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Iridology : A critical reveiw

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Page 1: Iridology : A critical reveiw

ACTA OPHTHALMOLOGICA 63 (1985) 1-8

E D I T O R I A L

lridology A critical reveiw

\

Lennart Berggren

Department of Ophthalmology (Head: Lennart Berggren), University Hospital, Uppsala. Sweden

Abstract. Iridology has existed for more than 100 years and has now aroused new interest in the age of alterna- tive medicine. The conception that disorders in different organs of the body are projected in the iris by the appearance of a variety of signs and spots has repeatedly been rejected by medical science, apparently with little success. Supporters of iridology pretend that their critics have a professional unwillingness to accept unorthodox ideas and that future research will demonstrate the true value of iridology. An evaluation of the concepts of iridology and of controlled scientific reports has, how- ever, established the following points: The basis of irido- logy and the different iris signs are explained by physio- logical variations of the normal human iris; controlled clinical trials and experiments conclusively show that iridology has no ability to detect disorders in other parts of the body; there are sufficient proofs that iridology is purely conjectural. Iridology is of no medical value and might even be a potential danger to people seeking medical care. It should be exposed as a medical fraud.

Key words: alternative medicine - charlatanry - holo- graphic medicine - iris diagnosis.

Technological progress in medical science has pro- duced outstanding achievements in the last de- cades. I t has also become a primary cause of people’s lack of confidence in modern clinical prac- tice, which is criticized for emphasizing the dis- eased parts rather than the whole person. Holistic or alternative medicine stresses the importance of an integration of physical, psychological, emotional and social factors and the necessity of healthy life-styles and self-care. Those insights are, how- ever, not controversial. They could serve as guide- lines to every physician with a sense of responsibi-

lity (Relman 1979). O n the other side of the coin the holistic movement is, however, very doubtful. T h e growing mistrust of established medicine has promoted the revival of occultism as well as several forms of spectacular charlatanry. Holographic methods such as zone therapy, auriculo therapy and iridology are growing, and their credibility is seldom seriously questioned. They maintain that the wholeness is revealed in the detail and assume that projections or miniature charts of the body are represented in peripheral parts such as the sole of the foot, the outer ear, or the iris. Their lack of medical knowledge might be a potential danger to the patients in need of medical care.

There is a popular view that there must be ‘something’ in iridology and that the negative atti- tude of medical science depends merely on its reluctance to accept new, unorthodox ideas from outside. Even some physicians have subscribed to these views. A German internist was the co-author of a well-known book on iridology (Vida & Deck 1954). As late as in 1983 a Norwegian physician and author of popular books on alternative medi- cine declared that iridology should be taught in medical education and used as a diagnostic tool of physicians. He also considered the results of irido- logy to be well documented and that medical science would realize its value if more research was carried out (Schjelderup 1983).

Such positive views on iridology have no support from hard facts. T h e purpose of the present report is to refute iridology on rational grounds by pre- senting: first, a summary of the collected know- ledge of the origin and development of iridology;

I Acta Ophthal. 63, I 1

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second, physiological explanations of the signs in iridology; third, an account of published controlled trials and experiments on the ability of iridology to detect disorders in the human body.

The discoverers and their followers

More than 100 years have now passed since Ignatz von Peszely (1880) introduced the iris diagnosis or iridology. The method is based upon the conviction that by looking at the appearances and locations of spots and other signs in the iris it is possible to draw detailed conclusions as to diseases in other parts of the body. His work ‘Anleitung zum Studium der Diagnose aus den Augen’ apparently awoke only little interest, but was revived by the editor of a homeopathic journal (Homeopathische Monats- blatter 1886). The Swedish clergyman Liljequist is the second founder of iridology. The first edition of his Eye Diagnosis (‘Ogondiagnostiken’) was published in 1890 and also translated into German. The second edition (1903) comprises over 300 pages. Besides being a guide to iridology the book is full of contemptuous attacks on traditional medi- cine.

After the Second World War iridology experien- ced a revival, especially in Germany. The ideas, presented in books such as those by Maubach (1952), Vida & Deck (1954), and Lang (1954), were, in a joint effort of several scientists, refuted from different medical aspects (Biicherei des Augenarztes 1955).

In the last decades people seem to want a new faith rather than reason. So iridology has arisen a- new. There are numerous new guide books, among others a German one (Kriege 1980), an American one Uensen 1980) and a Scandinavian one (Gronvall 1981). Indologists nowadays con- sider themselves to be scientists. They have founded an international society and there is even a gold medal award in iridology Uensen 1980). The diagnostic equipment has become radically im- proved. The modern iridologist has substituted the slit-lamp microscope and iris camera for the simple magnifying glass. The interpretations of different iris signs have undergone modifications, but the basic concepts of von Peszely and Liljequist are still in force.

