Stories From the Clinic

by Emily C. Lierman. Stories From the Clinic was first published in 1926.



CHAPTER VI


VARIOUS INTERRESTING CASES


FOREIGN BODIES


A WOMAN who could not speak a word of English tried very hard to tell me of her suffering. Her son, aged fourteen, was with her and he repeated to me in English what she told him in Greek. Twice she had had the muscles of her left eye cut in order to relieve her pain. She was discouraged, the boy said, because two operations had done her no good.


Dr. Bates examined her left eye very carefully and when he turned the upper eyelid inside out, he discovered two small eyelashes growing in. This had caused all her suffering, because every time she closed her eye the end of these eyelashes rubbed the cornea of her eye. Under the supervision of Dr. Bates, I promptly removed the two lashes with a pair of tweezers and immediately her trouble was over. I cannot describe my happiness when patients show their gratitude after their sufferings are relieved.


Dr. Bates told me that day about a patient who came to him who had been treated medically by other doctors for syphilis. When he did not respond to the treatment the medicine was changed. Then they gave him treatment for rheumatism. The pain still continued, so he called on Dr. Bates. The doctor examined his eyes and found a foreign body, a cinder, lodged in his cornea. This was removed and, for the first tune in weeks, the poor man was relieved entirely of pain. My experience in clinic work makes me believe that in some places charity patients are not always thoroughly examined.


OPERATIONS AT THE CLINIC


Many of our office patients have asked me if Dr. Bates approved of operations on the eye, or if he ever operates for cataract or other conditions. Others wish to know if there is a little Christian Science mixed with our method of treatment. I do not know anything about that, but I do know that Dr. Bates does operate on the eye when it is absolutely necessary.


I remember a dear old Italian woman, eighty-three years of age, whose daughter was just about to become a mother. The daughter had already made arrangements with the hospital upstairs and the newcomer was expected any day. The daughter was anxious that her mother should not suffer while she herself was away from home, so she appealed to Dr. Bates to operate on her mother. An operation was necessary, for the lower eyelid of her left eye was inflamed and swollen from an abscess of the left tear duct. For a long time the old lady had been coming faithfully to the clinic, but her condition gradually became worse, so that there was nothing else to do but to relieve her by an operation.


Of course such cases could have been sent to the hospital, but if it were at all possible to send the patient home after the operation, Dr. Bates would perform it himself, and so take away the fear and dread that some of these poor patients have of a strange doctor. This old Italian woman, who had the kindliest and sweetest expression of any woman I have known, smiled as though we were arranging a party for her. She did not seem to mind it in the least as we placed her on the operating table. Most patients sigh and show traces of fear, which is natural, for I dread operations myself, and I understand their feelings, but she looked at me with kind eyes and smiled. I returned that smile in full measure. She in turn glanced at her daughter, who stood on the opposite side of her, and as she smiled at me again she said something in Italian. Her daughter promptly translated what her mother said, and as I remember, these were the words: "She say, you nisa da lady, you bigga da heart. She lovva you, she no afraid." I pressed the mother's hand gently.


She had the same smile and the same loving words for Dr. Bates when he began to operate. Not once did I hear her moan. When she wished to be reassured, all she did was to press my hand. Such courage is indeed admirable. The operation was accomplished without pain under cocaine anesthesia, and the patient was able to walk home an hour after the operation without assistance. Two days later she again came to the clinic with her grandchild, a girl about ten years of age. She stood among the patients waiting for attention and when I asked her how she felt, she told her grandchild to explain that she had slept peacefully the night after the operation, better than she had for a long time. She had no more pain and the eye was almost healed. The grandchild informed me that upstairs was a new baby brother and that mother was doing fine. Grandma wanted me to know that she had placed a candle in church, which was blessed for Dr. Bates and me in appreciation of what we had done for her. Grandma soon got well and that was the last we saw of her.


Another day a young woman who was troubled with chalazion tumors was also operated on. I cannot say that she behaved as well during the operation as did the old Italian lady, but we had a lively time while the operation was going on. The poor thing was extremely nervous, but she tried hard not to show it. She suffered no pain, but talked a blue streak. She informed us that her husband was employed on a ship making regular trips back and forth to Panama, and that we were going to receive the most wonderful fruits that we had ever tasted in our lives. I believe that if this woman had owned the whole of Panama we might have had it,—so many different things were never promised to us by one single patient. Doctor and I were working fast all the while, but just the same I wanted to giggle. Then she asked me if the doctor wore Panama hats during the summer, but Dr. Bates himself got ahead of me and promptly answered; "Indeed, never in my life could I afford a Panama hat."


"Well," said she, "kindly tell me your head size and I will see that you get one." Then she asked me if I would like to have one also.


"Of course," I replied.


We were finally told that within two weeks or so we would be presented with our Panama hats. This operation was in the summer of 1921, and we are still waiting for our Panama hats. But I really feel that the poor woman had the best of intentions, and I hope that her husband is still making his regular trips to Panama.


Later a young man entered the clinic with a small baby in his arms. Anxiety and worry showed in his face and he looked as if he had not slept for a week. As the baby was crying continuously, Dr. Bates immediately stopped work with other patients to attend to the little one. The young father, with tears in his eyes, told the doctor that for five days and nights the baby never stopped crying. Its mother had taken the child to another clinic, where the doctor told her that the child had a cold in his eye, and that drops applied in the eye would soon cure it. As Dr. Bates placed the child on his lap, the father asked: "Please, doctor, don't tell me that the baby has a terrible disease of his eye, and that he might lose it; please tell me that you can help him."


I held the baby's head in my hands, and as the doctor carefully examined the eye he found a foreign body, a piece of steel, firmly embedded in the cornea. In less than five minutes it was out, and the baby stopped crying. As the father passed out the door, he said: "Thank you, doctor, from the bottom of my heart."


Dr. Bates turned to me, saying: "Did you hear that? That 'thank you came from the man's heart, and it is worth a great deal to me because he meant it."


