Another popular belief is that the blind are naturally very religious. Unfortunately, this belief seems to be shared by those who selected many of the books to be printed in raised types, since about one-half of the books selected are of a religious character. The blind are naturally introspective, and their power of concentration is greater than that of the average person, but I have not found them to be unusually religious. I do not think that blindness increases or decreases the religious tendency.

A third fallacy is that the blind can tell colors by feeling. This is absolutely impossible. I have heard of men who could tell the difference of color in horses, but, upon questioning them closely, I found that the texture of the hair varied in light and dark colored animals. Of course, there is an odor about some colored dyes, such as black and indigo blue. Some of the blind are themselves responsible for fostering this belief, but they do it to test the credulity of the public, and they do not know the real harm they are doing to the cause.

It is a common belief, too, that all blind people like music, and are especially gifted in this art. I do not believe that the percentage of really musical blind people is greater than that of persons who see. Sometimes a blind man or woman will study music either as a pastime, or in the hope of making a living, but the lack of eyesight does not increase or diminish one's musical ability.

In the lecture on the psychology of blindness, I endeavored to prove that the blind were not possessed of greater faculties than their seeing fellows, but that loss of eyesight made it imperative to cultivate the remaining senses to a very high degree, and that such cultivation led to a greater keenness in the interpretation of the information furnished the remaining senses. When told that the blind do many things well and quickly by employing methods different than those who see, the information comes as a shock, when it is not entirely discredited. There is an idea prevalent among so-called well informed men and women that a loss of eyesight carries with it a loss of mental vigor, and a total inability to engage in any of the world's work. This belief, and the many foolish notions which it breeds, presents one of the greatest difficulties to be met, and, if possible, overcome, by the blind man or woman obliged to earn a livelihood. So potent is eyesight considered that, without it, some people think it impossible to perform even the simplest duties, and the person obliged to substitute fingers for eyes, and memory for pad and pencil is regarded as a marvel of intelligence and skill, and as possessing a sixth sense. Anything done by the blind, from recognizing a voice to remembering a street number, is considered wonderful by the average person, and this attitude is very trying to the blind adult who is striving to adjust himself to new conditions, and train his remaining faculties to the highest possible degree of efficiency. The commiseration and incredulous words of his friends is one of the greatest trials which the blind adult is called upon to bear, and it is not strange that he is often embittered and discouraged, and unwilling to subject himself to the thoughtless comments and undisguised pity of his former associates. These associates do not realize that their attitude has changed or that they are adding another burden to the already heavy load borne by their friend. They are sorry, honestly sorry, and want so much to help, but to their minds blindness is the greatest of all afflictions, and loss of eyesight is accompanied by a corresponding loss of physical ability and mental vigor, unless the person so afflicted is unusually gifted, and, in that case, he is regarded as the marvel of the age. Unfortunately, the percentage of gifted people is no greater among the blind than among the seeing, and so it is not strange that many of the former class are unable to cope with the difficulties and discouragements that blindness entails, when thousands of seeing people succumb to what they consider the unequal struggle for existence. As a class I honestly believe that blind people are more courageous than seeing people, and I am sure that a greater demand is made upon their stock of courage. This demand will be lessened when the public learns to look upon blindness as a physical, not a mental handicap, and when, instead of compelling persons so handicapped to sit on the side lines holding their broken swords, it leads them forward, places a new sword in their hands, and brings them the glad tidings that they are needed on the firing line. Loss of eyesight is always deplorable, but it is not so terrible as the isolation which generally follows it, an isolation due, in large measure, to misconception, lack of information, and misplaced sympathy on the part of the public, generous to a fault in bestowing alms, but slow to believe in the ability of the blind, and the wisdom of employing them. If the public could be brought to look upon the blind, not as an isolated class whose affliction entitles them to the pity and generous alms of those more fortunate, but as men and women, with normal aims and desires, just as full of hope, just as eager to work, and just as interested in things as when they saw them through the natural medium, their handicap would be lessened and their lives much happier. Most people think all that can be done for the blind is to divert them, amuse them, provide for them in institutions, or encourage them to accept private charity. This lack of understanding on the part of the public is the greatest drawback to the advancement of the blind, and often leads to untold misery. Occupation the blind should have, must have, if they are to enjoy any degree of happiness, or retain their self-respect. Loss of eyesight does not deprive a man of his desire to earn his daily bread, or to provide for those dependent upon him. He is willing and eager to work, and should be given the chance. A French physician, himself without eyesight, said: "So long as the blind can still bring their stone, however small it may be, to the building of civilization, or of bringing happiness to their kind, they feel that they live; and whatever be the wounds received, they are not out of the battle of life—the inequality of arms only increases their ardor." This inequality of arms should, and usually does, act as a spur to the courageous man or woman, but to the mind of the average sighted person, this inequality seems to apply inability, and so very little is expected of the blind, and little thought is given to their possibilities. Senator Gore, the blind Senator from Oklahoma, says: "It is a mistake to tell the sightless their loss is insurmountable or inconsequential. It is neither. The sightless confront a situation, not a theory. We ought to study their problems, and help them to lessen their burdens, to smooth their path, and to multiply their resources, to enable them to adapt themselves to a new and sometimes a strange environment; to help them to adjust themselves to a new set of circumstances, which presents a different problem, as it presents a different situation from those who possess the sense of sight." "And," the Senator concludes, "the greatest service we can render to the blind is to help them to help themselves." And this is where the public can help, though, as I have said, in its mistaken kindness, it more often hinders, and encourages the blind to accept alms, instead of making it possible for them to become self-supporting, self-respecting men and women.

