ALL the methods used in the cure of errors of refraction are simply different ways of obtaining relaxation, and most patients, though by no means all, find it easiest to relax with their eyes shut. This usually lessens the strain to see, and in such cases is followed by a temporary or more lasting improvement in vision.
Most patients are benefited merely by closing the eyes; and by alternately resting them for a few minutes or longer in this way and then opening them and looking at the Snellen test card for a second or less, flashes of improved vision are, as a rule, very quickly obtained. Some temporarily obtain almost normal vision by this means; and in rare cases a complete cure has been effected, sometimes in less than an hour.
But since some light comes through the closed eyelids, a still greater degree of relaxation can be obtained, in all but a few exceptional cases, by excluding it. This is done by covering the closed eyes with the palms of the hands (the fingers being crossed upon the forehead) in such a way as to avoid pressure on the eyeballs. So efficacious is this practice, which I have called "palming," as a means of relieving strain, that we all instinctively resort to it at times, and from it most patients are able to get a considerable degree of relaxation.
But even with the eyes closed and covered in such a way as to exclude all the light, the visual centers of
the brain may still be disturbed, the eye may still strain to see; and instead of seeing a field so black that it is impossible to remember, imagine, or see anything blacker, as one ought normally to do when the optic nerve is not subject to the stimulation of light, the patient will see illusions of lights and colors ranging all the way from an imperfect black to kaleidoscopic appearances so vivid that they seem to be actually seen with the eyes. The worse the condition of the eyesight, as a rule, the more numerous, vivid and persistent these appearances are. Yet some persons with very imperfect sight are able to palm almost perfectly from the beginning, and are, therefore, very quickly cured. Any disturbance of mind or body, such as fatigue, hunger, anger, worry or depression, also makes it difficult for patients to see black when they palm, persons who can see it perfectly under ordinary conditions being often unable to do so without assistance when they are ill or in pain.
It is impossible to see a perfect black unless the eyesight is perfect, because only when the eyesight is perfect is the mind at rest; but some patients can without difficulty approximate such a black nearly enough to improve their eyesight, and as the eyesight improves the deepness of the black increases. Patients who fail to see even an approximate black when they palm state that instead of black they see streaks or floating clouds of gray, flashes of light, patches of red, blue, green, yellow, etc. Sometimes instead of an immovable black, clouds of black will be seen moving across the field. In other cases the black will be seen for a few seconds and then some other color will take its place. The different ways in which patients can fail to see black when their eyes are closed and covered are, in fact, very numerous and often very peculiar.
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Some patients have been so impressed with the vividness of the colors which they imagined they saw that no amount of argument could, or did, convince them that they did not actually see them with their eyes. If
Fig. 42. Palming
This is one of the most effective methods of obtaining relaxation of all the sensory nerves.
other people saw bright lights or colors, with their eyes closed and covered, they admitted that these things would be illusions; but what they themselves saw under the same conditions was reality. They would not believe, until they had themselves demonstrated the truth, that
their illusions were due to an imagination beyond their control.
Successful palming in these more difficult cases usually involves the practice of all the methods for improving the sight described in succeeding chapters. For reasons which will be explained in the following chapter, the majority of such patients may be greatly helped by the memory of a black object. They are directed to look at such an object at the distance at which the color can be seen best, close the eyes and remember the color, and repeat until the memory appears to be equal to the sight. Then they are instructed, while still holding the memory of the black, to cover the closed eyes with the palms of the hands in the manner just described. If the memory of the black is perfect, the whole background will be black. If it is not, or if it does not become so in the course of a few seconds, the eyes are opened and the black object regarded again.
Many patients become able by this method to see black almost perfectly for a short time; but most of them, even those whose eyes are not very bad, have great difficulty in seeing it continuously. Being unable to remember black for more than from three to five seconds, they cannot see black for a longer time than this. Such patients are helped by central fixation. When they have become able to see one part of a black object darker than the whole, they are able to remember the smaller area for a longer time than they could the larger one, and thus become able to see black for a longer period when they palm. They are also benefited by mental shifting (see Chapter XV) from one black object to another, or from one part of a black object to another. It is impossible to see, remember, or imagine anything, even for as much as
Mental Shifting! 127
a second, without shifting from one part to another, or to some other object and back again; and the attempt to do so always produces strain. Those who think they are remembering a black object continuously are unconsciously comparing it with something not so black, or
Patient with atrophy of the optic nerve gets flashes of improved vision after palming.
else its color and its position are constantly changing. It is impossible to remember even such a simple thing as a period perfectly black and stationary for more than a fraction of a second. When shifting is not done unconsciously patients must be encouraged to do it consciously. They may be directed, for instance, to remember successively a black hat, a black shoe, a black velvet dress, a black plush curtain, or a fold in the black dress or the
_ . .
black curtain, holding each one not more than a fraction of a second. Many persons have been benefited by remembering all the letters of the alphabet in turn perfectly black. Others prefer to shift from one small black object, such as a period or a small letter, to another, or to swing such an object in a manner to be described later (see Chapter XV).
