[Footnote 1: A lecture delivered before the Franklin Institute,
December 5, 1890.--_From the Journal of the Institute_.]
By L. WEBSTER FOX, M.D.
Medical science, as taught in our medical colleges to-day, has two
objects in view: (1) the prevention of disease; (2) the amelioration
of disease and its cure. Some of our advanced thinkers are suggesting
a new mode of practice, that is the prevention of disease by proper
hygienic measures. Chairs are being established and professors
appointed to deliver lectures on hygiene. Of what value is the
application of therapeutics if the human economy is so lowered in its
vital forces that dissolution is inevitable? Is it not better to
prevent disease than to try the cure after it has become established,
or has honeycombed the constitution?
These few preliminary remarks are _apropos_ to what is to follow in
the subject which I have selected as the topic for discussion this
evening.
Vision is the most useful of all the senses. It is the one gift which
we should cherish and guard the most. And at no time in one's life is
it more precious than in infancy and youth.
In infancy, when the child is developing, the one great avenue to the
unfolding, or more properly speaking, the development, of the
intellect is through the eye. The eye at this period holds in abeyance
all the other senses. The child, when insensible to touch, taste,
smell or hearing, will become aroused to action by a bright light or
bright colors, or the movement of any illuminated object, proving to
all that light is essential to the development of the first and most
important sense. Again, the infant of but six days of age will
recognize a candle flame, while its second sense and second in
importance to its development--hearing--will not be recognized for
_six_ weeks to two months. Taste, touch and smell follow in regular
sequence. Inasmuch as light makes thus early an impression on the
delicate organ of vision, how necessary it behooves us to guard the
infant from too bright lights or too much exposure in our bright
climate. Mothers--not only the young mother with her first child, but
also those who have had several children--are too apt to try to quiet
a restless child by placing it near a bright flame; much evil to the
future use of those eyes is the outgrowth of such a pernicious habit.
Light throws into action certain cells of that wonderful structure of
the eye, the retina, and an over stimulus perverts the action of those
cells. The result is that by this over-stimulation the seeds of future
trouble are sown. Let the adult gaze upon the arc of an electric light
or into the sun, and for many moments, nay hours, that individual has
dancing before his vision scintillations and phosphenes. His direct
vision becomes blurred, and as in the case of a certain individual I
have in mind, there may be a permanent loss of sight. Parents should
take the first precaution in the child's life, and not expose it to a
light too bright or glaring. When in the open air let the child's eyes
be protected from the direct rays of the sun. While it is impossible
to give all children the advantage of green fields and outdoor
ramblings, yet nature never intended that civilization should debar
the innocent child from such surroundings.
An anecdote is related of a French ophthalmic surgeon, that a
distinguished patient applied to him for relief from a visual defect;
the surgeon advised him to go into the country and look out upon the
green fields. The green color with its soothing effect soon brought
about a restoration of vision. What I wish to illustrate by this
anecdote is that children should be allowed the green fields as their
best friend in early life. It tones up the system and rests the eye.
After outdoor exercise and plenty of it, we should turn our attention
to the home surroundings of our little ones. The overheated rooms of
the average American home I am sure have more to do with the growing
tendency of weak eyes than we feel like admitting. Look at these frail
hot-house plants, and can any one believe that such bodies nourished
in almost pestilential atmosphere can nourish such delicate organs of
vision, and keep them ready for the enormous amount of work each
little eye performs daily? The brain developing so rapidly wills with
an increasing rapidity the eye to do increasing duties; note the
result--a tendency to impoverished circulation first, and the eye with
its power to give the brain a new picture in an infinitesimal short
space of time means lightning-like circulation--the eye must give way
by its own exhaustion.
Civilization is the progenitor of many eye diseases.
After a boy has grown to that age when it becomes necessary for him to
begin the education prescribed by the wise men, obstacles are placed
in his way to aid again in causing deterioration of vision. It is not
so much the overcrowded condition of our school rooms as the enormous
amount of work that causes deterioration of sight. Our children begin
their school life at a time when they are too young. A child at six
years of age who is forced to study all day or even a part of a day
will not run the same race that one will who commences his studies at
ten--all things being equal. The law prescribes that so much time must
be devoted to study, so many forms must be passed, so many books must
be read, so many pages of composition written--all probably in badly
lighted rooms, or by artificial light. Note the effect. First,
possibly, distant vision gives way; the teacher, sympathizing with the
overburdened child, tries to make the burden lighter by changing his
position in the room or placing him under the cross light from a
window; as the evil progresses, the child is taken to an ophthalmic
surgeon, and the inevitable result, glasses, rightly called "crutches
for the eyes," are given. What would be thought of a cause which would
weaken the legs of that boy so that he would have to use crutches to
carry him through life? If civilization be responsible for an evil,
let our efforts be put forth in finding a remedy for that evil.
