Glaucon

“ A Cyprian, noting they [pg 321] had lost their ram, strove to charge them bow to bow. The skill of the governor avoided that disaster. They ran under the stem of a Tyrian, and Glaucon proved he had not forgotten his skill when he sent his javelins among the officers upon the poop. A second Sidonian swept down on them, but grown wise by her consort’s destruction turned aside to lock with an Æginetan galley. How the fight at large was going, who was winning, who losing, Glaucon saw no more than any one else. An arrow grazed his arm. He first learned it when he found his armour bloody. ”

“ And therefore, I said, Glaucon, musical training is a more potent instrument than any other, because rhythm and harmony find their way into the inward places of the soul, on which they mightily fasten, imparting grace, and making the soul of him who is rightly educated graceful, or of him who is ill-educated ungraceful; ”

“ Shall we propose, as a third branch of our education, astronomy? ‘Very good,’ replied Glaucon; ‘the knowledge of the heavens is necessary at once for husbandry, navigation, military tactics.’ I like your way of giving useful reasons for everything in order to make friends of the world. And there is a difficulty in proving to mankind that education is not only useful information but a purification of the eye of the soul, which is better than the bodily eye, for by this alone is truth seen. Now, will you appeal to mankind in general or to the philosopher? ”

“ Here Socrates is insisting that the theory of music should be studied as a branch of mathematics, not by observation of the sounds and concords actually heard, about which musicians spend toil in vain. 'Yes,' says Glaucon, 'they talk of the close-fitting of intervals, and put their ears down to listen for the smallest possible interval, which is then to be the measure.' The smallest interval was of course the Enharmonic diesis or quarter of a tone, and this accordingly was the measure or unit into which the scale was divided. ”

“ Glauconite, glaw′kō-nīt, n. the mineral, a silicate of iron, which gives a green colour to some of the beds of the greensand strata, whence their name.—adj. Glauconit′ic. [Fr.,—Gr. glaukos, bluish-green.]
Glaucous, glaw′kus, adj. sea-green: grayish-blue: (bot.) covered with a fine green bloom.—n. Glauces′cence.—adj. Glauces′cent, somewhat glaucous. [L. glaucus, bluish—Gr. glaukos, blue or gray.]
Glaucus, glaw′kus, n. a genus of Gasteropods, in the warmer parts of the Atlantic and Pacific Oceans. [Gr. glaukos, a fish—glaukos, bluish-green.] ”

“ There were some that were of so rare a beauty that my pleasure on catching sight of them was enhanced by surprise. By what privilege, on one morning rather than another, did the window on being uncurtained disclose to my wondering eyes the nymph Glauconome, whose lazy beauty, gently breathing, had the transparence of a vaporous emerald beneath whose surface I could see teeming the ponderable elements that coloured it? ”

“ Returning to the 17 cases in which the angle of the chamber was closed, and to certain other eyeballs in which it seemed probable that glaucoma had at some time been present, we found that in every one of them one or other of the accepted causes of secondary glaucoma was revealed when looked for; in some, more than one such cause was discoverable. We shall content ourselves with enumerating these factors. ”

“ Since then I have used the same treatment in many cases, and I have never seen one in which the pain and tension could not be relieved in a few minutes by palming, while permanent relief was obtained by more prolonged treatment.
One of the worst cases of glaucoma I ever met with came to me on Feb. 2, 1920. The patient was sixty years of age, and his vision in the right eye or better eye was only 20/100, with marked contraction of the field on the nasal side. In the left he had only light perception. ”

“ At this point he stopped the treatment against my advice, and I have not seen him since. He was greatly helped by the universal swing, which he practiced all day. The truth about glaucoma is that it is a functional neurosis caused by strain, and as such is curable. You can produce hardness in a normal eye by having the patient strain to see (see page 2) , and you can soften a glaucomatous eyeball by relief of strain. These changes are so rapid that no change in the contents of the eyeball could account for them. ”

