BETTER EYESIGHT
A MONTHLY MAGAZINE DEVOTED TO THE PREVENTION AND CURE OF
IMPERFECT SIGHT WITHOUT GLASSES
JANUARY,
1926
The Period
THE perfect memory or imagination of a period is a cure for imperfect sight.
Only the color needs to be remembered. The size is immaterial, but a small period is remembered with more relaxation than
a large one. It is true, however, that with perfect sight, one has the ability to remember all things perfectly.
One
cannot remember a period perfectly by any kind of an effort. It usually happens that one may remember a period for a time,
and then lose it by an effort. To remember a period stationary, is impossible. One has to shift more or less frequently in
order to remember one period perfectly all the time, or one has to imagine the period to be moving, or one has to remember
the period by central fixation,—one part best. By shifting, is meant to look away from the period and then back, but
to do it so quickly that it is possible to remember the period continuously, although you are not looking at it all the time,—this
with the eyes closed. Every time you blink, you shift your eyes. You can blink so rapidly that it is not noticeable. When
you close your eyes and remember a period, you cannot remember it unless you are, with your eyes closed, going through the
process as though you were blinking, looking away from it and back again, but so quickly that it seems as though you were
looking at the period continuously. You cannot remember the whole of the period at once. No matter how small the period is,
you cannot see or remember it perfectly, all parts equally well at the same time. You cannot remember the period perfectly
by any kind of an effort. When the memory of the period is perfect, the mental and physical efficiency is increased. A perfect
memory of the period does not necessarily mean that one should think only of the period.
Shift
on the period from part to part, small point to small point: left and right, top and bottom, diagonally and in any direction.
Swinging
By W. H. BATES, M.D.
Swinging: When the eyes move slowly or rapidly from side to side, stationary
objects appear to move in the direction opposite to the movement of the head and eyes.
PEOPLE with normal vision are
not always conscious of the swing. When called to their attention, however, they can always demonstrate it, and are always
able to imagine all stationary objects to be moving. In imperfect sight, the swing is modified or absent. This is a truth
which has been demonstrated over a long period of years by a great many people, and no exceptions have been found.
The
normal or perfect swing is slow, short, easy and continuous. When the swing is normal, it is always true that not only is
the vision normal or perfect, but also the memory, the imagination, or the mental efficiency correspond. When the memory is
imperfect, the imagination, the mental efficiency, and the sight are also imperfect.
All cases of imperfect sight from
myopia, or near-sightedness, become normal when the swing becomes normal. The same is true in cataract, glaucoma, diseases
of the optic nerve and retina. For example, a woman, aged sixty-three, was treated for imperfect sight from cataract. Her
vision was 10/200, and was not improved by glasses. For twenty years she had not been able to read a newspaper with or without
glasses. In three visits, with the help of the normal swing, her vision improved to 10/10 minus, with flashes of normal vision,
and she read diamond type at twelve inches rapidly without glasses. Other similar cases have been relieved as promptly.
It is important to understand how the swing can be imagined. Some people with mild cases of imperfect sight can imagine
a letter or other object to be moving when they see or remember it perfectly. There are many others who fail. Severe pain,
fatigue, or worry often prevent the demonstration of the swing. Blinking and palming are helpful in demonstrating the swing.
The distance of the object regarded is important. The patient should be placed at a distance at which he can best demonstrate
the swing. The distance varies with the patient.
It is unfortunate that many patients consider the swing complicated
or impossible. However, they can usually demonstrate that a stare or strain lowers the vision. When holding a test card at
a convenient distance from the eyes, patients may be convinced that the test card is seen better when moving. They may not
profit by their experience, but continue to stare or strain, which always lowers the vision.
One patient was unable to
imagine any kind of a swing. He was suffering from pain, mental depression, and imperfect sight for the distance. Reading
the newspaper, even with glasses, was impossible. Since nothing he tried gave him any relief, I suggested that he stop trying
to see and make no effort to imagine stationary objects to be moving. He practiced this while sitting in my waiting room.