A discussion, in a recent number of the _British Medical Journal_,[2]
on "The Claims and Limitations of Physical Education in Schools," has
many valuable hints which should be followed by educators in this
country. Dr. Carter, in the leading paper on this subject, makes the
pregnant remark: "If the hope is entertained of building up a science
of education, the medical profession must combine with the profession
of teaching, in order to direct investigation and to collect material
essential to generalization. Without such co-operation educational
workers must continue to flounder in the morasses of empiricism, and
be content to purchase relative safety at the cost of slow progress,
or no progress at all." In other words, an advisory medical board
should coexist with our board of public education, to try to hold in
check or prevent a further "cruelty in trying to be kind." Private
institutions of education recognize the importance of physical
training and development, and in such institutions the deterioration
of vision is in proportion less than in institutions where physical
training is not considered. In one school of over 200 middle class
girls, Dr. Carter found that, during a period of six years, no fewer
than ten per cent. of the total number of girls admitted during that
time have been compelled to take one or more terms' leave of absence,
and of the present number twenty-eight per cent. have medical
certificates exempting them from gymnastic exercise and 10.25 per
cent. of the total present number wear eye glasses of some kind or
other. From my own experience the same number of students in our
schools would show about the same percentage of visual defects. These
questions are of such growing importance that not only instructors,
but the medical fraternity, should not rest until these evils are
eradicated.
[Footnote 2: Nov. 1, 1890.]
Dr. J.W. Ballantyne, of Edinburgh, in a lecture[3] on diseases of
infancy and childhood, says: "The education of the young people of a
nation is to that nation a subject of vital importance." The same
writer quotes the startling statement made by Prof. Pfluger, that of
45,000 children examined in Germany more than one-half were suffering
from defective eyesight, while in some schools the proportion of the
short sighted was seventy or eighty per cent., and, crowning all, was
the Heidelberg Gymnasium, with 100 per cent. These figures, the result
of a careful examination, are simply startling, and almost make one
feel that it were better to return to the old Greek method of teaching
by word of mouth.
[Footnote 3: _Lancet_. Nov. 1, 1890.]
Prof. Pfluger attributes this large amount of bad sight to
insufficient lighting of school rooms, badly printed books, etc. One
must agree with a certain writer, who says: "Schools are absolute
manufactories of the short sighted, a variety of the human race which
has been created within historic time, and which has enormously
increased in number during the present century." Granting that many
predisposing causes of defective vision cannot be eliminated from the
rules laid down by our city fathers in acquiring an education, it
would be well if the architects of school buildings would bear in mind
that light when admitted into class rooms should not fall directly
into the faces of children, but desks should be so arranged that the
light must be sufficiently strong and fall upon the desk from the left
hand side. My attention has repeatedly been called to the cross lights
in a school room. The light falling directly into the eyes contracts
the pupil which is already contracted by the action of the muscle of
accommodation in its effort to give a clearer picture to the brain.
This has a tendency to elongate the eyeball, and as a permanent result
we have near sightedness. Where the eyeball has an unnatural shortness
this same action manifests itself by headaches, chorea, nausea,
dyspepsia, and ultimately a prematurely breaking down of health. The
first symptom of failing sight is a hyper-secretion of tears, burning
of the eyelids, loss of eyelashes, and congestion either of the
eyelids or the eyeball proper.
The natural condition of aboriginal man is far sighted. His wild life,
his nomadic nature, his seeking for game, his watching for enemies,
his abstention from continued near work, have given him this
protection. Humboldt speaks of the wonderful distant vision of the
South American Indians; another traveler in Russia of the power of
vision one of his guides possessed, who could see the rings of Saturn.