In some cases the following method has proved successful: When the patient sees what he thinks is a perfect black, let him remember a piece of starch on this background, and on the starch the letter F as black as the background. Then let him let go of the starch and remember only the F, one part best, on the black background. In a short time the whole field may become as black as the blacker part of the F. The process can be repeated many times with a constant increase of blackness in the field.
In one case a patient who saw grey so vividly when she palmed that she was positive she saw it with her eyes, instead of merely imagining it, was able to obliterate nearly all of it by first imagining a black C on the grey field, then two black C's, and finally a multitude of overlapping C's.
It is impossible to remember black perfectly when it is not seen perfectly. If one sees it imperfectly, the best one can do is to remember it imperfectly. All persons, without exception, who can see or read diamond type at the near-point, no matter how great their myopia may be, or how much the interior of the eye may be diseased, become able, as a rule, to see black with their eyes closed and covered more readily than patients with hypermetropia or astigmatism; because, while myopes cannot see anything perfectly, even at the near-point, they see
Imperfect Memory Useful 129
better at that point than persons with hypermetropia or astigmatism do at any distance. Persons with high degrees of myopia, however, often find palming very difficult, since they not only see black very imperfectly, but, because of the effort they are making to see, cannot remember it more than one or two seconds. Any other condition of the eye which prevents the patient from seeing black perfectly also makes palming difficult. In some cases black is never seen as black, appearing to be grey, yellow, brown, or even bright red. In such cases it is usually best for the patient to improve his sight by other methods before trying to palm. Blind persons usually have more trouble in seeing black than those who can see, but may be helped by the memory of a black object familiar to them before they lost their sight. A blind painter who saw grey continually when he first tried to palm became able at last to see black by the aid of the memory of black paint. He had no perception of light whatever and was in terrible pain; but when he succeeded in seeing black the pain vanished, and when he opened his eyes he saw light.
Even the imperfect memory of black is useful, for by its aid a still blacker black can be both remembered and seen; and this brings still further improvement. For instance, let the patient regard a letter on the Snellen test card at the distance at which the color is seen best, then close his eyes and remember it. If the palming produces relaxation, it will be possible to imagine a deeper shade of black than was seen, and by remembering this black when again regarding the letter it can be seen blacker than it was at first. A still deeper black can then be imagined, and this deeper black can, in turn, be transferred to the letter on the test card. By continuing this
process a perfect perception of black, and hence perfect sight, are sometimes very quickly obtained. The deeper the shade of black obtained with the eyes closed, the more easily it can be remembered when regarding the letters on the test card.
The longer some people palm the greater the relaxation they obtain and the darker the shade of black they are able both to remember and see. Others are able to palm successfully for short periods, but begin to strain if they keep it up too long.
It is impossible to succeed by effort, or by attempting to "concentrate" on the black. As popularly understood, concentration means to do or think one thing only; but this is impossible, and an attempt to do the impossible is a strain which defeats its own end. The human mind is not capable of thinking of one thing only. It can think of one thing best, and is only at rest when it does so; but it cannot think of one thing only. A patient who tried to see black only and to ignore the kaleidoscopic colors which intruded themselves upon her field of vision, becoming worse and worse the more they were ignored, actually went into convulsions from the strain, and was attended every day for a month by her family physician before she was able to resume the treatment. This patient was advised to stop palming, and, with her eyes open, to recall as many colors as possible, remembering each one as perfectly as possible. By thus taking the bull by the horns and consciously making the mind wander more that it did unconsciously, she became able, in some way, to palm for short periods.
Some particular kinds of black objects may be found to be more easily remembered than others. Black plush of a high grade for instance, proved to be an optimum
(see Chapter XVIII) with many persons as compared with black velvet, silk, broadcloth, ink and the letters on the Snellen test card, although no blacker than these other blacks. A familiar black object can often be remembered more easily by the patient than those that
No. 1. - Owing to paralysis of the seventh nerve on the right side, resulting from a mastoid operation on the right ear, the patient is unable to close her lips.