He paid no attention to the apparent movement of stationary objects, nor did he look at any object more than a fraction of
a second. His vision after that improved from 20/50 to 20/10. He became able to imagine the movement of objects and demonstrated
that all his pain and mental depression were caused by a stare or an effort to see all things stationary, when he regarded,
remembered or imagined them. He was comfortable when he imagined objects moving or swinging, but very uncomfortable when he
made an effort or imagined them to be stationary.
Recently, I tested the sight of a girl about ten years old. She read
the Snellen card at ten feet with normal vision. She was asked: "Do you see any of the small letters moving from side
to side?"
"Yes," she answered, "they are all moving."
"Now can you imagine one of
the small letters stationary?" At once she quickly looked away and frowned.
"Why did you look away?" her
father asked her.
She replied: "Because it gave me a pain in my eyes and head, and the letters became blurred. Don't
ask me to do it again."
The experience of this child is the same as that of everyone, young or old, with perfect
or imperfect sight. When the sight is normal and continuously good, to try to stop the swing of a letter or other object necessitates
a strain,—an effort which always lowers the vision and produces discomfort or pain in one or both eyes.
It has
been repeatedly demonstrated that a letter or other object cannot be remembered or even imagined perfectly and continuously,
unless one can imagine it to be moving or swinging. Not only does the sight become imperfect, but also the memory, imagination,
judgment, and other mental processes are temporarily lost. These facts should be known to teachers, because they greatly affect
the sight, the mental efficiency, and the scholarship of their pupils.
When the memory, imagination and vision are normal,
the eyes, the brain and the entire nervous system are at rest. The reverse is also true, for when the muscles and nerves of
the body are not at rest, the sight, memory and imagination are imperfect, and the mental efficiency is lessened or lost.
It is impossible to imagine pain, or any symptom of disease and the normal swing at the same time. Children with whooping
cough have been immediately relieved by the relaxation obtained from the swing. Many patients suffering from severe attacks
of bronchitis have been promptly relieved in the same way. Angina pectoris, pneumonia, trifacial neuralgia, and other serious
diseases have also been relieved after relaxation or rest was obtained with the aid of the swing.
The swing is generally
beneficial. Some patients obtain more relaxation from one type of swing than from another. The long swing, however, is most
helpful in a great many cases.
LONG SWING:
Stand with the feet about one foot apart. Turn the body to the right, at the same time lifting the heel of the left foot.
The head and eyes move with the movement of the body. Do not pay any attention to the apparent movement of stationary objects.
Now place the left heel on the floor, turn the body to the left, raising the heel of the right foot. Alternate. Pain and fatigue
are relieved promptly while practicing this swing. When done correctly, relief is felt in a short time. The long swing, when
done before retiring, lessens eyestrain during sleep.
VARIABLE
SWING: Hold the forefinger of one hand six inches from the right eye and about the same distance to the right. Look
straight ahead and move the head a short distance from side to side. The finger appears to move in the direction opposite
to the movement of the head and eyes.
DRIFTING
SWING: The patient does not think of nor regard anything longer than a fraction of a second. It is helpful in doing
this for the patient to imagine himself floating down a river. He may be able to imagine the drifting movement of the boat
in which he is floating, better with the eyes closed than with them open. In this case, alternate the imagination with the
eyes open and with them closed. The imagination may be improved in this way.
SHORT SWING: When the sight is normal, one can demonstrate the short swing. When it is imperfect,
one can demonstrate only the longer swing. When a patient with imperfect sight regards the Snellen test card at ten or fifteen
feet, he may be able to imagine one of the letters on the card to be swinging a quarter of an inch or less. The imagination
of a shorter swing always improves the sight. Some patients can imagine the short swing better with their eyes closed than
with them open. Alternate the imagination of the swing of the letter with the eyes closed and with them open. By repetition,
the vision of the letter with the eyes open will improve (at first in flashes, later more continuously), if the memory of
the short swing is perfect with the eyes closed.
