient was brought to my office by Dr. Orin W. Moon, of Lockport, Ill. She says she has suffered for the past ten years from female weakness consisting of chronic inflammation and neuralgia of the ovaries; severe headache preceding and through the menstrual period; has always been of a delicate habit; catarrh of the throat, eustachian tube and internal ear has been increasing for the past ten years with a gradual loss of hearing; for the past two years the right ear has been totally deaf while the left could distinguish loud conversation only at a close distance. Has taken various remedies almost continuously for the past ten years. The catarrhal difficulty and deafness were treated locally, the treatment including dilatation with the Pulitzer bag and catheter. Vertical muscles apparently balanced; 5 deg. of convergence at the far point; esophoria at the near point, thirteen inches; at the start I fortun- ately suspected this to be a case of reverse manifestation. I suspended ciliary strain with a +5 D glass, and with 30 deg. of prism, base in, found that the patient could fuse at the near 126 point. I directed her to read in the above com- bination, and in ten minutes she could hear a faint whisper in the left ear and ordinary conversation in the right. By repression I developed exo- phoria of 20 deg. at the far point, and on the fourth day made a complete division of the ten- don of the external rectus of the left eye. All of the previous disturbances were at once relieved; within one month the catarrh had disappeared; all sensitiveness and neuralgia in the ovaries were now gone, and for the first time in her life the monthly sickness came and passed without the slightest headache of local disturbance. In every way the general health has been much improved and the patient says she feels perfectly well. I do not present this case as an ordinary one, but because it is one of the quickest and most remarkable cures in the history of my practice. The following tabulated list of clinics has been selected from a large number of cases for the express purpose of showing what class of cases have yielded and may possibly yield to repression treatment. Failures in about the proportion noted in the preceding detailed clinics could be shown. A report of adverse results would be of no value as it is the object of this work to show what can be accomplished through the visual centers. The failures are due to several causes, 127 especially neglect to follow treatment, and to the fact that some cases are beyond or outside of its influence ================================================================================= | O | | | | | |M R | | | | | |A | | | | | |R S | |SEX.|AGE | PERIOD | |R I | DURA- | | | OF | DISEASE. |I N | TION. | | | TREAT- | RESULT. |E H | | | | MENT. | |D G | | | | | | L | | | | | | E | | | | | ------------------------------|----|-------|----|----|--------|------------------ Ovaritis with general fe- | | | | | | male weakness . . . . . . . | M. | 5 yrs.| F. | 38 | 3 mos. | Cured. Prostatitis with inflamma- | | | | | | tion of the neck of the | | | | | | bladder . . . . . . . . . . | M. | 12 " | M. | 58 | 1 mo. | Cured. Insanity . . . . . . . . . . | M. | 5 " | M. | 50 | 8 mos. | Cured. Uric Acid Diathesis, rheu- | | | | | | matism and general ner- | | | | | | vous debility . . . . . . . | M. | 8 " | F. | 53 | 2 mos. | Cured. Chronic Rheumatism . . . . . | S. | 10 " | M. | 48 | 4 mos. | Very much re- | | | | | | lieved. Asthma . . . . . . . . . . . | S. | 20 " | F. | 51 | 1 mo. | Cured. Insanity . . . . . . . . . . | M. | 5 " | F. | 32 | 7 mos. | Cured. Diabetes Mellitus . . . . . . | S. | 4 " | M. | 40 | 1 yr. | Cured. Paralysis hemiplegia . . . . | M. | 12 " | M. | 55 | 1 yr. | Cured. Motor Ataxy . . . . . . . . . | S. | 3 " | M. | 38 | 5 mos. | Much improved. Prostatitis and irritation of | | | | | | the bladder . . . . . . . . | S. | 12 " | M. | 50 | 5 mos. | Cured. Rheumatism . . . . . . . . . | M. | 8 " | F. | 55 | 6 mos. | Cured. Consumption . . . . . . . . . | S. | 1 " | F. | 22 | 8 mos. | Cured. Consumption with ner- | | | | | | vous debility . . . . . . . | S. | 15 " | M. | 25 | 8 mos. | Cured. Ovaritis . . . . . . . . . . | M. | 8 " | F. | 20 | 3 mos. | Cured; was pre- | | | | | | viously