No. 2. - After palming and remembering a perfectly black period she became able not only to close the lips, but to whistle. The cure was permanent.
are less so. A dressmaker, for instance, was able to remember a thread of black silk when she could not remember any other black object.
When a black letter is regarded before palming the patient will usually remember not only the blackness of the letter, but the white background as well. If the memory of the black is held for a few seconds, however, the background usually fades away and the whole field becomes black.
Patients often say that they remember black perfectly when they do not. One can usually tell whether or not this is the case by noting the effect of palming upon the vision. If there is no improvement in the sight when the eyes are opened, it can be demonstrated, by bringing the black closer to the patient, that it has not been remembered perfectly.
Although black is, as a rule, the easiest color to remember, for reasons explained in the next chapter, the following method sometimes succeeds when the memory of black fails: Remember a variety of colors - bright red, yellow, green, blue, purple, white especially - all in the most intense shade possible. Do not attempt to hold any of them more than a second. Keep this up for five or ten minutes. Then remember a piece of starch about half an inch in diameter as white as possible. Note the color of the background. Usually it will be a shade of black. If it is, note whether it is possible to remember anything blacker, or to see anything blacker with the eyes open. In all cases when the white starch is remembered perfectly the background will be so black that it will be impossible to remember anything blacker with the eyes closed, or to see anything blacker with them open.
When palming is successful it is one of the best methods I know of for securing relaxation of all the sensory nerves, including those of sight. When perfect relaxa-
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tion is gained in this way, as indicated by the ability to see a perfect black, it is completely retained when the eyes are opened, and the patient is permanently cured. At the same time pain in the eyes and head, and even in other parts of the body, is permanently relieved. Such cases are very rare, but they do occur. With a lesser
Fig. 1. - Patient with absolute glaucoma of the right eye. He had suffered agonizing painfor six months and had no perception of light. He was photographed when testing the tension of his eyeball, which he found to be perfectly hard.
Fig. 2. - The patient is palming and remembering a perfectly black period. After half an hour the eyeball became soft the pain ceased, and the patient became able to see the light. After three years there was no return of the glaucoma.
degree of relaxation much of it is lost when the eyes are opened, and what is retained is not held permanently. In other words, the greater the degree of the relaxation produced by palming the more of it is retained when the
eyes are opened and the longer it lasts. If you palm perfectly, you retain, when you open your eyes, all of the relaxation that you gain, and you do not lose it again. If you palm imperfectly, you retain only part of what you gain and retain it only temporarily - it may be only for a few moments. Even the smallest degree of relaxation is useful, however, for by means of it a still greater degree may be obtained.
Patients who succeed with palming from the beginning are to be congratulated, for they are always cured very quickly. A very remarkable case of this kind was that of a man nearly seventy years of age with compound hypermetropic astigmatism and presbyopia, complicated by incipient cataract. For more than forty years he had worn glasses to improve his distant vision, and for twenty years he had worn them for reading and desk work. Because of the cloudiness of the lens, he had now become unable to see well enough to do his work, even with glasses; and the other physicians whom he had consulted had given him no hope of relief except by operation when the cataract was ripe. When he found palming helped him, he asked:
"Can I do that too much?"
"No," he was told. "Palming is simply a means of resting your eyes, and you cannot rest them too much."
A few days later he returned and said:
"Doctor, it was tedious, very tedious; but I did it."
"What was tedious?" I asked.
"Palming," he replied. "I did it continuously for twenty hours."
"But you couldn't have kept it up for twenty hours continuously," I said incredulously. "You must have stopped to eat."
Tedious But Worth While 135
And then he related that from four o'clock in the morning until twelve at night he had eaten nothings only drinking large quantities of water, and had devoted practically all of the time to palming. It must have been tedious, as he said, but it was also worth while. When he looked at the test card, without glasses, he read the bottom line at twenty feet. He also read fine print at six inches and at twenty. The cloudiness of the lens had become much less, and in the center had entirely disappeared. Two years later there had been no relapse.
Although the majority of patients are helped by palming, a minority are unable to see black, and only increase their strain by trying to get relaxation in this way. In most cases it is possible, by using some or all of the various methods outlined in this chapter, to enable the patient to palm successfully; but if much difficulty is experienced, it is usually better and more expeditious to drop the method until the sight has been improved by other means. The patient may then become able to see black when he palms, but some never succeed in doing it until they are cured.