UNIVERSAL
SWING: When the eyes are at rest, they are always moving. When the body is at rest, it can always be imagined, one
part in turn, to be moving or swinging. The chair, on which the patient is sitting, is swinging. The floor, on which the chair
rests, is also swinging. The walls of the room also swing when the floor swings. When one part of the building swings, one
can imagine the whole building to be swinging. The ground, on which the building stands, is also swinging. When the ground
swings, other buildings connected with it swing. One can imagine the whole city to be swinging, this continent and all other
continents on the earth can be imagined swinging. In short, one can imagine not only that the whole world is moving, but also
the universe, including the sun, the moon and stars. The practice of the universal swing is of the greatest benefit, for in
this way one can obtain the maximum amount of relaxation.
All objects appear to move, ‘swing’
in the opposite direction the eyes shift to.
The Figure Eight is a new, improved version of a few different swings combined
into one.
Trace up the center and to the left first for correct left and right brain hemisphere activation, integration.
Stories from the Clinic
No. 71: PARTIAL PARALYSIS OF THE THIRD NERVE
By EMILY C. LIERMAN
GEORGE, aged five years, was sent to me by a physician, who diagnosed his
case as paralysis of the third nerve of the right eye. A number of eye specialists said that he could not be cured. One gave
him internal treatment for about six months and used electricity on the eye without much permanent benefit. When a nerve is
paralyzed, its function is lost. In other words, the nerve is not able to bring about a contraction of the parts supplied
by the nerve. To explain further, that branch of the third nerve distributed to the muscle which raises the lid had lost its
function. In general, it has been believed for many years that a paralyzed nerve is relaxed. After many years of observation
and experimental work, it was demonstrated that a paralyzed nerve was under a great tension. Treatment which relieved the
tension and brought about a sufficient relaxation was a cure for the paralysis.
In Dr. Bates' book is an illustration
of a patient with paralysis of the seventh nerve. One of the functions of the seventh nerve is to close the eyelid. When it
is paralyzed, the eye remains open. Not only does the eye remain in this way, but the lips are separated. The patient is not
able to close the lips sufficiently to whistle. By palming and swinging, relaxation is obtained,—the patient becomes
able at once to close the eyelid, and to close the lips sufficiently to whistle. These cases of paralysis do not need electrical
nor other stimulation. They are cured by rest. I believe that electricity is a valuable remedy, but it has lost much of its
prestige by being employed in cases where it was not needed.
Georgie's mother has unusual intelligence, and she came
to us confident we could relieve or cure Georgie's eyes. This is the history of his case as she described it: When he was
born his right eye was wide open, and the child was unable to close the eye. About three months later the eyelid closed, and
the child was unable to open his eye. Several eye specialists in Brooklyn told the mother that the eye could not be cured.
From the very beginning, Georgie was a source of pleasure to me. He seldom spoke above a whisper and preferred to go through
each treatment without speaking at all, if possible. At such times he was given the card with the letter E pointing in different
directions. When I asked him which way the E's were pointing, as I pointed to each one with my pencil he would say left, right,
up, down. But if he were not in the mood, he would raise his hand and indicate the direction in which the E was pointing.
In the beginning, this card was the only one used in his treatment, because he did not know all the letters of the alphabet.
After he was admitted to the kindergarten school, he asked for the alphabet card, and also a figure card, which children favor
a great deal for testing their sight. When Georgie's first test was made, he was unable to open his right eye. The left eye
was normal, or 10/10.
I taught him to palm, and while he sat quietly, I began to talk to his mother. The conversation
was solely for his benefit, so I talked about him. Like all mothers of her type, she praised her little boy and informed me
of all the wonderful qualities of his mind, and that he was most obedient. I saw him smile, and for a moment he peeped a little
through his fingers. After he had rested his eyes for ten minutes, I told him to keep his left eye covered, and look at the
card with his right eye. His mother sat facing him, with her eyes wide open with astonishment, as she saw the eyelid open
just a trifle. He was able to keep his right eye open long enough to read 10/70, then the eyelid dropped again. His mother
obtained a number of different Snellen test cards and used them at home for the daily treatment of the paralyzed eye.