My recent examinations among Indian children of both sexes also
confirm this. While the comparison is not quite admissible, yet the
recent investigations carried on by Lang and Barrett, who examined the
eyes of certain mammalia, found that the larger number were
hypermetropic or far sighted. With all the difficulties which
naturally surround such an examination they found that in fifty-two
eyes of rabbits, thirty-six were hypermetropic and astigmatic, eight
were hypermetropic only, five were myopic and astigmatic, and others
presented mixed astigmatism. In the eyes of the guinea pig about the
same proportion of hypermetropia existed. The eyes of five rats
examined gave the following result: Some were far sighted, others were
hypermetropic and astigmatic, one was slightly myopic and one had
mixed astigmatism. Of six cows, five were hypermetropic and astigmatic
and one was slightly myopic.
Six horses were also examined, of which one had normal sight, three
were hypermetropic and astigmatic, and two had a slight degree of
astigmatism. They also examined other animals, and the same proportion
of hypermetropia existed. These gentlemen found that as an optical
instrument the eye of the horse, cow, cat and rabbit is superior to
that of the rat, mouse and guinea pig.
I have for the last five years devoted considerable attention to the
vision of the Indian children who are pupils at two institutions in
this city. I have at various times made careful records of each
individual pupil and have from time to time compared them. Up to the
present there is a growing tendency toward myopia or short
sightedness, i.e., more pupils from year to year require near sighted
glasses. The natural condition of their eyes is far sighted and the
demands upon them are producing many nervous or reflex symptoms, pain
over the frontal region and headaches. A good illustration of the
latter trouble is showing itself in a young Indian boy, who is at
present undergoing an examination of his vision as a probable cause
for his headaches. This boy is studying music; one year ago he
practiced two hours daily on the piano and studied from three to five
hours besides. This year his work has been increased; he is now
troubled with severe headaches, and after continued near work for some
time letters become blurred and run together. This boy is far sighted
and astigmatic; glasses will correct his defect, and it will be
interesting to note whether his eyes will eventually grow into near
sighted ones. I have several cases where the defective vision has been
due entirely to other causes, such as inflammation of the cornea,
weakening this part of the eye, and the effect in trying to see
producing an elongation of the anterior portion of the eyeball, and
this in turn producing myopia. The eye of the Indian does not differ
materially from that of any deeply pigmented race. The eyeball is
smaller than in the Caucasian, but when we examine the interior we
find the same distribution of the blood vessels and same shape of the
optic nerves. The pigment deposit in the choroid is excessive and
gives, as a background to the retina, a beautiful silvery sheen when
examined with the ophthalmoscope. One thing which I noticed
particularly was the absence of this excessive deposit of pigment and
absence of this watered silk appearance in the half breeds, they
taking after the white race.
Many of the intraocular diseases common among the white children were
also absent, especially those diseases which are the result of near
work.
It is a well known fact among breeders of animals that where animals
are too highly or finely bred, the eye is the organ first to show a
retrogression from the normal. In an examination by myself some years
ago among deaf mutes, I found the offspring of consanguineous
marriages much affected, and while not only were many afflicted with
inflammatory conditions of the choroid and retina, their average
vision was much below the normal.
My quoting Messrs. Lang and Barrett's figures was to bring more
prominently to the notice of my hearers the fact that the eyes of
primitive man resembled the eyes of the lower mammalia and that the
natural eye as an organ of vision was hypermetropic, or far sighted,
and that civilization was the cause of the myopic or near sighted eye.
Nature always compensates in some way. I grant that the present
demands of civilization could not be filled by the far sighted eye,
but the evil which is the outgrowth of present demands does not stop
when we have reached the normal eye, but the cause once excited, the
coats of this eye continue to give way, and myopia or a near sighted
condition is the result.
Among three hundred Indians examined, I found when I got to the
Creeks, a tribe which has been semi-civilized for many years, myopia
to be the prevailing visual defect.
Without going into statistics, I am convinced from my experience that
the State must look into this subject and give our public school
system of education more attention, or we, as a people, will be known
as a "spectacled race."