The constantly increasing number of blinded men in the warring countries has made it imperative to find work in which they can successfully engage, and trades and occupations hitherto untried have been found to be both practicable and lucrative. What Sir Arthur Pearson is doing for the blinded soldiers at St. Dunstan's is little short of marvelous, and his success should help the cause in all parts of the world. In Eastern cities, a large number of the blind are gainfully employed, and new avenues of usefulness are being opened to them. At Ampere, New Jersey, Dr. Schuyler S. Wheeler has formed what he calls the Double Duty Finger Guild. This is composed of some twenty blind people, sixteen men and four women, and they have been taught to wind coils for armatures used in electric motors and mill machinery. These people earn from a dollar and a half to two dollars a day, and their work is done as well as that of the sighted employees, though, just at first, a little more time is required. They are making up this discrepancy slowly, but surely, and it is thought they will soon do the work as fast as the sighted operatives. Unfortunately, on this coast, we have no factories where this winding is done, as most of the electric concerns here do repair work, which varies so that it would be difficult for the blind operative to keep changing from one kind of work to another. Henry Ford employs a number of blind men in his factory at Detroit. There the men fit nuts to bolts, wind armatures, assemble different parts of machinery, and fold paper boxes. In his factory Mr. Ford also employs other handicapped men, and has machinery especially devised for their use. He believes that all large factories should employ a certain percentage of handicapped workers, as its contribution to the rehabilitation movement, and it is to be hoped his example may be followed by employers all over the country. The Light-House for the Blind in New York City, the Cleveland Association for the Blind in Ohio, and other similar associations are doing splendid work in arousing the interest of the public, and in finding employment for blind men and women, both in their homes, and in shops with sighted persons. Mattress making and upholstering have been found particularly adapted to the blind, and in Boston thousands of mattresses are made and renovated yearly by blind workers employed in the shops of the Massachusetts Commission for the Blind. Folding towels in laundries, wrapping bread, packing catsup bottles and fruit cans are some of the things being successfully done in the East. And the increasing shortage of labor will induce employers throughout the country to see the light, and realize that what the blind operative loses because of lack of sight, he makes up by increased concentration and faithfulness to duty. In the West, the people have very little faith in the ability of the blind, but in time we hope the social consciousness will become less lethargic, and that the mental and physical needs of this class will be given the consideration accorded to them in the larger cities throughout the East. The San Francisco Association for the Blind, a privately-maintained institution, is doing good work in arousing public interest, and in its shops the men are taught to make brooms and reed furniture, and the women to weave rugs and make baskets. It is in constant search for new fields of endeavor, and this spring it induced one of the largest canneries to employ over twenty blind people to sort asparagus, and the same cannery has selected a number of the best workers to cut fruit in its orchards in the Santa Clara Valley. All this is very encouraging, but it is only a beginning, as there are hundreds of blind in this state who should be contributing to their own support. This is why an enlargement of the plant of the Industrial Home for Adult Blind in Oakland is so urgently needed, for, after all, the state should assume the duty of providing its handicapped civilians with employment, instead of caring for them in almshouses, or permitting them to become objects of private charity. The state should see to it that its blind children receive an education which will fit them to earn their own living. All schools for the blind should be under the direct supervision of Boards of Education, who should give the same careful consideration to the problem of educating blind children as is now given to the education of seeing children. And this is one argument in favor of classes for the blind in the public schools. Vocational training is of more importance to the blind child than to his more fortunate brother, and when this is recognized, one of the barriers to his success will be removed. Is there any reason why an intelligent blind youth especially interested in medicine, should not be trained as an anatomist, a heart and lung specialist, an osteopath or a masseur? He does not need eyes to listen to heart beats, find the third vertebra, or rub the kinks out of a refractory muscle. In Japan the government reserves massage as an occupation for the blind, and in the hospitals of England and France blind masseurs are given the preference, and their work receives the highest commendation. Los Angeles has a blind anatomist at the head of its College of Osteopathy, and several blind osteopaths.

When mentally equipped, all blind students should be sent to college, and urged to fit themselves as teachers. In every college and university blind men should occupy chairs in history, English, economics, and mathematics. I know two blind men in this state well qualified to teach any of these subjects, who are forced to accept inferior positions, because educators generally fail to realize that blindness is no bar to mental attainment, and that the ability to teach does not depend upon the ability to see with the eyes. This will be better understood when the coeducation of blind and seeing children becomes more general—God speed the day! As music teachers, concert players, leaders of orchestra, or masters of the violin and 'cello, the blind should have an even chance of success, but their inability to read music at sight, or watch the director's baton often deprives them of positions which their quick ear and well trained memory would enable them to fill with profit to themselves and satisfaction to the public.

And so in all the professions. I know a man who, before he lost his eyesight, was considered an eminent lawyer, but now his associates regard him pityingly, and his clients take their business elsewhere. When the light went out of the eyes of this brilliant man, it did not take his brain as well. He is fitted to be a consulting lawyer or court pleader, and could occupy a chair in a college of law. Surely, there is something radically wrong when these conditions exist! Surely the public needs to open its eyes, and polish its glasses in order to see more clearly that there is a mental blindness, more pitiful, more far-reaching in its consequences, than physical blindness, however hard or uncomfortable the latter condition may be. Some one facetiously suggested that I call this lecture "bringing light to the seeing," and, in a sense, this is what I am trying to do. But the light is carried by a kindly hand, and the hand is the index to a heart in which there is no bitterness, no malice, no distrust—a heart brimming over with love, with hope, with confidence, and with a belief that the public will see the light, and, seeing it, and reading my message in its beams, will pass it on to others, adding to it as it goes, until it floods every corner of our vast state, and result in untold good for my people. And let me tell you how this light may be disseminated—let me apportion your share in this labor of love, this highest form of social service, this movement of re-education now sweeping over the land.

