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MEDICAL INTRO
BOOKS ON OLD MEDICAL TREATMENTS AND REMEDIES

THE PRACTICAL
HOME PHYSICIAN AND ENCYCLOPEDIA OF MEDICINE
The biggy of the late 1800's. Clearly shows the massive inroads in medical science and the treatment of disease.

ALCOHOL AND THE HUMAN BODY In fact alcohol was known to be a poison, and considered quite dangerous. Something modern medicine now agrees with. This was known circa 1907. A very impressive scientific book on the subject.

DISEASES OF THE SKIN is a massive book on skin diseases from 1914. Don't be feint hearted though, it's loaded with photos that I found disturbing.

Part of  SAVORY'S COMPENDIUM OF DOMESTIC MEDICINE:

 19th CENTURY HEALTH MEDICINES AND DRUGS

 

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Short-sightedness.

The condition, Short-sightedness, which is technically termed myopia, consists in a limitation of the range of distinct vision to comparatively near objects. The natural eye is so adapted that it can accommodate itself so as to see objects situated at any distance which is more than five or six inches from the eye. As has been already stated, this power to see objects at different distances - far or near - depends upon the power possessed by the eye of changing the curvature of the crystalline lens. In order that the object shall be distinctly seen, a picture of it must be formed at the back of the eye upon the retina. This picture is formed by the focusing of the rays of light by means of the crystalline lens. When the object is situated at a distance from the eye, the lens is comparatively flat; when, on the other hand, it becomes necessary to view an object situated only a few inches from the eye, the lens is, through the action of the ciliary mziscle, made more curved. In every case the curvature of the lens is such that the rays of light are properly focused so as to produce a picture upon the retina.

If from any cause the picture is not properly focused upon the retina, the individual perceives only a blurred image.

Now, it is evident that the failure to focus the picture properly upon the retina may result from either one of two causes : First, the curvature of the lens may be improper - that is, the lens may be too flat or too curved ; second, the retina may be situated too far back or too far forward - that is, the eye may be too long or too short ; for it is evident that a lens which can focus the rays so as to produce a definite picture on the retina in one eye, will have an improper curvature for producing the picture in the second eye, in which the retina is situated further back than in the first. This can be readily illustrated by taking an ordinary sun­glass, which is a lens shaped almost exactly like the crystalline lens in the eye.

This lens may be held so as to produce a perfect picture of the sun - that is, a bright spot-on a sheet of paper held below it. If this paper be now moved a little further from or a little nearer to the lens, there will be seen upon it a large bright circle but not the brilliant image of the sun.

Now, the short-sighted eye is, in the majority of cases, too long; that is to say, the distance from the lens to the retina is so great, that the rays of light cross each other before reaching the retina. If the retina could be moved a little further forward toward the lens, the short-sighted eye would become a perfectly natural one. In many, perhaps most cases, the short-sighted eye was in childhood a perfectly natural one ; but in consequence of improper use, straining of the muscles, etc., the eye has become compressed and the back part - that is, the retina - has been pushed further backward away from the lens, so that the eye becomes too long, in other words short-sighted.

It would be out of place here to discuss the various causes concerned in the production of short-sightedness, but it is necessary to make some remarks upon the practical application connected therewith.

A short-sighted individual has a certain range of vision in which he sees objects quite as distinctly as those whose eyes are naturally formed. This range varies from about ten inches to six, eight, ten or more feet. His vision differs from that of those with natural eyes in two respects : First, he is able to see objects when brought closer to the eye, as a result of which he can distinguish smaller objects than other people can ; second, he is Uxiable to see objects at a distance. The result of this is that the individual gets in the habit of bringing objects close to the eye, since by so doing he does not feel the same strain upon his eyes as when he looks at them at a greater distance.

Whenever an individual who can see near objects quite distinctly cannot distinguish objects at a distance, we may suspect that he is short-sighted. The question can be easily settled by holding before his eyes a concave lens. If his sight for distant objects is improved by the assistance of this lens, the person is undoubtedly short-sighted.