AN ACCIDENT


A big negro, six feet tall, came into our room very quietly, and sat in a corner with his head down. Evidently he was trying to hide the right side of his face. When I came close to him, I found that he had a very good reason for doing so,—there was a big cut over his right eyebrow which had been stitched up by one of the house surgeons the night before. We have to meet all kinds of people, and all kinds of cases, and we must not be afraid. Knowing that this huge bulk of dark humanity had been in a fight, I was very cautious as I approached him, but was relieved to note real kindness shining out of his good eye as he looked at me. I said:


"Poor fellow! How did this happen?"


In a kindly but very unsteady voice, he answered: "Well, ma'am, don't you feel sorry for me, ah was in a fight. You see ah had too much hootch."


It was not necessary for him to tell me he had been drinking,—I could smell it. So could everybody else in the room. Never would I have had the courage to approach him anywhere else but in the clinic, that is certain. He would have scared me to death if I had chanced to meet him in the street, Dr. Bates looked at his bad eye, or, I should say the place where the eye ought to be, and after the man had palmed for a little while, the eyelid opened. Dr. Bates prescribed eye-drops and salve. The patient was a happy individual when he learned that his sight was not destroyed, and that the eye would soon be well again. As the man left the room, I tried to say something encouraging to him, and his answer was this:


"Now, ma'am, don't you worry 'bout me; you oughter see de other fellow; he's in de hospital; yes, ma'am."


IRITIS - Case No. 1


A young man complained of pain in his eyes and head, and sensitiveness to light. He told Dr. Bates that he had been to other clinics where they diagnosed his case as iritis. Getting no relief from eye drops which were prescribed, he came to us to see if we could help him.


Dr. Bates examined his eyes and agreed with the other doctors that the patient had iritis. Not knowing what the discussion was between this young man and Dr. Bates, I started to treat this case of iritis without realizing that the eye was diseased. I noticed, however, that the eyes were inflamed.


I placed the young man ten feet from the test card and asked him to read as much as he was able. He complained that the electric light near the test card caused a severe pain in his eyes. I placed him in the sun and used a sun glass. I flashed the strong rays on the white part of his eyes, after I had raised his upper eyelid and had him look down. Again I placed him ten feet from the test card, and this time he began to read the letters without complaining about the light. He finished reading the forty line, when he declared that the pain had returned.


I taught him how to palm and left him for half an hour. When I returned to him I was much surprised to find that the inflammation of his eyes had disappeared. His vision also improved to 10/10 with each eye separately. All this time Dr. Bates was busy with other patients and was paying no attention to the young man or me. I was very happy when the doctor told me what I had accomplished.


He said: "Did you know that this man had iritis?"


I replied, "No."


Then he proceeded to explain the customary experience with the treatment of iritis; namely, that these cases required usually three or more days before the pain in the eyes was relieved. In most cases it might require two weeks of treatment before the sight could become anything near normal. Always eye-drops were prescribed to be used frequently during the day, sometimes at night, in addition to general treatment which continued often for several years. To relieve a case of iritis in the short time of one hour was extraordinary—and this without local treatment or internal medicine.


"Never in my life," the doctor said, "have I seen such a bad case of iritis obtain perfect sight so quickly and acquire such relief in the condition of the eye."


IRITIS - Cases No. 2 and 3


Iritis is usually very painful, and causes a patient to feel much depressed. A matron of a Working Girls' Home telephoned me to ask if it were possible to treat a young girl under her care. This girl was Florence, who was not the type generally found at the clinic, hut as she was an orphan, we made an exception in her case and admitted her. Both her eyes were bloodshot, and she continually tried to shield them from the light. Even ordinary light was painful. The trouble began in her right eye, about a month before I saw her. Shortly afterwards, the left eye became inflamed. She was treated by a number of competent eye doctors, who said she had iritis. They gave her drops to put into her eyes, but the pain persisted. Later, one of these doctors advised her to have her teeth and tonsils examined, but instead of doing this, she came to me.


Dr. Bates examined her eyes with the opthalmoscope. Then he asked me to examine them also, and tell him what I saw. When I looked into the pupil of the right eye, I could see the whole area covered with small black spots. It resembled the top of a pepper box. Her left eye was also affected, but not so much as the right.


Her pain was so intense that I did not test her vision with the test card immediately. She was told to palm and remember something pleasant. While palming, she described to me how her room was arranged. She remembered the figured draperies on her windows, which matched those on her chairs and bed. She removed her hands and opened her eyes before I told her, but the pain had disappeared, and she wanted me to know it.


I then placed her in the sun, being sure that her eyes were closed. The strong light of the sun was focussed on her closed eyelids for a moment only. She drew away from the light quickly,—which is the usual thing for such patients to do. I encouraged her to let me try again. She closed her eyes and I led her into the sunlight once more. She liked the treatment.


Florence was advised to blink often, and to palm her eyes early every morning and during the day when possible. Six days later, I saw her again. The ophthalmoscope showed a decided improvement in the pupil of her right eye, there were only a few small spots in one side of it, and the left pupil was entirely clear. Florence stated that she had been working unusually hard, and also late at night. Therefore, she feared that the vision of her right eye would not be so good. She read 10/15 with the right eye on a strange card, but the letters were not clear. After she had rested her eyes by palming and practicing the sway, the letters cleared up, and she also read 10/10. Her left eye had normal vision. Then I gave her the sun treatment. The third time I saw her, which was also her last visit, both eyes had normal sight, and her pain had disappeared entirely.


Later we had another case of iritis, a woman much older than Florence. She was almost insane with pain in both her eyes. For an hour or more I could do nothing with her, because of her extreme nervousness. I placed the palm of my right hand over her closed eyes, as she leaned her head against me. Fortunately, she had her little girl, Betty, with her. While I palmed the poor mother's eyes, I held a conversation with Betty, solely for the benefit of her mother.


Mother love is one of the greatest things in the world. Betty was telling me how her mother had suffered all day long, and at night she had walked the floor because she could not sleep with the pain. As I held her close I could feel the mother relax. Then she began to talk about Betty's good qualities, and what a help she was. I placed the mother in the sun, still keeping the palm of my hand over her eyes. Then I held my sun-glass in a position so that the strong light of the sun would focus directly on her closed eyelids when I removed my hand. Knowing that the sunlight had been painful to her during her illness, I did not tell her what I was about to do. I planned to use the sun-glass very quickly, and not give her a chance to strain. I did this successfully, although I feared I would not, as some patients strain so in their agony of pain, that it is difficult to use the sun-glass for the first time. After the first treatment this patient enjoyed it.