I
treated Georgie again, one week later, and I immediately had him practice the palming. So many patients have failed to palm
successfully, because they stare even with their eyes closed. Georgie palmed successfully because, at my suggestion, he remembered
the things that were pleasant and easy to recall. If I could not think quickly enough of a story to tell him, I would show
him something in my room which pleased him. Then he would palm and describe it to me. At one time I showed him a box of bonbons,
which were attractively arranged, and promised him some if he would sit and palm for a long time. His mother and I were amused,
because he was unusually quiet when he remembered the candy. After he had palmed awhile, I suddenly asked him what he was
thinking about. He opened his eyes long enough to say the word "candy" and then closed them again. The vision of
his right eye improved from 10/70 to 10/50 that day, and the eyelid was more open than before. The left eye improved to 12/10.
At every visit his vision was improved, while the paralysis diminished with the increased relaxation of his eye. I noticed
that occasionally he would forget to blink, and then he would stare and strain, which lowered his vision and increased the
paralysis. His eyelid has opened more, and his vision has improved since he became the owner of a little puppy. Whenever he
played with the little dog, his mother noticed that both eyes would blink. This is evidence that things seen in motion are
seen best. The vision of his right eye was improved to more than 10/10, while that of his left eye to 18/10, which is very
unusual in a child six years of age. He had been under my treatment for about a year.
The Blinking Knight
By GEORGE M. GUILD
INSIDE
a dark, dingy, little shop, a group of children bent over their work. Outside, New Year's revelry echoed along the streets,
but the day held no joy nor merriment for these little workers. It was just like every other day. It meant sitting from early
morning until late at night stringing countless numbers of little beads together, to make ornaments. They stooped over their
tasks until their sight grew dim, and colored spots danced before their eyes. They could not stop their work nor rest for
even a moment, but the angry proprietor prodded them on.
Today, fear and dread settled in the hearts of the poor children.
Had they not been told that their work was very bad and that they would be dismissed? They knew it was, because they could
not see to match the beads in the dull light of the shop. Perhaps glasses would help them, but where was the money to come
from?
As evening approached, the light grew dimmer and dimmer. It seemed to the children that they could no longer go
on, when from a dusty comer they heard a voice say, "Good evening, children." As they looked, they saw a light shining.
The light grew stronger and stronger, and seemed to fill the room. The little workers almost shouted aloud with joy. Suddenly
a little man with a flaming sword jumped out to the center of the room. On his head he wore a soft velvet hat with a very
large brim; a cluster of huge diamonds shone on the front, while smaller ones covered the hat band. His coat had a long tail,
which swayed with every movement he made. The many glittering buttons were immense diamonds. His yellow vest, which contained
a great many more pockets than any vest the children had ever seen, was decorated with diamonds, rubies, emeralds, and sapphires.
His violet trousers reached only to his knees, and they, too, were covered with jewels. He wore long stockings of fiery red,
and his low patent leather shoes were trimmed with large silver buckles. The belt of the scabbard for his sword sparkled with
jewels.
When the children gazed on this knight, they became very quiet and curious to know who he was. His eyes were
sympathetic as he smiled good-naturedly on them. When he spoke, his voice was like music to their ears and made them all feel
comfortable and at peace with the world. "Children," he said, "the fairies have sent me to help you to be happy.
I love each and every one of you and want to cure your eyes, so that you will be able to have perfect sight all the time.
You will be able to see even in the dimmest light without glasses. All of you are working too hard. Make believe that you
can see fairies, that you can talk with them, dance with them, and be like them. When I was a boy, I wanted to be a fairy,
but when I grew up, the king made me a knight and sent me out into the world to slay as many bad people as I could. I was
very skillful at doing this.
