The Bates method is not widely accepted by conventional eye doctors as a legitimate approach to improving vision. Some have come around, but the large majority of them continue to prescribe glasses and tell their patients that nothing can be done to reverse myopia and other conditions. After all, that’s what they were taught in school.
This is a point-by-point response to Dr. Philip Pollack’s article Fallacies of the Bates System at quackwatch.com, a website with the purpose of upholding the outdated status-quo in all fields of medicine and condemning any and all alternative therapies. It’s been referenced often by critics as proof that the Bates method doesn’t work, so it’s a good one to go over. The article was originally chapter 3 in Philip Pollack’s 1956 book The Truth About Eye Exercises. I have also continued on to a part of chapter 4, which has some more relevant content.
Except when otherwise noted, all quotes are from Dr. Pollack’s article.
Let us begin.
As stated by Duke-Elder, all authorities are in agreement that the lens increases in thickness during the act of accommodation. All, that is, with the exception of Dr. Bates!
There are behavioral optometrists, ophthalmologists and scientists who believe that Helmholtz’s theory of accommodation that has been accepted since the mid-19th century is wrong or incomplete. See Ophthalmology Times, SciELO, and a summary of a couple other theories on Wikipedia.
These investigations into other theories brings to light how flimsy the evidence supporting the accepted facts on this topic is.
Dr. Bates demonstrated several things regarding the issue. One was that the muscles surrounding the eye are capable of producing nearsightedness, farsightedness, and astigmatism, depending on the adjustment made, for as long as the contraction lasts. It follows that chronic tension of the involved muscles would sustain the refractive error for an indefinite period of time, making them appear as permanent conditions.
Even so, it must be recognized that whose theory is correct or most correct doesn’t determine whether the Bates method works. The proof is in the results obtained by its use, regardless of the explanation of exactly how the adjustments are made inside the visual system.
The human body is an incredibly complex set of systems that somehow manages to recover from countless problems everywhere, from adjusting the position of organs and tissue to facilitate movement, to keeping the integrity of its parts intact and not interfering with others, to creating new tissue and reforming the whole body constantly… It’s amazing handiwork that all somehow works to keep us alive and functioning, as long we take care of ourselves well enough. And if we screw up and cause problems in our body, it recovers from those too, if we change our ways and give it a chance. What I’m getting at is the idea here seems to be that the eye is the one part of the human body that so easily finds itself incapable of even the smallest adjustment in structure just to perform its only task with decent results.
The reality here is that the exact mechanism of accommodation is not important in the big scheme of things, as the body is perfectly capable of making adjustments as needed, provided that you are not preventing it from doing so.
As novelist Aldous Huxley, in his book about the Bates Method, put it:
… the art of seeing does not stand or fall with any particular physiological hypothesis. Believing that Bates’ theory of accommodation was untrue, the orthodox have concluded that his technique of visual education must be unsound. Once again this is an unwarranted conclusion, due to a failure to understand the nature of an art, or psycho-physical skill.
(Aldous Huxley, The Art of Seeing, p23)
Pollack’s next statement:
Throughout the book, Dr. Bates describes rare anomalies and, presenting them as typical, uses them to justify his theories. For example, it is true that, in an insignificant minority of cases, people whose lenses have been extracted because of cataracts can read small print through their distance glasses. This seems impossible since they have lost their power of accommodation and therefore should require reading glasses that are stronger than the distance pair. In studies of such cases, ophthalmologists concluded that the patients were able to do this by moving their distance glasses a trifle away from their eyes (which has the same effect as increasing the power) or by looking through the lenses obliquely, which has the same effect. In no case was there evidence of true accommodation.
Bates’s work began when he found cases that didn’t fit the accepted theories and performed experiments that also showed the fallibility of the theories. One of Bates’s statements regarding accommodation without a lens:
In all these cases the retinoscope demonstrated that tha apparent act of accommodation was real, being accomplished, not by the ‘interpretation of circles of diffusion,’ or by any of the other methods by which this inconvenient phenomenon is commonly explained, but by an accurate adjustment of the focus to the distances concerned. (Bates, Perfect Sight Without Glasses, ch6)
Such cases would obviously have had to come under the observation of other ophthalmologists, both before and after Bates. However, it isn’t surprising that they either didn’t take such cases seriously, disregarded them with a theory, chose to forget them, wisely chose to remain silent, or were not published by the journal editors. It’s inconvenient to start questioning everything and upset the status-quo. Winston Churchill once said, “All [people] occasionally stumble upon the truth – but most pick themselves up, dust themselves off, and carry on as if nothing had happened.”