The vision in both eyes was 10/40, but none of the letters was clear. After the use of the sun-glass, I encouraged her to palm while Betty and I started another conversation. The subject was all about her baby brother. Betty would exaggerate once in a while about some of the things brother did, then her mother would correct her, and explain things differently. This was just what I wanted. Anything but the memory of her pain and discomfort would be a help. When she left the clinic she was temporarily relieved of pain.


Betty was invited to come with her mother at her next treatment. An eye specialist was visiting us, and after his examination with the ophthalmoscope, he pronounced it a bad case of iritis. He was quite positive that the patient could not be cured in less than six weeks. My patient came every day for one week, and at the end of the second week she was entirely well. During the time that her pain was being relieved, her vision also improved. The only methods I used were sun treatment, palming, and perfect memory.


I did not realize how great a help Betty was during her mother's treatment, until after her mother was cured. When patients suffer intense pain, I seem to feel it, and unconsciously I lower my voice, and speak as softly as I can. I believe that we all respond to kindness, which we need most of all when we are ill. Betty repeated to her mother at home a great deal of what she heard me say at the clinic. She tried to use the same tone of voice, and smoothed her mother's throbbing forehead, even during the long nights when sleep was an impossibility. Truly, Betty was my assistant in the cure of her mother's eyes.


RETINITIS PIGMENTOSA - Case No. 1


When this case was brought to my attention, I knew very little about the disease of the eyes known as retinitis pigmentosa, except how to relieve it. I had been told that in this condition spots of black pigment are deposited in the retina, that parts of the retina are destroyed, and that the nerve of sight is diseased. Eye books which describe the disease say that it usually begins in childhood and progresses very slowly, until it ends in complete blindness. The field of vision is contracted, and, because they cannot see on either side of them, patients frequently stumble. In most cases the vision is worse at night than in the daytime. The books say further that no treatment is known which helps these cases. Nevertheless, Dr. Bates reported in the New York Medical Journal of February 3, 1917, a case of retinitis pigmentosa which had been materially benefited through treatment by relaxation. By the use of the same methods, I have been able to improve the sight in similar cases.


In October, 1917, Pauline, aged twelve, was under treatment for retinitis pigmentosa. At five feet from the card she could read only the seventy line, and her eyes vibrated continually from side to side, a condition known as nystagmus. She was very shy and extremely nervous, and appealed to me for glasses, so that she could see the blackboard. I have noticed that eye patients often suffer from extreme nervousness, but this poor child had the worst case of nerves I ever saw, and the slightest agitation affected her sight if, in asking her to read a line on the test card, I raised my voice and spoke rapidly, her face would flush, and she would say, "I cannot see anything now." But as soon as I lowered my voice and spoke gently her sight cleared up.


I told her to cover her eyes with the palms of her hands and remember the last letter she had seen on the card. This improved her sight so much that before she left the clinic that day she was able to see all of the fifty line at five feet. What thrilled me most of all was the fact that the dreadful movement of her eyes had stopped. Pauline came quite steadily to the clinic, and each time her vision improved. At last she was able to read the writing on the blackboard from her seat in the classroom.


Then I did not see her again for six months. When Pauline returned she told me that she had left school because she hated to study. She had also been ill during the summer. Her mother had taken her to a hospital for treatment. While there an eye specialist had looked at her eyes, and the inspection made her so nervous that they started to vibrate again from side to side. He said to her: "You ought to have your eyes treated; they are very bad."


"I am having them treated at the Harlem Hospital Clinic," she answered, "I know how to stop that vibration."


Then she palmed for a while and when she uncovered and opened her eyes, the doctor looked at them again.


"Why, they seem all right now," he said. "You had better go to that doctor until you are cured. He can do more for you than I can."


I was very much pleased to find that in spite of having stayed away so long Pauline had not forgotten what I had told her, and was able to stop her nystagmus. I tested her sight again and found that it was no worse than when I had last seen her. In fact, in some ways, it was better. She became a steady patient again and was anxious to have me help her more. I told her to palm as usual, and left her for a while. Later she read the thirty line at fifteen feet. When she looked first to the right of the card and then to the left, and noted that it appeared to move in a direction opposite to the movement of her eyes, she read two letters on the twenty line. At a later visit she read the whole of the twenty line at fifteen feet.


After a long absence Pauline again made her appearance, not for treatment, but to pay me a friendly visit.


Five years had passed since I first treated her, and it was a joy to learn that she had stayed cured. She waited until our patients had all gone and then she told me of her experiences. She is poor in mind as well as in purse and education, therefore we will excuse her for her diction:


"Gee, nurse," she said, "I'm awful glad to see you again. Gee, you don't look a day older. Don't yer ever get tired treatin' us poor people? I made a lot o' money this last year. Worked in a doll factory and made eighteen per with overtime. Yeah, I was engaged to be married, but I changed me mind and gave him back his ring. Oh, gee, you ought ter see the sparkler it was too! But I'm honest I am, so I didn't keep it. Ain't that the right thing to do?"


I said, "Surely."


"Me mother says if I ain't careful I'll be an old maid. My guy was a real estator too, he sells houses and lots. Well anyhow I lost him."


RETINITIS PIGMENTOSA - Case No. 2


The next patient I treated for this dreadful disease was an old man of seventy. When I first saw him he was standing with many others, waiting patiently for Dr. Bates to speak to him. Because of his unusual appearance, I at once singled this dear old man out from the crowd. Most men of his age who come to our clinic are unkempt, dirty, and ragged—pitiable objects generally. But this man was well groomed, his clothes, though worn and old, were welt brushed; his shoes were polished, his collar clean, his tie neatly adjusted. He had an abundance of snow-white hair, neatly parted and brushed, and his skin was like a baby's, pink and white.


I placed him five feet from the card, asking him to read what he could.


"I'm afraid I can't see so well, ma'am," he said; "My eyes bother me a good deal."


