STORIES FROM THE CLINIC 2. A Case of CataractBy EMILY C. LIERMAN One day as I entered the clinic I found a little white haired woman waiting patiently to be treated. I had not seen her before, and did not know what her trouble was. The usual crowd of patients was waiting for Dr. Bates and myself, so when he said to me, “See what you can do for this woman,” I did not ask any questions, for I knew that whatever the condition of her eyes relaxation would help her. I placed her four feet from the test card, at which distance she read the forty line (read by the eye with normal vision at forty feet), and told her how to rest her eyes by palming and how to avoid staring by shifting from one side of a letter to another. These practices helped her so much that before she left she was able to read the thirty line. Later I learned that she had first seen Dr. Bates in March, 1919, and that she had incipient cataract of both eyes. In October, 1916, she had visited another dispensary where an operation was advised when the cataracts were ripe. I also learned that in spite of her seventy-three years she worked hard every day for her living, being employed in an orphan asylum where she mended the children’s clothes. The fact that she was very deaf I saw for myself, of course, at the first interview, for I had to scream to make her hear. Her courage and cheerfulness under circumstances that might have daunted the bravest spirit were amazing. Her face was always radiant with smiles, and she was so witty, and so appreciative of everything that was done for her, that each one of her visits to the clinic was a pleasure to me. “I have so much to be thankful for,” she said one day. “I know I will see all right again. They are waiting to operate at the other dispensary, and I am waiting to fool them.” The orphanage is about two miles from the clinic, and often she walks the entire distance rather than bother waiting for a car. She insists after these feats that she isn’t a bit tired. One day there were no cars running and the walking was so bad that a friend urged her not to go out unless she was prepared to swim. She came just as usual, however. Why should she stay in, she asked, because other people were afraid to go out. She wasn’t tired either, and she hadn’t even got her feet wet. She just dodged the snowdrifts. Most patients frown when they cannot see a letter, but my little cataract patient smiles instead and remarks cheerfully, “That’s the time you got me.” One day she did not do as well as usual, and I found that the people in the place where she worked had been saying unpleasant things. I told her she must try not to let things of this sort disturb her, because that made her strain and made the cataracts worse. “Well,” she said, “it is mighty hard not to worry; but I’ll try not to.” At a recent visit she explained that she wouldn’t he able to do very well because she hadn’t had time to practice. “Never mind,” I said. “Just do as well as you can.” Without her knowing it I placed her two feet farther from the card than usual. Then I told her to palm, and after a short time I pointed to a small letter on the bottom line and asked her if she could see it. She recognized it immediately. Then I pointed to another, but she was so eager to see it that she tried too hard and failed. She closed her eyes for a few minutes without palming, and when she opened them she read the whole line. I then told her that she was two feet farther away from the card than she usually was. She was very happy about this and said, “That’s the time you fooled me.” She has since become able to read the bottom line at ten feet, and one day she read it at eleven feet, without knowing it and without having done any practicing at home. On sunshiny days she can read the “W. H. Bates, M.D.” on Dr. Bates’ card, and for over a month she has done all her sewing without glasses. There is no doubt that she is going to fool them at the other dispensary. Along with the improvement in her eyes has gone a considerable improvement in her hearing. Noises in her ears which she describes as a “ringing and a singing” are promptly relieved by palming, and she says that the relief, which at first was only temporary, is now becoming more constant. She also says that she hears conversation better than she used to.
A CASE OF CATARACTBy VICTORIA COOLIDGE After I had made one visit to Dr. Bates, I was so much encouraged that I asked him if he could do anything for my father, eighty-one years old, who had cataract in each eye. He said he could, provided the patient had all his faculties and would follow directions. I replied that he was not only in full possession of his faculties but that he was blest with vigorous health besides, and I felt sure that he would be willing to do anything to restore his sight. When I went home, I told my father what Dr. Bates had said, but the treatment seemed so simple for such a difficult case, and his mind was so thoroughly imbued with the idea that nothing but an operation would help him, that he did not make up his mind to see Dr. Bates until four months later. He remembered having had remarkably keen vision as a young man, and in 1862 passed as normal the army eye test, which was very strict at the beginning of the Civil War. When he was about fifty years old, however, he began to have trouble in reading and other near work, so he put on glasses to correct this difficulty, and seems to have had the same experience that so many people have—they were nearly, but not quite right. He went from one doctor to another, but the result was always the same. Finally, in 1907, he consulted a well-known specialist in Albany, who, in 1919, at his request, sent him the following record of his case as it was at the time of that visit:
CATARACT: ITS CAUSE AND CUREBy W. H. BATES, M. D. Cataract is a condition in which the lens becomes opaque. It is commonly associated with advancing years, but may occur at any age. It may also be congenital (present at birth). The opacities take many different forms, and may occur in a hard or a soft lens. According to the orthodox teaching the condition is incurable except by the removal of the lens, although in the earlier stages it is sometimes ameliorated by means of drops that expand the pupil and by glasses. The text-books are full of statements to this effect. Yet it is perfectly well known that cataract does sometimes recover spontaneously. Many such cases are on record, and probably most ophthalmologists who have been practicing for any length of time have seen them. Fifteen or twenty years ago, when I was assistant surgeon at the New York Eye and Ear Infirmary, I collected, at the request of the surgeon, Dr Henry D. Noyes, a large number of records of such cases. The removal of the lens, when it is soft, is usually accomplished by the operation of needling, whereby the tissues are broken up so that they may be absorbed. A hard lens is extracted through an opening at the margin of the cornea, and the best results are believed to be obtained when the opacity has become complete. Otherwise part of the lens substance is liable to be left behind and cause trouble. Thus the patient may be kept for years in a condition of semi-blindness. The results of the operation are not always as satisfactory as might be desired. A considerable proportion of patients regain what is considered to be normal acuteness of vision with very strong glasses, and the results are considered good when they become able to read large print at the near-point and 20/50 at the distance. The patient is obliged, usually to have two sets of glasses, one for distant vision to replace the focusing power of the lost lens, and the other for reading to compensate for the impairment of the accommodative power which usually follows the operation. This impairment of accommodative power is not due to the removal of the lens, which has nothing to do with accommodation, but to the fact that the patient strains so to see that the muscles that control the shape of the eyeball fail to act properly. In some cases it is regained, after the patient becomes accustomed to the new situation, without treatment, and in rare cases patients have become able to do without glasses entirely, because the eyeball elongated sufficiently to compensate for the loss of the lens. I began to treat cataract by the operative method, because I did not know anything better to do. Then I learned from Dr James E. Kelly of New York that incipient cases would yield to hygienic treatment. My first inkling of the value of central fixation in such conditions came to me through a patient who had incipient cataract in one eye and hypermetropia (farsight) in the other. By the time the error of refraction had been relieved the cataract had disappeared. After this I had many similar experiences, but it did not occur to me that a ripe cataract, or a congenital cataract, could by cured by this or any other treatment. In 1912, however, a young girl of seventeen came to my clinic with the left eye enucleated and a congenital cataract in the right. The left had been operated upon for the same condition, and, having become infected, was taken out to save the better eye. The latter having recently become worse, the patient had come to have it operated upon. Before performing the operation I thought it best to treat her by the method of relaxation, for the purpose of improving the condition of the eye as much as possible so that the operation might have a better chance of success. To my surprise the vision improved and kept on improving, until in three months it was normal and the cataract had disappeared. One day, some half a dozen years later, a lady, fifty-five years of age, came to me to be cured of presbyopia (old-age sight.) Her distant vision