NORMAL SIGHT AND THE RELIEF OF PAIN FOR
SOLDIERS AND SAILORS
THE Great War is over, and among the millions of brave men who- laid down their lives in the cruel conflict there were some who thought that they were doing so that wars might be no more. But the earthIS still filled with wars and rumors of war, and in the countries of the victorious Allies the spirit of militarism is rampant. In the United States we are being urged to increased naval and military expenditure, and there is a strong demand for universal military training. Whether it is necessary for us to join in the competition of armaments which resulted in the terrific convulsion through which we have just passed, is a question which need not be entered into here; but if we are going to do so, we may as well have soldiers and sailors with normal sight; and if we attain this end we shall not have borne the burdens of militarism and navalism altogether in vain.
After the United States entered the recent war, I had the privilege of making it possible for many young men who had been unable to meet the visual requirements for admission to the army and navy, or to favorite branches of these services, to gain normal vision; and seeing no reason why such benefits should be confined to the few, I supplied the Surgeon General of the Army with a plan whereby with far less trouble and expense than was involved by the optical service upon which
A Leading Cause Of Rejection 285
we were then depending to make the worst of the enlisted eye-defectives available for service at the front, normal vision without glasses might have been insured to all soldiers and sailors. This plan was not acted upon, and I now present it, with some modifications, to the public, in the hope that enough people will see its military value to secure its adoption.
If we are to have universal military training, we shall find, as the nations of Europe have found, that it will be necessary to take measures to provide suitable material for such training. In Europe this necessity has resulted in extensive systems of child care, but in this book we are concerned only with the question of eyesight. In the first draft for the recent war, defective eyesight was the greatest single cause for rejection, while in later drafts it became one of three leading causes only because of an enormous lowering of an already low standard. Yet there is no impediment to the raising of an army which might be more easily removed. If we want our children to grow big enough to be soldiers, without losing most of their teeth and developing flat feet and crooked spines before they reach the military age, we shall have to make some arrangements, as every one of the advanced countries of Europe has done, for providing material as well as intellectual food in the schools. We shall have to employ school physicians on full time, and pay them enough to compensate men of eminence for the loss of private practice. We shall also have to see that the children are not sacrificed to the ignorance or poverty of their parents before they reach school age. But to preserve their eyesight it is only necessary to place Snellen test cards in every school classroom, and see that the children read them every day. With this simple
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system of eye education beginning in the kindergarten and extending through the whole educational process up to the university and the professional school, it would soon be found that the young men of the country, on arrival at the military age, were practically free from eye defects.
But some years must elapse before this happy result can be achieved; and all eyes, moreover, no matter how good their vision, are benefited by the daily practice of the art of seeing, while by such practice those visual lapses to which every eye is subject, and which are particularly dangerous in military and naval operations, are either prevented or minimized. Therefore a system of eye education for training camps and the front should also be provided. For this purpose the method used in the schools could be modified.
Under conditions of actual warfare, or on the parade grounds of training camps, a Snellen test card might be impracticable; but there are other letters, or small objects,. On the uniforms, on the guns, on the wagons, or elsewhere, which would serve the purpose equally well.
Letters or objects which require a vision of 20/20 should be selected by some one who has been taught what 20/20 means, and the men should be required to regard these letters or objects twice a day. After reading the letters they should be directed to cover their closed eyes with the palms of their hands to shut out all the light, and remember some color, preferably black, as well as they are able to see it, for half a minute. Then they should read the letters again and note any improvement in vision. The whole procedure would take not more than a minute. It should be made part of the regular drill, night and morning, and men with imperfect sight
No Soldier Should Wear Glasses 287
should be encouraged to repeat it as many times a day as convenient. They will need no urging; for imperfect vision is a bar to advancement, and excludes from the favorite branch of the service, namely, aviation.
In each regiment every ten men should be under the supervision of one man who understands the method, and who must possess normal vision without glasses. He should carry a pocket test card, consisting of a few of the smaller letters, and should test the vision of the men at the beginning of the training, and thereafter at intervals of three months, reporting the results to the medical officer in charge.
Since errors of refraction are curable, no soldier should be allowed to wear glasses; but if the use of these aids to vision is permitted, the men wearing them should not be required to take part in the eye drills. as the method will do them no good under these conditions. When they see the benefits of eye education, however, they may wish to share them, and will, no doubt, be willing to submit to the inconvenience resulting, temporarily, from going without their glasses.
In military colleges the same method could be used as in the schools; but a daily eye drill should also form part of the maneuvers on the parade ground, so that the students may be prepared to use it later in training camps, or at the front.
To aviators, whether engaged in military or civilian operations, or whether they are flying merely for pleasure, eye education is of particular importance. Accidents to aviators, otherwise unaccountable, are easily explained when one understands how dependent the aviator is upon his eyesight, and how easily perfect vision may be lost amid the unaccustomed surroundings, the dangers and
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hardships of the upper air. It was formerly supposed that aviators maintained their equilibrium in the air by the aid of the internal ear; but it is now becoming evident from the testimony of aviators who have found themselves emerging from a cloud with one wing down, or even with their machines turned completely upside down, that equilibrium is maintained almost entirely, if not altogether, by the sense of sight. If the aviator loses his sight, therefore, he is lost, and we have one of those "unaccountable" accidents which, during the war, were so unhappily common in the air service. All aviators, therefore, should make a daily practice of reading small, familiar letters, or observing other small, familiar objects, at a distance of ten feet or more. In addition, they should have a few small letters, or a single letter, on their machines, at a distance of five, ten, or more feet from their eyes, arrangements being made to illuminate them for night flying and fogs, and should read them frequently while in the air. This would greatly lessen the danger of visual lapses, with their accompanying loss of equilibrium and judgment.
As has already been pointed out, eye education not only improves the sight, but affords a means by which pain, fatigue, the symptoms of disease and other discomforts, can be relieved. For this latter purpose it is of the greatest value to solders and sailors; and if, during the recent war, they had only understood the simple and always available method of relieving pain by the aid of the memory, not only much suffering, but many deaths from the destructive effects of pain upon the body, might have been prevented. A soldier in a flooded trench, if he can remember black perfectly, will know the temperature of
1 Anderson Lancet, March 16, 1918, 398: Hucks: Scientific American.
Palming Instead Of Morphine 289
the water, but will not suffer from cold. Under the same conditions he may succumb from weakness on the march, but will not feel fatigue. He may die of hemorrhage, but he will die painlessly. It will not be necessary to give him morphine to relieve his pain; and thus to the dangers of the battlefields will not be added the danger of returning to civil life under the handicap of a lifelong morphine habit.
This danger, there is reason to believe, assumed enormous proportions during the war. The Germans-used a bullet which broke when it struck the bone and caused intense pain. The men often died of this pain before help arrived. When they were rescued the surgeons at once gave them morphine. A few hours later the injection was probably repeated. Then the drug was given less frequently, but in many cases it was not discontinued entirely while the man was in the hospital. A Red Cross surgeon at a meeting of the New York County Medical Society stated that he had been responsible for producing the morphine habit in thousands of soldiers, and that every physician at the front had done the same. By such a simple method as palming all this might have been prevented.
If we are going to have universal military and naval training, an essential part of that training should be the instruction of the prospective soldiers and sailors in the art of relieving their own pain; and in the event of war every one who goes to the front, in whatever capacity, from the generals and admirals down to the ambulance drivers, should understand palming. Everyone in the war zone, no matter how far behind the lines, may need this knowledge to relieve his own pain, and everyone may need it to relieve the pain of others.