"I'll show you how to rest your eyes so that they won't bother you," I answered.


The best he could do at this distance was to read the fifty line. I told him to palm, and in a short time he saw a number of letters on the forty line. The next time he came I placed him ten feet from the card, and at this distance he read all the letters on the thirty line. He was so happy and excited over this that I too became excited. I forgot that I had other patients waiting for me and encouraged him to talk. I was glad afterward that I did so, for he had a wonderful story to tell.


"Do you know, ma'am," he said, "for two nights I palmed and rested my eyes for a long time before I went to bed,—and what do you think? I slept all the night through without waking up once. Now I think that's great, ma'am, because for years I have had insomnia. I would sleep only a little while; then t would get up and smoke my pipe to pass the time,"


At a later visit I placed him twelve feet from the card and at this distance he was still able to read the thirty line. When he understood how easy it was to improve his vision by palming, he was pleased and excited.


"You know I'm so much better," he said, "that I didn't even notice that I was further away from the card than usual. Thank you, ma'am. God bless you, ma'am."


During the practice, when he failed to see a letter at which I was pointing, I said: "Close your eyes and tell me the color of your grandchild's eyes."


"Blue, ma'am," he replied.


"Keep your eyes covered, keep remembering the color of baby's eyes."


He did this, and after a few minutes his sight cleared up and he saw the letter. After we had finished the practice I again encouraged him to talk, and he told me more about his insomnia.


"Do you know, ma'am," he said, "after I had had two nights' sleep without waking up, I didn't dare tell any of my family about it, for fear it wouldn't last and I would only disappoint them. So I waited. Now, do you know, ma'am, it is just two weeks that I have slept the night through without waking up once, and so I told my wife about it. She is so happy, ma'am, I just can't tell you, for it has been many years since I was able to get such rest."


I wish I could have had a picture of his face when he was telling me of the improvement in his eyesight and general health. It would have been a picture of gentleness, love, kindness and gratitude.


At another visit he looked up into my face and said: "I am seeing you better now, ma'am. You look younger." Dr. Bates heard this remark and laughed. In two months time this patient's vision improved from 10/200 to 12/30.


A CASE OF INTERSTITIAL KERATITIS


A school nurse who was puzzled about the condition of a child's eyes, feared that the little one would be hopelessly blind within a very short time. She brought her to the clinic.


After Dr. Bates had examined her he said her trouble was interstitial keratitis, caused by syphilis. Such cases do not recover usually without local application of atropine and general treatment. But the child received no local or other treatment while she was under my care.


At first I could not do anything with her. She would not look at the test card when I asked her, neither would she look at me, but I was not annoyed at her because I knew that the poor child was suffering. Speaking softly and kindly to her worked like a charm.


When she finally looked at the card she could see only the large letter on the top at ten feet, or 10/200. When I told her to keep her eyes closed for a little while, she obeyed. Resting them in this way helped. They became clearer and she read 10/70 with both eyes.


I told her again to close her eyes to prevent staring, and to remember the last letter she had read on the card. The last letter of the seventy line on the clinic test card was an E, and when she tried to remember the whole of the letter, she said that her eyes began to pain her. I told her to remember only one part of the B at a time. This she liked to do because it was easier than to remember all of the letter at once. I stood close to the test card, pointing to the letter below the E, and when I told her to open her eyes again she saw the letter instantly. This was the fifty line.


I was sorry that I had to send her home at that moment. I wished to treat her for at least a half hour longer, but others were waiting. She was advised to practice palming and resting her eyes regularly six times a day, and to return in two days for further treatment. Her first visit began two weeks before Christmas. Each time she was treated I mentioned the possibility of a gift for her if she would do her best in practicing at home.


Much to the surprise of Dr. Bates, she made rapid progress. He informed me that her case was so bad that he did not expect much improvement for a month or more. After two weeks' treatment she read 15/30 and her eyes looked much clearer. I noticed, also, that she no longer held her head down. Neither did she complain that the strong light hurt her eyes, Hi it did before her treatments began. It was not at all easy to treat this poor little girl because she sulked, and I had to spend at least five minutes every visit to encourage her, and make her understand that working with her eyes, while it was hard for her, was surely worth the trouble.


A doctor, who was a stranger both to Dr. Bates and to me, was in our room at the time, and he watched us closely as we encouraged and benefited each case. The only remark he made to me was: "Why don't you fit them with glasses and be done with it? In that way you can get rid of these poor individuals much more quickly. They don't pay anything, so why waste your time?" I was so upset when he said this that I lost my temper, but Dr. Bates rescued the visiting doctor and kindly ushered him out of the room.


ALBERT


Since we have had our private clinic, the charity patients come mostly from physicians. Others are sent by ministers of all denominations.


Albert, aged sixteen, was sent to us by a dentist's assistant who told me of his pitiable condition. His first visit was on December 6, 1924. Albert's sister, who is devoted to him, was present, being anxious to know if we could help him. When he appeared he was wearing a black patch over his left eye because the light troubled him and he suffered intense pain. With the test card the vision of his right eye was normal, or 10/10, but the left eye had only tight perception. This is a copy of his prescription for glasses, which he had worn for some time:


R + 0.50 D. C. 90
L + 2.00 D. C. 90


Dr. Bates examined him with the ophthalmoscope and found keratitis, or inflammation of the front of the eyeball of the left eye. The right eye was normal. While the examination was in progress, Albert's sister was weeping, though she tried unsuccessfully to conceal her tears. They had been to other doctors and were told that Albert would always have to wear glasses to save the right eye; that nothing more could be done for the left eye. The last oculist whom they consulted said that the left eye had cataract, and as there was no sight, it was useless to operate. What a shock it was to his family!


I placed Albert in the sun with closed eyes, raised the upper lid, and with the sun-glass I quickly focussed the strong light of the sun on the white part of the eye as he looked down. Immediately he called out to his sister: "I see the light. I can see a sort of web inside of my eye when the light is focussed on it." This made me very happy indeed. I knew then that Albert could be benefited. His sister was overcome. While the tears flowed down her cheeks she said: "If you can only save that eye, there is nothing in the world I would not do for him. Mother and I will take care of him. He need never work again. I can earn enough money for both of us and he can spend all his time taking care of his eye. He must not go blind." The girl was hysterical, of course, but she meant every word she said; she loved her brother. At her age other girls are usually planning a future for themselves, but she was willing to sacrifice herself so that her brother would not go blind. That is love indeed.