in the right eye was 20/20, and in the left she had only light perception. This was due to the presence, in this eye, of a mature cataract. I began to treat her by the aid of the memory and imagination for presbyopia, and, in order to prove to her the relation between these mental faculties and the state of the vision, I asked her to cover her right eye and note that she could not remember or imagine a black period as well as when it was open. She replied that she could, and I said it was impossible. She insisted that, nevertheless, she did it. Thinking that at the near-point she would realize the imperfection of the sight of the left eye more clearly than at the distance, I brought the card closer and said: “You cannot remember the period looking at this card with your good eye covered.” She replied: “I can, and what is more, I can read the card,” which she did, both at two feet and at twenty. This was naturally a shock to me. It did not seem to me possible that a mature cataract could melt away in such a short time, but the ophthalmoscope confirmed the statements of the patient. When she remembered a period perfectly I could see the optic nerve and other details of the eye-ground. Since then I have cured a great many similar cases, one of the most remarkable having been reported in Better Eyesight for June, 1920. I had another shock when a few months ago a traumatic cataract began to melt away under the influence of relaxation treatment. The patient came to my clinic with an eye which had been completely blind for four years from traumatic cataract complicated with detachment of the retina. The opacity completely covered the pupil, and with the ophthalmoscope no red reflex (light reflected from the retina) could be seen. After a few treatments the patient became able to see the movements of his hand on the temporal side. Later he became able to see the hand in all parts of the field. Now he is beginning to read. Another case of the cure of traumatic cataract is reported in the following article. These cures are very remarkable. A traumatic cataract is one which follows an injury (trauma) to the lens, the opacity being due largely to the formation of connective tissue in the pupil, and, in advance of the event, I should have pronounced the cure of such a condition impossible, although I had previously demonstrated that when patients practice central fixation connective tissue is absorbed in the optic nerve, retina and cornea. In the retina and optic nerve the circulation can be seen to improve as the connective tissue disappears, and I can only assume that this is the cause of its disappearance. Equally remarkable is the cure of diabetic cataract without relief of the disease. A patient with such a cataract came to me on April 29, 1918, her vision being 10/200 — in the right eye and 20/30 — in the left. She had been seen a year and a half previously by a well-known ophthalmologist who had advised several operations, but, fortunately, she had not submitted to them. By the aid of palming, swinging, imagination and memory, her vision improved rapidly. On May 15 that of the left eye was 20/70, while later it became normal. On May 22 the vision of the right became normal temporarily. Since then she has had slight relapses in the right eye, but few or none in the left. The general diabetic condition has not changed, and it is remarkable that when it is at its worst there is very little lowering of the vision. It is quite evident from the foregoing facts that the cause of cataract (other than traumatic) is strain, and I have found much evidence, both clinical and experimental, to the same effect. I have not been able to produce cataract in a normal eye by strain, but in a cataractous eye I have seen the opacity come and go according as the mind of the patient was relaxed or under strain. In one of these cases the opacity was so dense that no red reflex could be seen. Another doctor who was present looked at the eye and made the same observation. I asked the patient to remember a swinging O perfectly black, with a perfectly white center. This meant perfect relaxation, and when she did it I saw some of the details of the retina and the optic nerve, while the other doctor again confirmed my observation. I then asked her to think of the O as stationary, with grey outlines and a clouded center. This meant great strain, and while she did it neither I nor my colleague could see the red reflex. In experimental animals I have produced cataract by operating upon the external muscles in such a way as to increase their pressure, and have then relieved it by cutting these muscles.
TRAUMATIC CATARACT DISAPPEARSBy MARGARET DOWNIE This patient was first seen on October 18, 1920, when her vision in the right eye was 20/100 and in the left 14/200. She had compound myopic astigmatism in the right eye, and the pupil of the left eye was covered by a traumatic cataract which prevented ophthalmoscopic examination of the eye-ground. On December 6, the cataract had been absorbed except for a spot about the size of a pin-head, and I was able to see the optic nerve and the retina clearly. With a glass to replace the focusing power of the lens—convex 7.00D.S. combined with convex 3.00 D.C., 75 degrees—she was able with this eye to read 20/40, and on the same day, after palming and swinging, she obtained temporary normal vision in both eyes, the left eyeball having elongated sufficiently to compensate for the loss of the lens. The fact that astigmatism should have developed in the right eye after the injury to the left is interesting, as astigmatism has been supposed, until recently, to be congenital. When I was thirteen years of age a bullet from an air-gun, rebounding from a tree, struck my left eye and injured the lens. This resulted in the formation of a cataract which was operated upon three times. After the third operation about one third of the cataract remained, but the doctor was afraid to operate again. I was now able with this eye to distinguish, with the aid of a strong glass, only the outline of near-by objects. Previous to the accident my eyes had been straight, and the vision of both normal, so far as I was aware. After the last operation, however, I found myself unable to read writing on the blackboard at school. I went to the specialist who had performed the operations and he was astounded to find that I had a bad case of astigmatism in the good eye. He gave me the following glass: convex 3.00 D.C., 105 degrees, combined with concave 2.50 D.C., 15 degrees. Later my left eye began to turn out. I wore my glasses constantly, putting them on the first thing in the morning, and taking them off the last thing at night. I went swimming with them, and if they were lost or broken, I remained in my room until they were found or repaired. My condition caused me much unhappiness, and I was particularly disturbed about the squint. I wrote to every medical journal that I knew about and to many other publications, asking if there was any cure for squint; but none of them was able to suggest anything but an operation. A few months ago I happened to hear about Dr. Bates, and I resolved to see him as soon as an opportunity offered. At the beginning of the season I came to New York from my home in Texas to study music, but with Dr. Bates in the background of my mind. Nevertheless I did not look him up immediately. One day in the elevator of a department store my glasses were swept from my face, disappearing as completely as if they had never existed. I went to the Lost Property Office, but after waiting there a long time failed to recover them. It was a horrible experience, and the realization of my helplessness without glasses depressed me terribly. However, it resulted in my looking up Dr. Bates immediately, it was a good thing. I went to him with the hope that he might be able to cure my squint and astigmatism, but I never dreamt that he could cure cataract also. When he told me he could do so I hardly knew what to think, but I resolved to do everything I could to help him cure me. I carried out the swinging treatment so vigorously that I used to get dizzy, and fall over on my bed. Of course I was not doing it right, but the doctor had told me to swing, and I was determined to do so. I was positively terrified when he told me to palm and remember all sorts of strange things, such as the letter F on a piece of white starch, because I thought he was trying to hypnotize me, but I did my best, nevertheless, to carry out his instruction. Later I bought and read all the back numbers of the magazine, and learned the scientific principles on which the treatment is based. My eyesight is now steadily improving, and I intend to keep up the treatment until I have normal vision. I have given up the music for the time being—my eyes are more important, ten times more important—and the ridicule of my friends does not disturb me. As long as that old cataract continues to melt away nothing else matters. In addition to the improvement in my eyesight I have noticed an improvement in my memory. My memory for the things I learned out of books at school was always poor, while my memory for music has always been exceptionally good. I suppose the difference was due to the fact that one set of impressions reached me through my eyes, and the other though my ears. Now that my vision is improving I can remember the things that I see better. I wish everyone could know of this remarkable method of curing defects of vision. I know in the end it must surmount all opposition, but meantime how many persons as afflicted as I once was will remain unhelped! It is right that we should be dubious of the new, but to hang so tightly to tradition as the medical profession seems to do makes progress unnecessarily hard.
