And we are to believe wonders on the strength of this scanty
communication! It is an every-day experience that a person who squints,
who has just asserted his inability to read the largest type,
immediately afterwards reads smaller and the smallest type, and it would
at least first have to be determined that all endeavours to produce a
better visual result before tenotomy were unsuccessful; but as the
communication stands, the conclusion as to the effect of tenotomy is
quite a superficial _post hoc ergo propter hoc_. Moreover, I had this
case in view when I spoke on this matter in the first edition of my
'Handbook:'--"The frequently repeated assertion that a considerable
improvement of vision may occur as a direct result of tenotomy, is so
little in accordance with all the laws of physiology, that inquiries
must be instituted _ad hoc_, and carried out with the most perfect
exactitude. Only trials of vision which are carefully carried out and
repeated several times before the operation, and which have regard to
visual acuteness for distance as well as for near objects, the latter
indeed by the aid of convex glasses or Calabar extract, can be
recognised as proving anything in face of such a perfectly improbable
assertion. In the course of examinations so instituted I have not myself
found that tenotomy exercises any direct influence on visual acuity."
I would not have given so much space to this explanation had not a
principle been in question. The occurrence of amblyopia as a result of
non-use has been deductively constructed and is not inductively proved
by observation. It is just an article of faith, and in science we cannot
rely on such things; we must not depart from the inductive method.
ON THE CURE OF SQUINT.
Therapeutic investigations have their safest and most instructive basis
in observation of the course of a disease as it appears without
complications, and with no unusual symptoms; we can only arrive at a
certain decision as to the extent of our therapeutics when we know
exactly what will happen without skilled assistance. When squint is once
present it is seldom complicated by fresh symptoms; on the other hand,
spontaneous cures unquestionably take place. We must certainly not rely
simply on the statements of patients themselves. On p. 1 we have seen
what mistakes occur, even when it is a question of whether squint is
present or not. How little such vague statements are worth is seen by
the fact, that the question as to the direction of the previous squint
very seldom finds a satisfactory answer; as a rule it is impossible to
determine whether periodic or permanent squint has been present.
Public-domain text, read in full here on John Shaqi.
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