“ There seems to be a special liability to glaucoma among those residing at high altitudes, best explained by nerve influence. The frequency of glaucoma among Jews may be due to a small cornea, as suggested by Priestley Smith; but it is quite as reasonable to connect it with a racial excitability or nervous instability. More definite knowledge of the nervous mechanism concerned in the regulation of intra-ocular pressure and the production of glaucoma is much needed. ”

“ Cases of simple glaucoma do run their course of many years to complete blindness, or to death, without exacerbations, inflammation, or characteristic pain. In such cases the intra-ocular tension does not rise suddenly; and it may be little or not at all elevated above the usual normal limit.
For nine years I have watched the progress of such a glaucoma in a man now aged 87, with slow development of glaucomatous cupping of the optic disc, now more than 3 D. deep. The tension has never been noted at more than Plus T (?) , and when taken with the tonometer varied from 9 to 32 mm. ”

“ The chief lymph stream flows from the posterior chamber past the margin of the lens, through the zonula of Zinn, beneath the iris, through the pupil into the anterior chamber, thence through the tissue at the junction of the iris and sclera into the circular canal of Schlemm and from this space into the external lymph channels. Obstruction to the steady escape of the intra-ocular fluids at any point in this drainage system or any undue increase of the fluids themselves may [Pg 103] produce glaucoma. ”

“ Where the iris tissue lies in contact with the cornea, the stroma of the iris almost totally disappears. In some cases the iris becomes totally adherent to the cornea.
Ciliary Body and Chorioid. In acute glaucoma there is congestion of the entire uveal tract, the congestion partaking more of a venous stasis than of an active or arterial congestion. The vessels of the [Pg 46] ciliary process, which are larger and more tortuous in adults of advanced years than in the young, become enormously distended, causing almost complete obliteration of the perilental space. ”

“ If we regard only the retinal and nervous elements, and for the moment pay no attention to the existence of the tube, Götte's observation that the true retina has been formed from the optic plate (Sinnes-platte) to which the retinal portion of the brain (retinal ganglion) has become firmly fixed, and that then the optic nerve has been formed by the withdrawal of the rest of the brain (optic lobes) , is word for word applicable to the description of the development of the compound retina of the arthropod eye, as has been already stated. ”

“ The arrangement of the arteries at the disc, passing out as they do from the nasal side, of necessity make the vessels that pass to the temporal part of the retina longest and of less caliber. These vessels and their terminals are first to suffer marked diminution in size; death of the perceptive elements supplied with nutrition by these vessels follows. For this reason the nasal part of the field of vision is more often the first to disappear. In [Pg 49] congestive (inflammatory) glaucoma, the typical field of vision shows most marked contraction on the nasal side. ”

“ A characteristic of this condition is increase of the intra-ocular tension, which has a deleterious effect on the optic nerve end and its ramifications in the retina. The cause of the rise of tension is partly congestive, partly mechanical. The effect of glaucoma, when untreated, is to cause ever-increasing loss of sight, although the time occupied by the process before it leads to complete blindness varies within such extraordinary wide limits as from a few hours to many years. ”

“ Any process that increases the volume of the contents of the vitreous chamber, as hemorrhage, neoplasm, profuse serous or plastic exudation, may by pushing iris and lens forward produce an attack of acute glaucoma.
Buphthalmos. Reis (Graefe's Arch. f. Ophth. V. LX. 1905) states that there is always obliteration of the anterior scleral venous channels (Schlemm's canal) in buphthalmos. Seefelder (Graefe's Arch. V. LXIII. 1906) mentions the abnormal position and abnormal narrowing of Schlemm's canal and the imperfect and insufficient differentiation of the cornea-scleral junction. ”

“ The increased tension is supposed to be due to an excess of fluid in the eyeball, and this is commonly attributed to an impeded outflow. The aqueous humor, which is secreted very rapidly, is supposed to escape at the angle formed by the junction of the iris with the cornea, and in glaucoma it is believed that the iris adheres to the cornea so that the angle is obstructed. ”

“ Only a few years ago the literature of glaucoma was big with discussions of the comparative value of the surgical and non-surgical treatment of glaucoma, and especially of the chronic types of this disease. Now, thanks to the achievements of Lagrange, Fergus, Herbert and Elliot, the value of a filtering cicatrix, although known for a long time, has attained increased importance, due to the improvement and elaboration of operative technic, and the medical journals of the day are weighted with [Pg 62] opinions and experiences from all over the world as to these surgical measures. ”