Myopia or short-sightedness among the Germans is growing at a
tremendous rate. While I do not believe that the German children
perform more work than our own children, there is one cause for this
defect which has never been touched upon by writers, and that is the
shape of the head. The broad, flat face, or German type, as I would
call it, has not the deep orbit of the more narrow, sharp-featured
face of the American type. The eye of the German standing out more
prominently, and, in consequence, less protected, is thereby more
prone to grow into a near-sighted eye. One of the significant results
of hard study was recently brought to my notice by looking over the
statistics on the schools of Munich in 1889. In those schools 2,327
children suffered from defective sight, 996 boys and 1,331 girls.
Of 1,000 boys in the first or elementary class, 36 are short-sighted;
in the second, 49; in the third, 70; in the fourth, 94; in the fifth,
108; in the sixth, 104; and in the last and seventh, 108. The number
of short-sighted boys, therefore, from the first class to the seventh
increases about three-fold. In the case of girls, the increase is from
37 to 119.
These statistics in themselves show us the effects of overwork,
incessant reading or study by defective gas or lamp light, or from an
over-stimulating light, as the arc light, late hours, dissipation, and
frequent rubbing of the eye, also fatigue, sudden changes from
darkness to light, and, what is probably worse than all, reading on
railway trains. The constant oscillations of the car cause an
over-activity of the muscle of accommodation, which soon becomes
exhausted; the brain willing the eye to give it a clear photograph
continues to force the ciliary muscle, which muscle governs the
accommodation, in renewed activity, and the result may easily be
foretold.
The fond parents finding that the vitiated air of the city is making
their once rosy-cheeked children turn pale, seek a remedy in the fresh
air of the country. The children find their way to city schools; this
necessitates traveling so many miles a day in railway cars. The
children take this opportunity of preparing their studies while _en
route_ to the city, and here is where they get their first eye-strain.
Children have the example set them by their parents or business men,
who read the daily papers on the trains. Children are great imitators,
and when their attention is called to the evil, quote their parents'
example, and they follow it. No wonder each generation is growing more
effeminate.
The light in sick rooms should never fall directly on the eyes, nor
should the rooms be either too dark or too light.
The Esquimaux and Indians long ago noted the fact that sunlight
reflected from freshly fallen snow would soon cause blindness.
The natives of northern Africa blacken themselves around the eyes to
prevent ophthalmia from the glare of the hot sand. In Fiji the
natives, when they go fishing, blacken their faces. My friend. Dr.
Bartelott, presented me with a pair of eye protectors, which he
brought from Alaska. The natives use them to protect themselves from
snow blindness. These snow spectacles, or snow eyes, as they are
called, are usually made out of pine wood, which is washed upon their
shores, drift wood from southern climes.
The posterior surface is deeply excavated, to prevent its obstructing
the free motion of the eye lids; on each side a notch is cut at the
lower margin to allow a free passage for the tears. The upper margin
of the front surface is more prominent than the under, to act as a
shade to the eyes. The inner surface is blackened to absorb the
excessive light. The openings are horizontal slits. The eyes are thus
protected from the dazzling effect of the light.
My friend, Dr. Grady, of Omaha, communicated to me a history of three
hunters who almost lost their eyesight by too long exposure to the
bright rays of the sun falling on snow.
The abuse of tobacco leads to impairment of vision in the growing
youth. Cigarette smoking is an evil. I am inclined to believe that the
poison inhaled arrests the growth of boys; surely it prevents a mental
development, and, when carried to excess, affects vision more by
lessening the power of nerve conduction than acting directly on the
eye.
It is not the one cigarette which the boy smokes that does the harm,
but it is the one, two, or three packages smoked daily. This excessive
smoking thoroughly perverts all the functions which should be at their
best to aid this growing youth. First we have failing digestion,
restless nights, suspension of growth, lack of mental development, the
loss of nerve tone, loss of the power of accommodation in vision,
failing sight, headaches, enfeeblement of the heart. Let a man who is
a habitual smoker of cigars attempt to smoke even one package of
cigarettes and he will complain of nausea, dry throat, and loss of
appetite. If a strong man is so much affected by this poison, how much
less can a boy resist the inroads of such poisons? In Germany the law
forbids the sale of cigarettes to growing boys. New York State has a
similar law, and why should our own or any other State be behind in
passing prohibitory laws against this evil?--and this is a growing
evil.
