When conditions are favourable, sick organisms tend to recover through their own inherent powers of self-healing. If they do not recover, it means either that the case is hopeless, or that the conditions are not favourable — in other words, that the medical treatment being applied is failing to achieve what an adequate treatment ought to achieve.
ORDINARY TREATMENT OF DEFECTIVE SIGHT
In the light of these general principles let us consider the current medical treatment of defects of vision. In the great majority of cases the only treatment consists in fitting the patient with artificial lenses, designed to correct the particular error of refraction which is held to be responsible for the defect. Medicus curat; and in most cases the patient is rewarded by an immediate improvement in vision. But in the meanwhile, what about Nature and her healing process? Do glasses eliminate the causes of defective vision? Do the organs of sight tend to revert to normal functioning as the result of the treatment with artificial lenses? The answer to these questions is, No. Artificial lenses neutralize the symptoms, but do not get rid of the causes of defective vision. And so far from improving, eyes fitted with these devices tend to grow progressively weaker and to require progressively stronger lenses for the correction of their symptoms. In a word, medicus curat, natura NON sanat. From this we can draw one of two conclusions: either defects in the organs of seeing are incurable, and can only be palliated by mechanical neutralization of symptoms; or else something is radically wrong with the current methods of treatment.
Orthodox opinion accepts the first and more pessimistic alternatives, and insists that the mechanical palliation of symptoms is the only kind of treatment to which defective organs of vision will respond. (I am leaving out of account all cases of more or less acute disease of the eyes, which are treated by surgery and medication, and confining myself to those much more commonplace visual defects now treated by means of lenses.)
CURE OR PALLIATION OF SYMPTOMS?
If orthodox opinion is right — if the organs of vision are incapable of curing themselves, and if their defects can only be palliated by mechanical devices — then the eyes must be totally different in kind from other parts of the body. Given favourable conditions, all other organs tend to free themselves from their defects. Not so the eyes. When they show symptoms of weakness, it is foolish, according to orthodox theory, to make any serious effort to get rid of the causes of those symptoms; it is a waste of time even to try to discover a treatment which will assist nature in accomplishing its normal task of healing. Defective eyes are, ex hypothesi, practically incurable; they lack the vis medicatrix naturae. The only thing that ophthalmological science can do for them is to provide them with the purely mechanical means for neutralizing their symptoms. The only qualifications to this strange theory come from those who have made it their business to look into external conditions of seeing. Here, for example, are some relevant remarks taken from the book Seeing and Human Welfare by Dr. Matthew Luckiesh, Director of the General Electric Company’s Lighting Research Laboratory. Eye-glasses (those ‘valuable crutches,’ as Dr. Luckiesh calls them) ‘counteract effects of heredity, age, and abuse; they do not deal with causes.’
‘Suppose that crippled eyes could be transformed into crippled legs. What a heart-rending parade we would witness on a busy street! Nearly every other person would go limping by. Many would be on crutches and some on wheel chairs. How many of these defects of the eye are due to poor conditions for seeing, that is, to indifference towards seeing? Statistics are not available, but a knowledge of seeing and its requirements indicates that most of them are preventable and most of the remainder can be improved or arrested by adequate and proper conditions.’ And again, ‘even the refractive defects and other abnormalities of eyes induced by abuses are not necessarily permanent. When we become ill, Nature does her part, if we do ours, towards getting well. Eyes have various recuperative powers, at least to some degree. Reducing their abuse by improving seeing conditions is always helpful, and there are many cases on record where great improvement has followed on this procedure. Indeed, without correction of the abuse, the disorder generally becomes progressively worse.’ These are encouraging words that leave us with the hope that we are to be given a description of some new and genuinely aetiological treatment of visual defects, to take the place of the purely symptomatic treatment at present in vogue. But this hope is only imperfectly fulfilled. ‘Poor lighting,’ Dr. Luckiesh goes on, ’is the most important and universal cause of eye-strain, often leading to progressive defects and disorders.’ His whole book is an elaboration of this theme. Let me hasten to add that, within its limitations, it is an admirable book. To those suffering from defects of vision the importance of good lighting is very great indeed; and one can only be grateful to Dr. Luckiesh for his scientific clarification of the meaning ‘good lighting’ in terms of standard, measurable entities such as foot-candles. One’s only complaint is that foot-candles are not enough. In treating other parts of the organism doctors are not content to ameliorate merely the external conditions of functioning; they also seek to improve the internal conditions, to work directly on the physiological environment of the sick organ as well as on the physical environment outside the body. Thus when legs are crippled, doctors refuse to let their patients rely indefinitely on crutches. Nor do they consider that the laying down of rules for avoiding accidents constitutes sufficient treatment for the condition of being crippled. On the contrary, they regard the use of crutches as merely a palliative and temporary expedient, and while paying attention to external conditions, they also do their best to improve the internal conditions of the defective part, so that nature may be helped to do its work of healing. Some of these measures, such as rest, massage, applications of heat and light, make no appeal to the patient’s mind, but are aimed directly at the affected organs, their purpose being to relax, to increase circulation and to preserve mobility. Other measures are educational and involve, on the patient’s part, a co-ordination of mind and body. By means of this appeal to the psychological factor astonishing results are often obtained. A good teacher, using the right technique, can often educate a victim of accident or paralysis into gradual recovery of his lost functions, and through that recovery of function, into the re-establishment of the health and integrity of the defective organ. If such things can be done for crippled legs, why should it not be possible to do something analogous for defective eyes? To this question the orthodox theory provides no answer — merely takes it for granted that the defective eye is incurable and cannot, in spite of its peculiarly intimate relationship with the psyche, be re-educated towards normality by any process of mind-body co-ordination.