I am so often asked by those who wish to volunteer in their country's service, "What can I do to help in the re-education of the blinded soldier?" And I invariably answer, "You can first help in the re-education of the public, and this will be the greatest service you can render to the men blinded in battle." In order to know what lines of work will be available for them when they return, we must look about and see what the adult blind of our civil communities are doing. If we can not employ all these who are willing and able to work, how can we hope to employ an increased number later on? Let us ask ourselves what the blind can do, and then, how much of this are we permitting them to do? If we are an employer of salesmen, and one of our employees has recently lost his eyesight, let us ask ourselves why, when he came to us and urged us to let him continue to sell our goods, we told him that, although he had been a faithful worker, and we were exceedingly sorry for his misfortune, we could not retain his services, because competition was so great, and so many unexpected things happened, and we felt we could not entrust our business to any one who did not possess all his faculties. We meant to be very kind, and we thought every word we said was true, but was it true? Did that man sell our goods with his eyes, or did he sell them by using his tongue and his personality to persuade customers to patronize us? If he had a boy to go about with him, could he not talk as convincingly, work as hard, and, indeed, might he not put forth a greater effort to extend our business and make himself invaluable to us? This is a typical case, and one that occurs almost daily. So it is in all lines of work the blind man or woman attempts. A blind piano tuner asks for work from house to house, just as a sighted tuner has to do, but, whereas we sometimes employ the latter, we refuse the former, saying, we could not trust our instrument to the hands of a blind man, and maybe we offer him a small piece of silver to lessen the hurt we have unwittingly inflicted. Perhaps a man with defective eyesight asks to clean house or help in the garden, or work on a ranch, or perform some light task in a store. The same condition obtains. We are so hurried these days, we must have the work done with the greatest possible expediency, and so we can not entrust it to any one who is handicapped, although we are sorry, and really wish we could do something for such people. And so sometimes, men who started out with high hopes and lofty ideals are forced to the streets, there to depend upon the spasmodic charity of the passerby, and to attract this wavering attention of the public, the man resorts to all sorts of subterfuges, from holding up pencils and gum to grinding out popular tunes on a wheezing old hand organ. Sometimes these men have families and feel they must make this effort to maintain them. Many of them try to sell newspapers on the corners of our principal streets, but here, too, the competition is very great, and little boys patrol the curb, holding the ever-ready paper under the nose of the hurrying pedestrian who, though he may be conscious of the blind man selling in front of a building, thinks he can not spare time to go to him for a paper, and so snatches one from the waiting boy, throws him the pennies, and jumps on a moving car. Selling newspapers is better suited to a blind man than almost any other line of business. I mean the man who has never learned a trade, or who has no special profession. If the government could commandeer this line of work for its blind civilians, I am sure there would be fewer itinerant street musicians, gum or pencil venders. Of course, after a while, the blind man reduced to playing on the streets, becomes accustomed to the excitement, the roar of traffic, and covers, I will not say earns, more money than he could by canvassing, piano tuning, or making brooms. And so, once started on this road, once accustomed to the acceptance of public charity, it is almost impossible to induce the street vender or musician to try a more legitimate means of livelihood. He invariably says, in answer to the protest of those who have the interest and advancement of the blind at heart, "When you can find me a job where I can earn as much as I do right here, I'll take it, but until then, I must live, and I must help to support my family." Meanwhile these street merchants are creating an erroneous impression in the minds of the unthinking, but ever sympathetic public, leading it to believe that begging is all that the blind can do; and so, when asked to employ a blind person, even in the smallest capacity, people mention the blind of the street, and say they will gladly contribute to the support of the sightless either in institutions, or by private charity, but they do not believe in their ability to perform work of any kind. Of course, this is not the answer given in every case, but it is the reply generally made to all such requests. This is the sad state of affairs here and in many of the large cities throughout the country, and this is why the State Library is conducting a campaign for the enlightenment of the public. Whenever possible, I raise my voice in this cause, before clubs and organizations, high schools and colleges, in order to change this mistaken attitude, in order to urge a saner point of view. In presenting this gospel of work for the blind, I put the matter very plainly, prove to the public that it is to blame for many of the conditions I deplore, laugh at its incredulity, score its misconception, urge a broader, more comprehensive sympathy, and usually leave the platform with the assurance that I have won many recruits in this campaign so dear to my heart.