I have never seen a case of tobacco amblyopia in boyhood, but such a
condition is not infrequent in adults. In boys the action of nicotine
acts especially upon the heart, the impulse is rendered weaker and
intermittent, and many young boys lay the seeds of organic disease
which sooner or later culminates fatally. Boys should be prohibited
from smoking, first by their parents, second by law, but not such laws
whose enforcement is a failure, third by placing a heavy fine upon
dealers who sell to minors. The pernicious evil of intoxication is no
less an evil upon the nervous system of a youth than is the habit of
cigarette smoking, but, fortunately, this habit is less common. Having
traced from aboriginal man to the present civilized individual the
cause of his myopia, what must we do to prevent a further
deterioration of vision? Unfortunately, the physician of our country
is not, as I am told, like the Japanese physician. Our medical men are
called to attend people who are ill and to try to get them well--the
Japanese physician is paid only to keep his patients in health.
The first effort parents should make is to see that their children
have plenty of outdoor exercise. Good, warm clothing in winter, and
light texture cloth in summer. A great difference of opinion exists as
to the age at which a child should begin its studies. I feel sure that
the boy who commences his studies at ten will far outrun the one who
commences study at six. Every child should commence his lessons in the
best kindergarten, the nursery. Let object lessons be his primer--let
him be taught by word of mouth--then, when his brain is what it should
be for a boy of ten, his eyes will be the better able to bear the
fatigue of the burdens which will be forced upon him. Listen to what
Milton has left on record as a warning to those young boys or girls
who insist upon reading or studying at night with bad illumination.
"My father destined me, from a child, for the pursuits of polite
learning, which I prosecuted with such eagerness that, after I was
twelve years old, I rarely retired to bed, from my lucubrations, till
midnight. This was the first thing which proved pernicious to my eyes,
to the natural weakness of which were added frequent headaches."
Milton went blind when comparatively a young man, and it was always to
him a great grief. Galileo, the great astronomer, also went blind by
overwork. It was written of him, "The noblest eye which ever nature
made is darkened--an eye so privileged, and gifted with such rare
powers, that it may truly be said to have seen more than the eyes of
all that are gone, and to have opened the eyes of all that are to
come."
When the defect of far sightedness or near sightedness exists, we have
but one recourse--_spectacles_.
Some time ago I published, in the _Medical and Surgical Reporter_ an
article on the history of spectacles. The widespread interest which
this paper created has stimulated me to continue the research, and
since this article appeared I have been able to gather other
additional historical data to what has been described as an invention
for "poor old men when their sight grows weak."
The late Wendell Phillips, in his lecture on the "Lost Arts," speaks
of the ancients having magnifying glasses. "Cicero said that he had
seen the entire _Iliad_, which is a poem as large as the New
Testament, written on a skin so that it could be rolled up in the
compass of a nut shell;" it would have been impossible either to have
written this, or to have read it, without the aid of a magnifying
glass.
In Parma, a ring 2,000 years old is shown which once belonged to
Michael Angelo. On the stone are engraved the figures of seven women.
You must have the aid of a glass in order to distinguish the forms at
all. Another _intaglio_ is spoken of--the figure is that of the god
Hercules; by the aid of glasses, you can distinguish the interlacing
muscles and count every separate hair on the eyebrows. Mr. Phillips
again speaks of a stone 20 inches long and 10 wide containing a whole
treatise on mathematics, which would be perfectly illegible without
glasses. Now, our author says, if we are unable to read and see these
minute details without glasses, you may suppose the men who did the
engraving had pretty strong spectacles.
"The Emperor Nero, who was short sighted, occupied the imperial box at
the Coliseum, and, to look down into the arena, a space covering six
acres, the area of the Coliseum, was obliged, as Pliny says, to look
through a ring with a gem in it--no doubt a concave glass--to see more
clearly the sword play of the gladiators. Again, we read of Mauritius,
who stood on the promontory of his island and could sweep over the sea
with an optical instrument to watch the ships of the enemy. This tells
us that the telescope is not a modern invention."
Lord Kingsborough, speaking of the ancient Mexicans, says: "They were
acquainted with many scientific instruments of strange invention,
whether the telescope may not have been of the number is uncertain,
but the thirteenth plate of _Dupaix's Monuments_, part second, which
represents a man holding something of a similar nature to his eye,
affords reason to suppose that they knew how to improve the powers of
vision.