When we started treatment, Albert became enthusiastic and palmed his eyes for more than a half-hour. He was told to think of pleasant things while palming. Being a perfectly normal boy, he could easily think of such sports as baseball and other outdoor games. He liked to think of the movies and imagine scenes from the picture called "The Covered Wagon."


One could hear a pin drop when Albert first looked at the test card with his left eye, still keeping the right one covered. The test card was placed ten feet from his eyes, and, while swinging his body from side to side, he flashed the large C on the top of the card. I was careful not to have him strain to see more, so he was told to sit comfortably and palm again.


He was with me over two hours that day and I improved his left eye to 10/100 by alternately palming, swinging, and blinking. When we first removed the black patch, the sclera or white part of his left eye was bloodshot. It looked very much as though blood was ready to pour from it at any moment. When it was first exposed to the light a considerable watering of the eye resulted, which was stopped instantly by the sun treatment.


Before Albert left us after his first visit, Dr. Bates asked me if I had time to treat him every day, saying that Albert's trouble was so serious that only by frequent treatment could he be cured. I was glad to give the time for which I have been well repaid. Our dear boy is almost cured. Every night I prayed earnestly for Albert and I know that without God's help I could not have accomplished what I did. Albert believes that, too.


Every day of sunshine he improved a little with the test card. On January 17, 1925, all the redness of the sclera had entirely disappeared. Then his visits became less frequent. I told him to come once a week instead of daily. But Albert practiced at home every day for hours at a time. The condition of his eye improved steadily and by the end of February, 1925, the vision of the left eye was almost normal.


I am proud of Albert for another reason. He would not allow his sister to support him. He asked me if shoveling snow would make his eye worse again, I said no, as shoveling snow would be practicing the swing, and the exercise would be a benefit.


Then he said, "Please pray for snow. I want to work." Again our prayers were answered. That very night we had a big snow storm, and when Albert came the next day, he told me:


"I stood in line with my shovel and stretched myself as much as possible to look big. I got a job all right, and I will earn $5.00 a day while the snow lasts." We had one snow storm after another and Albert had plenty of work to do.


Albert's case was most remarkable because he did not at any time suffer a relapse. I believe, also, that the sun was the main factor in the relief of his trouble. I cannot understand why so many eye specialists shield the eyes of a patient from the sun. Bandaging them not only frightens the patient, but makes him very uncomfortable. It is true that some patients demur when they first learn that they are to be treated with a sun-glass, but as soon as the light is thrown on the closed eyelids, they relax and smite and ask for more. The sun is our greatest blessing.


ATROPHY OF THE OPTIC NERVE - Case No. 1


In the year 1892 a patient came to the New York Eye Infirmary with well-marked atrophy of the optic nerve. According to all that we know of the laws of pathology, he should have been totally blind,—yet his vision was normal. The case was considered so remarkable that it was exhibited before a number of medical societies, but it was by no means an isolated one. On February 8, 1917, Dr. Bates published in the "New York Medical Journal," under the title, "Blindness Relieved by a New Method of Treatment," [link] a report of a case in which the vision was improved from perception of light to normal. He has had quite a number of such cases.


In 1914 a colored woman was led into the clinic by a friend. She had heard of Dr. Bates, and had come to him in the hope that he might be able to restore her sight. The doctor examined her eyes, and found that she had atrophy of the optic nerve, complicated with other troubles. She could not count her fingers, nor had she any perception of light whatever. The doctor turned her over to me, saying:


"Help her, will you?"


She was the real "mammy" type of negress, very good-natured and motherly. She greeted me with a smile and said:


"May de good Lor' bless you, ma'am, ef you can gib me again de light ob day."


The words came from an humble heart, and her voice sounded hopeful. When I heard her speak I lost some of my Courage. Perhaps I should not be able to do anything for her, and I dreaded to disappoint her. My work is not always easy; yet I like difficult cases to come my way, because when I can help them I feel that I have done something worth while.


"Won't you tell me how long you have been blind?" I asked.


"Yes, ma'am," she replied. "Ah hasn't seed nothin' for two years. Ah has been in de hospital all dat time an' de doctors say dat mebbe ah nebber sees again. Some friend ob mine says to me, 'You jes goes to de Harlem Hospital Clinic. Dere you find de doctor what makes you tee.' So ah jes come; dat't all."


I told her to cover her eyes with the palms of her hands and asked if she could remember anything black. She replied:


"Yes, ma'am, Ah 'member stove polish black, all right."


"That's fine," I said. "Now keep remembering the black stove polish, and that will stop the strain in your eyes. When your eyes first began to trouble you, you strained to see, and every time you did that, your eyes became worse. Now let us see what will happen when you stop the strain."


I had stood her against the wall to make things easier for her, for we only had a few chairs at the clinic. I left her to treat other patients, telling her not to open her eyes, nor to remove her palms from them, not even for a moment. Presently I became aware of a strange sound, a sort of mumbling. I was greatly puzzled, but as I approached my blind patient, I discovered where the sound came from. She was saying in a low tone, "Black polish, black polish," just as fast as she could. I held a test card covered with E's of various sizes, turned in different directions, a foot away from her eyes, and told her to take her hands down and look at it. The doctor, the other patients, and myself were quite scared at the outburst that followed.


"Ma'am, dat's a E; dat's a sure-enough E. Ah is sure dat's a black E on some white paper."


This was a large letter on the first line, read by the normal eye at two hundred feet.


But the next moment it faded from her eyes. That was my fault. I was not quick enough. What I should have done was to have her close her eyes and palm again, the moment she saw the E. But I was greatly encouraged, not only because the patient had had a flash of vision, but because Dr. Bates had said he was lure I would help her to see again. I again told her to palm and remember black, and when, in a few moments, I asked her to take down her hands and look at the card she saw the E, blacker than the first time. I then told her to close her eyes for a minute and open them for just a second, alternately, while remembering the stove polish continuously. She did this for a while, and was able to see the E each time she opened her eyes.