As I said in my last lecture, the government has a well-defined plan for the re-education of its blinded soldiers. But suppose this plan is carried out, and the men are returned to their home cities, qualified to pursue a certain line of work, only to find that the public does not share the government's confidence, is unwilling to give them an opportunity to prove their ability? The public will cheerfully pay taxes to care for these men in idleness and seclusion, thus diverting to the rear of life's battle line these heroes who have given the most precious of all their physical possessions in their country's cause. The soldier killed on the field of battle pays the supreme sacrifice all in a moment, but the sacrifice of the blinded soldier is lifelong. Are we going to find employment for these returned heroes, or are we going to add yet another burden to their already heavy load? Are we going to add the burden of dependence to the burden of darkness? If we want these men to know that we appreciate the service they have rendered to their country, let us provide occupations for them, and in order to do this let us begin by employing the civilian blind, the blind right here in our midst. Let us study the problem with an open mind, freed from the old prejudice and unbelief; let us turn the light on ourselves, and see that it is we who sit in darkness. Let us ask the blind leaders of the blind what work can be done without eyesight, and let us be guided by their judgment, their experience. And, as a bit of Red Cross service, let us employ the blind; let us create a demand for their labor; let us ask for work made by the blind, and tell our friends to ask for it; let us buy our newspapers from the men on the streets, and let us give our magazine subscriptions to blind men who have subscription agencies; let us patronize blind lawyers, osteopaths, salesmen, piano tuners and musicians. Let us find other and broader avenues of usefulness for these our civil blind heroes, who went into the dark with no blare of trumpets, no applause from cheering multitudes, and who wear no badge of honor on their breasts. Let us do this, so that when the blinded soldiers return, we may welcome them with the glad tidings that we have work waiting for them, that we know they can do it, because blind men and women here have blazed the trail, and have, by their splendid courage and boundless enthusiasm, succeeded in changing the attitude of the public, and removing the last lingering vestige of doubt as to the ability of the blind to become self-supporting, self-respecting citizens. In this campaign of enlightenment, this bit of Red Cross service for the blinded soldiers and the blind adults of our civil communities, every one of you can help, and I feel sure it will be unnecessary for me to ask a pledge of co-operation from any one who has heard me speak this afternoon. The State Library is heartily with me in every phase of this campaign, and, with its co-operation and encouragement, I go fearlessly forward, overcoming obstacles, uprooting prejudices, laboring with heart and mind and voice in the service of the blind and in the hope of bringing about a clearer understanding of their needs in the minds of the public.

And now, in conclusion, let me tell you my dream for the future of the blind, a dream which, please God, will one day come true. I dream of seeing blind men occupying chairs in our colleges and universities, blind heart and lung specialists, anatomists and osteopaths, lawyers and lecturers. In my dream, I see blind salesmen, telegraphers, musicians, piano tuners and electricians, and other men making brooms, brushes, mattresses and furniture now so often made by prison labor. And in my dream, I see blind women teachers, stenographers, dictaphone and switchboard operators; and other women knitting, crocheting, sewing, cooking, weaving rugs and making baskets, and doing the work side by side with their more fortunate sisters, and doing it as well, and often better. Then and only then will the greatest sting be removed from blindness; then and only then will the blind beggar depart from our public thoroughfares, and when all these things come to pass, my dream for my people will be realized. Aren't you going to help to make my dream "come true"?



PREVENTION OF BLINDNESS AND CONSERVATION OF VISION IN ADULTS AND CHILDREN.[2]

Helen Keller, in writing on prevention of blindness, says: "Try to realize what blindness means to those whose joyous activity is stricken to inactivity. It is to live long, long days, and life is made up of days. It is to live immured, baffled, impotent, all God's world shut out. It is to sit helpless, defrauded, while your spirit strains and tugs at its fetters, and your shoulders ache with the burden they are denied—the rightful burden of labor."

[Footnote 2: Reprinted from News Notes of California Libraries, vol. 14, no. 1, Jan. 1919.]

When I was twelve years old, the well-known oculist, Dr Barkan of blessed memory, came to examine the eyes of all the children in the School for the Blind at Berkeley. I was the first to be examined, and I remember distinctly every word of the great doctor when, after looking at my eyes, he turned to the superintendent, and said sadly, "Needlessly blind! her eyesight could have been saved." These words made a profound impression upon my childish mind, and as I sat and listened, while child after child was examined, and heard again and again the same remark, "needlessly blind!" I resolved to know more about this eye disease with the very long name, ophthalmia neonatorum, to learn its cause, and see just how it might have been prevented. But we did not hear as much about prevention as we do now, and, although I did not forget the matter, it was many years before I had an opportunity to study it further. When I did, I found that at least one-fourth of the children in schools for the blind in this country were there, just because a simple precaution was not taken at the time of their birth.

Five years before I knew there was such a thing as unnecessary blindness (since I had been told I was blind as the result of a severe cold in the eyes), a Belgian doctor, Professor Crede, a famous obstetrician of Leipsic, appalled at the number of children who lost their eyesight within a few days after birth from a virulent eye infection, determined to try the effect of a simple prophylaxis, a two per cent solution of nitrate of silver, dropped in the eyes of every newborn child. The effect of the prophylaxis used in Dr Crede's clinic was marvelous, reducing the number of cases from ten per cent in 1880, to one-fourth of one per cent in 1886.

"Babies' sore eyes," or ophthalmia neonatorum, is defined by Dr Sydney Stephenson as "an inflammatory disease of the conjunctiva, usually appearing within the first few days of life, due to the action of a pus-producing germ introduced into the eyes of the infant at birth." Dr Crede found that, by putting two drops of the solution into each of the infant's eyes at birth, all danger of infection was averted. The solution is harmless to healthy eyes, and, in ninety-nine cases out of a hundred, destroys infecting germs when they are present. The cost of the drops is nominal, about two cents per patient, and yet over ten thousand persons in the United States, and as many more in other countries, have been deprived of the most important of the special senses through the ignorance and neglect of doctors and midwives, and the public at large, as to the gravity of the disease, and the methods of prevention. It is estimated that twenty babies in every one thousand have sore eyes, and that from five to eight of these cases are serious, and capable of causing blindness. Infant ophthalmia is found among all classes, but more especially among the poor, who must so often depend upon the services of a midwife or neighbor who, in most instances, does not know the meaning of the word antiseptic. Consequently, it was found necessary to make laws for the prevention of this disease. For various reasons, it is difficult to pass a law making the use of a prophylaxis compulsory, and in only a few states has this been done. But in more than thirty states the immediate reporting of infants' sore eyes is compulsory, and in thirteen states the prophylaxis is distributed free to doctors and midwives.