INCIPIENT CATARACT RELIEVEDBy C. L. STEENSON, M. D. New York. This patient when first seen had a vision of 20/200 in each eye, and was wearing, for distant vision, the following glasses: right eye, concave 6.00 D.S. combined with 1.00 D.C., 90 degrees; left eye, 10.00 D.S. combined with 1.00 D.C., 60 degrees. Owing to the presence of incipient cataract in each eye these lenses improved his vision only 20/50 in the right eye and 20/100 in the left. For reading his glasses were three diopters weaker. He now has flashes of normal vision. He was helped most by the use of his imagination. Since boyhood—I am now sixty-five—I have had myopia and astigmatism, for the correction of which I have worn glasses and spectacles. About two years ago cataract developed in my right eye, and a few months later in my left eye. Both were in mild degree, but still bad enough to seriously obscure the field of vision. I had previously been annoyed by vitreous opacities which made little black spots dance in the field of vision. I also suffered from frequent severe headaches. My glasses were often changed without much relief. About November 1st of this year (1920) I consulted Dr. Bates, of whom I had heard much and favorably. His methods of treatment seemed exceedingly rational, and he gave me great hopes of getting rid of my eye troubles. First of all he made me discard my glasses, which, at first, seemed rather hard, but to which I have gradually become reconciled. Through what I would call a system of progressive education of sight, I have now almost got rid of the myopia, the vitreous opacities do not bother me any more, and, apparently, the cataracts are disappearing by degrees. The headaches have also disappeared. I have resumed, to a great extent, the literary and research work on which I have been engaged since my retirement from active practice, and I have no doubt that, ultimately, I shall be in possession of full visual power. Upon my future progress I will report at a later date. No. 122 West Ninety-ninth Street
Cataract CureBy HERBERT PARRISH Rector of Christ Church, New Brunswick, N. J. AN aged member of my congregation, nearly eighty, who had been accustomed to read the Bible every day of her life, and who could also read the newspaper and thread needles and sew, suddenly lost her sight early in February. She became increasingly blind and by the end of March was unable to do any reading whatever or to sew. Since there was little else that she could do, life seemed to have gone out for her, into darkness, and she was greatly distressed. In April her daughter took her to one of the best eye specialists in this vicinity who made an examination of her eyes, said that nothing could be done at that time, charged her five dollars for the examination, and handed the daughter a slip of paper as she left the office. The daughter supposed that the paper was a receipt for the five dollars, but on reaching home and opening the paper she found that it contained a single word, “Cataract.” The Doctor evidently hesitated to distress the old lady by telling her directly what was the matter. She had gone blind from cataracts. Shortly after I visited the old lady at her home in order to administer the Sacrament. After the service I told her about the methods Dr. Bates used to cure cataract and I suggested that she should try palming her eyes three times a day and swinging. This she did very faithfully and before the end of the month she became able to read the larger print of the newspapers. Gradually she regained her sight and in the course of a month or two was able to resume her practice of reading the Bible daily and the ordinary print of the newspaper. She also was able again to thread needles and to sew. She continues the palming and swinging. Her eyes have cleared up and are bright.
CataractBy W. H. BATES, M.D. Cataract is a form of imperfect sight in which the lens of the eye becomes opaque. It usually begins after the age of fifty, and may progress in the course of a year or longer to complete blindness. In most cases perception of light can be demonstrated in all parts of the field. In many cases, cataract in one or both eyes is found at birth. There are also a smaller number of cataracts which appear after an injury to the eyes. Diabetes and other general diseases are believed to be a cause of cataract. As a rule cataract is progressive. In 1895, a well-known ophthalmologist asked me, one of his assistants, to collect the histories of all cases of cataract which recovered without treatment. There were many such cases. It seemed to me that since recovery of cataract occurred without treatment, although the majority needed an operation for the removal of the lens before they were able to see; some form of treatment might help more of these cases. I sent some of my private patients to general practitioners who at that time by various methods did benefit these patients in quite a number of instances. Not long afterwards I attended a meeting of the Ophthalmological Section of the American Medical Association, and listened to a paper on the treatment of cataract in which the writer declared that any doctor who claimed to cure cataract without an operation was a quack or something worse. I did not think he was right, and gave a talk on my experience, which produced something of a sensation. More than forty years ago, when I was a student in a medical college, one of the professors gave a lecture on the eye. He had a number of nucleated eyeballs from the cow. He demonstrated that when the eyeball was squeezed with the aid of his fingers, an opacity or cataract of the lens at once appeared. I could see this more than twenty feet away. When the squeeze was relieved, the lens at once became apparently perfectly clear. I have repeated this experiment on the eyes of other animals without failure. One day I was studying the eye of a patient with partial cataract. While the patient was talking of various things of no special consequence, I could see through several openings in the cataract, areas of a red reflex, which was evidence that the lens was not completely opaque. I asked the patient how much she could see, and while she told me the letters on the Snellen test card that she could read, the opacity of the lens was incomplete. She then made an unsuccessful effort to remember some of the smaller letters, when much to my surprise, the whole lens became opaque. I repeated the observation as follows: I asked her: “Can you remember that you saw the big C?” “Yes,” she answered, and then at once the lens cleared in part, and I could see the red reflex through the open spaces. Then I asked her: “Can you remember having seen any of the smaller letters on the bottom line?” I could see that she was making a considerable effort when the lens became completely opaque. I was so interested that I had a number of friends of mine repeat the experiment, and they were just as much astonished as I was when they obtained the same result. So many patients are depressed, or become very unhappy, when they learn that they have cataract. The prospect of an operation, with its dangers and uncertainties, is too often a punishment. When an elderly patient with loss of vision is brought to me for treatment, the friends or relatives usually request me not to tell him that he may have cataract. For many years I followed this practice, gave the patient glasses, and deceived him as well as I knew how. I felt a great responsibility which I was always anxious to be rid of. I was ashamed of my cowardice. It was a great relief to have such patients consult some other physician. At the present time this has all been changed. I welcome cataract patients now, and rejoice in the fact that they have cataract because I am always able to improve the vision at the first visit, and ultimately cure them if they continue some months, or longer, under my supervision. Cataract is more readily cured than diseases of the optic nerve or retina. I believe that I am justified in telling the patients that the cause of the imperfect sight is due to cataract, because when they know what is wrong with them, they are more likely to continue to practice methods of treatment which are helpful. The vision of every case of cataract always improves after palming, when the patient learns how to do it right. I have seen many serious cases obtain normal vision with the disappearance of the cataract, by practicing the palming and nothing else. It was a shock to me to see a case of traumatic cataract recover with the aid of palming. Cataract, occurring in patients with diabetes, has also disappeared without treatment or cure of the diabetes. Treatment which is a benefit to cataract has for its object relaxation of the eyes and mind. The quickest cure of cataract is obtained by the memory or imagination of perfect sight. It can be demonstrated that when the patient remembers some letter as well with the eyes open as with the eyes closed, that the vision is improved, and when the memory is perfect with the eyes open, perfect vision is obtained at once and the cataract disappears. This startling fact has been ridiculed by people who did not test the matter properly. When the patient stares, concentrates, or makes an effort to see, the memory, imagination, the vision, always become worse. The patient and others can feel, with the tips of the fingers lightly touching the closed upper eyelid, that the eyeball becomes harder when imperfect sight is remembered or imagined. But when perfect sight is remembered or imagined, it can always be demonstrated that the eyeball becomes as soft as is the case in the normal eye. When the patient practices the swing successfully, or practices other methods which bring about relaxation of the muscles on the outside of the eyeball, it becomes soft, and the cataract is lessened. After an operation for the removal of cataract, a thin membrane usually forms over the pupil of the eye, which impairs the vision. This membrane is called a secondary cataract. Sometimes another operation, a puncture through this membrane, is beneficial. In a recent case, a man, after the removal of the lens for congenital cataract, came to me for treatment. Without glasses his vision was 15/200; with convex 15.00 D. S., the vision was improved to 15/70+. The patient hesitated about taking treatment at this time because he had heard that I always removed the glasses. He felt that on account of his work, he had better defer the treatment until such time as it was convenient to go without his glasses. I asked him if he would go without his glasses if I improved his vision so that he could see as well, or better, without them, as he was now able to see with them. He answered that he would do as I recommended. With the aid of palming, swinging, and perfect memory and imagination, the vision very promptly improved to 15/15.
