acts of manual skill, in combination with the use of language, contributed to man's understanding of the world around him. "Out of the experience gained in con stantly performing acts of skill, the knowledge of cause and effect is even tually acquired. T h u s the creature came to understand that a remembered act would entail certain consequences. In other words, it gradually acquired the faculty of shaping its conduct in anticipation of results." In learning to execute movements of delicacy and precision, the prefrontal region, the cortical area that is preemi nently concerned with the phenomena of attention, grew until eventually it became the most distinctive character istic of the human brain. In an address on "The human brain", one of a collection of four essays on "The evolution of man," Elliot Smith quotes with approval a claim by Profes sor Pear for the "intellectual respecta bility of muscular skill." T h u s from the kindergarten through all the forma tive years of childhood and on into the later developmental sphere of adult life, "manual training" retains a position of dignity in the growth and activity of the mind. W. H. Crisp.
OPTOMETRY NOT A PROFESSION The joint committee on optics and visual physiology appointed by the several national societies of ophthal mology was originally designated as the "Committee on Optometry", and one of its functions was to try to find some common ground upon which to meet others interested in refraction, and to discuss matters of common inter est. As has been pointed out, for in stance by Lancaster in the chairman's address of 1928 before the section on opbthalmolology of the American Medical Association, the main difficulty is that "optometry", as understood in the United States, is a trade and not a profession, and that most optometrists
lack the professional spirit and the pro fessional point of view. This is very well illustrated in articles that appear from time to time in the publications of the wholesale optical houses, in which much advice is given as to how to "drum u p " trade and sell people more and higher priced glasses than they need or desire. T w o recent articles illustrate this so well that they will be quoted. The first article contains a paragraph headed " W h a t becomes of the old glasses"? and concludes as follows: "Which calls to mind what one Pitts burgh refractionist did recently along these lines. He discovered that the patient had five old frames, and ended by selling five sets of new lenses for the old frames, and two new sets com plete, frames and glasses, outfitting the patient for his office and his home". The other article, also recent, con tains the following: " W h a t interest are you taking in the eyesight of your local athletes? Have you written a personal letter to the athletic leaders in your community, pointing out how glasses have been of benefit to nationally known athletic stars? Have you ever explained to the manager of your home town baseball club the advantage of glasses? If you do fit any locally or nationally known athletes with glasses, be sure to give the case the publicity it deserves". These are not isolated examples, but rather the usual thing. They show how very far the majority of "nonmedical refractionists" are from the state of mind which would favor any com mittee of opthalmologists meeting with them formally, or recognizing them as professional people actuated by a pro fessional spirit. If such a meeting were arranged, they could probably be de pended on to "give the case the pub licity it deserves". E. C. Ellett.
COLOR P H O T O G R A P H Y OF T H E EYE Elsewhere in this issue of the Journal Redway describes the special apparatus
EDITORIALS which he has devised for instantaneous color photography of the eye. Four of his excellent results are reproduced by the four-color engraving process, in the frontispiece of this issue. Every enthusiastic photographer has felt more or less disappointment con cerning the fact that no process for di rect printing of color photographs had been discovered. The work of Redway, and the earlier work of others along these same lines, have been devoted to the production of color transparencies, and prints from such transparencies can only be made by the expensive process of color photo-engraving. Redway points out that to some ex tent an illusion of stereoscopic depth is obtained from a color photograph as compared with a black and white pic ture of the same subject. This prob ably applies more particularly to trans parencies than to reproductions on paper. For some years Morax, of Paris, has made a great many photographic trans parencies, in color, of the anterior seg ment of the eye, using a stereoscopic camera. In a recent issue of the Annales d'Oculistique (1929, April, page 261) he briefly describes his method, and re produces on paper three excellent pairs of color photographs, showing respec tively trachoma with pannus, metastatic abscess of the episclera, and sar coma of the ciliary body developing in the anterior chamber. The lighting system employed by Morax differs radically from that of Redway. While the latter resorts to the electric carbon arc, Morax avails himself of the magnesium flash. Judg ing from Morax' reproductions, the magnesium gives an illumination of ex cellent and uniform quality. H e further uses Lumiere autochromes, and the photographic camera designed by Driiner thirty years ago but since improved as to detail. The composition of magnesium pow ders varies, so that it is necessary al ways to use the same product. More over, the flash involves some danger and certain inconveniences, including the voluminous smoke resulting from
the explosion, and the necessity for pro tecting the patient against flying metal lic sparks. IV. H. Crisp.
RADICAL TREATMENT OF TRACHOMA The presessional volume of the sec tion on ophthalmology of the American Medical Association for 1929 presented, as always, an abundance of significant material. Among the most interesting papers was that by McHenry on the treatment of trachoma. When an experienced ophthalmolo gist states that trachoma is curable in ninety-nine per cent of all cases his method challenges serious considera tion, especially by those who practice in regions where trachoma is rife. Such optimism is refreshing, for to most ophthalmologists trachoma is a very intractable disease and lasting cures are rarities. The trachoma operations commonly recommended include grattage, expres sion, brossage, and tarsectomy. The striking feature of McHenry's argu ment is the emphasis laid on operative technique, especially as regards inclu sion of the caruncle in all expression procedures. Hypertrophy of the orbicularis, for which canthotomy is performed, is said to be a particularly constant con comitant of chronic trachoma. In our Saint Louis clinics this operation is not very frequent, as hypertrophy of the orbicularis with spasm of that muscle has not been a conspicuous feature of the disease. Nor has free incision with expression of the contents of the caruncle been generally practiced. But perhaps in these two procedures lies much of the secret of success. Probably the fact that McHenry's cases were private was also in some measure responsible for the outcome, since the private patient can be handled much more satisfactorily than the charity subject. The former has more leisure, more intelligence, and more persistence, and he is apt to receive more of the doctor's time and attention.