Our first positive knowledge of spectacles is gathered from the
writings of Roger Bacon, who died in 1292.[3] Bacon says: "This
instrument (a plano-convex glass or large segment of a sphere) is
useful to old men and to those who have weak eyes, for they may see
the smallest letters sufficiently magnified."
[Footnote 3: _Med. and Surg. Reporter_.]
Alexander de Spina, who died in 1313, had a pair of spectacles made
for himself by an optician who had the secret of their invention. De
Spina was so much pleased with them that he made the invention public.
Monsieur Spoon fixes the date of the invention between 1280 and 1311.
In a manuscript written in 1299 by Pissazzo, the author says: "I find
myself so pressed by age that I can neither read nor write without
those glasses they call spectacles, lately invented, to the great
advantage of poor old men when their sight grows weak." Friar Jordan,
who died in Pisa in 1311, says in one of his sermons, which was
published in 1305, that "it is not twenty years since the art of
making spectacles was found out, and is indeed one of the best and
most necessary inventions in the world." In the fourteenth century
spectacles were not uncommon and Italy excelled in their manufacture.
From Italy the art was carried into Holland, then to Nuremberg,
Germany. In a church in Florence is a fresco representing St. Jerome
(1480). Among the several things represented is an inkhorn, pair of
scissors, etc. We also find a pair of spectacles, or _pince-nez_--the
glasses are large and round and framed in bone.
It was not until 1575 that Maurolicus, of Messina, pointed out the
cause of near sightedness and far sightedness and explained how
concave glasses corrected the former and convex glasses the latter
defect.
In the wake of advanced, education stalks the spectacle age. Any one
watching a passing crowd cannot fail but note the great number of
people wearing spectacles. Unfortunately it is not limited to adults,
but our youths of both sexes go to make up this army of ametropes.
At what age should children first wear glasses? This is a much
debatable question. Where there is simply a defect of vision I should
never prescribe a pair of glasses for a child under ten years of age.
A child under this age runs many risks of injury to the eyeball by
accident to the glasses, and to cut the eye with glass is a very
serious affair. Rather let a child go without study, or even with
impaired vision, than run the risk of a permanent loss of sight.
Another source of evil I must call your attention to, and that is the
indiscriminate use of glasses given by itinerant venders of spectacles
who claim a thorough knowledge of the eye, who make examination free,
but charge double price for glasses.
Persons, before submitting themselves into the hands of opticians,
should know that they are not suffering from any incipient disease of
their eyes. I do not, for a moment, claim that a practical optician
cannot give you a pair of glasses which will make you see--he does
nothing more than hand you a number of pairs of glasses and you select
the one pair which you think answers the purpose. How can anyone but a
medical man know that the impairment of vision does not arise from
diminished sensibility of the retina? If so, the glasses just
purchased, which may be comfortable for a time, may cause an
irreparable loss of vision. Every ophthalmic surgeon will tell you
that he has had a number of such cases. Do not be misguided by
purchasing cheap spectacles. Glasses advertised as having "remarkable
qualities" are always to be passed by. They have "remarkable
qualities;" they always leave the person wearing them worse at the end
of a few months. Whenever an eye finds relief in a shaded or colored
glass, something is going wrong with the interior of that eye. Seek
advice, but do not trust the eyes of yourself, much less those of your
children, in the hands of the opticians who advertise their
examinations free.
Such individuals should be brought before a tribunal and the matter
sifted as to whether the sense of sight is less to be taken care of
than if that same patient were ill with pneumonia and a druggist were
to prescribe remedies which might or might not aid this patient. If
one man must comply with the law, why should not the other? Our
medical colleges are lengthening the course of studies; the advances
in the various departments of science demand this. It is by the aid of
the ophthalmoscope that many obscure diseases are diagnosed, and while
it is impossible for every young man who obtains a diploma to become
thoroughly proficient in the use of this instrument, yet the eye shows
to him many conditions which guide him to the road of successful
treatment. Think of a case of optic neuritis--inflammation of the
optic nerve--going to an optician and fitting one set of glasses after
another until the patient suddenly discovers that blindness is
inevitable. Many individuals, and very intelligent ones at that, think
that so long as a glass makes them see, that is all they need. When we
know that scarcely two eyes are alike, we can at once feel that it is
very important that each eye should be properly adjusted for a glass;
by this we are sure of having comfort in reading and preserving
vision.