CataractBy W. H. BATES, M.D.
DefinedCataract is an opacity of the lens of the eye. The lens of the eye is located in the pupil just behind the colored part of the eye, the iris. The lens is about the size of an ordinary pea. It is curved more on the front part than on the back. It is suspended in the eye by a bag-shaped structure, called the capsule. The capsule is a thin membrane. Covering the inside of the front part of the capsule is a layer of cells resembling in form and structure some of the layers of the skin of the body. The cells of the front part of the capsule are believed by some authorities to cause a secondary cataract after the lens has been extracted. Some years ago, I demonstrated by a long series of experiments that secondary cataract is not caused by these epithelial cells, but by scar tissue. The lens, itself, is composed of a number of layers of transparent tissue, which lie parallel to each other. When one places a number of sheets of plane window glass in a pile, with each pane of glass parallel to all the others, the pile of glass is transparent, but if one sheet or more is at an angle, that is, not parallel, the pile of sheet glass is clouded. This is a simple description of what takes place in the lens of the eye when it becomes opaque. When the lens is clear, its layers are parallel to each other. When the lens is opaque, one or more of the layers is at an angle to the rest. Some patients with normal eyes are able by means of an effort to consciously produce a cataract. When the cataract is beginning to show, it can be increased consciously by the memory of imperfect sight, which requires an effort with a resultant contraction of the muscles on the outside of the eyeball. When one group of eye muscles contract, the eyeball is lengthened and myopia is produced. When another group of muscles contract, the eyeball is shortened with a production of hypermetropia. When all the muscles of the eye contract sufficiently, the eyeball is squeezed in such a way as to change the parallelism of the layers of the lens with a consequent loss of its transparency.
OccurrenceSENILE CATARACT. There are various kinds of cataracts. The most common form is called senile cataract, because is usually occurs in elderly people after the age of fifty. Exceptions, however, are found in which the cataract may occur at a much earlier period. In the senile cataract at the beginning of the cloudiness of the lens, one sees opacities extending in nearly straight lines from the periphery, or the outside margin of the lens, to the center. Later on, the parts of the lens between these lines of opacities become clouded until the whole lens becomes totally opaque. A lens is said to be ripe when its whole structure becomes opaque, when the patient’s vision becomes so poor that he is unable to count his fingers held about a foot from the eyes. CONGENITAL CATARACT. When a child is born with an opacity of the lens, such a cataract is called congenital. TRAUMATIC CATARACT. A traumatic cataract is caused by some mechanical injury like a blow or the puncturing of the lens by a sharp object. Being struck by a baseball or having a sharp object, such as a stick or a toy, thrust in the eye, is a common cause of traumatic cataract. COMPLICATED CATARACT. When in addition to cataract, the patient has some disease of the eye, glaucoma, atrophy of the optic nerve, or serious inflammation of the interior of the eyeball, he has what is called complicated cataract. In these cases, the patient is usually unable to distinguish light in some parts of the field. There are other kinds of cataract which occur less frequently.
SymptomsOccasionally, a cataract may be sufficiently prominent to be recognized with the naked eye. In most cases, however, one cannot discover the cataract without the aid of the ophthalmoscope. When cataract is far advanced or the lens becomes totally opaque, the red reflex of the normal eye is not seen in the area of the pupil. If the cataract is only partially developed, one sees a red reflex shining through a clear part of the lens while other parts of the lens are more or less opaque.
DemonstrationsSome years ago, when I was attending lectures at a medical college, an experiment was performed which was so convincing that I have always remembered the details. A professor was talking about the eye. He showed us an enucleated eyeball of a cow, and called our attention to the fact that when he held the eyeball loosely in his fingers, the pupil was perfectly black. Then, when he squeezed the eyeball, almost immediately the pupil of the cow’s eye became distinctly white from the pressure exerted upon the lens. Then, when the lecturer relaxed the pressure of his fingers, the pupil at once became perfectly black as it was before, and the cataract disappeared. The experiment was repeated a number of times. The pressure on the eyeball always produced cataract; relaxation of the pressure was always followed by the disappearance of the cataract. Some years ago, I performed an experiment on a rabbit which had just been killed by chloroform. By dragging upon the muscles on the outside of the eyeball, it was possible to obtain pressure on the lens and produce a temporary cataract. When pressure on the eyeball was released, the cataract disappeared. By advancing the muscles and fastening them permanently to the back part of the eyeball with the aid of sutures, the cataract which appeared in the pupil was permanent so long as the pressure was maintained by the advancement of the muscles. The facts demonstrated very conclusively that cataract in the rabbit’s eye can be produced by pressure on the eyeball with the aid of the muscles on the outside of the globe.