The orthodox theory is, on the face of it, so implausible, so intrinsically unlikely to be true, that one can only be astonished that it should be so generally and so unquestioningly accepted. Nevertheless, such is the force of habit and authority that we all do accept it. At the present time it is rejected only by those who have personal reasons for knowing it to be untrue. I myself happen to be one of these. By the greatest of good fortune I was given the opportunity to discover by personal experience that eyes do not lack the vis medicatrix naturae, that the palliation of symptoms is not the only treatment for defective vision, that the function of sight can be re-educated towards normality by appropriate body-mind co-ordination, and finally that the improvement in functioning is accompanied by an improvement in the condition of the damaged organ. This personal experience has been confirmed by my observation of many others who have gone through the same process of visual education. It is therefore no longer possible for me to accept the currently orthodox theory, with its hopelessly pessimistic practical corollaries.
CHAPTER II
A Method of Visual Re-Education
IN THE EARLY years of the present century Dr. W. H. Bates, a New York oculist, became dissatisfied with the ordinary symptomatic treatment of eyes. Seeking a substitute for artificial lenses, he set himself to discover if there was any way of re-e
ducating defective vision into a condition of normality.
As the result of his work with a large number of patients he came to the conclusion that the great majority of visual defects were functional and due to faulty habits of use. These faulty habits of use were invariably related, he found, to a condition of strain and tension. As was to be expected from the unitary nature of the human organism, the strain affected both the body and the mind.
Dr. Bates discovered that, by means of appropriate techniques, this condition of strain could be relieved. When it had been relieved — when patients had learnt to use their eyes and mind in a relaxed way — vision was improved and refractive errors tended to correct themselves. Practice in the educational techniques served to build up good seeing habits in place of the faulty habits responsible for defective vision, and in many cases function came to be completely and permanently normalized.
Now, it is a well-established physiological principle that improved functioning always tends to result in an improvement in the organic condition of the tissues involved. The eye, Dr. Bates discovered, was no exception to this general rule. When the patient learnt to relax his tenseness and acquired proper seeing-habits, the vis medicatrix naturae was given a chance to operate — with the result that, in many cases, the improvement of functioning was followed by a complete restoration of the health and organic integrity of the diseased eye.
Dr. Bates died in 1931, and up to the time of his death he continued to perfect and develop his methods for the improvement of visual function. Furthermore, during the last years of Dr. Bates’s life and since his death, his pupils, in various parts of the world, have devised a number of valuable new applications of the general principles which he laid down. By means of these techniques large numbers of men, women and children, suffering from visual defects of every kind, have been successfully re-educated into normality or towards normality. For anyone who has studied a selection of these cases, or who has himself undergone the process of visual re-education, it is impossible to doubt that here at last is a method of treating imperfect sight which is not merely symptomatic, but genuinely aetiological — a method which does not confine itself to the mechanical neutralization of defects but aims at the removal of their physiological and psychological causes. And yet, in spite of the long period during which it has been known, in spite of the quality and quantity of the results obtained through its employment by competent instructors, Dr. Bates’s technique still remains unrecognized by the medical and optometrical professions. It is, I think, worth while, before going any further, to enumerate and discuss the principal reasons for this, to my mind, deplorable state of things.
REASONS FOR ORTHODOX DISAPPROVAL
In the first place, the very fact that the method is unrecognized and lies outside the pale of orthodoxy is a sufficient invitation to the petty adventurers and charlatans who hang upon the skirts of society, ever ready and eager to take advantage of human suffering. There exist, scattered about the world, some scores or perhaps hundreds of well-trained and thoroughly conscientious teachers of Dr. Bates’s method. But there are also, unfortunately, a number of ignorant and unscrupulous quacks, who know little more of the system than its name. The fact is deplorable, but not at all surprising. The number of those who fail to obtain relief from the current symptomatic treatment of visual defect is considerable, and the Bates Method has a high reputation for effectiveness in such cases. Moreover, the technique is unorthodox; therefore no standards of competence are legally imposed upon its teachers. A large potential clientele, a desperate need of help, and no questions asked as to knowledge, character and ability! These are the ideal conditions for the practice of charlatanism. What wonder, then, if certain unscrupulous people have taken advantage of the opportunities thus offered? But because some unorthodox practitioners are charlatans, it does not logically follow that all must be. I repeat that it does not logically follow; but, alas, as the history of almost any professional group clearly demonstrates, orthodox opinion would always very much like it to follow. That is one of the reasons why, in this particular case, the unwarranted assumption that the whole business is mere quackery is widely accepted, in spite of all evidence to the contrary. The cure for charlatanism is not the suppression of an intrinsically sound method, but proper education for, and control of, its teachers. Proper education and control are equally the cure for that licensed charlatanism among opticians, which has been described and denounced in articles appearing in The Reader’s Digest (1937) and the New York World-Telegram (1942).