"One day, while riding through a wood, I saw some blue flowers. They were so beautiful
and fragrant that I said aloud, 'Oh, you lovely blue flowers, how I wish you were all fairies,' and then, much to my surprise,
every flower turned into a blue fairy. They climbed upon my steed and urged him to canter as fast as he could. Very soon we
came to a field of beautiful yellow flowers. While I looked at them, entranced, myriads of little yellow fairies danced gaily
from the petals and mingled and danced together, leading us on, until we reached a meadow of violets nodding in the breeze.
They were even more beautiful than the others. I wished that they too were fairies. All at once the violets turned to violet
fairies and they frolicked with the other fairies."
The knight ceased to speak for a moment and then suddenly held
up a bouquet of blue, yellow and violet flowers. The children saw him leap to the middle of a large table in center of the
room. There he began to dance, and as he danced he blinked his eyes and waved the flowers around his head, crying out to the
children, "Make believe that these flowers are fairies. Remember the colors perfectly. Blink your eyes as you see me
blinking, and never forget what you will see now." Immediately the flowers all turned to fairies of the same color.
At once they all began to dance around the blinking knight, laughing, shouting, and enjoying themselves. The knight touched
each child in the shop with his wonderful sword, and each child as soon as she was touched, turned into a fairy. Some blue,
some yellow, and some violet, and all blinking as frequently as the blinking knight.
"Now that you are all fairies,"
he said, "you must think, remember, imagine, and believe all things which are good. Tomorrow morning, you will all waken
and believe that all this was a dream. I want to tell you that I was born a thousand years ago. I speak with the wisdom of
the ages when I say to you, that if you will only remember me and make believe that you are fairies, you will always be happy
and good the rest of your lives."
How Estelle Helped
By BEATRICE SMITH
THERE
are many cases of imperfect sight, many cases of pain and fatigue, which can be cured by other patients who have obtained
normal sight without glasses by practicing relaxation methods.
About three years ago, a young man, aged seventeen, suffered
very much from pain in his right eye. The pain increased quite rapidly and finally became so severe that in order to get any
relief, he was compelled to take morphine. As time passed, the dose of morphine was increased and increased with unusual rapidity.
The outlook seemed dismal. The eye specialists in some of the large cities prescribed glasses for him, but without benefit.
One day while walking along the street, he met a lady whose daughter had been cured by the treatment of imperfect sight without
glasses, discovered and practiced by a physician living in New York City. The lady recommended him to practice palming, swinging
and some other methods described in a book called Perfect Sight Without Glasses. The palming gave instant relief. By palming
for fifteen minutes every night and morning, the pain was relieved or prevented. This treatment was continued for some months,
usually about three times daily for fifteen minutes each time. As the days went by without a return of the agonizing pain,
he practiced palming less frequently, until after three months, not having had an attack of the pain, he stopped the palming
and forgot all about his right eye.
The patient lived in one of the large cities of the West. It was interesting to learn
of the great number of people who followed the treatment of this case of pain and kept in mind all the particulars. When the
boy began to lessen the number of treatments by palming, some of his friends were very much concerned for fear that he was
stopping the treatment too soon. When he remained free from pain for some time, they were relieved, but still more or less
apprehensive. I believe the boy felt deep down in his heart that if that pain ever came back, he would know how to handle
it.
The patient, who recommended the boy to palm, had a daughter about ten years old, who had been to New York, taken
the treatment and been cured of imperfect sight without glasses. This little girl kept after the young man in the early days
of his treatment and insisted that he practice all those methods, which were beneficial, repeatedly and continuously. I believe
it was the efforts of the little girl, which did more than anything else to benefit the patient. True, he was willing to palm
and did palm, but there were days when he would forget and she kept after him until he was cured.
I believe that she
had more to do with the cure of the boy's pain than did the supervision of other people.