In our own state, every precaution is taken to prevent infant ophthalmia. Dr Edward F. Glaser, secretary of the State Board of Health, has given this subject unlimited time and study, and, with the help of the California State Library, California Society for the Prevention of Blindness, and many social and civic organizations, has conducted a continuous campaign, and has succeeded in passing a law which is both simple and effective, and which has resulted in lowering the percentage of infantile blindness, and in arousing the public to a sense of its duty in this regard. Dr Glaser and the above-named organizations have also rendered yeoman service in securing the passage of laws prohibiting the use of a roller towel, and for the licensing and registering of midwives.

In this state, the law for the prevention of infant ophthalmia provides for the immediate reporting of every case of babies' sore eyes, and failure to do so is considered a misdemeanor, and a third offense results in the revocation of the license to practice medicine. In 1915, the State Board of Health purchased 23,000 prophylactic outfits. These are little wax ampules, containing just enough one per cent nitrate of silver solution for the eyes of a child at birth. These ampules are distributed free to physicians and midwives all over the state, and in the past two years, more than 16,000 have been so distributed. In California, the birth certificate asks these questions: "Was a prophylactic for ophthalmia neonatorum used? If so, what?" The birth certificate must be filed within five days. Few doctors have the temerity to ignore these questions, or confess that they have used no prophylactic, so the questions on the certificate insure the use of the nitrate of silver solution in nine cases out of ten, though its use at birth is not made compulsory. Dr Glaser reports that the birth certificates in fourteen of the largest cities of the state, for the year 1917, show that on eighty-seven per cent of the certificates filed, the questions had been answered, and the prophylactic used. In Berkeley, every one of the birth certificates filed in 1917 reported the use of a prophylactic. The State Board of Health insists on the reporting of all communicable diseases, and infant ophthalmia is considered one of these, and in this connection, Dr Glaser says, "a case reported is a case safeguarded, a physician aided, and a community protected." But it is necessary to urge a ceaseless warfare against this most prolific cause of infantile blindness, and social and civic organizations, churches, schools, and all individuals who deplore needless suffering, are asked to give the subject the widest publicity. Physicians are only now beginning to realize that, in all phases of preventive medicine, their strongest, most necessary, and, indeed, essential ally, is the public, and the needed stimulus to a better medical performance is an intelligent knowledge on the part of the people as to what should be done.

It is a common belief that ophthalmia neonatorum is an indication that one or both of the infant's parents have led unclean lives, and so, until recently, it has been difficult to have all such cases reported. While ophthalmia neonatorum is often the result of the social evil, the introduction of other pus-producing germs into the eyes at birth is responsible for a large number of cases. So it should be remembered that babies' sore eyes is not a disgrace (any baby may have the disease), but blindness from babies' sore eyes is a disgrace, for, in almost every case, it can be prevented.

Dr Park Lewis says: "And when we think of the long life of darkness of the blind, the limited possibilities of the child to be educated, the narrow lines in which he may hope to be trained, the fields of usefulness from which he will be cut off by his blindness, his dependence on others for things he should otherwise do for himself, the financial loss to the community for his maintenance when he might, under happier conditions, not only have been self-supporting, but possibly independent—the pity of it all comes with added emphasis. The importance, then, increases of every intelligent human being knowing that the most serious forms of birth infection of the eyes, in almost every instance, should not have occurred." Dr Lewis continues, "The majority of the blind are not wage earners, and are thus not only an added expense, but an economic loss. The education of each blind child costs the state yearly about three hundred and fifty dollars, while it costs but thirty dollars to educate a seeing child for the same period. Ophthalmia neonatorum is a crime, because of the suffering it brings to helpless, innocent persons, and because it leads to a reduction in economic efficiency, deprivation of many pleasures and privileges and, very often, immeasurable misery, suffering and sorrow during a lifetime in the dark."

Of the twenty children brought to me for inspection during the past three years, fifteen were blind from infant ophthalmia, and, as I myself am a victim of this same disease, I am leaving no stone unturned in my efforts to save other children from hardships and limitations that are wholly preventable, and I feel that I am peculiarly fitted to help in this great work.

There are other common causes of blindness in children, one of which is phlyetenular keratitis, usually the result of poor or improper feeding, or lack of ventilation, and it often leaves the cornea badly scarred. Tuberculosis of the eyes results in much the same condition, often causing total blindness. Measles and scarlet fever cause blindness or defective vision. Parents do not realize the gravity of these diseases, and fail to cleanse the eyes frequently, or to keep the room properly darkened. In some cities, during epidemics of these diseases, health officers are requested to distribute circulars, calling attention to the danger to the eyes, and giving instructions as to their care. In this state, measles and scarlet fever are among the communicable diseases which must be reported.

Trachoma, a virulent form of conjunctivitis, is a communicable eye disease which must be carefully safeguarded. It flourishes in unsanitary surroundings, camps, and homes where the family uses the common wash basin and towel. There are not many cases in this state, but even one is too many. We are profiting by the unhappy experience of Kentucky and other Southern states, and are adopting drastic measures for its prevention.