barren; | | | | | | had a healthy | | | | | | babe 1 yr. after | | | | | | treatment Hay Fever . . . . . . . . . . | M. | 10 " | M. | 34 | 3 mos. | Cured. Heart disease functional . . | S. | 5 " | F. | 16 | 3 mos. | Cured. Glaucoma . . . . . . . . . . | M. | 5 " | M. | 53 | 4 mos. | Cured; one eye | | | | | | was blind at | | | | | | beginning of | | | | | | treatment. Nystagmus . . . . . . . . . . | S. | 20 " | M. | 28 | 1 mos. | Cured. Heart disease functional . . | S. | 3 " | F. | 22 | 6 wks. | Cured. Prostatitis . . . . . . . . . | M. | 20 " | M. | 65 | 1 mo. | Cured. Rheumatism . . . . . . . . . | M. | 15 " | F. | 58 | 1 yr. | Cured. Diabetes Insipidus . . . . . | M. | 3 " | F. | 37 | 8 mos. | Cured; was pre- | | | | | | viously barren; | | | | | | gave birth to a | | | | | | healthy babe 18 | | | | | | months after | | | | | | treatment. Ataxy . . . . . . . . . . . . | S. | 1 " | M. | 32 | 3 mos. | Much improved. Bright's disease . . . . . . | S. | 2 " | F. | 40 | 4 mos. | Cured. Ovaritis . . . . . . . . . . | M. | 6 " | F. | 30 | 2 mos. | Cured, previously | | | | | | barren; 18 mos. | | | | | | after treatment | | | | | | gave birth to a | | | | | | healthy babe. 128 ================================================================================= | O | | | | | |M R | | | | | |A | | | | | |R S | |SEX.|AGE | PERIOD | |R I | DURA- | | | OF | DISEASE. |I N | TION. | | | TREAT- | RESULT. |E H | | | | MENT. | |D G | | | | | | L | | | | | | E | | | | | ------------------------------|----|-------|----|----|--------|------------------ An‘mia and general ner- | | | | | | vous debility . . . . . . . | M. |10 yrs.| F. | 32 | 4 mos. | Cured; previous- | | | | | | ly barren; had | | | | | | babe 10 mos. | | | | | | after treatment. Insane and paralyzed . . . . | S. | 6 mo. | F. | 11 | 9 mos. | Cured. Prostatitis and irritation of | | | | | | the bladder . . . . . . . . | M. |10 yrs.| M. | 68 | 1 mo. | Cured. Cirrhosis of the liver . . . | M. |12 " | M. | 45 | 4 mos. | Cured, has re- | | | | | | mained per- | | | | | | fectly well for | | | | | | two years. Melancholia and sterility . . | M. | 8 " | F. | 37 | 1 yr. | Cured; gave | | | | | | birth to babe | | | | | | 10 months after | | | | | | treatment. Constipation and nervous | | | | | | debility . . . . . . . . . | S. | 12 " | M. | 27 | 6 mos. | Cured. Insanity . . . . . . . . . . | M. | 8 " | F. | 51 | 9 mos. | Cured. Chorea . . . . . . . . . . . | S. | 2 " | F. | 12 | 3 wks. | Cured. Diabetes mellitus . . . . . . | M. | 1 " | M. | 49 | 9 mos. | Cured. Shaking Palsy . . . . . . . | M. | 10 " | M. | 60 | 1 mo. | Cured. Rheumatism, chronic . . . . . | M. | 9 " | F. | 63 | 7 mos. | Cured. Melancholia, constant | | | | | | dread . . . . . . . . . . | S. | 6 " | M. | 41 | 6 mos. | Cured. Diabetes mellitus . . . . . . | M. | 1 " | M. | 49 | 9 mos. | Cured. Shaking Palsy . . . . . . . | M. | 10 " | M. | 60 | 1 mo. | Cured. Rheumatism, chronic . . . . . | M. | 9 " | F. | 63 | 7 mos. | Cured. Melancholia, constant | | | | | | dread . . . . . . . . . . | S. | 6 " | M. | 41 | 6 mos. | Cured. Asthma . . . . . . . . . . . | S. | 12 " | F. | 28 | 2 mos. | Cured. Prostatitis . . . . . . . . | M. | 9 " | M. | 50 | 6 mos. | Cured. Ovaritis, sterility . . . . . | M. | 9 " | F. | 26 | 5 mos. | Cured; had heal- | | | | | | thy babe 9 | | | | | | mos.after treat- | | | | | | ment. Chronic ulcerative catarrh . | M. | 6 " | F. | 43 | 8 mos. | Cured; had been | | | | | | pronounced and | | | | | | treated as syph- | | | | | | ilitic catarrh. Hay fever . . . . . . . . . | M. | 12 " | F. | 36 | 1 mo. | Cured. Motor Ataxy . . . . . . . . . | S. | 5 " | M. | 45 | 4 mos. | Much improved | | | | | | in every way. Constipation and dyspep- | | | | | | sia . . . . . . . . . . . | M. | 50 " | F. | 72 | 2 mos. | Cured. Sciatica and uric acid | | | | | | diathesis . . . . . . . . . | M. | 15 " | M. | 65 | 6 mos. | Cured. Hay fever . . . . . . . . . | S. | 6 " | M. | 51 | 3 mos. | Cured. Consumption . . . . . . . . . | M. | 18 mo.| M. | 45 | 7 mos. | Cured. Diabetes insipidus . . . . . | M. | 2 " | M. | 43 | 1 mo. | Cured. Shaking Palsy . . . . . . . . | S. | 5 " | M. | 65 | 3 mos. | Cured. +--------------------+ | End of Chapter VII | pages 79-128 +--------------------+