"Now," I said, as I raised my hand and held it one foot from her eyes, "how many fingers can you see?"


"Three," she replied, which was correct.


I told her to rest her eyes by palming many times a day at home, and to come and see me three times a week. I also gave her some advice about her diet.


The next clinic day she saw the seventy line of letters at one foot, and they did not fade away as did the E the first time she saw it. I told her to palm again, and in a few minutes she counted my fingers correctly every time I asked her to, with only one exception.


"If dis here seein' keeps up, ma'am." she remarked, "Ah sure will be able to earn mah livin' again. De Lor' bless you, ma'am."


She continued to come and made slow but sure progress. Then came a time when she stayed away for several months. As I was very anxious to cure her, I worried about her considerably. Then one day she turned up again, apparently very much frightened about something, though her eyes looked better. I was glad to see her. She was very much upset, so I refrained from scolding her, and in the course of time I learned the reason for her absence. She had been under treatment for some other troubles, and some doctor or nurse had scared her into discontinuing her visits to our clinic. She had, however, continued to palm several hours a day with most gratifying results.


"Do you know, ma'am," she said, "Ah can see ebery house number as Ah goes visitin', and Ah goes out to a day's work once in a while."


She came regularly and her improvement continued. Sometimes I would find that she did not see so well as at her previous visit, but immediate improvement always followed palming. Her gratitude was pathetic, and every little while she would bring a package saying:


"Dis here is fo' you, ma'am. You sabe me from blindness. Yes, you did; an' Ah is mighty grateful."


The packages contained gifts of various kinds—a cocoanut from the West Indies, grapefruit and cucumbers, a necklace made of tropical beans of various colors.


A short time later she washed a full set of Dresden china for her employer, without breaking a single piece, and earned four dollars and ten cents for her day's work.


Mammy had considerable trouble in keeping her eyes open while in the sun. With Dr. Bates' permission I gave her the sun treatment with the sun-glass, which always improved her vision, both near and distant. She began to see busses and automobiles a city block away, and then one day she told me the most marvelous thing that had ever happened to her.


"One day Ah was on de roof ob our house, an as Ah was bathin' mah eyes wid de warm sunlight wid mah eyes closed, Ah suddently opened mah eyes and dere, way up in de heabens, Ah sees a big white cloud, and de blue sky, and good Lor'! Ah calls mah frien' an shows it to her, an' she says Ah was correct sure nuf. Ah was thinking ob you ma'am, and de good Dr. Bates, an' Ah says, Lor' bless 'em."


The swing also helped in the improvement of her vision. She would stand twenty feet from the card and sway her body as far as possible alternately to the right and left. She could imagine objects in front of her moving from side to side, with great speed. Then she would shorten the swing until she imagined the card moving less than one inch from side to side. Her vision improved in flashes to 20/30 minus, and it is still improving. The long swing alternating with the palming is slowly but surely bringing about a cure. For the first time in many years, she is able to read, without glasses, the larger print of the newspaper.


Dr. Bates was very much interested in her improvement. He examined her optic nerves with the ophthalmoscope, and found that the circulation was returning, and that the optic nerves were becoming pink as they are in the normal eye.


ATROPHY OF THE OPTIC NERVE - Case No. 2


While it is true that one sees at the hospital a great deal of suffering, sorrow, and poverty, it is a pleasure to be able to relieve some of the suffering. For instance, the case of a blind negro, which really ought to have been sad, turned out, instead, to be very amusing. In spite of his affliction, the patient seemed to be in a happy mood and well pleased with himself. He was neatly dressed and his shoes, though shabby, were carefully shined, and over them he wore spats. His cravat was a brilliant red and his hat a light shade of tan. A cane, which his blindness compelled him to carry, completed a costume which I am sure he considered to be that of a "swell" gentleman. When I approached him, he said in a gracious manner: "Glad to see you, ma'am. Glad to see you."


And yet he could not see me, as I soon found out. I held my fingers before his eyes and asked him if he could see them. He answered no. Further tests showed that he had no light perception whatever, and after an examination Dr. Bates said that his condition was due to atrophy, of the optic nerve. I showed him how to palm, and in a little while he pointed to an electric light in the ceiling, and said: "It looks light there."


At once I told him to palm again, and when he opened his eyes he saw the shadow of my fingers moving from side to side before his face. He did not laugh, but giggled, rather, just like a girl. In a few moments, however, the blindness returned. Again I told him to palm and while he was doing so I asked him if he could remember a black object, or something else that he had seen before he became blind, such as a beautiful sunset, or a white cloud in a blue sky. He thought a while, and then remembered that in the days when he had been a house painter he had used black paint. I told him to remember the black paint while he was palming, and then I left him to attend to other patients. When I came back to him, I held two of my fingers close to his face and asked if he could see them.


"Ma'am," he said, "I'm not at all sure, but I think I see two fingers."


The man must have been popular with the ladies, for he then remarked that one of his "lady friends" would be pleased if he became able to see her. He attended quite regularly for a time, and I noticed an increasing improvement in his vision. Sometimes this was not very marked, and then I knew that he had not been palming or resting his eyes sufficiently at home. He was greatly helped by the focusing of the sun's rays upon the white of his eyes with a sun-glass, a treatment that had a soothing effect. Soon he was able to dispense with his guide, and, when leaving the clinic, used his cane to avoid collisions with benches, nurses and patients.


One day as he was leaving the room, Dr. Bates called my attention to him, and I noted that instead of tapping with his cane upon the floor, he was carrying it on his arm. With head erect he walked down the long corridor, opened the door, and left the hospital, as easily as a person with perfect sight. A little later he came without the cane. On his last visit he read the fifty line at ten feet with each eye. One day as Dr. Bates and I were walking toward the Harlem Hospital, we saw this colored dandy walking with his "lady friend" as though he owned the earth. He was all dressed up in a black and white checked suit, with a red necktie and spats, and a "sparkler" on his little finger. His eyes were fairly rolling in his head as he strutted along.