TreatmentIf cataract can be produced in a rabbit’s eye experimentally, one would expect the same thing to occur in the human eye. Treatment which relieves pressure on the eyeball is always beneficial. It is very interesting to discover that all cases of uncomplicated senile cataract have been benefited by relaxation or rest, at first temporarily, later more continuously or permanently. There are a great many methods of treatment which bring about relaxation in the cure of cataract. The measures employed are not injurious. In fact, there is no possibility of making the condition of the eye worse. It is well to emphasize the fact that the same method of treatment to obtain relaxation is not a benefit in all cases. Patients need to be treated as individuals. 1. REST. Closing the eyes and resting them, or covering the closed eyelids with the palm of one or both hands, without exerting any pressure on the eyelids, has improved the majority of my patients. In my book, I report a case of cataract which was cured permanently by palming for a long period of time, twenty hours continuously. Palming for five minutes hourly is usually beneficial. With the eyes closed and covered, it is well that the patient allow his thoughts to drift from one thing to another without trying to remember one thing in particular all the time. By thinking of pleasant things, it is often possible for the patient to forget that he has eyes and in this way a larger amount of relaxation is attained. 2. SWINGING. Swinging is very helpful in the cure of cataract. This swinging of the body can be done with the patient standing or sitting. Some patients have practiced the swing while sitting in a chair for many hours during the day. When tired, they would alternate with palming. When the swinging is done correctly, it is restful and a benefit not only to cataract, but to other conditions of the eye. In swinging, one moves the body, head and eyes from side to side. When the body sways to the right, the head and eyes move in the same direction. When the body moves to the left, the head and eyes also move to the left. When the eyes move to the right, all objects not regarded are to the left of where the eyes are looking. When the eye moves to the left, all objects not regarded are to the right. By practicing the swinging exercise, many patients soon become able to imagine stationary objects to be moving in the opposite direction to the movement of the head and eyes. The great benefit derived from the sway is that the stare, the strain, and concentration are prevented. One cannot sway, move the eyes, and at the same time hold the eyes stationary in order to stare or concentrate. The normal eye with normal sight never sees anything with perfect sight continuously, unless it can become able to imagine it to be moving. This movement is usually about one-quarter of an inch from side to side. Things imagined to be stationary soon become imperfect. 3. MEMORY, IMAGINATION. It is not possible to remember a letter of the Snellen test card perfectly unless it is seen perfectly. It is not possible to imagine a mental picture of the letter perfectly unless it is remembered perfectly. Furthermore, it is not possible to see the letter perfectly unless one has a perfect imagination of a known letter or other object as well with the eyes open as with the eyes closed. One of my patients had normal sight with the right eye, but only perception of light with the left eye which had a ripe cataract, or a cataract in which the whole lens was opaque. With the right eye, she could remember or imagine perfectly the letters that she was able to see perfectly. When she covered the good eye with a screen, she told me that she could imagine the small letter on the Snellen test card as perfectly with her left eye as she, could with her right. She was told that because of her poor sight in the left eye, she was unable to imagine perfectly at the same time with her left eye open. She remonstrated with me and was very positive that she could imagine as well with her left eye open as with her right. Finally, I asked her how much she could see on the strange card, and much to my surprise she read it with normal vision. When the eye was examined with the ophthalmoscope at the same time that she said her vision was normal, the cataract had disappeared. She was right and had demonstrated the truth that when her imagination was perfect, her sight was also perfect and in order to have perfect sight, it was necessary for the cataract to disappear, which it did. This case was one of the strongest evidences that imagination treatment is one of the best methods that can be employed to cure cataract. It interested me so much and emphasized the value of the imagination so greatly that it has become a routine treatment for my other cases. While it is beneficial in most cases, it is seldom curative because very few patients have so perfect an imagination. I treated a woman, aged fifty-six for the first time on November 7, 1923. The right eye had incipient cataract with a vision of 15/70. The left eye had a ripe cataract with a vision of only perception of light. The numerous eye doctors, whom she consulted all advised an operation for the removal of the cataract of the left eye, and told her that no other treatment would be of any help. The patient was benefited by palming, by swinging, and most of all by the use of her imagination. When her imagination, with the right eye open, improved, her vision improved to the normal. With her left eye open, her imagination was not so good, but even with an imperfect imagination her vision at once improved to 15/200. After two weeks of treatment, there were days in which her imagination became, with the left eye open, as good as with her right eye open, with normal vision in each eye. After some months of treatment without my supervision, the vision of the right eye became permanently normal and the cataract disappeared. By continuing the treatment at home, the left eye obtained normal vision for short periods of time only. Since she obtained normal vision with the left eye, although temporarily, it is possible for the temporary improvement to become permanent. The memory of perfect sight is a rest to the eye, with a coincident relaxation of all tension or strain of the muscles of the eye. 4. FINE PRINT. Cataract patients become able to read fine print at six inches or nearer to their eyes more quickly than do patients with imperfect sight from other causes. By reading fine print frequently, or for long periods of time, the cataract becomes less. 5. SUN TREATMENT. The eyes need sunlight. People who work in mines, where there is no sun, sooner or later develop inflammations of the interior of the eyes. The cloudiness of the lens from cataract is lessened by exposing the eye to the direct rays of the sun. When using the sun treatment, it is best to let the eyes become accustomed to the sun by mild treatment at first. Have the patient sit in a chair with his eyes closed and his face turned toward the sun. He should slowly move his head a short distance from side to side. The movement of the head prevents concentration of the sun’s rays on one part of the eye. After some days of treatment, or when the patient becomes more accustomed to the light, one may use the sun-glass with added benefit. Direct the patient to look far down and while he does this, lift the upper lid gently, exposing to view the sclera or white part of the eye. Now, with the aid of the sun-glass focus the sunlight on the forehead or on the cheek, and then rapidly pass the concentrated light over various parts of the sclera. This requires less than a minute of time. It is not well to be in a hurry. One should wait until the patient becomes sufficiently accustomed to the sun to permit the upper eyelid to be raised while he looks far down, exposing the sclera only. It is important that the patient be cautioned not to look directly at the sun.
PrognosisThe cure of cataract is usually accomplished more quickly than the cure of some other diseases of the eye. My assistant, Emily C. Lierman, has had unusual success in treating cataract cases, as she adapts my methods to each individual case. In her book, “Stories from the Clinic,” the treatment is described in detail.
Stories from the Clinic NO. 76: CATARACTBy EMILY C. LIERMAN Many patients, after being cured of imperfect sight, go their way and we never see them again. However, many come back, even after a period of five years or more, to report, or to show their gratitude. If a patient is cured quickly, he is very apt to forget that he ever had eyestrain. Normal vision helps him to forget, and he is able to go on with things that interest him without tension or strain. There is nothing that affects the whole nervous system more than eye strain. I have deep sympathy for patients suffering from cataract. Some of these have told me that, when they first discovered, or were told that they had acquired cataract, the shock was so great it sometimes made them very ill. I have often wished that I could broadcast to every human being troubled with cataract, that they need not worry about an operation, nor fear blindness. While treating patients at the Harlem Hospital Clinic, Dr. Bates placed under my care many patients with cataract. Some of them were children who were born with it, while others acquired it from an injury of some sort. If they faithfully practiced the daily treatment for their particular case, they always improved. There were no exceptions, although in all cases where the patient did not practice enough, it took much longer for a cure. Adults were also cured quickly when the directions for home treatment were faithfully carried out. Age made no difference. A colored mammy, who was a faithful servant of one of our private patients, came regularly, three days a week for many months, and was treated for cataract. I have described her case in my book, “Stories from the Clinic.” In the beginning of her treatment, she could not see the letters of the test card at five feet. As she explained it in her dialect: “Do you know, ma’am, ah can see nothin’, no ma’am, nothin’ at all at dis distance!” Long periods of palming, early in the morning and late in the afternoon, when her work was done, helped her sight. In the clinic she was taught to sway her body slightly from side to side and to blink all the time. The swaying helped her to see things about the room moving opposite to the movement of her body. The blinking prevented the stare, which is usually the cause of cataract. The quickest way to obtain a cure is by palming, and I advise my private patients to practice it for several hours or many times each day. It would be impractical, however, to advise a clinic patient to use the same method, because they cannot spare the time from their work, nor can the employer spare them. If such advice were given them, their answer would surely be: “This treatment is only for those who can afford the time.” Dr. Bates often tells them that it takes less time to use their eyes correctly than it does to use them incorrectly. Clinic patients, as well as private ones, are advised to relax all day long. Mammy was to see things moving all day by watching her broom as she swept the floors; the washboard as she washed the clothes; the clothes-wringer as she turned the handle; and the dishes as she dried them and put them in the cupboard. We treated her many times, but occasionally she had a relapse. These were sad times for mammy, when she had tears in her eyes and a heavy heart. Frequently she would say: “Ma’am ah knows der is no hope for me. Ah has displeased de good Lord.” A kind word or two always helped her, and I made sure that she received many of them. As time went on, she obtained normal vision with the use of the test card, and became able to read very fine print and to thread a needle. We left the Harlem Hospital Clinic, never thinking that we would hear from her again. Six years had passed, and new patients were coming and going from our own clinic, when one day about three months ago, we received a letter from mammy. All through the letter were words of gratitude and praise for what we had done for her. She is now seventy-eight years old, and can still read her newspaper and thread a needle. She asked for permission to come to see us. She wanted the Doctor to look at her eyes to prove that her cataract had entirely disappeared. We, of course, were anxious to see her. When she came both of her eyes were examined and no sign of cataract was found in either eye. Her vision with various test cards was 10/10, and she read fine print without any difficulty, because she did as she was told. She was cured. It was not always easy for her as her work at times required good eyes. Her madam had patience with her for she, also, was under treatment. During mammy’s last visit, she said: “Ah jest knowed dat ah was cured ’cause ah could see de crumbs on de carpet to brush up, an’ ah could see de dust all ober de furniture an’ ah cleans better. De sun is clear now an’ not in de mist no mo’.” About a month ago, another patient came with a report of good vision. She is over eighty years old, and has a disposition just as cheery as she had when I first knew her, about eight or nine years ago. Perhaps our readers will remember an article I wrote about her. She is the patient who was employed in an orphanage. Her duties there were to see that all the buttons were sewed on the clothes of little ones at the Home. She said she was the only daisy in the country while she was there. From the very beginning she had infinite faith that Dr. Bates could cure her without an operation. During one of her early treatments, when she noticed a decided improvement in her sight while palming, she could not resist the temptation to peep through her fingers at me and say: “I’ll fool them yet.” I asked her what she meant and she answered: “Oh! The other doctors who want to operate on my eyes.” Well, she kept her word. She fooled them and was entirely cured. She has never worn glasses since her first treatment and the only reason for her being cured is, that she practiced faithfully the methods of treatment that helped her most. When she looks at you, her young, blue eyes twinkle and she wears a smile that won’t come off.