There are several popular beliefs respecting short sight, some of which are quite enoneous.

First among these is the general impression that short-sighted eyes are particularly " strong " eyes. This belief results from the fact that short-sighted persons can distinguish smaller objects than other people can, and that they can see in a less brilliant light than others. A moment's thought shows, however, that both of these characteristics result from the ability of short-sighted people to see objects when held close to the eyes. For we know that the nearer an object is to the eye the larger it appears. Now a person with natural eyes can not see small print, for instance, at a distance less than eight or ten inches; the short-sighted person, on the other hand, can see the same print at a distance of four or five inches; but at this distance it appears, of course, larger than it did at ten inches. In the same way a person with natural eyes may fail to distinguish very fine particles, such as minute pieces of sand or dust, merely because he has to hold objects so far away from his eyes in order to see distinctly. The short-sighted individual cannot see these objects at the same distance - eight or ten inches - any better than the person with natural eyes, but he has this advantage over the latter, that he can bring the object much closer to his eye and still see distinctly. Thus he is enabled to see smaller objects than the person with natural eyes.

The ability to see distinctly in a faint light ;s explained in ex­ actly the same way. The nearer an object approaches the eye the more light enters the eye from it. Hence, the short-sighted individual who can see distinctly at a distance of four or five inches is able to recognize objects which another person, who is compelled to hold them eight or ten inches distant, can not see. The difference lies not in the relative strength of the eyes, but simply in the fact that the object appears brighter because brought closer to the eye.

Another popular impression regarding short-sighted eyes is the belief that short-sight improves as the person grows older. This belief rests upon the fact that many short-sighted persons do not require such strong glasses in middle life as they were compelled to use in youth. This is often the case, but it depends not upon any inherent improvement in the condition of the eyes, but simply on the changes which naturally occur in the eye as the individual grows older. Such persons often say that they " are not so short-sighted as they were." They forget, however, that the measure of short-sight is in seeing distant objects and not near ones. They will find that while they may be able to see small objects better without glasses than they formerly could, yet they require glasses for distant objects just as before.

The one advantage which short-sighted people enjoy consists in their freedom from the necessity of the ordinary spectacles which most people require in advanced life. This freedom is due simply to the defect in the eye, which counterbalances the second defect consequent upon old age. As will be explained subsequently, the structure of the crystalline lens changes somewhat as a person becomes older, so that he cannot increase its curvature as he formerly did when looking at near objects. This change happens in the eye of a short-sighted person just as well as in that of another ; but whereas the latter is compelled to use glasses in order to counteract the defect in his lens, the short-sighted individual does not require the glass, since the defect in his lens is already counterbalanced by the defect in his eye which makes him short-sighted. In consequence of these two defects, and their effect in counterbalancing each other, it sometimes happens that a person who in youth and early life was compelled to wear glasses to correct his short-sightedness, is able to get along without them in advanced life. Such people are said to have " wonderful sight," or, as it is sometimes expressed, " second-sight. "

This is the sole advantage possessed by short-sighted people; the disadvantages, on the other hand, resulting from the peculiar formation of the eye constituting short-sight, are numerous and serious. In the first place, the eye cannot be used to the same extent as the natural eye without pain, nor even without danger.

Even when protected by glasses, the short-sighted eye is constantly in danger of certain accidents, if the degree of short-sight be considerable. After continued strain, such as reading for a number of hours, the eye usually becomes somewhat painful ; and it has repeatedly happened that hemorrhage has occurred within the eye, causing serious impairment of vision for a time, or even permanently. The sight may also be partially destroyed by what is called " detachment of the retina," as a result of short-sightedness.

Another affection incident to short-sightedness is the change in the position of the eye, called " squint," or technically strabismus. This is, especially apt to occur if the degree of short-sightedness be considerable. This can often be prevented by the use of appropriate glasses so soon as the first evidences of squinting are manifested.

