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If there is call for medicines I do not hesitate to give them, but in many cases I think that there has been sufficient medicine given, and if nature is allowed to assert itself and given full sway, with the help of the glasses removing all refractive errors and the strain that it produced, the trouble will disappear. In a very few cases it is necessary to prescribe prisms, but I never re ort to this method of relief unless there is an Hyperphoria combined with one or both of the other phoria and never then in their full strenght, leaving some work for the affected muscle to do, and as soon as it is practicable I change these, either weakening the prisms or taking them off altogether. As a prism an. swers the same purpose to the eye as a crutch does to an injured limb, as soon as the muscle gets so it can do its work I abandon

its use.

In one hundred and cases examined for glasses in the past six months, I have found the following troubles required correction:

Hyperopia (far-sight),
Myopia (near-sight),

Astigmatism (oval, or irregular sight), 65
Presbyopia (old-sight),

.. 50

18 cases.


The presbyopia was complicated with astigmatism in 33 cases, with simple Hyperopia in 18 cases and Myopia in 1 case.

Some Heterophoria was found in 86 cases, while the other 55 did not reveal any when the tests were made; these muscu. lar insufficiencies are divided as follows:

Hyperphoria (tending of one visual line above the other) alone,

3 cases Exophoria (with and without Hyperphoria) 18 Exophoria (with and without Hyperphoria). 65

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86 Of these there was Hyperphoria combined with Exophoria in

4 cases Hyperphoria combined with Esophoria in

24 Esophoria for distance with Exophoria for near



23 cases

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Exophoria for distance with Exophoria for near

12 cases
Hyperphoria at distance with Exophoria for near

2 cases Exophoria (with no distance unbalance) for near vision only

2 cases In other words there were sixty seven of the cases out of the eighty six that had more than one condition of Heterophor. ia, or barring say five cases that had all three of the difficulties there were fifty eight cases that had two conditions of Heterophoria, along with the refraction errors.

Out of this entire number there were less than five pairs of prisms prescribed to help the muscles regain their normal tone, and of these it can safely be said that they will be taken from the wearers in less than a year.

I have seen but two ca. ses in this number, and only three others in nearly a thousand cases where I have told them that a tenotomy would have to be performed. Two of these cases have absolutely refused operation, one has gotten beyond my jurisdiction, and the other three desire to exhaust all other methods before consenting to the operation. In all the rest I have obtained the excellent result and given the patient perfect comfort simply by fitting the frames to the face in such a manner that the lenses are carried in the proper position before the eyes, and placing therein the lenses that give the best vision, and correct the refraction error.

In some few cases I have found it necessary to exercise the muscles with prisms and subsequent to each treatment apply the galvanic current and instruct the physician to give the indicated remedy, or if he prefers I give it, myself. I have cured some very obstinate and persistent headaches in this manner. I will cite one case that will give us the different con ditions, as an illustration.

Miss H. A., age 25, clerk in notion department of a large department store; has suffered with sick-headaches since a child, and is now unable to pursue her duties without some aid for the vision; is extremely nervous, pain in the eye-balls, al. ways worse by gas light.

R. Eye. v-20-70 A. plus .75 d. cyl. Axis 90 combined with a minus 1.50 d. Cyl Axis 180 v.-20-20.

L. Eye. v.-20-70 A plus .75 D. Cyl. Axis 90 combined with aminus 1.50 D. Cyl Axis 180 v.-20-20.

She has left Hyperophoria of 1.2 degree, an Exophoria for distance of 2 degrees, and near vision of 8 degrees. The proper lenses were prescribed for constant wear and tipped slightly so that looking down she would not see the rims, and she was requested to return in two weeks for an examination of the mus. cular difficulty, which had not grown less. I then began exercise with the prisms with the base outward, and kept this up once a day for over a month, when the difficulty was much less. For the first six treatments I gave the galvanic current after the exercise, then told her how to use the prisms at home, and report every two weeks. After two months I am unable to find any muscular insufficiency, and the patient works with perfect ease and comfort all day and reads as much as she desires at night.

