each containing a special quantity, and so arranged that it may be used drop by drop. These, properly enclosed, accompanied by a brief lucid explanation of the danger of the disease, the necessity of this germicide, the method of its employment, and the right subsequent care of the eyes, should be sent to the obstetrician on the receipt of each birth certificate.
“I have said that responsibility for the indifference that is annually resulting in such frightful disaster lies primarily with the state, the public and the medical profession.
“The state is already aroused to the necessity of taking effective measures to wipe out this controllable plague. Bills have been introduced in the legislature of Massachusetts and of New York, providing for the appointment of commissions for the blind, one of whose duties will be to study the causes of unnecessary blindness and to suggest preventative measures.”
One of the most common diseases of the eye is trachoma, often called “granular lids,” because the inner surface of the lid seems to be covered with little granulations. The disease sometimes lasts for years without causing blindness, though it gives rise to great irritation. It is generally Trachoma.attended by a discharge, which is highly contagious, producing the same disease if it gets into other eyes. Want of cleanliness is one of the most important factors in the propagation of trachoma, hence its great prevalence in Oriental countries. Trachoma is very prevalent in Egypt, where those suffering from total or partial blindness are said to amount to 10% of the population. During Napoleon’s Egyptian campaign, nearly every soldier, out of an army of 32,000 men, was affected. During the following twenty years the disease spread through almost all European armies. In the Belgian army, there was one trachomatous soldier out of every five, and up to 1834 no less than 4000 soldiers had lost both eyes and 10,000 one eye. It is a disease which is very common in workhouse schools, orphan asylums and similar establishments. Unlike ophthalmia of new-born children, it is difficult to cure, and a total separation of the diseased from the healthy children should be effected.
About one-half of those who are blinded by injuries lose the second eye by sympathetic ophthalmia. It is a constant source of danger to those who retain an eye blinded by injury. Blindness from this cause can be prevented by the removal of the injured eye, but unfortunatelySympathetic inflammation. the proposal often meets with opposition from the patient.
Glaucoma is a disease which almost invariably leads to total blindness; but in most cases it can be arrested by a simple operation if the case is seen Glaucoma.sufficiently early.
Myopia, or “short-sight,” makes itself apparent in children between the ages of seven and nine. Neglect of a year or two may do serious mischief. Short-sight, when not inherited, is produced by looking intently and continuously at near objects. Children should be Short-sight.encouraged to describe objects at a distance, with which they are unacquainted, and parents should choose out-door occupations and amusements for children who show a tendency to short-sightedness.
A report was issued in 1906, by the school board of Glasgow, as to an investigation by Dr H. Wright Thomas, ophthalmic surgeon, regarding the eyesight of school children, which includes the following passage. Dr Wright Thomas states that the teachers tested the visual acuteness of 52,493 children, and found 18,565, or 35%, to be below what is regarded as the normal standard. He examined the 18,565 defectives by retinoscopy, and found that 11,209, or 21% of the whole, had ocular defects. The proportion of these cases was highest in the poor and closely-built districts and in old schools, and was lowest in the better-class schools and those near the outskirts of the city. Defective vision, apart from ocular defect, seems to be due partly to want of training of the eyes for distant objects and partly to exhaustion of the eyes, which is easily induced when work is carried on in bad light, or the nutrition of the children is defective from bad feeding and unhealthy surroundings. Regarding training of the eyes for distant objects, much might be done in the infant department by the total abolition of sewing, which is definitely hurtful to such young eyes, and the substitution of competitive games involving the recognition of small objects at a distance of 20 ft. or more. An annual testing by the teachers, followed by medical inspection of the children found defective, would soon cause all existing defects to be corrected, and would lead to the detection of those which develop during school life.
History of Institutions
Although there is a record of a hospital established by St Basil at Caesarea, Cappadocia, in the 4th century, a refuge by the hermit St Lymnee (d. c. 455) at Syr, Syria, in the 5th century, and an institution by St Bertrand, bishop of Le Mans, in the 7th century, the first public effort to benefit the blind was the founding of a hospital at Paris, in 1260, by Louis IX., for 300 blind persons. The common legend is that he founded it as an asylum for 300 of his soldiers who had become blinded in the crusade in Egypt, but the statutes of the founder are preserved, and no mention is made of crusaders. This Hospice des Quinze-Vingts, increased by subsequent additions to its funds, still assists the adult blind of France. The pensioners are divided into two classes—those who are inmates of the hospital (300), and those who receive pensions in the form of out-door relief. All appointments to inmates or pensions are vested in the minister of the Interior, and applicants must be of French nationality, totally blind and not less than forty years of age.
From the time of St Louis to the 18th century, there are records of isolated cases of blind persons who were educated, and of efforts to devise tangible apparatus to assist them.
Girolamo Cardan, the 16th-century Italian physician, conceived the idea that the blind could be taught to read and write by means of touch. About 1517 Francesco Lucas in Spain, and Rampazetto in Italy, made use of large letters cut in wood for instructing the blind. In 1646 a book, on the condition of the blind, was written by an Italian, and published in Italian and French, under the title of L’Aveugle affligé et consolé. In 1670 a book was written on the instruction of the blind by Lana Terzi, the Jesuit. In 1676 Jacques Bernoulli, the Swiss savant, taught a blind girl to read, but the means of her instruction were not made known. In 1749 D. Diderot wrote his Lettre sur les aveugles à l’usage de ceux qui voient, to show how far the intellectual and moral nature of man is modified by blindness. Dr S. G. Howe, who many years after translated and printed the “Letter” in embossed type, characterizes it as abounding with errors of fact and inference, but also with beauties and suggestions. The heterodox speculations contained in his “Letter on the Blind” caused Diderot to be imprisoned three months in the Bastille. He was released because his services were required for the forthcoming Encyclopaedia. Rousseau visited Diderot in prison, and is reported to have suggested a system of embossed printing. J. Locke, G. W. Leibnitz, Molineau and others discussed the effect of blindness on the human mind. In Germany, Weissembourg had used signs in relief and taught Mlle Paradis.
Prior to the 18th century, blind beggars existed in such numbers that they struggled for standing room in positions favourable for asking alms. Their very affliction led to their being used as spectacles for the amusement of the populace. The degraded state of the masses of the blind in France attracted the attention of Valentin Haüy. In 1771, at the annual fair of St Ovid, in Paris, an innkeeper had a group of blind men attired in a ridiculous manner, decorated with peacock tails, asses’ ears, and pasteboard spectacles without glasses, in which condition they gave a burlesque concert, for the profit of their employer. This sad scene was repeated day after day, and greeted with loud laughter by the gaping crowds. Among those who gazed at this outrage to humanity was the philanthropist Valentin Haüy, who left the disgraceful scene full of sorrow. “Yes,” he said to himself, “I will substitute truth for this mocking parody. I will make the blind to read, and they shall be enabled to execute harmonious music.” Haüy collected all the information he could gain respecting the blind, and began teaching a blind boy who had gained his living by begging at a church