“ He returns to the sea, and there finds the body of Scylla, whom the goddess has not transformed but drowned. Glaucus learns that his destiny is that, if he passes his thousand years in collecting all the bodies of drowned lovers, a youth beloved of the gods will appear and help him. Endymion fulfils this prophecy, and aids in restoring Glaucus to youth, and Scylla and all the drowned lovers to life.
The following is Glaucus's account of his feelings after his "sea- change":
"I plunged for life or death. ”

“ In glaucoma of long standing the veins of the retina bend round the margin of the optic disc, and if the margin be unusually prominent they are lost sight of for some distance. This causes the portions of the veins in the optic disc to appear as if they were not the continuations of those in the retina. ”

“ The early pain may be ascribed (1) to injury to the nerves of the ciliary body and iris, especially when the laceration of those structures is considerable, as our clinical experience and our specimens alike show it sometimes is; (2) to hæmorrhage from the vessels of the ciliary body, the iris, the choroid or the retina: such hæmorrhage may produce pain in two ways— (a) by dissecting up sensitive structures, and (b) by increasing the tension of the eye; and (3) to the rapid production of early glaucoma. There are several ways in which we may conceive that such a glaucoma might be produced. ”

“ Glaucoma.—According to Elliott glaucoma is very much more common in the East than in Europe. He states that simple chronic glaucoma is extraordinarily common in India. Often the only symptoms are retraction of the field, cupping of the disc and at a later stage impairment of the central visual acuity. He notes that the advancement of the disease is often as unobtrusive as it is relentless. These patients often only present themselves at the clinic in the late stages of the disease ”

“ Still another way to see the interior is to cut out a piece of the sclerotic about the size of a twenty-five-cent piece; then pinch up and tear out the choroid and the retina under the opening made in the sclerotic. (Fig. 57.) Hold the eye, the cornea forward, close to a bright light, and the image of the light will be seen upon the retina. The closer the light is to the eye, the greater the illumination will be in the [111] interior of the eye. If the opening or “window” is close enough to the optic nerve, the optic papilla can be seen easily. ”

“ Fully to understand the mechanism for its regulation would carry us far toward an understanding of the causes of glaucoma. Normal [Pg 10] tension is maintained with a continuous flow of fluid into the eye and a corresponding outflow. Complete interruption of the nutritional stream would be speedy death; partial interruption may be held responsible for most of the visual impairment and pain of glaucoma.
The balance of intra-ocular pressure is not maintained by the slight distensibility of the sclero-corneal coat. Increased pressure does not open new channels for the escape of intra-ocular fluid ”

“ Glaucus. Probably just a god. Doubtless there are gods of nothing in particular, merely decorative. Ione. Doubtless. Glaucus. Well, I would rather be that than no god at all. Ione. I fear it. Glaucus. Endymion, you must tell me in writing when we go home, if one of the chief minor gods was punished some fifty years ago by the loss of all knowledge of his own identity. Ione. Father, he does not know a word you say: He understands no language I can speak— [Aside.] Except that of my eyes. If I can read The fire of his they tell me priceless tales.
Enter Silenus, Satyrs, and Bacchantes. ”

“ After iridectomy the attacks ceased, leaving no pathological cupping of the disc, full vision, and a good field. I have seen cases of this type in women under middle age, and of marked nervous instability.
A third type which will come to be more generally recognized, as the tonometer comes to be more widely used, includes cases in which there is little beside the increase of intra-ocular tension to justify their mention in a discussion on glaucoma. ”

“ The presence of the iris greatly diminishes the extent of surface designed for the reception of light; the whole pencil of rays that falls on the cornea, as supposed, in Fig. 3, not reaching the retina, but only as shown in Fig. 4, on that section of it which enters the pupil. Though much of the volume of light is thereby lost, the restriction is highly beneficial, by sharpening the image on the retina; for the refraction of the rays is much more equal in the centre than toward the margin. ”