Dr. Bates looked on and in his quiet, humorous way said to me, "Such dignity I long to possess!"


ABSOLUTE GLAUCOMA


In absolute glaucoma there is no perception of light, a condition considered to be incurable. It may or may not be accompanied by pain, and in the former case the only remedy previous to Dr. Bates' discovery, was enucleation, or removal of the eyeball. So far as Dr. Bates is aware, there is no case of absolute glaucoma on record in which any measure of sight has been restored by any method except the one described below.


The patient was a woman, aged seventy-nine. At first glance one could see that she was refined and of a gentle nature. I guessed that at one time she had been a woman of means. As she stood apart from the rest of the patients waiting to be attended, she took not the slightest notice of what was going on around her, and occasionally I heard her moan.


When Dr. Bates was able to examine her eyes, he found that she had glaucoma in both eyes, and that the right eye was blind, without even light perception. The vision of her left eye was 10/70. He asked me to do what I could to help her and stop her pain. Placing a stool before a table upon which she could rest her elbows, I showed her how to palm, which she did very readily. In just a few minutes the pain ceased and the eyeballs became soft. I told her to remove her hands from her eyes, but she still kept her eyes shut. I thought this was because I had not told her to open them, but when I said she might do so, she asked:


Are you sure the pain will not come back if I open them? For many days and nights I suffered such constant pain that I could not sleep. Now I feel such a sense of 'relief that I would really like to keep my eyes closed."


"I don't think the pain will come back right now," I said, "and if it does you can palm again."


I held a test card about two feet front her eyes, and told her to cover her left eye, and look at the card with the right. That day, we had several visiting doctors whom Dr. Bates had told about this case of absolute glaucoma. These doctors also examined her eyes and said the diagnosis was surely correct. They were all standing by with Dr. Bates when I asked the patient to look at the card, and the excitement was intense when she stated that she saw the large letter at the top of the card.


"Oh, Doctor," I said, "she sees it."


"Yes, I see it, I really see it!" added the patient, scarcely able to credit her senses.


It has long been the belief of eye doctors that glaucoma with blindness cannot be either improved or cured. It should be emphasized that this patient offered good evidence that glaucoma with blindness is not hopeless, and that it can be benefited or cured.


After a little more treatment I told her that she must keep her eyes shut as much as possible when she was at home, and to palm many times every day. I also told her never to look at any point or object more than a fraction of a second at a time and to keep constantly shifting. She went away pleased and grateful, for the pain had not returned.


The next time she came. Dr. Bates treated her and was able to improve the vision of the right eye to 10/200, while that of the left eye improved to 10/40. The third time the came she was treated by me. She was very happy and wanted to talk, which I encouraged her to do. She said she was living in a small furnished room and that I had no idea how worried she had been about going blind, because she had no one to look after her.


"But now," she added, "I have all sorts of hopes for the relief of my trouble, because you and Dr. Bates have done so much for me. Palming helps me so that I am now able to sleep at night. I like to do it for hours at a time, because it takes the terrible pain away."


She came regularly for six months and her improved vision wit most encouraging. We continually reminded her to use her imagination to improve her sight and relieve the pain. Most of the clinic patients become confused when I ask them to do this, but this dear old lady did not find it a bit difficult. I told her to palm, and then imagine a florist's window filled with flowers. Next I told her to imagine that she had entered the shop and was observing the flowers, and I called to her mind the red rose and the white rose, the carnation, the violet, and other blossoms. Then I asked her if she could imagine the green fields in the country where the daisies grow, and she said: "Yes, and I can imagine that I am picking the daisies too."


Then I told her to remove her hands from her eyes. I was overjoyed when she saw a T on the thirty line at ten feet. The patient herself laughed out loud and cried: "I cannot believe it."


She was steadily improving, so I was not prepared to find her one day looking very much depressed. The trouble was that she had had a visitor who talked to her—or at her, I should say—for two long hours; this had upset her nerves so that the pain had returned, and her vision had been lowered. I pictured to myself what it must mean to listen to a steady stream of gossip for two hours, and my sight at once became imperfect. I told her what a dangerous thing it was for her to allow herself to be tortured in this way, and said that if her friends insisted upon talking to her for such a length of time, she must keep her eyes closed as much as possible. Otherwise the strain would cause her to go blind.


For a time she got along nicely. Then I left the city for a much needed vacation, and while I was away I received word that she was getting worse. For her sake I came back to town immediately and, as she was not able to come to the clinic, I called upon her.


"Oh, nurse," she said, as soon as she saw me, "my right eye pains me so that I think of nothing but death."


Her thin face was lined with pain, and I could see that she was in agony. I began to talk to her about the days when she did not suffer and how she had stopped the pain by remembering the daisies. She began to palm without my telling her to, and became able to imagine a daisy waving in the breeze. I asked her to imagine that her body was swinging with the flower. She did this, and within a few minutes her pain left her and she smiled.


"Now, isn't it strange," she remarked, "but I forgot all about using my imagination."


She said that I had worked a miracle; but I explained that when she used her imagination she had to relax enough to relieve the strain in her eyes, and then the pain stopped.


We often hear the remark: "This person makes me sick," or "That person makes me nervous," but it remained for my glaucoma patient to make me realise that these observations are literal statements of fact. All about the walls of her little room, which was very clean and sunshiny, were photographs of her children and their families. With a great deal of pride she named each one in turn, but when she came to the picture of a man and woman, hanging a little apart from the rest, her tone changed.


"This is my daughter," she said of the woman, and I could see that she was very fond of her, but when she pointed to the man she said: "I cannot bear him. He makes me nervous and sick, because he is not a good man."


She began to strain at once, and had to do some palming to relieve her pain. Evidently it is important, if we want to avoid eyestrain, that we should keep away from the people we dislike, and think of them as little, as possible.


She became able to visit the clinic again, and her vision improved to 10/20 with the right eye and 10/10 with the left in five months' time. I never mentioned pain to her, and she never spoke of having any more pain. When her daughter called one day to say that her mother was leaving for the country, I felt that something worth while had been accomplished.