One of the unfortunate features about myopia is the fact that t is progressive. As has been already stated, it is probable that most of those eyes which subsequently become short-sighted, were originally of natural shape, and that the defect has resulted from pressure upon the eye. In many cases this increase in the length of the eye progresses constantly as the individual becomes older, so that his vision becomes more and more defective, and may even finally result in total blindness. It is, therefore, ?extremely important that the eyes of a short-sighted person should be submitted at regular intervals to examination by a competent surgeon ; for if it becomes evident that the disease is advancing, the greatest possible care In the use of the eyes must be observed in order to arrest the progress of the affection.

A short-sighted eye should always be looked upon as a weak eye. It will not stand the same amount of wear and tear as a natural eye ; it is liable to several accidents and dangers to which other eyes are not subject.

As to the causes of myopia we are not, as yet, fully informed.

Certain it is that the affection is hereditary ; that is, it appears in successive generations of the same family; it seems to be probable that children may be more or less short-sighted at birth. Examinations of the eyes indicate that such is actually the case. At any rate the tendency to this elongation of the eye-that is, a weakness of the coats of the eye, so that they give way under pressure -is certainly inherited. Short-sightedness is pre-eminently an affection of civilization; it is practically unknown among savage races, as well as among the lower animals. This fact is quite comprehensible when we remember that the affection results from the excessive use of the eyes in gazing at small objects, and that it is the employments of civilization which require the use of the eyes in this way.

Numerous attempts have been made to ascertain which of the elements peculiar to civilized life are especially important in induc­ ing the development of short-sightedness. The first attempts were made in Germany, where short-sight is especially frequent. Dr. Cohn, of Breslau, examined the condition of the eyes in ten thousand children in the schools of that city. Among these he found one thousand who were short-sighted. Among the important facts brought to light by his examination, and confirmed by similar examinations which have since been made by others, are the observation that the amount of short-sight steadily increases from the lowest to the highest classes in the school; that is, both the relative number of the cases and the degree of short-sight are greater after the pupils have spent several years in the school. He found further that the amount of short-sightedness was greater in badly lighted and badly ventilated schools; and that it seemed also to be increased among those pupils who were compelled to use poorly constructed desks, which required them to stoop in the performance of their tasks.

These observations of Dr. Cohn have been confirmed by repeated examinations of many thousand pupils in public schools, in various parts of the world. There is no question that improper illumination and furniture of school­rooms have great influence in promoting the occurrence and progress of short-sightedness. This is especially manifest in Germany, where the school buildings are not always built with especial reference to the requirements of the pupil, and where children are sent to school at an early age and are kept closely confined many hours a day. In Germany, too, the hereditary influence of short-sightedness is especially manifested, since educational requirements have there been severe during many generations ; the tendency to short-sightedness is not only pro­ moted by the arrangement of the school­rooms, but is derived from ancestors who have suffered in like manner. An eminent English surgeon, in discussing this question, says:

