Vol. 60, 1909 - University of North Carolina at Chapel Hill

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232 THK CHAKLOITE MKDICaU JOURNAL.
strength, before advancing to the next charlatan in nature and did very little to
stronger solution, he is only to proceed by introduce to the world any correct surgical
two points instead of one, and the rate of method for the relief of squint. The first
increase, instead of being 29.1 per cent., practical operation is described in 1838 by
would be double that, or .58.2 per cent., Strotneyer. This grew out of the theory
which would likely never be exceeded. that the contracting muscle was shorter and
Such a dose scale should be of benefit thicker, and the first authentic operation
alike to the specialist and to the general was similar to the one of the present day
practitioner. It is to the latter that I can
see a very positive advantage. The number
of persons during the year to whom he
for tenotomy,
After this the pendulum swung rapidly
aud operations were indiscriminately made,
administers tuberculin, are necessarily few.
The danger lies in the reaction,—not the
with, of course, frequent bad results.
Von Graefe, in the fifties, demanded
slight evanescent ones, whether local, focal more conservative policy. Then came
or systemic, but in the severer grades. Such Bonders, with his theory of strabismus bea
dose scale as the above will reduce to a ing due to errors of refraction, arising from
minimum the dangers attending the thera- disturbed relationship between the accompeutic
administration of this drug. modation and oonvergence.
Co)iclusio7is
I- That strabismus convergens is de-
pendent upon hyperopia.
ist. The immunizing effects of tuberculin
are best brought about by an even gradua-
n. That strabismus divergens is de-
pendent upon myopia.
tion of dose-increase.
2nd. The present method of increase by . Bo"ders theory was readily accepted and
is
volume is most uneven and is attended
adhered to
by
by many today, though theoreti-
""^^^"^
greater danger of producing reactions.
^" practically shown to be inaccu-
^^^e.
3rd. A system of dosage based
tor a time previous to this all squmt-
on a uninig
eyes
form ratio-increase, such as I have formuwere
operated upon. Fhe reaction
°f tlie
lated, is most in keeping
pendu um swung rapidly back and
with the theory of
the production of immunitv, and constitutes "^^^^^^^^ almost as harmful advice,-to
^ }^
wait until the child
the safest mode of administering
had outgrown the detuberculin,
^^_^_^^
formity.
Squint and the Importance ol Its Early There are two forms of strabismus, the
Correction.* paralytic and concomitant variety. The
By Dr. Hugh M. Lokey, Atlanta, Ga.
method of determining the paralytic from
^j^^ concomitant is as follows:
iStrabismus was mentioned in the earliest I" the paralytic form the axes of the
medical writings, but was regarded as a ^^ed and the deviating eye do not mainpermanent
deformity. Hippocrates in his taiu the same relationship when the eye
writings twenty-two centuries ago refers to moves from side to side, while m the conit
as a distortion, and recognized its inher- comitant the same relationship of the axes
itance. Celus in the first century of our is maintained in all positions. According
era, refers to it, but at this time it was not to Bonders' theory, strabismus and hetecoiisidered
ameliorable to treatment. Pau- rophoria are produced by the same causes
lus Aginetta in the seventeenth century and are confused by some,
recommends the wearing of a mask extend- Worth's view is that squmt is due to deing
below the nose, with openings for each ficiency in the development of the fusion
eve, to induce the eves to assume their prop- faculty: (this is frequently inherited) acer
position. Pare, in 1561 to '77 describes counting for the frequent occurrence of
squint eve as an inequal vision caused bv children of squiting parents possessing the
the cradle being placed so that the child same defect. Breslau states that 2:S per
sees the light from one side, thus causing cent, give this history.
the eves to divert towards the light. Many Fritz Kehr, in (Wachenschrift fur The-
|
still adhere to Pare's etiology, and many of rapie und Hygiene des Auges, Becember
the laitv now, as well as some of the pro- S, 1904,) divides the authors of the several
fession, attribute deviation to the fault of theories into three classes.
the cradle, a lock of hair hanging over the 1st: Those who believe amblyopia is the
temple, &c. result of strabismus: A. Von Graefe, Bou-
In 1737, or before, John Taylor announced ders, Javal, Grunfeld.
an operation bv which he could straighten 2nd; Those who believe that it is partly
crossed eyes. His practice was to a degree the cause and partly the result of strabis-
-— -—
, „ . mus: Alfred Graefe, Schweigger, Silex.
*Read before Georgia btate Medical Association, -, i . T:„h,. iiinicplf
at Macon, Georgia, April 21,
-^^y^' ^^'^^' ^^'mseil.
s t' 22, 23. J 1909.
^
. , y y
^jjg ^|.gj ^^^Q believe it can be improved,
tStevtns but Kehr believes it is the result of ambly-
i