How it ‘works’

A childhood event remembered by the adult von Peszely is the origin of iridology. As a boy he once succeeded in catching an owl with his bare hands. During the struggle he accidentally broke one of the legs of the owl and could at that moment observe the appearance of a vertical streak in the eye of the bird. From this observation he developed a complete iris chart system. There is supposed to be a relationship between iris spots and various parts of the body. Every organ or tissue has its definite location and organs in pairs are symmetri- cally located in the two irises.

The basis of iridology seems rather weak to a rational mind. Iridologists have not considered it necessary to re-examine this fundamental incident. The textbook of iridology by Vida & Deck (1954) mentions negative experiments on animals with fractures, but the authors do not draw the obvious conclusion : to abandon their belief in iridology. Modern iridology (Jensen 1980) declares further- more that anaesthesia by short-circuiting nerve impulses prevents the development of iris spots, a statement which also effectively prevents ortho- paedic surgeons from testing the concepts of irido- logy in clinical practice.

There is a popular view that owls generally have

Fig. 1. Wohlisch’s owl experiment. The black border of the nictitating membrane passes over the pupil of the left eye. (Reproduced with the kind permission of Dtsch Med

Wochenschr).

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slit-shaped pupils. Jaensch (1955) and Pau (1978) have suggested that the contraction of the owl pupil to a slit might have simulated the develop- ment of a streak in the vertical meridian of the iris. The hypothesis is, however, invalid. Owls have round pupils (Rochon-Duvigneaud 1943 ; Walls 1963), and there is only one exception to this rule, the black skimmer (Rynchops niger). Starting from his studies on tame owls Wohlisch (1957) has presented a very convincing explanation of the von Peszely phenomenon. The uncoloured nearly transparent nictitating membrane of the owl has a well-defined, thin, black border. When the owl closes its lids the membrane moves across the cornea. Lid closure and opening do not always occur simultaneously in the two eyes. Wohlisch has photographically documented a unilateral event. A black almost vertical streak could be seen to pass over the yellow iris of the left eye (Fig. 1) .

Books on iridology are remarkable evasive and vague when it comes to explaining how and why the iris projection of body organs has developed. The following two quotations from Jensen (1980) may illustrate this vagueness.

‘The iris is connected to every organ and tissue of the body by way of the brain and nervous system. The nerve fibres receive their impulses by way of their connections to the optic nerve, optic thalami and spinal cord’. Rohen remarked already in 1954 that due to the crossing of the spinal nerves the organs should be represented in the opposite iris. His criticism was rejected by an iridologist on the ground that the additional crossing of the optic nerve fibres in the chiasma turned the connections back to the ipsilateral side! Rohen (1954) made a thorough anatomical investigation and could in all points refute the speculations of Lang (1954) who had presented a hypothetical chart of the nerve connections from the spinal cord to the iris.

‘In this way Nature has provided us with a miniature television screen showing the most re- mote portions of the body way of nerve reflex responses. We are discovering that the eye works two ways; not only does it enable us to bring images of the outside world within; it also shows images of what is within to the outside’. If Nature had pro- vided us with a chart of the body in the iris it would certainly have been developed with a purpose. N o iridologist has even tried to explain why the projec- tion of body organs in the iris stands alone in Nature without any purpose, except for the benefit of iridologists.

Iris colour

Books on iridology point out that blue eyes which have a less dense structure are easier to study and analyse than brown eyes.

Pure unmixed blue colour is a sign of health according to Liljequist (1903). This prejudiced clergyman does not hesitate to discriminate brown- eyed people. They are weak, nervous and peevish, and he warns innocent blue-eyed boys against marrying browneyed partners, which will only lead to an unwished increase of brown-eyedness. Particularly German iridologists consider that brown-eyed people have a ‘haematogenous’ consti- tution, whereas blue-eyed people have a ‘lymphatic’ constitution. The former are believed to develop all kinds of cancer, and the latter to develop serious infections.