" For the prevention of myopia in schools there can be no doubt that good and well-placed windows are essential, and that fittings of judicious design would be useful; but neither of these will be effectual or will prevent children from drooping over their work unless the matter receives the constant and vigilant attention of teachers, and unless the sanitary state of the buildings, and the time relatively given to work and to play, are such as to meet the requirements of physical health. It is a curious illustration of the essential mechanical character of certain minds, that the progress of the myopia should, in Germany, have been referred to the enforced convergence alone, and that better light and better fittings should have been put forward as sufficient to bring about a better state of things. Dr. Agnew, of New York, with more practical knowledge and with deeper wisdom, pointed out that a feeble and easily extensible character of the coats of the eye would be a condition largely dependent upon general debility ; and that the treatment of this debility by food, tonics and exercise, as well as by an ample supply of pure and often renewed air in the schoolrooms, a judicious shortening of tasks requiring the close application of the eyes, and the use of books printed in bold characters, would be of great assistance in bringing about a much needed reform. The robust faith of the average school­master in the efficacy of what he calls teaching is probably not destined to survive the time when a somewhat better acquaintance with the nature of mental operations will become diffused abroad ; and in the meanwhile, and with reference to the frequent sacrifice of the physical side of the development of the young it is not uninteresting to recall the results of an experiment made some ten or twelve years ago in the village school at Ruddington, in Nottinghamshire, under the direction of the late Mr. C. Paget, sometime 1*1, P. for Nottingham. In this school Mr. Paget introduced a half-time system as an experiment, to which only a portion of the children were subjected, and which amounted to a substitution of garden work for about one-half of the ordinary school hours. The children who were so treated, were found after a short period altogether to outstrip in their school work those who devoted, or who were supposed to devote, twice as much time to it. The prevention of the increase of short-sight in schools, is less in my judgment, an affair of desks and fittings than of careful and judicious sanitation ; for I have no doubt that the optical conditions which would produce myopia in weakly children would fail to do so in the robust. None the less, however, should these optical conditions, together with the lighting and the distance of the work, receive a due share of attention; although such mechanical matters must not be expected to supersede the necessity for the constant supervision of a directing intelligence. "

When it is discovered that a child is short-sighted, the line of treatment to be pursued is very simple. The evils to be apprehended result from the strain which the eyes are compelled to exert in order to see distinctly; and this strain is merely the consequence of the lack of proportion between the curvature of the lens and the depth of the eye. If we could change this proportion by making the eye shallower ; that is, by bringing the retina forward and somewhat nearer to the lens, we would obviate the difficult}'.

This, of course, cannot be done ; the form of the eye cannot be changed, but the other factor is a possibility-that is, we can change the direction of the rays of light before they enter the eye so that they shall be focused upon the retina. This is accomplished by the use of spectacles, a concave glass being placed in front of the eye.

The treatment of short-sightedness consists, therefore, in the use of spectacles. The object of these glasses is not to make the patient see better than before. Indeed, the short-sighted individual will often complain at first that he can see better without the glasses than with them. The benefit derived from the glasses is simply that they compel the patient to hold objects further from his eyes ; by this means the eyes are relieved from the strain which is the cause of danger for the future.

At first the patient will experience some inconvenience and perhaps even discomfort in wearing spectacles. This is merely the result of the pernicious habit which the eyes have so long maintained. It disappears in time, so that the patient feels much comfort in the use of his glasses, and much discomfort without them.

The effort required to accustom the eyes to the glasses is greater in advanced years than in early childhood, since the habit of straining the eyes is of longer duration. It is especially desirable that glasses shall be worn so soon as the short-sight is discovered, which is almost always in childhood. For not only are the evils which follow upon short-sight thereby averted, but the progress of the affection may be entirely arrested ; hence after the individual attains maturity he may, in many cases, unless he devote himself to some profession requiring close application of the eyes, give up the glasses entirely.