OPACITY OF THE CORNEA


Myopic and far-sighted patients are numerous, and I always feel confident that in a short time I can improve their sight. I suffered a case of cold feet, however, when Dr. Bates placed in my care a young colored woman, aged twenty-seven. She had a scar oh her right eye almost in the center of the sight. All the doctor said to me was, "Help this patient, please." It was my first experience with a case of this kind. I asked the girl how long the scar had been there and also what caused it. Being a Southern darky, she spoke with an accent, and this is the way she answered me:


"When Ah was twelve years old, mah granmah was settin' bah de fireplace a-smokin' a pot pipe an', as Ah was removin' a boilin' kettle ob water, ole granny upsets de pipe ob hot ashes an done burned mah eye. Lordy, ma'am! Ah thought mah eye was burned from de socket. De doctors says Ah would neber see again out ob dat eye."


I tested her sight, and with her left eye she read 15/40, while with her right eye she could barely see my fingers one foot away. I had not the slightest idea that I could improve the right eye at all. However, I told her to stand in a comfortable position and palm for a least a half hour. Then she was told to keep her right eye covered and read the test card with her left eye. The left eye improved to 15/15. With her right eye she was able to distinguish 'the 200 line letter at the same distance. Dr. Bates was amazed. He said that, although he had seen opacities of the cornea resulting from constitutional disease clear up, he had never before, in his thirty-odd years of experience, seen any improvement in an opacity resulting from an injury, even after years of treatment. This encouraged me so much that I told the patient to palm again, and before she left the clinic that day her right eye had improved to 15/70. She became hysterical when she found that she could see objects again with her right eye. For a while she came quite regularly to the clinic, and at her last visit her right eye improved to 15/50, while with the left she became able to read 15/10. Dr. Bates declared it was a miracle.


HOW PATIENTS BENEFIT OTHERS


Many reports have been received from those students of Dr. Bates who are conducting clinics. It is encouraging to know that this work is spreading rapidly. Clinics are being formed not only in America, but in Europe as well, and our representatives deserve the highest praise for their faithful work. A number of patients have taken a course from Dr. Bates, or myself, so they could teach others how to obtain normal vision. Mothers find it a great help to study the Bates Method. Some of them bring one of their children for treatment, and when they see the child obtain normal sight, they become eager to learn how to cure other members of their family. In this way the work has spread. If we could have a Bates Clinic in every town and city, people would be very much benefited.


There are many patients in the West, who are treating the poor without any compensation whatever. They may not have regular clinics, but it is clinic work just the same. We have over fifty patients in Cleveland, Ohio, and some of them are helping the poor there. A teacher in one of the public schools has cured many of her little charges who had defective sight. In her reports to Dr. Bates, she mentioned several eases of defective minds that she had benefited by palming, blinking and swinging. After a number of her pupils were relieved of mind strain, they were placed in regular classes.


This teacher had to be careful not to offend the authorities nor to mention that she was using any system or method. She had the pupils practice for a few minutes every day in her class-room. She could appreciate eye education and common sense, because she was a cured patient.


A few grateful patients, well-known women of Cleveland, go about from place to place, helping unfortunate people who have imperfect sight. While I was visiting at the home of Mrs. H. D. Messick, I discovered that she was conducting regular clinic sessions in her home every week. Although she is a busy woman, she gives part of her time to treating patients who cannot come to Dr. Bates. She has done remarkably well with many difficult cases, some of which I would like to report:


A little girl, nine years old, had convergent squint of her left eye. Very little of the iris was visible when I first met her. I was surprised when I saw her again, about six months later. The left eye was almost as straight as the right, and with Mrs. Messick's help, her vision had improved to 10/10 at times.


A woman, with atrophy of the optic nerve of the right eye, and myopia in the left, was first examined by me in December, 1924. Her face was lined with pain, and she seemed to have no desire to smile. The right eye was nearly blind, and she could not see letters of the test card at any distance with that eye. Her vision was about 10/50 with the left eye.


She was directed to palm for about five minutes or longer, and then stand and swing her body from side to side, with a slow, easy sway. The vision of her left eye improved to 10/30, and she flashed the large C of the test card .with her right eye. She was advised not to wear her glasses again, and to practice regularly every day. Mrs. Messlck's efforts in helping this woman were certainly not in vain.


The last report I received was most encouraging, and ought to be so to any patient afflicted as this woman was. The vision of her right eye was 8/40, and the left eye was, I believe, normal at the time of her writing. However, she could read quite a little with comfort, and did not complain of pain any more. Her facial expression changed for the better, and she was very grateful for what had been accomplished.


Another case that I started about the same time, was that of a fifteen-year-old boy, who was wearing glasses for myopia. His left eye was almost blind, and the vision of the right was 10/30. I taught him to palm and swing, and in less than half an hour his vision in the right eye became normal, or 10/10. When he covered his right eye, the vision of his left began to improve for the large letters of the card, although they were not clear or distinct. I told him that if he wished to be cored, he would have to practice faithfully every day, as he was directed. He promised to do his part. I just gave him a start, but it was Mrs. Messick who cured him.


I visited him some months later, and found his vision normal when he read the test card with each eye separately. He saw as well with the left eye as he did with the right. He displayed some marvelous drawings of ships, which were done after he was cured. The letter I afterwards received from him is printed below:


August 26, 1925.     


My dear Mrs. Lierman:


I am so grateful to you and Mrs. Messick for having helped me to follow Dr. Bates' method, that I am writing to tell of my experience with my eyes.


About December, 1924, we were examined by the school doctor. He told me my left eye was nearly blind.


Mother immediately took me to a well-known oculist in Cleveland, and after several visits to his office, he prescribed glasses for me, to be worn always. A week had passed when I met you at Mrs. Messick's. You told me to discard my glasses and practice palming and swinging, which I gladly did.


Some of the teachers knowing I had worn glasses and seeing that I didn't after I had met you, tried to persuade me to wear them; but I wouldn't, when I noticed how my eyesight was improving.


After seeing Mrs. Messick once a week, and practicing regularly at home five minutes in the morning and five in the evening, my left eye gradually improved to normal.


With deep gratitude for being spared the great annoyance of wearing glasses, I am


Yours sincerely,          
Mac.     


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