In a comprehensive investigation comprising se- veral hundreds of individuals Kibler & Sterzing (extensively commented by Muller 1960) could reject these assumptions. Patients with cancer or tuberculosis were compared with normal healthy subjects. N o differences in ‘haematogenous’ or ‘lymphatic’ constitution were found between the normal groups and the groups with disease.

lris signs and spots

The task of separating and analysing all parts of the body organs and their disorders in the small area of the iris appears almost impossible even with the aid of a slit-lamp. An iris area of roughly 80 mmz leaves only a fraction of one mm* to each detail. The locations of the organs and the inter- pretations of the signs might also differ in various chart systems. To give an idea of what the charts are like 4 of them are shown in Fig. 2. Simplified keys with examples of the locations of different organs are outlined in Fig. 3. It may seem unfair to refer to some old charts of iridology. The diffe- rences from the modern variants are, however, strikingly small. In the iris area of the ‘brain’ Liljequist (1903) has, for instance, found the loca- tions of remarkable centres such as hysteria, sexual perversities, epilepsy, will-power and dizziness. Conceptions of centres like these, which neurophy- siologists have been unable to locate in the brain, cannot be put off as obsolete absurdities. In a modified version they still appear in modern irido- logy. Jensen (1980) has in the same area found centres of mental sex, ego pressure, mental ability, animation of life and dizziness.

Real pathologic changes in the iris caused by eye

3 I *

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H6gra P

I R I S C H A R T S

R I G H T EYE

WON PESZELY 1 8 8 0

L I L J E Q U I S T 1 9 0 3

VIOR RND DECK 1 9 5 4 JENSEN 1 9 8 0

Fig. 2. Four different iridology charts. Right eye. Von Peszely (1980): Liljequist (1903); Vida & Deck (1954); Jensen (1980).

diseases and general diseases are remarkably un- known to the iridologist. The formation of new vessels in diabetes, granulomas in sarcoidosis, hete- rochromia in iritis and malignant melanomas are, for instance, not mentioned. The iris signs to which the iridologist attaches great importance belong to the anatomy and physiology of the normal human eye (see for instance Rohen 1958 and Hogan et al. 1971).

The pupillury mfJ The posterior pigmented layer of

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the iris is visible at the pupillary border. Some iridologists, considering it a sign of a nervous constitution, call it the ‘neurasthenic’ ring.

The pupillury zone is the area between the pupillary border and the collarette. Its width and thickness varies with the amount of embryological atrophy. It is often irregular and displays superficial con- spicuous trabeculae. It represents the stomach- intestine field of iridology and irregularities point to dysfunctions of these systems.

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The collarette or the anulus iridir minor is anatomically the embryonic site of the minor arterial vascular circle of the iris. In iridology it is called the auto- nomic nerve wreath. The nervous constitution of the individual is believed to be reflected in the appearance of this circle.

The ciliary zone is the part between the collarette and the periphery. The anterior stroma contains radial vessels. Branching collagen trabeculae on the sur- face enclose shallow and deep troughs. Con- spicuous trabedulae represent ‘a poor constitution’. The circular furrows are contraction furrows and depend upon the movements of the iris. To the iridologist these furrows are ‘nerve rings’ and are important signs of nervous activity.

0

B E

P F

Fig. 3. Simplified keys to iridology. Right eye. A. Bones and muscles: 1) nose and jaw. 2) back. 3) leg. 4) arm. 5) shoulder. B. Digestion: 1) mouth and tongue. 2) stomach. 3) intestine and colon. C. Internal organs: 1) thyroid. 2) kidney. 3) testis or ovary. 4) liver. D. Ner- vous system: 1) ear. 2) brain. 3) eye. 4) ‘nerve rings’. 5) autonomous nerve wreath. E. Circulation and respira- tion: 1) lung. 2) blood- and lymphatic circle. 3) bronchial

tree. F. Skin - Toxic signs: 1) scurf rim. 2) Psora.

Lesions, lacunae and c%ts are troughs of different depths between the trabeculae in the ciliary zone. These troughs are often diamond-shaped due to the precise pattern of iris connective tissue fibres. Round openings or Fuchs’ crypts are continuous with the spaces in the stroma permitting fluid and particles to pass into the stroma (Gregersen 1958). According to their appearances and depths these signs are thought to represent acute or chronic inflammations or degenerative processes.

Coloured spots are localized accumulations of mela- nocytes. They are common particularly in pig- mented irises in the antehor border layer where they form freckle-like patches. Von Peszely discov- ered spots in patients who declared themselves healthy. He could not fit these signs into his projec- tion system. The patients were asked if they had not some time suffered from itch (scabies) and many of them, not surprisingly, admitted having had this disease in childhood. The spots were then classified as itch marks by von Peszely and Lilje- quist. The emphasis on scabies is interesting. It originates from the founder of homeopathy, Hahnemann, and his ‘psora’-concept from the ear- ly part of the 19th century. Hahnemann was of the opinion that a vast majority of all chronic diseases were due to the treatment of scabies with ointments which caused the putrefaction products of the dead itch-mites to be absorbed and develop internal diseases. It is not surprising that the iridologists adapted this line of thinking and contended that treated scabies could also give rise to coloured spots in the iris. Liljequist even argues that the death of the Emperor Napoleon is a tragic example of what happens to those who are treated for scabies by doctors.