Dr. Bates is regarded as a discoverer of new truths by his disciples. Yet all he did was to resuscitate a discredited, early-nineteenth-century theory, moving not forward to the future but backward to the past.
Bates accomplished more than presenting his theory of accommodation, which is what Pollack is referring to (and which Bates acknowledged up-front that he didn’t invent). He discovered that poor vision is primarily a mental problem. He discovered the principles of relaxed use of the eyes that promote good vision. He discovered that problems long held to be incurable are in fact curable. He came up with ways for someone who is straining to help relax. He offered this information in his book, his Better Eyesight magazine articles, numerous articles in respectable medical journals, and in appeals to the ophthalmological community. He spent hundreds of free “Clinic Days” treating the public who walked in his door without any compensation for his time, taking away their glasses and showing them how to see.
He also made significant contributions before his discoveries of the mind’s role in vision around the turn of the century. He invented an operation for persistent deafness, consisting of puncturing the ear drum membrane. He discovered a new medical use for adrenaline. He invented and performed astigmatic keratotomy, an operation that modern refractive surgery has its roots in.
Dr. Bates’ interpretations of his findings are not always consistent throughout the book. During most of it, he seems to base his system of treatment on his theory of accommodation; but when he discusses “wrong thoughts” as the cause of nearsightedness and farsightedness, the argument shifts. It is not the extrinsic muscles in this case that are responsible for the refractive errors, but disturbances in the circulation of the blood! Nor do these muscles seem to enter the picture when it comes to staring — which produces poor vision, according to Dr. Bates, because the eyes are used to continual movement and staring causes a loss of vision in the macula.
Bates’s points are entirely consistent. The confusion may lie in the fact that he illustrates the problem from different angles. A mental dysfunction is the cause of refractive errors. This condition can also be described as a wrong thought, for the person has somehow convinced himself that a different way of using the eyes is necessary or helpful. The act of staring (keeping the eyes completely still in an attempt to see something clearer) is one way the intention manifests. Another is trying to see too large an area with equal clarity at once.
The correlation between chronic tension and poor circulation is well-established by research done since the 1970s.
Take ‘palming.’ According to Dr. Bates, when you close your eyes and palm them, you see a perfect black if your eyes are normal, and gray shapes or colors if you are farsighted or nearsighted.
The truth is: nobody, whether his eyes are normal or otherwise, can see a perfect black when his eyes are closed. As stated by Duke-Elder, even a healthy eye is never free from luminous sensations under these conditions. What one sees is a slightly luminous field that is neither black nor white but a subdued ‘mean gray.’ Besides, there are fluctuations between darker and lighter tones, the changes corresponding to the respiratory rhythm. There may be spots or ribbons of light, or floating luminous clouds. This is all due to the intrinsic light of the retina — caused, according to scientists, either by mechanical pressure of the blood against certain cells of the retina, or by other factors. It has no possible relationship with nearsightedness or farsightedness.
What can be demonstrated is that the eyes see a “subdued mean gray” when not totally relaxed. When under a significant strain, blobs of other colors are often seen, either afterimages of objects just seen with the eyes open or other colors brought up by the mind. When someone is more relaxed, a more uniform black is seen. Nobody with perfect sight has perfect sight all of the time, and when he does not, a perfect black is not seen with the eyes closed and covered. When he relaxes more deeply, the illusory colors disappear and he perceives blackness.
One of the strangest things in this strange book is Dr. Bates’ methods of determining whether or not a person’s vision is normal. He can tell by merely looking at him or at his photograph! If a person is staring or squinting a little, he is ipso facto myopic at that particular moment. Captions beneath photographs in his book of primitive people refer to individuals in the group who have “temporarily imperfect sight” or are “probably myopic.” It need hardly be pointed out that a person with normal vision may also stare or squint as well as a nearsighted person. Only a careful, scientific eye examination can reveal whether eyes are normal or not.