Interstitial keratitis, or inherited syphilis, is a common cause of blindness in children, though, in many cases, the blindness is only partial, and, if taken in time, the remaining eyesight may be saved. This disease usually appears between the ages of four and twenty, often following some childish malady, and it requires the greatest care and most nourishing food to counteract its pernicious effects. The victim of interstitial keratitis is never strong, and, although a blood test may show a negative condition, any serious illness may cause the constitutional trouble to reappear.

It is a common belief that children will outgrow cross-eyes. This is not true, for the eye that turns either in or out, will, sooner or later, become useless, simply from disuse. Such children should have attention as early as possible, even in infancy, as properly fitted glasses will usually restore such eyes to their normal condition.

Children are often needlessly blind as the result of an unwise and harmful selection of toys, such as scissors, forks, toy pistols, air rifles and bows and arrows. The observance of a sane Fourth of July has lessened the number of accidents to the eyes of children.

I have thus far spoken of the prevention of blindness in children, and now I wish to call your attention to what is being done for the conservation of vision in childhood. In the lecture on the development of the blind child, I mentioned special classes for blind children in the public schools. In most of the cities having such classes (Chicago and Los Angeles excepted), sight saving classes, as they are called, are maintained. In these conservation classes, the children do not read with their fingers, but books in heavy face, large type are provided. And for these books we are indebted to Mr R. B. Irwin, the blind supervisor of special classes in Cleveland. So here again we find a blind man planning not only the advancement of blind children, but the conservation of vision of partially-sighted children. In these classes desk blackboards are provided, and a great deal of oral instruction is given, and the amount of reading is limited. A great deal of handwork is required and everything possible is done to save eyestrain. Much time and thought is given to the proper lighting of schoolrooms, and to the color scheme of the buildings. Light should not be judged by its brightness, but rather by the way it helps us to see what we are looking at. Walls should have light paper or tinting, as dark walls absorb light strongly, instead of reflecting it. Reds, greens and browns reflect only ten to fifteen per cent of the light which falls on them; while cream-color or light yellowish tints reflect over one-half the light.

As a result of the ophthalmic work of the medical inspection departments of many of our public schools throughout the country, much is being done to help children who are partially blind, or suffering from some visual defect which may lead to blindness if they continue in school under ordinary conditions. Every large city should have one or more of these conservation classes, and the demand for them will increase when the public realizes their importance in saving the sight of school children. Dr De Schuynitz, an eminent oculist of Philadelphia, in an address on conservation of vision, asked these questions: "Shall children be allowed to trifle with their most precious possession? Shall our homes be permitted to disregard the rules of visual hygiene? Shall children, and those children of the larger growth—men and women—remain on the side lines because they can not see well enough to play the great game of stirring life, with its joy of untrammeled effort? Shall they not have a game which they can play? Shall we of these better walks of life pursue our way in smug contentment, and permit the preventable causes of blindness to continue their black business, and ever add to the roll of their victims?" The leading oculists of the country recommend sight-saving classes, and many of them give their time and money to the service of these handicapped children, establishing clinics for their care and treatment. In Los Angeles the Parent-Teacher Association has a wonderful clinic, and Dr Ross A. Harris and his assistants have saved the eyes of hundreds of children who would otherwise have become public charges. But here again it is necessary to educate the public. An old schoolmaster, rich in the wisdom of ripe experience, has said, "More children's eyes are injured in the home than in the school," and his words receive daily verification. But in schools where medical inspection is given, and where a visiting nurse is in attendance, untold good is being accomplished, and children who should wear glasses, and attend conservation classes are promptly sent to the oculist, and assigned a place in school.

The commonest visual defects are, first, inflammation of the cornea, or imperfections of the lens—the cornea is often so scarred as to make vision imperfect; second, myopia, or progressive shortsightedness, a condition in which the axis of the eye gradually grows longer. This lengthening is accompanied by stretching of the eyeball, and such children always run the risk of the inner and most important part of the wall of the eye, the retina or nerve layer, being torn away, and blindness resulting. When nearsightedness is discovered early, and glasses are given that make distant vision normal, and all needless near work forbidden, the myopia may be held in check, and any considerable increase prevented. Teachers are usually the first to notice such defects, but many parents do nothing when their attention is called to the matter. But happily these conditions are improving, and the school nurse and school clinic, and all the clinics maintained by public and private charities, are accomplishing wonderful results. When preventive medicine and preventive social service are joined in the effort to help mankind, there must result a saving of our most precious physical possession, and an addition to human joy. The National Committee for the Prevention of Blindness and Conservation of Vision, with headquarters at 130 East Twenty-second street, New York City, carries on a ceaseless campaign of enlightenment by means of pamphlets, lectures, charts, lantern slides and posters, and the work of this society is directed by Mr Edward M. Van Cleve, Superintendent of the School for the Blind in New York City. The leading oculists of the United States are members of the society. Charts and lantern slides are loaned to societies for the prevention of blindness in the various states, and pamphlets on many important topics are sold at a nominal cost. When addressing a large gathering in New York, and urging the wisdom of publicity, Dr De Schuynitz said: "We are here to help in the work of health education, of eyesight protection; we are to call on society for aid in devising measures, and for means to carry them out, in order that effective results shall merge into perfect victory. We are here, too, I take it, to cure those who are dull-sighted in this regard, so that, with vision cleared, they shall join in the struggle for ocular conservation and make it possible to give sweetness of disposition and ever-present cheerfulness, not to the blind, the good God sees to that, but to those who shall be saved from blindness."