Scabies is nowadays much rarer, but coloured spots in the ins are still very common, and the iridologists have adjusted their conceptions to the problems of modern society. The brown spots in the iris are still called ‘psora’ but they are now regarded to be the result of inherited chemicals passed on from the parents. Small light-brown spots in the iris are drug deposits, generally acquired from the environment.

Arcus senilir. This white ring in the cornea is called a sodium ring and is an indication of a chemical imbalance in the body. So-called scleral overriding in the cornea is an indication of cerebral anaemia. Probably these landmarks are mistaken for signs in the iris.

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Location7 and appearances of iris signs. A11 anatomical landmarks in the iris shift appearance and location with the direction and angle of the incident light and with different pupil widths. The changes de- scribed by iridologists can be fully explained by the normal variations in the iris structure. It has even been pointed out (Jaensch 1955; Schreck 1955) that some colour photos in well-known iridology guides which are shown to demonstrate different disorders are in fact due to uncontrolled variations in examination techniques.

Research on iridology

Iridologists always emphasize the high relevance of their methods, but without presenting definite proofs of this conception. Vida & Deck (1954), for

instance, declared that in 640 cases with a number of different and previously verified diagnoses they were able to observe the corresponding iris signs in 74%. The high score may seem impressive to the public, but in the absence of a normal control group it remains scientifically unproven. It is also customary for the practising iridologist to discover several different disorders in his examination. The chance of finding a diagnosis which corresponds to the symptoms of the patient increases markedly with this technique, and so does the credibility of the iridologist. However, there are several exam- ples of controlled investigations on iridology in literature and a summary of these revealing trials is presented in Table 1 .

1. Early trials Three investigations are all from hospitals in Ger- many (Jaensch 1955). The first one is from Kre-

Table I. Controlled clinical investigations on iridology.

Controlled investigations on the ability of iridology to detect diseases Results

1 . Early trials False positive diagnoses Krefeld 1909 N = 100diagnoses 96 %

Hamburg 195 1 N = 47 diagnoses 72 % Stuttgart 1942 N = 83 diagnoses 77 %

2. Iris signs in different diseases Differences between groups with disease and controls N o significant differences found Kibler & Sterzing (1956). 1181 cases (lung

tuberculosis, heart diseases, gastric ulcers, liver diseases, kidney diseases, rheumatic diseases, cancer, appendicitis and major operations).

3 Iris chart test Jancke (1956). 150 cases. Iris chart original position Iris chart turned 90°C Iris chart turned 180°C Iris chart turned 270°C

Score of correct diagnoses

34 % 33 % 30% 31%

4. Randomized test in chronic kidney disease Statistic analysis Simon et al. (1979). 143 cases Sensitivity = 57% (48 with kidney disease, 95 normal subjects). Specificity = 57%

Predictive value = 2.5%

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feld. The clergyman and well-known iridologist Felke was brought to court for malpractice and ordered to show his ability in 20 cases in the hospital of the town. He discovered more than 100 different diagnoses and failed in 96%. The Stutt- gart investigation and the Hamburg investigation were also performed on hospital materials. In the former 4 iridologists failed in 77%, and in the latter the participating iridologist failed in 72%. Conclu- sion: A11 3 investigations demonstrate high percen- tages of false-positive diagnoses.

2. lrissigns in different diseases

A very extensive investigation has been carried out by Kibler 8c Sterzing (thoroughly commented by Miiller 1960). They compared the iris signs in different groups of diseases with control groups of adult normal subjects and children.

The groups with diseases comprised 65-255 cases and the range of control groups 70-100 subjects. No significant differences were found between the iris signs in the groups with disease and the corresponding control groups. Conclu- sion: The abundance of iris signs in the normal eye agrees with the alleged iris signs in a number of diseases.

3. Iris chart test

The ophthalmologist Jancke (1955) performed a chart test on 150 cases with different verified diagnoses. He used a well-known chart and com- pared his chart diagnoses with the verified diag- noses. He then repeated the test after turning the iris chart go", 180" and 270". His score was similar, 30-34% in all tests. Conclusion: This experimen- tal study verifies that the rich amount of iris signs in the human eye is likely to lead to reasonable explanations of the symptoms of the patient.