CataractBy W. H. Bates, M.D. Some years ago a professor of anatomy was exhibiting the effect of pressure on the enucleated eyeballs of a dead cow and some other animals. At a distance of about twenty feet from the eye, the audience observed that the pupil was perfectly clear. Immediately after the eyeball was squeezed by the fingers of the professor, the area of the pupil became at once completely opaque, from the production of a cataract. Then when the pressure on the eyeball was lessened, the cataract at once disappeared and the eyeball became normal. Again squeezing the eyeball, a cataract was produced as before. And again, the cataract disappeared when the pressure was lessened. The experiment was repeated a number of times with the result that the pressure on the eyeball always produced a cataract, which was relieved by reducing the pressure. There are two oblique and four straight or recti muscles on the outside of the eyeball. The superior and inferior oblique pressing on the eyeball at the same time have always been followed by lengthening of the eyeball. The four straight muscles on the outside of the eyeball shorten the globe or eyeball by their contraction. In animals the eyeball has been shortened experimentally by operations on each of the four straight muscles, which increased the pressure temporarily. These operations were performed after death. Similar operations on the two oblique muscles at the same time produced pressure and increased hardness of the eyeball with cataract following. Patients suffering from cataract have increased the hardness of the eyeball, at the same time increasing the density of the cataract. While the cataract is being observed with the aid of the ophthalmoscope, it can be seen to change in size or density when the patient consciously or voluntarily increases or diminishes the hardness of the eyeball with the aid of the memory or the imagination. When a word, a letter, part of a letter, or other object is remembered perfectly with the eyes closed or open, the cataract can be seen by the observer to become less. But if memory of letters, colors or other objects is imperfect, the cataract always is seen by the observer to become worse. A great many cases of senile and other forms of cataract have been temporarily improved and this improvement has become more complete and more permanent by the practice of a perfect memory. A perfect memory usually becomes manifest when the patient practices the optical swing. However, the cataract always becomes worse when the optical swing or the perfect memory is not practiced. To keep the eyeball hard by practicing an imperfect memory is difficult and requires effort. The practice of an imperfect memory is tiresome and requires constant attention of the patient. In others it can be demonstrated that the formation of cataract in elderly people requires hard work and is exceedingly difficult. These patients are difficult to treat because they cannot control the functions of the mind. A perfect memory is easy. It is quick, continuous and beneficial. Patients with a perfect memory have consciously or unconsciously a perfect optical swing. They are able to remember, to imagine letters, colors and other objects continuously without any strain or fatigue. These cases are favorable and recover from cataract after they demonstrate that a perfect memory is beneficial. The study of cataract has occupied the attention of eye doctors for many hundreds of years. It occurs very frequently in India, China, Japan and among people of the highest intelligence, as well as among those whose intelligence is of the lowest order. Some cases appear without apparent cause. It may increase rapidly or slowly and continuously, until the vision is completely lost. Of all organic diseases of the eye which have received medical attention, measures of relief by operation or by the use of eyedrops have usually, in a large number of cases, been unsatisfactory. Cases have been operated upon in which a temporary cure was obtained. However, in too many of these cases the good vision obtained soon after the operation did not remain good. In some of these cases and without apparent cause, inflammation of the interior parts of the eye developed and was followed by serious loss of vision. Some cases of cataract are found in the eyes of children soon after birth, sometimes in one eye, less frequently in both. The cataract which occurs in children is softer than in the eyes of adults and is more readily benefited by operation than in the eyes of adults. In some cases of cataract in children, the front part of the lens becomes opaque. Such a cataract is called an anterior polar cataract. Often, after the lens has been punctured, it becomes absorbed and good vision is obtained. In other cases an opacity forms on the back part of the lens which increases until the lens becomes entirely opaque. Here again repeated puncturing of the lens is followed by a total opacity of the lens, and its complete absorption. In a third variety of cataract in children, an opacity of the lens forms in one or more layers of the lens, which is usually absorbed after repeated punctures of the lens are made with a sharp needle. This operation has been called “needling of the lens.” When cataract occurs in adults of forty years or older it is called senile cataract. In adults, the operation of needling the lens is not so successful in being followed by absorption of the lens. In some cases, if not in a large number, better results are obtained by removing the whole lens by one or more operations. There are many diseases of the eyes such as inflammations of the iris and choroid which are believed to produce cataract. The removal of the lens is usually very difficult without injuring the iris, choroid and retina. In cataract the crystalline lens becomes opaque and being opaque it interferes very seriously with the vision. To obtain good vision, eye doctors were usually able to improve the sight by the removal of the opaque lens. After the lens was removed, the vision was materially improved by the use of strong glasses, which rarely improved the sight to normal. I have studied the physiology of the eye and I have repeatedly published the fact that it is much better to cure the opacity of the lens so that the patient could have normal vision with a normal eye rather than to relieve the blindness by the removal of the lens. Curing rheumatism of the hand by an operation which removes the hand is not the best treatment. Likewise rheumatism of the big toe is not considered a proper case for amputation. Medical or simple treatment without an operation will usually result in a cure. I do believe in operations when necessary or where medical treatment fails to correct the trouble. However, removing the lens from the eye does not cure cataract of the lens nor does it prevent cataract from forming in the other eye. Since cataract or opacity of the lens is caused by tension, relaxation should cure or prevent the trouble. If relaxation fails to cure cataract we should consider this fact an evidence that tension is not the cause of cataract. Relaxation can be obtained with the aid of memory, imagination and sight. If the eye of a child is injured by a blow and a cataract forms early or late in life it has always been demonstrated that the eye with cataract is under a tension. Treatment which brings about relaxation always cures the cataract after a considerable amount of treatment which may require several months or longer. Among the many methods of treatment, the amount of relaxation necessary to be followed by a cure is a perfect memory, perfect imagination and the benefit obtained by sun treatment. Central fixation has in some cases cured all forms of cataract – senile cataract, soft cataract in children, cataract caused by sugar in the blood and other poisons. It is found that when patients sit facing the sun with both eyes closed and move the head a short distance from side to side, they can stand the strong light of the sun for longer periods of time than they can with the eyes open. When the sun is not shining, a strong electric light is a good substitute. Much quicker improvement in the sight can be obtained with the proper use of the sunglass. The patient is directed to look down while facing the sun and to do this continuously without effort or strain. The operator lifts the upper lid with the thumb of one hand. When the white part or sclera of the eyeball is exposed to view he quickly concentrates or focuses the strong light of the sun on the sclera, moving it continuously and only for an instant at a time.