There is a very important defect in vision which should be detected as
early in life as possible, and that is color blindness. The boy who is
a color blind will always remain a color blind, and as forty in every
1,000 of the male sex are color blind, it is essential that they know
their defect, and train their course accordingly. It would be to the
advantage of all boys to undergo such an examination once in their
school life; a color blind would be useless where the selection of
color entered into his life work. If a boy had a talent for drawing or
engraving, and were color blind, he would make a success of his life,
whereas if he would attempt to mix paints of different colors he would
be a failure.
I shall not dwell upon the scientific part of color blindness, nor
discuss either the Young-Helmholtz or the Hering theories of color
defect, but shall deal with its practical use in everyday life.
Until the year 1853, very little was known about color blindness, and
much less written about it.
Dr. George Wilson, in 1853, wrote several articles, which were
published in the _Edinburgh Monthly Journal of Medical Science._ These
articles created such an interest in the scientific world that Dr.
Wilson brought out a book, entitled "Researches on Color Blindness,"
two years later. So thoroughly did Dr. Wilson sift this subject that
no writer up to the present day has added anything practical to what
was then known.
Dr. Wilson writes in his preface: "The most practical relation of
color blindness is that which it has to railway and ship signals." He
further states: "The professions for which color blindness most
seriously disqualifies are those of the sailor and railway servant,
who have daily to peril human life and property on the indication
which a colored flag or a lamp seems to give."
Dr. Bickerton, in an article on this same subject, speaking of the
careless way in which lights were used on ships at sea, says: "Until
the year 1852, there were no definite rules regarding the carrying of
lights at night by vessels at sea.... At this time the subject of
color blindness had not awakened the attention of practical observers,
and had the fact been known that between three and four per cent. of
the whole male population are color blind, some other mode might have
been devised to indicate the positions of vessels at night than by
showing red and green lights."
If it is so very important to have sailors with good color perception,
where, at least, four men are on the lookout, how much more important
is it to have our engine drivers with perfect color perception, where
one man alone watches the signal of safety or danger.
The growth of our railway system is constantly increasing. We have
to-day probably 150,000 men employed in this service. The boys
attending public schools to-day in a few years will have to fill the
ranks of these men. How important for these boys to know that they
have not this defect. If the forty boys in every 1,000 are found, what
is to be done with them? The engraver, the wood cut engraver, the
etcher, all wish apprentices. I am also informed that these
occupations pay well. It requires talent to fill them, and here is an
opening for the color blind. Hear what a color blind writes:[4] "I beg
to offer some particulars of my own case, trusting it may be of use to
you. I am an engraver, and strange as it may appear, my defective
vision is, to a certain extent, a useful and valuable quality. Thus,
an engraver has two negative colors to deal with, i.e., white and
black. Now, when I look at a picture, I see it only in white and
black, or light and shade, and any want of harmony in the coloring of
a picture is immediately made manifest by a corresponding discord in
the arrangement of its light and shade or, as artists term it, the
_effect_. I find at times many of my brother engravers in doubt how to
translate certain colors of pictures which to me are matters of
decided certainty and ease. Thus, to me it is valuable." Having
already spoken about the importance of having all boys undergo an
examination for color blindness once in their school lives, we have
two very good reasons for making this suggestion.
[Footnote 4: Wilson, p. 27.]
First, prevent a boy following a trade or occupation where he is
incapacitated, and, secondly, let him be trained for a certain trade
or occupation when the defect exists. The savage races possess the
perception of color to a greater degree than do civilized races. I
have just concluded an examination of 250 Indian children; 100 were
boys. Had I selected 100 white boys from various parts of the United
States I would have found at least five color blinds; among the Indian
boys I did not find a single one. Some years ago I examined 250 Indian
boys and found two color blind, a very low percentage when compared
with the whites. Among the Indian girls I did not find any. When we
know that only two females in every 1,000 among whites are color
blind, it is not surprising that I did not find any examples among the
Indian girls.
The usual tests for color blindness are the matching of wools; the
common error the color blind falls into is matching a bright scarlet
with a green. On one occasion, a color blind gentleman found fault
with his wife for wearing, as he thought, a bright scarlet dress, when
in point of fact she was wearing a bright green. Another color blind
who was very fond of drawing, once painted a red tree in a landscape
without being aware that he had done so.