4. Randomized test of iris signs in kidney disease

Simon et al. (1979) have carried out an important and instructive investigation. Three iridologists were asked to analyse in a randomized order the stereophotos of patients with chronic kidney dis- ease and those of normal subjects. The material comprised 143 subjects (48 with kidney disease, 95 normal subjects). Not less than 15% of the total material were cases requiring maintenance haemo- dialysis. The ability of the iridologists to detect kidney disease was strikingly disappointing. False- positive answers varied between 43-8896 and

false-negative answers beween 12 -43%. Data from the best screener showed that iridology has a low specificity (57%) and a low sensitivity (57%) in detecting kidney disease. The predictive value to detect kidney disease by iridology was only calcu- lated to 2.5%. Coqclusion: Low specificity and low sensitivity in detecting kidney disease make irido- logy a potential danger to the public.

Discussion

Medical science has had strong reasons to criticize iridology for using untrustworthy methods (Jaensch 1955; Muller 1960; Trevor-Roper 1977; Simon et al. 1977; Seland 1981). It is then distress- ing to note that iridology has survived for more than 100 years and even attracted new interest.

Large groups in modern society have no longer confidence in traditional medicine. People suffe- ring from real organic diseases usually turn to traditional medical care and usually also receive a highly qualified treatment. On the other hand, people who have indistinct diseases where no orga- nic basis of the symptoms can be found often consider that modern medicine pays little attention to their conditions and in general shows a negative attitude. These people turn to alternative treat- ments, but have no possibilities of valueing the qualities of different methods. They meet a thera- peutist who shares their views, affirms their symp- toms and engages in curing a disorder of the body by activating the subjects' own life energy. How- ever, this positive attitude must never be accepted as a pretext for the use of unverified methods, which pretend to be the ultimate truth.

It seemed therefore of importance to evaluate iridology and show what it stands for. The present report. has established that there are now conclu- sive, sufficient proofs that iridology has no medical value and that its concepts are purely conjectural.

The public should know that iridology is not a harmless activity. By its inability to discover serious diseases iridology exposes sick people to the danger of delayed medical care. Only on condition that people turn to alternative medicine as a last resort can this danger be regarded to be of less impor- tance. There is also another doubtful aspect of iridology. It is very probable that the iridologist in his examination discovers a number of non- existent disorders, thus causing unfounded alarm

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and anxiety. Good care of patients is inconsistent with deceptive methods, a n d iridology should be regarded as a medical fraud.

References

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Gronvall K (1981): Irisdiagnostik. 2nd edn. Arcanum Medicinsk Facklitteratur, Uddevalla.

Hogan M J, Alvarado J A, Weddell J (1971): Histology of the Human Eye. W B Saunders Company, Philadel- phia.

Jaensch P A (1955): Zur Geschichte der Augendiagnose in Irisdiagnostik - Eine Augenarztliche Kritik. Bucherei des Augenarztes 22: 1-35.

Jancke G (1956): Zur Irisdiagnose. Klin Monatsbl Augenheilkd 128: 229-230.

Jensen B (1980): Iridology simplified. 3rd edn. Iridolo- gists International, Escondido.

Kibler M L & Sterzing L (1956): Wert und Unwert der Irisdiagnose (commented by Miiller 1960). Stuttgart.

Kriege T h (1980): Fundamental bases of iris diagnosis. English edn. Fowler &Company Limited, Essex.

Lang W (1954): Die anatomischen und physiologischen Grundlagen der Augendiagnostik. Ulm.

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Rohen J (1955): Struktur und nervose Versorgung der Iris. In: Irisdiagnostik - eine Augenarztliche Kritik. Biicherei des Augenarztes 22: 36-50.

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Schjelderup V (1983): Lakekonst p i nya vagar (New paths in the art of healing). Wahlstrom & Widstrand, Stockholm.

Schreck E (1955): Wissenschaftliche Medizin und Iris- diagnostik - Eine Augenarztliche Kritik. Biicherei des Augenarztes 22: 52-90.

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Simon A, Worthen D M, Mitas J A (1979): An evaluation of iridology. JAMA 242: 1385- 1389.

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Vida Fr & Deck J (1954): Klininiche Priifung der Organ - und Krankheitszeichen an der Iris (commented in Biicherei des Augenarztes 1955). Ulm.

Wohlisch E (1957): Ignaz V. Peszely, das Eulenauge und das Mysterium der Irisdiagnostik. Dtsch Med Wochenschr 82: 970-973.

1 : 312-313.

877-879.

Received on March 19th, 1984.

Author’s address:

Lennart Berggren M. D., Department of Ophthalmology, Akademiska sjukhuset, S-75 185 Uppsala, Sweden.

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