In conclusion: I do not believe that all cases can be cured without other correction than the refraction error, but I believe that the majority of cases can be so cured; and that of the bal. ance exercise and proper medicinal treatment with a few applications of electricity, will cure all but about one per cent. I also believe that tenotomizing the strong muscle before devel. oping the weak one to its full capacity is harmful and if so it is wrong.



By Chas. S. Mack, M. D., La Porte, Indiana. I presume that if the question with which I have headed this article, was put to each reader of the THE CRITIQUE, the answers would be various, and it would not surprise me if no one of them was that which I shall here offer.

I presume that many would say that the larger body of physicians has, by excluding homeopaths from fellowship, forc. ed them to form a distinct body; nothing could be more true. Of various answers offered, several or all, though different might be correct.

What I wish here to do is to give what seems to me the very best single reason that can be given, why one who believes in homeopathy, may properly identify himself by name with it, bowever much of rational medicine he may practice. To many it has seemed an anomaly, that one who believes in ra. tional medicine just as truly as he does in homeopathy, should still identify himself by name with homeopathy.

I think that some homeopaths themselves, when asked to explain how they can consistently call themselves homeopaths and still freely use rational medicine, give a hesitating, halting! not clear-cut answer, which strikes the hearer as rather apologetic.

Now, when the matter is thoroughly understood, it becomes evident that no apology is due for accepting both in theory and practice, rational medicine and at the same time, homeopathy. One may consistently be enthusiastic over both rational prac. tice and bomeopathy, and a clear understanding of this fact is, in my opinion, the greatest need of the medical profession to-day.*

In this present paper I would give the key to the solution of what seem problems to many.

First: How can one consistently accept both rational medicine and homeopathy?

Second: How can one consistently identify himself by name with homeopathy, though he accepts rational medicine as well as homeopathy?

The key to the solution of these problems, lies in accurate definition of that particular cure of which similia similibus curantur is the law, and in accurate definition of rational practice. The cure of which similia is the law is an immediate transformation from abnormal to normal (or approximately normal) of vital processes and (in consequence) their effects, The word immediate here, has no reference to time, but simply means that no pathogenetic effect of the medicine is medi.

This matter is clearly presented in my little book, Principles of Medicine, published by the W. T. Keener Co., 96 Washington Street, Chicago.

ate to its curative effect. Now, it is evident that this particular cure cannot be attempted in rational practice, for the data to any given rational practice must be in themselves knowable, and vital processes are not in themselves knowable; they can be known only in their effects. The immediate end sought in any given practice of homeopathy is, then, something enti different from the immediate end sought in any given practice of rational medicine. It follows that there is no inconsistency whatever in accepting both rational practice and homeopathy.

It being seen that one may consistently accept both homeopathy and rational medicine, the remaining question is, how can one who accepts rational medicine as well as homeopathy, consistently identify himself by name with homeopathy?

The answer is, that as the particular cure sought in any given practice of homeopothy transcends the possibilities of rational medicine, it is proper for one who believes in that particular cure, and in similia, similibus curantur as the law of t, to identify himself by name with homeopathy, in order that i he may be distinguished from those physicians who regard rational practice as the ne plus ultra in medicine and who are in open hostility to those who would further the practice of that cure which transcends the possibilities of rational medicine.

The key to the most interesting and important problem in the medical world to-day is, then, accurate definition of the immediate end sought in any given practice of homeopathy. For lack of such definition, past controversies over homeopathy have been carried on at an immense disadvantage. Using such definition, I have (in the October, 1897, number of the American Medic il Monthly, Baltimore, and in two papers now in hands of the Hahnemannian Monthly, Philadelphia) shown that neither Brunton, nor H. C. Wood, nor Headland, nor Stille has while opposing homeopathy, understood even of what cure similia similibus curantur purports to be the law. I have no doubt that in the near future, all discussions of homeopathy's claims will be preceded by accurate definition of precisely what is that particular cure of which similia similibus curantur is the law. Such definition will be immensely useful in that, with it before them, the disputants will agree as to what they are talking about. For a time at least, there doubtless will be some

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