An undue effort to see, manifested incorrectly, is associated with refractive errors. The effects produced can be observed by anyone who understands how to identify it, not just Dr. Bates. There is a difference in the look or behavior of a person that is relaxed versus someone under a lot of stress. We all know that. If someone is myopic, the eyes may seem to bug out with an obvious effort to see. The eyes may be narrowed in a squint. The eyes may be held rigidly still. The tension may be observed in the whole face and in everything the person does! It . When these actions are corrected, the sight improves.
On other occasions, however, Dr. Bates seems to be more scientific, and bases his findings on the retinoscope. Unfortunately, his method of using this valuable instrument (which determines objectively whether a person is nearsighted or farsighted) is as bizarre as his other methods …
Dr. Bates claimed that, when the examiner is so close, the patient is rendered nervous, and this, according to his theory, is enough to make him nearsighted or farsighted. Hence, he taught that the examiner should be six feet or more away from the patient. It is a simple fact, easily verified, that at this distance it is difficult, if not impossible, to perform accurate retinoscopy because the pupillary area seen is markedly reduced and the shadow is barely perceptible. It is difficult enough even at the usual distance to see the shadow clearly in many cases, especially when the pupils are small and the patient is old. One can only marvel at Dr. Bates’ dogmatism regarding his findings under these conditions!
There is another, more serious criticism. When performing retinoscopy, it is important that the examiner make sure that the eye of the patient is fixed steadily on a distant point; otherwise the findings will be false. For example, if the patient is farsighted and he looks at a nearer object while being examined, the shadow will indicate nearsightedness instead. Was Dr. Bates careful to see that his patient’s eye was fixed steadily at a distant point? He tells us that he used the retinoscope when the subjects were stationary and in motion; while they were sleeping and even under ether or chloroform; when the eyes were “partly closed”; when the pupil was contracted to a “pinpoint” by a drug; when the eyes were “oscillating” from side to side; and that he had examined the eyes of thousands of animals, including cats and dogs, with a retinoscope. These statements are a measure of the dependability of Dr. Bates’ scientific research methods. It is impossible to get a reliable “shadow” when the pupil is as small as a pinpoint. There is obviously no shadow at all when the patient is asleep — unless he sleeps with his eyes open. Nor can the doctor get other than fluctuating findings when the eyes of the patient are oscillating; and how can he ask a chloroformed patient to keep looking at a distant spot? How can he ask it of a dog or a cat and then make sure the animal does not shift his gaze?
It is hardly likely that someone who made a hobby of using the instrument under all sorts of conditions and spent decades doing so would be incompetent in its use. Dr. Bates had remarkable eyesight after he cured himself of presbyopia, so it should not be surprising that he was more skilled in the use of the instrument than many others.
His findings with the retinoscope also stand the tests of experience. People who have discarded their glasses and begin to cure their poor eyesight notice dramatic changes in their quality of vision depending on their emotional state and other factors. This is something that will often vary little if glasses are worn, or go unnoticed if the assumption is held that the quality of vision does not change both for the worse and for the better depending on how the eyes are being used.
Glasses rarely have to be changed oftener than from one to two or even three years, depending on the age of the patient and other factors. In all but a tiny minority of cases, the emotional state of a patient has no effect on the nature or the degree of the refractive error, which depends chiefly on the structure of the eyeball. Eye specialists frequently tell their patients reporting for re-examination after a lapse of one or two years that their glasses are still correct and require no changing.
This isn’t always the case. Chronic myopia is sometimes progressive, suddenly increasing dramatically over a short period of time. The more rapidly the vision worsens, the more rapidly are the wrong habits of strain increased. Different eye doctors can also have significantly different measurements for one person’s vision, if they start out the test with no indication of what the glasses prescription “should” be.
It is not a minority of cases in which the mental state has an effect on the quality of vision. It is true for everyone.
Eye specialists frequently tell their patients reporting for re-examination after a lapse of one or two years that their glasses are still correct and require no changing. Yet, since seeing the doctor last, the patient may have told innumerable lies; staggered through more than one emotional crisis; or gone through bankruptcy or divorce. Many people whose eyes need strong glasses are normal and adjusted, while others who do not need glasses are tense and neurotic.
Anyone making an effort to see and producing imperfect sight has wrong thinking. They may be considered “normal” by other people with the same problem or even people who don’t consciously recognize the strain, but it is apparent to someone who knows what to look for.