In New York and Boston, the children are given instruction in hygiene, taught to properly care for the nose, throat, eyes and teeth. These lessons begin as early as the second grade, and are illustrated with charts showing how perfect teeth and eyes should look. These lessons include the harmful effect of enlarged tonsils and adenoids, and the children are very anxious to be in as perfect condition as those shown in the pictures. A teacher of one of these classes in Boston took her children to a museum, where they spent a morning studying statuary. The next day, wishing to see how they had been impressed by what they saw, she asked, among other questions, "What do you remember about Aphrodite?" One little boy held his hand up, saying, "She has adenoids." "What makes you think so?" asked the teacher, wonderingly. "Why, she had her mouth open all the time." The children learn just how far from the eyes a book should be held, and often call attention to a companion whose myopic condition makes it necessary to hold the book very close. And so the outlook for the children is very promising. With conservation of vision classes, classes in hygiene, with school nurses and clinics, with medical inspection of schools, and with the public aroused as never before to its responsibility towards its boys and girls, we should have less need for oculists and schools for the blind, and fewer persons should be obliged to go through life deprived of the light, which was God's first gift to the world.

Before discussing the prevention of blindness in adults, I wish to say a few words concerning the attitude of oculists toward patients suffering from eye diseases which, in all probability, will result in loss of vision. If, for some special reason, the oculist fears it would be unwise to tell the patient that blindness is imminent, he should at least urge him to conserve his remaining vision, and advise him to do as many things as possible by touch, and warn him of the consequences of eyestrain. But, whenever possible, it is kinder to prepare the patient for oncoming blindness, so that he may shape his life accordingly, and may be induced to learn to read raised type, and use a writing device, before the light is entirely gone. Most of us exclaim over our trifling hurts, the mosquito bites of life, but when the real trial comes, when we know we must face a great crisis, we square our shoulders, take a long breath, and meet the inevitable with courage and fortitude. I wish the oculists could hear as I do the despairing cry of men and women who were led, until the very last, to hope for a restoration of eyesight, and then told that in their particular case, all usual remedies failed. Dr Daval, an eminent French oculist, who lost his eyesight at sixty, makes an eloquent plea to his colleagues to tell their patients the truth, and, instead of treating them when they know that loss of eyesight is inevitable, advise them to study methods used by the blind, even though they may not need to use the knowledge for months or even years.

There are a number of eye diseases that may be inherited, and those having such diseases should be told that they will transmit them to helpless, innocent children. The social evil is largely responsible for the infections of which ophthalmia neonatorum is only one result, but since this disease comes so often from a cause which is not generally discussed, it is particularly hard to combat. Forty per cent of existing blindness, and a vast amount of physical degeneracy, is the direct result of venereal causes.

Certain forms of glaucoma may be inherited, and children whose parents have had this disease should watch their own eyes very carefully, since, if taken in time, the progress of this disease, in certain forms, may be arrested. Persons who see rings around the lights should heed the danger signal and see an oculist.

Retinitis may also be inherited. I have known of three generations becoming blind from this cause.

Nearsightedness may also be inherited. I have known this condition of the eye to be present in four successive generations, and in the last generation, the young woman became totally blind from detached retina, due to excessive eyestrain while in school. If you could see my records, and count the number of cases where blindness is given as the result of straining nearsighted eyes, you would realize with me that progressive myopia should be classed as one of the preventable eye diseases, and a vigorous campaign waged against the marriage of persons so affected. Nearsighted people should be especially careful to avoid eyestrain, and should not work by artificial light. Bookkeepers, hotel clerks, and women who do fine sewing at night should be cautioned against such work, if they are myopic.

Optic atrophy is an eye disease very baffling to oculists, sapping the vision slowly but surely, as a rule, but occasionally destroying eyesight in a very short time. Electricians and those working in chemical laboratories are susceptible to optic atrophy.

A common cause of eyestrain is reading on street cars, or using the last, lingering bit of daylight to finish a chapter or complete some fine work. It is easier to turn on the light than to spend years in the dark.

The eyes of many people are ruined because, instead of going to an oculist to have their eyes properly fitted to glasses, they go into a ten-and-fifteen-cent store, try on a lot of cheap glasses, and purchase the ones that magnify the best, and feel most comfortable on the nose. The cheap varieties of glasses are often made from bits discarded by opticians, and never intended to be used again. People are not always careful in selecting eye shades, and often use those made of very inflammable materials, which frequently catch fire, and destroy the eyesight.

I can not understand how people can trifle with the most precious of their physical possessions, and yet my records teem with such instances, and the victims realize when too late how criminally thoughtless and careless they were. Some of our grown-up children need instructions as to the use and abuse of their eyes. In Los Angeles, I addressed the various Parent-Teacher Associations on these important subjects, and I believe that the note of warning sounded by one who is herself a victim of unnecessary blindness, went straight home to every heart.