A Case Of CataractBy Emily C. Lierman There was a time when I thought that all cases of cataract could be treated and benefited by one and the same method. I know now that this cannot be done for many reasons. Age has nothing to do with treatment for the cure of cataract, because I have had patients over eighty years of age who responded much quicker and became well much sooner than younger patients who were troubled the same way. I was treating a woman with cataract who was seventy-seven years old, at the same time that I was treating another woman, age sixty-two. Both women had the same amount of vision with the test card, and neither one could read newspaper or book type. Yet, the elder of the two was benefited and the cataract of both eyes had entirely disappeared, while I was still working hard with the younger patient who was becoming irritable, rebellious and most discouraged, because of the increased length of time required to benefit her. Neither of us was at fault as far as my good judgment goes, because she was faithful in what I directed her to do when I was not with her. While I was treating her, I had to remember constantly that there was a man named Job who was severely tried, according to the Old Testament of the Bible. However, my dear patient did not know of my endurance because I kept smiling always. She was very nervous and had cause to be. Money was no object to her but a great disappointment had come into her life. So great was it in fact, that all who knew her thought she was losing her mind. For this reason, my heart went out to this patient who suffered mentally because of her wayward son. Extreme mental, emotional strain=strain, tension in the body, mind, eye muscles, eyes=cataract, unclear vision. During the hour, or I should say two hours of her treatment, because I could never accomplish anything much in less time, she would mention the name of her boy who, although he was of age and married, was still her little boy. Her room, which was cheerful and sunny, had pictures of him all over the walls. Some of them were baby pictures and there were others taken at the ages of sixteen and twenty-one and when he graduated from college. I noticed particularly that when she looked at his baby pictures her face would show signs of tenderness and relaxation. But when she looked at the pictures of his later years she would close her eyes and her face would become wrinkled with age and tension. For days after I had noticed this, I studied her case and planned a different way of treating her. All my spare moments were spent in thinking out the best way to relieve her strain which prevented a permanent benefit. Weeks grew into months before I finally conquered the wrong, or really helped her to overcome her disappointment and nervousness. In seven months’ time with treatment several times every week, never less than three treatments each week, she finally became able to read every test card, even to the ten line letters, at fifteen feet. She had been a great reader, and could read a whole book in less than two hours when she was much younger. Therefore it was a terrible disappointment to her when her sight failed and she had to forego that pleasure. Occasionally, a neighbor or a friend would visit her and read her favorite books aloud to her. Now at the end of seven months’ treatment of her eyes she was convinced that I had told her the truth; that she would become able to read again without the aid of glasses. Neighbors and friends were invited to call so that they could see with their own eyes what she was able to do. These friends knew how she had doubted me. They doubted me too, except one who was at one time a patient of Dr. Bates. This friend had not called because she was too far away, but she had written to my patient. What she wrote gave my patient enough faith and confidence in me to start the treatment, although she doubted me. She told me so in plain English. She was not the only patient who doubted me at the beginning of the treatment and who later on believed in me completely. When the vision of this patient became normal for distant sight, she soon was able to read the finest print readily without glasses. I had not tested her ability to read fine print because I feared the bad effect of disappointment if she failed to read it. My experience with other and similar patients encouraged me to believe that if I could improve her distant vision to the normal that she would soon become able to read the fine print, “diamond type,” without the aid of glasses. I felt that it was useless for me to test her ability to read fine print from our usual test cards, so I asked her if she had some book in her possession containing small print, and she answered me by pointing to a large dictionary fastened to a stand in a sunny corner of her room. Before I asked her to go near the dictionary, I said, “I have had patients with your trouble who became able to read the small print of the dictionary by placing a small card with much finer print in the neighborhood of the small letters of the dictionary.” As I watched her closely while saying this and noticed her frown, I said quickly, “Of course, I do not expect you to do this just now.” This remark worked something like a magnet, for she at once hurried to the dictionary and with the aid of the small card which she received from me and which contained fine print or diamond type, she read occasional words of the dictionary, much to her delight. There were times during the months which followed, when she had relapses which caused depression, but after she had removed some of the pictures of her son from the walls of her room, the conversation while I was with her was more about herself and the improvement in her eyes. In the beginning, her distant vision with the test card was 10/30 with the right eye and 10/50 with the left. At the end of her treatment her sight was better in each eye than the average normal eye. During the last treatment, I spent the day with her, and she read for me a large part of a book in which the print was very small. She announced with a great deal of pleasure that for years she had been unable to read this book, with or without her glasses. The cataract in both eyes was very materially improved. Only the lower inner part of the pupil had a trace of the cataract in each eye. The principal part of the treatment given this woman was the sun treatment. While I was with her, I applied the sun glass. When I was not with her she was able to use the sun glass with benefit or just the same as I used it. Because she was of a nervous temperament, I always focused the sunlight on the outside of her closed eyelids.