Stress is inevitable, but not everyone handles different types of stress in the same way. Some people have a tendency to take things hard and attempt to cope by changing the way they use their eyes. The reaction of changing the way the eyes are used causes vision problems. But it doesn’t necessarily become chronic, as everyone with even perfect sight has temporary lapses. And other people handle stress by developing tight muscles elsewhere or developing emotional problems.
To put it simply, if someone with normal sight doesn’t respond to stress by changing the way they use their eyes, they will still have normal sight.
As to staring into the sun, an important part of the Bates therapy — this is positively dangerous to sight.
In his book, Dr. Bates mentioned people with normal sight who were able to look directly into the sun without discomfort and without loss of vision afterwards. He does caution that people with imperfect sight are, in the vast majority of cases, likely only to increase eyestrain and lower the vision by sun-gazing. Nowhere does he actually recommend that the general public try it, but he made it clear that he could not find a case where being cured by his methods did not also make any negative effects of sun-gazing disappear. In other words, all of the people who were relieved of their vision problems also were relieved of negative aftereffects of sun-gazing. So he could not find a case of ill effects from looking at the sun that proved to be permanent.
He made efforts to disprove that light is not deterimental to sight. He flooded the eyes of animals for an hour or more with extremely bright light from a nitrogen lamp. Afterwards, examination of the eyes showed no negative effects that didn’t disappear within a few hours.
One other thing he mentioned in his book was the “sun treatment”, where he would focus the light of the sun directly onto the sclera of patients for brief instants at a time, moving the light constantly to avoid any risk of injury. He found that people were often so benefited by this that the practice was suggested regularly for the rest of his career.
Modern Bates teachers often teach “sunning,” the practice of closing the eyes, facing towards the sun, and moving the head slowly back and forth to allow the sunlight to shine through the closed eyelids.
There is only one method of treating the disease, and that is the use of drugs or surgery or a combination of both. The Bates treatment is worse than useless, for, while the patient is palming and trying to see black, pressure on the optic nerve, caused by the disease, continues unabated, and the damage to sight may be irreparable.
Dr. Bates cured patients of glaucoma with his method, as well as cataract and other diseases of the eye. It’s only natural that conditions associated with health and proper functioning of the eye should be improved when eyestrain is relieved and the eyes are used in a manner in harmony with their structure and function. This is not a phenomenon observed exclusively by Dr. Bates. Three prominent people come immediately to my mind – Meir Schneider cured himself of congenital cataract, became a vision teacher, and wrote a book on his experiences. Grace Halloran improved her retinitis pigmentosa and macular degeneration, became a vision teacher, and wrote a book also. Well-known novelist Aldous Huxley greatly improved his condition from the corneal scarring effects of keratitis punctata and wrote a book as well. Various modern teachers of the Bates method can also describe such cases that have benefited from the method, but they generally avoid making any such claims and getting into legal trouble for practicing medicine without a license.
Again, consider his statement that floating specks (‘muscae volitantes’) are optical illusions resulting from eyestrain. It is an incontrovertible fact that these specks are caused by translucent or opaque bodies floating in the vitreous humor of the eye and casting shadows on the retina. Far from being optical illusions, they are physical bodies that can be seen, when sufficiently large, by means of the ophthalmoscope. Dr. Bates claimed that they are illusions because he could not find them after a careful search. Perhaps the reason was that he used a ‘magnifying glass’ — and one cannot see the deep interior of the eye with a magnifying glass.
Dr. Bates did use an ophthalmoscope as well to look for them, but he did only have the technology of a century ago to work with. That aside, Dr. Bates’s point was that floating specks disappear when the strain is relieved. The important issue is not whether they are physical bodies or not, but that the problem ceases to exist when eyestrain is relieved and vision is normal; that is, they are no longer seen, and no longer an issue, whether anything is really there or not.
Although bodies that are assumed to account for the floating specks can apparently be seen when “sufficiently large,” it doesn’t automatically follow that all floating specks are such bodies.
On the same medieval-science level in his statement that glasses make a woman color-blind. This simply does not make sense, as color-blindness is an inherited defect which is unaffected by glasses. He claimed that colors appeared dull through corrective lenses, but the reverse is true. To a nearsighted person without glasses, colors are vague and dull. With glasses, the colors appear clear and brilliant, the reason being that colors as well as forms are blurred when they are not focused sharply on the macula of the retina.