The percentage of adult blindness is increasing at a very rapid rate, owing to the numerous accidents in factories and workshops, accidents that are, in many instances, preventable. Owners of factories, quarries, mines and other industrial plants have become alive to the necessity of safeguarding the eyes of their operatives, and much needed legislation is being enacted in all parts of the country. The National Council of Safety, an organization in existence but five years, has accomplished a great deal and this council co-operates with State Industrial Accident Commissions, and with civic and social organizations. The National Council of Safety estimates that there is one worker killed every 15 minutes, day and night, in the United States, and one injured every 15 seconds, day and night. This gives 30,000 killed and 2,000,000 injured, and of this number 200,000 are eye injuries. The National Committee for the Prevention of Blindness estimates that there are 100,000 blind in the United States, and half this number are needlessly so. Mr Will C. French of the State Industrial Accident Commission estimates that we have 1,000,000 employees in the state, and we have 300 industrial injuries daily, including Sundays. We thus have approximately 100,000 industrial accidents each year in this state. Since 1914, there were 23,451 eye injuries, and of these 549 were permanent injuries, and 11 resulted in total blindness. The medical and compensation costs of these eye injuries will be about $788,000. The 11 blind call for life pensions. The State Library home teachers are teaching 7 out of the 11 cases, and the Industrial Accident Commission is very glad to co-operate with us.

In California we have an average of 26 eye injuries each working day, and this number is likely to increase, especially in the shipbuilding industry, because of the chipping steel, use of emery wheels, and machinery in the construction of vessels. The State Accident Commission advocates goggles, one pair to each man. There are four kinds of goggles used. Those for the protection against flying material, for protection against intense heat and light, for protection against gases, fumes and liquids, and dust goggles. Masks are urged for welders and babbiters, and these masks are so strongly constructed that they not only fit the eye, but have shields at the sides of each lens to prevent the flying chips from entering the eyes from the sides. In most of the large plants there are committees of safety composed of employees, and they do much to reduce industrial accidents. Precautionary leaflets are circulated among the workmen, and attractive posters, printed in all languages, are used. Some of these are very effective. One shows a man saying "good-bye" to his wife and five little ones, and underneath is written, "How could they do without you?" One of the best known slogans, and one carrying conviction, is "You can see through glass goggles, but you can't see through glass eyes."

Many trades and occupations have their well-recognized types of injury. In the bottling works eyes are frequently lost through the impact of popping corks. The bursting of unprotected water gauges caused many cases of blindness yearly among engineers and machinists. In the grinding trades eyes are frequently lost by bits of flying emery becoming imbedded in the eyeball, and the Industrial Accident Commission recommends iron or glass guards for emery wheels. In factories, quarries and mines more serious damage is done by larger bits of metal or stone. Sometimes harm is done in an attempt to remove the foreign body from the eye, as the hands of the one performing this service may not be clean, or the instrument used may be the corner of a soiled handkerchief, a toothpick or match, or even, as sometimes happens, the tongue. More eyes are injured from infection than from the presence of foreign bodies, which, if properly and carefully removed, might result only in temporary inconvenience and the loss of a few days work. Workmen should not trust to the shop or factory doctor, but should go to the company doctor at once. Immediate and competent care should be secured without delay, and this will save eyes, and also save employers and insurance companies a great deal of money.

Lime-burn, solder-burn, and all the so-called dusty trades produce chronic inflammation of the eyes, which often results in total blindness. The National Council of Safety enumerates fifty-five industrial poisons, thirty-six of which affect the eyes. Absorption of drugs often causes blindness—tobacco, wood alcohol, lead, used in so many industries; bisulphide of carbon, used in making rubber; nitro-benzol, used in the manufacture of explosives, and some of the anilin dyes. Hoods and exhausts should be used to prevent the escape of dangerous fumes, vapors and gases. For men exposed to great heat, antisweat pencils have been manufactured, and when these are rubbed over the goggles, the glass will remain clear of steam for hours. Special eye coverings are designed for men working over acids, or in sand blasting. One of our pupils, a man past fifty, who had worked in a creamery for over twenty years, and who usually wore goggles when making tests with sulphuric acid, neglected to take the precautionary measure one morning, and some of the acid splashed up into his eyes. He is totally blind, and must begin life all over again. There have been so many cases of blindness as a result of dynamite explosions occurring in quarries and mines, that laws have been enacted for the protection of workmen. When a blast has been fired, and it is not certain that all the charges have exploded, no person is permitted to enter the place until forty-five minutes after the explosion. My records prove the great need for this precautionary measure, and I only wish it had been enforced years ago, before so many men in the prime of life had been deprived of eyesight, and of earning capacity as well.

Improper lighting and ventilating in factories, shops and stores, and work requiring excessive eyestrain, contributes to a long list of disabilities often resulting in total blindness. The passage, by our last Legislature, of the Common Towel Bill, prohibiting the use of roller towels anywhere in the state, has removed one of the most flagrant causes of infection, and one to which very little attention was paid by factory workers generally. I know one young man and two young women whose total blindness is the result of infection from the use of a roller towel.

I trust all these facts and figures may not prove wearisome, for it is necessary to know them if you are to realize the extent of the work being done here and elsewhere to prevent blindness and conserve vision. I have not mentioned all the activities of the State Industrial Accident Commission, or the National Council of Safety, but a visit to the Safety Museum, 525 Market street, San Francisco, or to the Union League Building, Los Angeles, will enlighten you further as to the progress of the Safety First movement, and convince you of the wisdom and humanity of it. Let us adopt prevention and conservation as household words; let us do our share in spreading the gospel, and soon we shall have fewer blind babies, fewer children sitting on the side lines, and fewer men and women deprived of eyesight at the floodtide of life. This is another of my dreams, and this one is already coming true. "Let there be light!" was the first recorded utterance of the Most High God. "Let there be light!" has been the watchword on the lips of human progress during all the centuries that have gone, and they must be the battle-cry of Progress during all the centuries that are to come. I am sure we shall all be glad to do our share to preserve this light for our own and future generations.

THE END