CataractBy W. H. Bates, M.D. Sinbad the sailor told many stories of his voyages which have pleased some adults and many children. I wish to maintain that some of his experiences were true while many were not. On one of his voyages, when sailing in the tropics, a violent storm struck the ship and he was wrecked on the shores of an island in the Pacific Ocean. As usual, most of the sailors were drowned but Sinbad lived to return home and tell of the wonders he had seen. It was related by him that the island was frequented by goats who were blind for a variable length of time. After a few days or weeks many of them recovered their sight, being cured in some way by a thorn bush which had large thorns. Sinbad watched them closely and discovered that each goat pushed each blind eye directly onto one of these thorns. After a few efforts the goat became able to see. How was it accomplished? The cause of the blindness was the presence of an opaque body behind the pupil. This opaque body is a cataract. There are numerous operations for the cure of cataract but all are planned to move it to one side, above or below the optic axis so that the pupil appears perfectly clear and permits good sight. Eye doctors during the period when Sinbad flourished had no other cure for cataract except an operation such as the goat performed on his own eyes. It was done so easily, so quickly, and in most cases so successfully that many quacks or irregular practitioners who did not understand it failed to remove the cataract properly and the sight was not improved. Sinbad wrote a very clear account of how the goats got rid of their cataracts. He told how a goat would, in his blindness, move his head and eyes about different parts of the thorn bush until he was able to push one of the thorns into his center of sight and push the opaque cataract out of the way. Sinbad wrote a great deal about the failures. He described how in many of the goats which operated upon itself, foul matter would form and destroy one or both eyes. But when the goat did things right, the eyes healed without any bad symptoms whatever. Sinbad’s operation for the cure of cataract was described so long ago that there are still many doctors who claim that as they had never heard of Sinbad’s operation there never was such a person as Sinbad. Modern physicians believe that the thorn is not the best instrument to use to remove the cataract in elderly people. Various and numerous operations have been recommended and practiced with good results. An opacity of the crystalline lens which is sufficiently opaque to interfere with the vision is called a cataract. There are two kinds of cataract – hard and soft. The hard cataract occurs usually in adults. An operation for its removal is usually advised for an improvement in the sight. When the operation is done properly, the vision is usually permanently improved. After the operation is completed without accidents, strong glasses are prescribed, which increase the vision. Two pairs of strong glasses are used by the patient. One pair is to improve distant vision, while a second pair with much stronger glasses may be necessary for reading, sewing, or other close work. Soft cataract occurs usually in children or in adults at the age of 45 or younger. One operation is called “needling,” in which a needle or very sharp knife penetrates a small part of the lens. A slight opacity of the lens may be seen for several days or longer, which usually causes no discomfort. It is customary to wait a few days or longer until the opacity made by the operation has disappeared. The operation is then repeated as before. By alternating in this way, the opacity of the lens becomes less after each needling until the cataract has disappeared altogether. The patient uses two pairs of glasses just the same as after the operation for the removal of a hard cataract. Who were the earliest physicians? Who were the best doctors to cure the blindness of cataract? Barbers at an early date always bled their patients to cure any disease. Their motto was to bleed the patient until he was cured. If the first bleeding failed it was considered good practice to bleed him some more. George Washington met his death at the hands of the barbers from too much bleeding. In the treatment of cataract in modern times we do things which are not always considered to be proper. At one of the best eye hospitals in this country patients suffering from severe pain and loss of sight have been bled from the temples and elsewhere and lost much blood that I considered unnecessary. While bleeding has apparently in some cases been a general benefit, this method of treatment is seldom indicated in a large number of patients. Cataract occurs in a small percentage of persons with imperfect sight. One and the same method of treatment for all cases of cataract is not advised. It has been demonstrated and frequently published in this magazine that the cause of the opacity in the lens is a strain, a stare, an effort to see. When the strain is removed by relaxation methods, the cataract disappears and good or perfect sight is obtained without an operation of any kind. This being true, the removal of the cataract by some sort of an operation is the same as it would be to amputate the foot to cure rheumatism of the big toe. People with cataract in one or both eyes may suffer from rheumatism, diabetes, bladder trouble, or other serious diseases which make it impossible for them to travel on land or water. Headache is sometimes continuous and of great severity. These patients may become bedridden and unable to walk without distress. The heart is often inflamed to such an extent that the slightest exertion brings on severe symptoms. Some years ago a very intelligent Spaniard called to see me in reference to treatment of his wife who was a very sick woman and had been bedridden for many years. Her vision was very poor. She was unable to count her fingers when held in front of her face at a distance of two feet or more. The husband was told that it would be better for his wife to be cured of cataract while she was at home as the trip to New York would probably cause her so much discomfort that it would be very difficult to cure or improve her cataract by treatment. I told him that it would be possible for him to learn relaxation methods and have his wife practice them under his supervision. The fact that he himself had good sight would enable him to treat her more successfully than someone who had poor sight. He accepted my suggestion and told me that he would faithfully carry out any treatment which I might suggest. The first thing I had him do was to: +Read the Snellen test card at fifteen feet with each eye separately. +Then he was directed to stand with his feet about one foot apart and to sway from side to side, while facing the Snellen test card. He learned how to do this very quickly. His attention was called to the fact that when the Snellen test card appeared to move in the opposite direction to the movement of his head, eyes and body, that the white card appeared whiter than it really was. The black letters also appeared much blacker and more distinct than when he did not practice the sway. +He was then told to close his eyes and by opening and shutting them alternately, his vision improved. +With his eyes closed he was able to imagine a small letter just as black as a large one and to imagine it better with his eyes closed than with his eyes open. When he imagined a small letter at the beginning of a line of letters perfectly black or as black as the larger letters, his vision improved to better than the average sight. I examined his eyes with the retinoscope and found that the memory of imperfect sight caused the area of the pupil to appear blurred. When he strained or made an effort to improve his sight, the area of the pupil became very cloudy, the eyeballs became hard and the vision worse – a condition similar to that which occurs in cataract. This man was told that with his good sight he could at will increase the hardness of his good eyeballs more readily and lower his vision more readily than his wife who had cataract. It is a truth that persons with normal eyes can produce imperfect sight at will to a greater degree than when the sight is imperfect from cataract. A large number of patients with cataract have been examined with the retinoscope at the same time that a strain is made to improve the sight. In all cases without exception the cataract became worse by an effort to see and the vision was still further lowered. Many persons with normal eyes were also examined at the same time. An effort to see better lowered the vision to a greater extent than occurred with the patients suffering from cataract. It should be emphasized that a stare or strain is the principal cause of cataract. The retinoscope demonstrates that when an effort is made the cataract becomes worse. When the patient remembered or imagined letters or other objects the cloudiness and imperfect sight disappeared. An important point is the readiness with which an eye with good sight is able to produce imperfect sight while one with imperfect sight has great difficulty in straining sufficiently to increase it. The husband was very much pleased because it seemed to him that there would be more difficulty in teaching his wife how to increase her cataract than to lessen or cure it. In due time I received a very grateful letter from him; he was much pleased to inform me that his wife had cured her cataract by my methods and after the cataract was cured, she became able to leave her bed. (She had been bedridden because of fear of walking about because of her poor eyesight.) The method was a benefit not only to her eyes but to her general health as well. We have received many letters of inquiry from patients who have cataract who ask the questions: Can people eighty years of age be benefited? Which are the best methods of helping cataract? These questions were answered by the results of treatment in a man who was 106 years old. He came to the clinic with cataract so far advanced in each eye that he was unable, even with strong glasses, to read ordinary type. He was treated by rest of his eyes with the aid of shifting, swinging, memory, and imagination. After the first visit, he became able to read large print without glasses. His vision rapidly improved so that after some weeks of treatment, the cataract had disappeared and his vision for distance became normal. It was interesting to watch his cataract disappear while he was forming mental pictures of the white spaces between the lines of black letters. Many patients with cataract who knew about this old man asked me how it was that he was cured in so short a time while many younger patients were not cured so quickly. The word obedience suggests that the reason this patient obtained so prompt and permanent a cure was because of his ability to obtain perfect relaxation of his eyes and mind as well as all the nerves of his body. For example, when he was told to close his eyes and keep them closed until told to open them, he did this thoroughly and well. Too many of my cataract patients do not practice central fixation as obediently as did my elderly patient. So many people with cataract, when they close their eyes, feel that they are doing what they were told and cannot understand why they obtain so little benefit. Closing the eyes is not always followed by relaxation and rest. In short, there are many patients with cataract who strain their eyes more when they are closed than they do when they regard letters and objects with their eyes open. These patients are directed to practice the universal swing, the long swing, the variable swing and other methods of obtaining relaxation. One of the best methods of lessening cataract is to encourage the patient to regard a blank wall of one color. When the eyes are examined at the same time, it is usually found that the cataract has become less because the eye is not straining to see any one particular object. Some cases of cataract acquire the ability to read without glasses very fine print held a few inches from the face. When such patients are recommended to read the fine print many hours daily, the cataract becomes less and the vision improves. The practice of regarding fine print or other small objects is one of the best methods of curing cataract.
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