Dr. Bates was simply pointing out that even plane glass lowers the color perception and that for this reason people often see colors better without them, especially at the distance at which they see best. His point was that one reason glasses are not the answer is glasses, no matter what strength, never improve the sight to what the person is capable of naturally. Color perception is one example.
However, it’s worth noting that Dr. Bates was able to relieve the color blindness in patients whose amblyopia also improved.
As to memory and familiarity with an object, which, according to Dr. Bates, can eliminate refractive errors, all they do is enable us to interpret blurred shapes more easily. If you are not familiar with the Greek alphabet and you see a slightly blurred character that is really delta, you will not be able to guess what it is, but your familiarity with English will enable you to identify most English letters that are blurred to the same extent. This does not mean, as Dr. Bates contends, that your vision is normal for English letters and myopic for Greek letters!
First, it’s a favorite argument of some optometrists that improvement on the test card is merely blur interpretation. But seeing is seeing. This is an example of the way the mind’s role in vision is often discounted as purely mechanical rather than intelligent and adaptive.
Second, familiarity with something improves the vision of it. Not just the logical interpretation of it, but the actual vision of it. Again, it isn’t just the eyes that are doing the job. Memory is closely allied with vision.
Third, when something is remembered as seen perfectly, the person is relaxed. With relaxation improves, so does the vision. Holding onto the memory of something seen perfectly is a subtle reminder of other conditions that existed at the time, including using the eyes more correctly. Even an imperfect memory of something can be helpful, if it’s of good enough quality. For example, someone with practically perfect sight won’t be benefited by a memory of something a little blurry, but someone with extremely poor sight could be benefited by such a memory.
It hardly seems necessary to refute any more of the misstatements in the book, such as the claim that movements of an object produce nearsightedness or farsightedness. We have said enough to indicate that the book is, in the words of Martin Gardner, ‘a fantastic compendium of wildly exaggerated case records, unwarranted inferences and anatomical ignorance.’
Pollack can only suggest that the case records were exaggerated. The inferences are clearly drawn out.
As for anatomical ignorance… In 1885 Bates graduated with a medical degree from the College of Physicians and Surgeons at the prestigious Columbia University in New York. In 1886 he introduced a new operation for persistent deafness, consisting of puncturing or incising the ear drum membrane. In that same year, he discovered the stringent and hemostatic properties of the aqueous extract of the suprarenal capsule, later commercialized as adrenalin. From 1886-1888 he was clinical assistant at the Manhattan Eye and Ear hospital and attending physician at Bellevue hospital. From 1886-1891 he was instructor in ophthalmology at the New York Post Graduate Hospital and Medical School. From 1886-1898 he was attending physician at the New York Eye Infirmary, Northern Dispensary, Northeastern dispensary, Northwestern Dispensary, and Harlem Hospital. In 1894 he invented the astigmatic keratotomy operation. There is no dispute that during this time period he was an ophthalmologist of high standing who was well respected by his peers.
With all this, how is it possible that Dr. Bates was anything less than extremely proficient with the facts and accepted theories of anatomy? That Dr. Bates with this background, plus years of experimentation beginning in 1896, challenged the accepted theories of ophthalmology makes his statements all that more powerful. As noted above, he was well respected by his peers, yet when he began making statements about the cure of myopia and other vision problems, he was ostracized and ignored.
He published several articles on his cure of defective eyesight in well-known, reputable medical journals of his day. For a doctor to make it into the medical journals is a high accomplishment. Dr. Bates was challenging up-front the theories on which practically every eye doctor in the country based his practice on, in doing so making significant enemies.
The matter is summed up succinctly by Dr. Glen R. Shepherd, who stated that eye exercises cannot reduce or eliminate any condition caused by ‘structural defect of the eyeball’ — hence they cannot possibly reduce or eliminate any refractive errors.
It’s becoming more accepted that the mind has a huge influence over the body and overcoming issues. It would be strange for a “structural defect” to be so infeasible to overcome when it comes to the eyes, when the whole body adapts and changes constantly in response to injuries, irritants, poisons, and diseases. That is assuming there is even a structural defect at all, and not just a temporary condition caused by tense muscles.
Despite the fact that Dr. Bates’ book was published over 35 years ago, in the words of Dr. Louis H. Schwartz, ophthalmologist: ‘Nowhere in the world has the medical profession accepted them.’