Another advantage in the use of glasses which is most important, though scarcely appreciated, is their value in bringing the individual into relation with the world. Those who have natural eyes which take in the usual range of vision, cannot appreciate the fact that the world of a short-sighted person extends only ten or fifteen feet around him ; yet such is the fact. The immense advantage derived from the use of the eyes in training the individual in a knowledge of external objects is lost, to a great extent, by the short-sighted person. Instances illustrating this fact are known to every surgeon who has much experience in the treatment of diseases of the eye. Thus Mr. Carter says : " I once prescribed glasses to correct the short-sight of a lady who had for many years been engaged in teaching, and who had never previously worn them ; her first exclamation of pleasurable surprise, as she put on her spectacles and looked around her, was a curious commentary on the state in which her life had until then been passed; she said, 1 Why, I shall be able to see the faces of the children/ If we think what this exclamation meant, and if we apply the lesson which it teaches to other pursuits, we shall not rail to perceive that the practical effect of myopia is to shut out the subject of it from a very large amount of the unconscious education which the process of seeing the world involves, and thus to occasion losses which can hardly be made up in any other way. Taken in detail, these losses- the mere not seeing of this or that seeming trifle-may appear insig niflcant; it is their aggregate which becomes important. A young lady was lately brought to me by her parents on account of the way in which the effects of her myopia had forced themselves upon their notice during a continental tour. Taken in detail, these losses- the mere not seeing of this or that seeming trifle-may appear insig niflcant; it is their aggregate which becomes important. A young lady was lately brought to me by her parents on account of the way in which the effects of her myopia had forced themselves upon their notice during a continental tour. Two school boys were of the party, and they subjected their sister to an unceasing chorus of ' Don't you see this ? ' and ' Don't you see that ? ' and ''How stupid you are ! " until it became manifest to the elders that a state of things which at home had always been accepted as a matter of course was really a very serious evil. A distinguished man of science, who is short-sighted in a high degree, and who did not receive glasses until he was 19 or 20 years old, has often told me how much he had to do in order to place himself upon the same level, with regard to experience of quite common things, with many of his normal-sighted contemporaries ; and it will be manifest on reflection that the matters which are lost by the short-sighted, as by the partially deaf, make up a very large proportion of the pleasures of existence. I am accustomed on this ground to urge upon parents the necessity of correcting short-sight in their children ; and I am sure that a horizon limited to ten or even twenty inches, with no distinct perception of objects at a greater distance, has a marked tendency to produce habits of introspection and reverie, and of inattention to outward things, which may lay the foundation of grave defects of character. Landscape painters are the only persons to whom a small degree of myopia can be useful.

I once accompanied a landscape painter on a sketching expedition, and after a time asked him whether he intended to omit a certain house from his drawing. He looked up with surprise and said, ' What house ? there is no house there.' I at once understood a curious haziness of aspect with which it was his custom to clothe distant scenery in his pictures, and which was greatly admired by many persons who mistook it for a skillful rendering of an uncommon atmospheric effect ; in fact, it was only what the short-sighted man saw always before him ; and I am sure he must himself have been greatly puzzled by much of the praise which he received.

The short-sighted child has no curiosity to explore a world which he sees but dimly, and his habit is to curl himself up in a corner and to pore over books. He is absolutely disqualified by his defect from taking part in many games, such as cricket, football, lawn tennis and the like, since all of them require distinct vision of some distant object. The spectacles, therefore, assuming them to be necessary in order to give the vision which is needed, will enlarge the sphere of his activity rather than curtail it, and any consciousness of their presence soon wears off under the influence of daily use. The apparent danger to the eyes from them, in consequence of falls or blows, is much in exgess of the reality, especially if the frames are so constructed so as to afford the greatest stability of position. Many short-sighted men habitually hunt in spectacles, and take their share of falls with as little injury as their neighbors ; while among the spectacled officers of the German army, in the war with France, the number of instances in which any wound was inflicted or aggravated either by the glasses or the frames was exceedingly small. "

Even when provided with proper spectacles, short-sighted children manifest a disposition, from the force of habit, to bring their books close up to the eyes, or to put their eyes close to their work. It is, therefore, important to see that the child maintains an erect attitude, and does not droop the head, since this stooping keeps the eyes filled with blood and interferes with the breathing. The care of short-sighted children includes, therefore, such attention and supervision as will enable them to get the greatest possible benefit from the spectacles provided for them. It should Be observed that the books furnished the child are printed in large, clear type.

Another bad habit which is unconsciously practiced by shortsighted persons, is the custom of reading by a dim light, such as twilight or the light of a fire. They are especially prone to this habit because they are able to read by a fainter light than suffices for people with natural eyes. It is, therefore, desirable that such children should be prevented from practicing this habit, as they will otherwise almost certainly do.

One other point should be mentioned here, namely, the curious popular impression that it is much better to go without glasses as long as possible. Many people even take a considerable pride and satisfaction in avoiding the use of glasses. Such a belief may lead to the most disastrous results. In every case the use of glasses is an absolute essential when the degree of short-sightedness is so great as to cause the patient annoyance.

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