Among the whites it affects all classes. It is found as relatively
common among the intelligent as the illiterate, and unfortunately, up
to the present, we have not discovered any remedy for this defect.
Without quoting many instances where a color blind man was responsible
for accidents at sea, I must quote a case where an officer on the
watch issued an order to "port" his vessel, which, if his order had
been carried out, would have caused a collision, and a probable
serious loss of life.
The letter was written by Capt. Coburn, and is to be found in the
_Mercantile Marine Reporter_, vol. xiv.
"The steamer Neera was on a voyage from Liverpool to Alexandria. One
night, shortly after passing Gibraltar, at about 10.30 p.m., I went on
the bridge, which was then in charge of the third officer, a man of
about forty-five years of age, and who up to that time I had supposed
to be a trustworthy officer, and competent in every way. I walked up
and down the bridge until about 11 p.m., when the third officer and I
almost simultaneously saw a light at about two points on the starboard
bow. I at once saw it was a green light, and knew that no action was
called for. To my surprise, the third officer called out to the man at
the wheel, 'port,' which he was about to do, when I countermanded the
order, and told him to steady his helm, which he did, and we passed
the other steamer safely about half a mile apart. I at once asked the
third officer why he had ported his helm to a green light on the
starboard bow, but he insisted it was a red light which he had first
seen. I tried him repeatedly after this, and although he sometimes
gave a correct description of the color of the light, he was as often
incorrect, and it was evidently all guesswork. On my return, I applied
to have him removed from the ship, as he was, in my opinion, quite
unfit to have charge of the deck at night, and this application was
granted. After this occurrence I always, when taking a strange officer
to sea, remained on the bridge with him at night until I had tested
his ability to distinguish colors. I cannot imagine anything more
dangerous or more likely to lead to fatal accidents than a color blind
man on a steamer's bridge."
A similar experience is thus related by Capt. Heasley, of Liverpool:
"After passing through the Straits of Gibraltar, the second officer,
who had charge of the deck, gave the order to 'port,' much to my
astonishment, for the lights to be seen about a point on the starboard
bow were a masthead and green light, but he maintained that it was a
masthead and red, and not until both ships were nearly abreast would
he acknowledge his mistake. I may add that during the rest of the
voyage I never saw him making the same mistake. As a practical seaman
I consider a great many accidents at sea arise from color blindness."
Dr. Farquharson has brought this subject before the House of Commons
in England and measures are being taken which will insure to the
traveling public immunity from accidents at sea. I need not mention
that the majority of railways of our country have a system of
examinations which prevents a color blind entering their service.
Dr. Wilson makes the suggestion that he noticed a singular expression
in the eyes of certain of the color blind difficult to describe. "In
some it amounted to a startled expression, as if they were alarmed; in
others, to an eager, aimless glance, as if seeking to perceive
something but unable to find it; and in certain others to an almost
vacant stare, as if their eyes were fixed upon objects beyond the
limit of vision. The expression referred to, which is not at all times
equally pronounced, never altogether leaves the eyes which it seems to
characterize."
Dr. B. Joy Jeffries, of Boston, has recently written an article on
this same topic, but unfortunately I have not his pamphlet at hand to
quote his views on this subject.
In this lecture I have shown that the normal eye is far sighted. The
mammalia have this kind of an eye; the Indian the same. The white man
is fast becoming near sighted. The civilized Indian is also showing
the effects of continuous near work; and now the question arises. What
are we to do to prevent further deterioration of vision? The fault
lies at our own doors. Let us try to correct these now existing evils,
so that future generations will, instead of censuring us, thank us for
our wisdom.
To aid in a feeble way for the protection of posterity I have
formulated ten rules on the preservation of vision:
(1) Do not allow light to fall upon the face of a sleeping infant.
(2) Do not allow babies to gaze at a bright light.
(3) Do not send children to school before the age of ten.
(4) Do not allow children to keep their eyes too long on a near
object, at any one time.
(5) Do not allow them to study much by artificial light.
(6) Do not allow them to use books with small type.
(7) Do not allow them to read in a railway carriage.
(8) Do not allow boys to smoke tobacco, especially cigarettes.
(9) Do not necessarily ascribe headaches to indigestion. The eyes may
be the exciting cause.
(10) Do not allow the itinerant spectacle vender to prescribe glasses.
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