Ideally, if something is of enormous practical universal use for aiding in relieving the suffering of human beings, it would quickly be adopted by the medical establishment and implemented to its fullest extent. Unfortunately, that is not the way things work. The medical establishment upholds the status-quo and a mechanistic worldview that says we are at the total mercy of biological processes.
However, the trend now is these ideas are beginning to catch on. People are beginning to see that we have more control over the condition of our body than we once believed.
He added: ‘Many patients supposedly cured by the Bates method had later to fall back on glasses again.’
Anyone who falls back on glasses has begun to misuse his eyes again. Such people were likely not completely recovered to begin with, as far as their corrected habits being rock-solid. Overcoming a disease or disorder can be a tenuous thing and takes dedication, as any recovering alcoholic will tell you.
As we have seen, Dr. Bates attached much importance to memory. Years before his book appeared, he had published a paper in a medical journal entitled: ‘Memory as an Aid to Vision.’
The reason for this emphasis may be found, perhaps, in the obituary that appeared in the July 11, 1931 issue of the New York Times, when Dr. Bates died. Under the subhead, ‘Victim, Many Years Ago, of a Strange Form of Amnesia, He Disappeared Twice,’ the obituary tells the strange story of how Dr. Bates had vanished seven years after graduation from the College of Physicians and Surgeons and how his wife found him later in London in a state of nervous exhaustion, with no recollection of recent events. She took him to a hotel but, after two days, he disappeared again. His wife sought him in different European countries but died without being able to locate him. Dr. Bates later reappeared in the Middle West. He started a practice in New York and married again.
His reported disappearance wasn’t seven years after graduation, but seventeen. He reportedly left New York in 1902. There was much confusion when he left New York, as even his wife didn’t know where he had gone. Elements of the amnesia story are suspicious. However, he was working in North Dakota with myopia in school children from 1903-1910 and apparently also went to London for reasons not currently known.
On to chapter 4 of Pollack’s book. Regarding Dr. Peppard, a Bates teacher:
He recommends playing tennis to overcome the lack of staring, which he claims is caused by lack of central fixation. (Some readers may be confused by this, since staring insures central fixation, which is focusing the object on the macula — but probably most readers would not notice the inconsistency.)
“Central fixation” is a term Dr. Bates used to describe the condition of seeing best in the smallest center of vision, an important element of normal vision that is disrupted by misusing the eyes. Central fixation requires constant movement to another point of focus. Staring at one point only, without allowing the eyes to move, is a good way to make your vision fade away and cause a noticeable amount of discomfort.
Did his treatment by Mrs. Corbett really enable [Aldous] Huxley to read without glasses? In his column in the Saturday Review for April 12, 1952, Mr. Bennett Cerf related how he saw Huxley read a prepared address without benefit of glasses. Impressed by this apparent demonstration of the efficacy of eye exercises, Cerf suddenly saw Huxley falter — and it dawned upon him that the novelist was not really reading his address. Apparently he had memorized it but had forgotten a passage. Bringing his eyes closer and closer to his manuscript, he still could not decipher the words. Finally he had to take a magnifying glass from his pocket in order to make the words visible. Cerf describes the moment as one of agony.
Huxley wrote about the Bates Method a book which included a description of his own improvement from the condition that his doctors claimed can only get worse. He then scheduled to present a speech without glasses in order to show that he could read it. How likely is it that he would dare present himself as evidence of the Bates Method’s efficacy, by reading without glasses, without being pretty sure beforehand that he was able to do so? Temporary relapses are extremely common with people improving their vision, until they are fully recovered to normal vision, especially under conditions of pressure. Huxley improved his condition, but he was never fully relieved of the condition. He claimed to be able to often read in good lighting without glasses, and how stupid would he have to be to say that without being able to do so at least part of the time?
Anti-spectacle eye-exercisers are not averse to glasses when it comes to their own eyes or the eyes of their immediate family. Dr. Schwartz tells of a Bates practitioner who sent his wife to him for a prescription for glasses. The Bates practitioner himself wore bifocals!
This would be an example of a teacher of the Bates method that was not fully recovered himself. Some people do get excited about their first signs of improvement and hurry on to start teaching other people. There is no legal certification to become a “Bates teacher” or any other such title, so you get all kinds.
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