The second reason for the non-acceptance of the method may be summed up in three words: habit, authority and professionalism. The symptomatic treatment of defective sight has been going on for a long time, has been carried to a high degree of perfection, and, within its limitations, is reasonably successful. If it fails in a certain proportion of cases to provide even adequate palliation of the symptoms, that is nobody’s fault, but a condition inherent in the nature of things. For years, the highest medical authorities have all asserted this to be the case — and who will venture to question a recognized authority? Certainly not the members of the profession to which the authority belongs. Every guild and trade has its own esprit de corps, its private patriotism, which makes it resent all rebellion from within and all competition or criticism from without.
Next there is the matter of vested interest. The manufacture of optical glass is now a considerable industry, and its retail sale, a profitable branch of commerce, to which access can be had only by persons who have undertaken a special technical training. That there should be, among these licensed persons, a strong dislike to any new technique, which threatens to make the use of optical glass unnecessary, is only natural. (It is perhaps worth remarking that, even if the value of Dr. Bates’s technique were generally recognized, there would be small likelihood of any immediate or considerable decline in the consumption of optical glass. Visual re-education demands from the pupil a certain amount of thought, time and trouble. But thought, time and trouble are precisely what the overwhelming majority of men and women are not prepared to give, unless motivated by a passionate desire or an imperious need. Most of those who can get along more or less satisfactorily with the help of mechanical seeing-aids, will continue to do so, even when they know that there exists a system of training which would make it possible for them, not merely to palliate symptoms, but actually get rid of the causes of visual defect. So long as the art of seeing is not taught to children as a part of their normal education, the trade in artificial lenses is not likely to suffer more than a trifling loss by reason of the official recognition of the new technique. Human sloth and inertia will guarantee the opticians at least nine-tenths of their present business.)
Another reason for the orthodox attitude in this matter is of a strictly empirical nature. Oculists and optometrists affirm that they have never witnessed the phenomena of self-regulation and cure described by Bates and his followers. Therefore they conclude that such phenomena never take place. In this syllogism the premises are true, but the conclusion is unsound. It is quite true that oculists and optometrists have never observed such phenomena as are described by Bates and his followers. But this is because they have never had any dealings with patients who had learnt to use their organs of vision in a relaxed, unstrained way. So long as the organs of vision are used under a condition of mental and physical tension, the vis medicatrix naturae will not manifest itself, and the visual defects will persist, or actually become worse. Oculists and optometrists will observe the phenomena described by Bates as soon as they begin to relieve the strain in their patients’ eyes by means of Bates’s method of visual education. Because the phenomena cannot occur under the conditions imposed by orthodox practitioners, it does not follow that they will not occur when these conditions are changed, so that the healing powers of the organism are no longer hindered, but given free play.
To this empirical reason for rejecting the Batesian technique must be added one more — this time in the
realm of theory. In the course of his practice as an oculist, Dr. Bates came to doubt the truth of the currently accepted hypothesis regarding the eye’s power of accommodation to near and distant vision. This matter was for long the subject of heated debate, until finally, a couple of generations ago, orthodox medical opinion decided in favour of the Helmholtz hypothesis, which attributes the eye’s power of accommodation to the action of the ciliary muscle upon the lens. Working with cases of defective vision, Dr. Bates observed a number of facts which the Helmholtz theory seemed powerless to explain. After numerous experiments on animals and human beings, he came to the conclusion that the principal factor in accommodation was not the lens, but the extrinsic muscles of the eyeball, and that the focussing of the eye for near and distant objects was accomplished by the lengthening and shortening of the globe as a whole. The papers describing his experiments were printed in various medical journals at the time, and have been summarized in the opening chapters of his book, Perfect Sight Without Glasses.
Whether Dr. Bates was right or wrong in his rejection of the Helmholtz theory of accommodation, I am entirely unqualified to say. My own guess, after reading the evidence, would be that both the extrinsic muscles and the lens play their part in accommodation.
This guess may be correct; or it may be incorrect. I do not greatly care. For my concern is not with the anatomical mechanism of accommodation, but with the art of seeing — and the art of seeing does not stand or fall with any particular physiological hypothesis. Believing that Bates’s theory of accommodation was untrue, the orthodox have concluded that his technique of visual education must be unsound. Once again this is an unwarranted conclusion, due to a failure to understand the nature of an art, or psycho-physical skill.
Complete Works of Aldous Huxley Page 567