A Student's Experience
By MARGARET ROBINSON
AUTHOR'S NOTE—Dr. Bates has asked me to send some report in regard to my teaching of his methods
in Bloomington, Illinois. Converts to the truth of Dr. Bates' explanation of eye troubles are persuaded that glasses, for
the average person, are unnecessary, also, that the vision is lowered as a result of their use. It is appalling to find how
many people are actually struggling with glasses, which, they have been told, would relieve their strain and save their vision.
If, in my very limited experience, I have found so many of this type, there must be a great number of such unfortunates in
every community. The three following cases illustrate what I mean:
MISS I., age thirty, had worn glasses since she was
ten years old. In the past two years, since a goiter operation, she said she had visited the oculist at least once a week.
He had changed her glasses four or five times during this period, had stopped all reading, and was putting medication in her
eyes to relieve a distress, which she said was almost constant. He seemed uncertain what to do next, as her vision was steadily
growing worse. With her glasses she read 10/30 with both eyes and 10/200 with the right eye alone. After taking off her glasses
and palming for a short time she read better than 10/20 with both eyes, and almost 10/70 with the right eye. The near vision
of the right eye was also impaired. On the first day, she could not read ordinary type with this eye alone. In two weeks she
lost all sense of strain and read 10/10 with both eyes and began to read 10/50 with the right eye. She read diamond type readily
with both eyes together and slowly with the right eye alone, at six inches. She reported that she was able, without fatigue,
to read two hours or more at a time, day or evening. She looked and acted ten years younger.
Miss J., age forty-two, was very much frightened about her eyes, and very loath to give up the large
glasses behind which her eyes looked so tired and drawn. She had been forced to give up her position at an embroidery counter
because of the failure of her vision. In eight months she had had three different pairs of glasses, and said that the oculist
told her frankly that he was much puzzled as to how to relieve her very serious strain. Four lessons, with her intelligent
co-operation, and less than a month's time, relieved the situation. Her eyes were comfortable and she was able to see satisfactorily
for reading and sewing, as well as at a distance. The look of relief on her face was very gratifying.
Mrs. W., age forty-nine, had suffered with very severe eye difficulties for twenty years. She had
been forced to give up her piano work, could do practically no reading, and said, in fact, that many of the interests of her
life had been dropped because of her eyes. Bright lights, and use of her eyes for close work, produced a sharp pain in her
head which she had learned to greatly dread. Said for about a year she was allowed to use "very strong" glasses
ten minutes at a time. Of late she had used them longer than that, but it made her eyes very tired to do so. There were dark
rings under her eyes and she was very nervous. Without her glasses she was able to read 10/15, also large clear type at reading
distance but better at arm's length. She did this, however, with fear and trembling, often stopping to close her eyes. In
two weeks, she was reading 10/10 readily without fear, also getting flashes of clear vision when practicing with the diamond
type card held at six or eight inches from eyes. She was comfortable, had lost all dread of bright lights, did not get the
pain in her head any more, and was losing the dark rings under her eyes. She stopped taking lessons at this point, but continued
to improve, according to reports which reached me several months later.
In each of these cases, glasses were not only
useless, but actual torture. In each case the individual had given up what she wanted to do because of her eyes. In each case
a couple of weeks without glasses, combined with learning how to relieve the eye strain, made life, as each wanted to live
it, possible. It seems incredible that the 'value of such facts is not more quickly and more generally accepted.
Questions and Answers
Q—I can read with no trouble but cannot distinguish things at a distance,
especially the features of people. What would you suggest?
A—You are near-sighted. The imagination cure is the
quickest and most satisfactory cure of myopia. Use two Snellen test cards, one held at one foot or nearer, or at a distance
where you can see it best; the other placed at five feet or further. Look at the first letter of one of the lines of the near
card and with the eyes closed remember it for half a minute or longer. Then look at the same letter on the distant card at
five feet or further and imagine that letter for not longer than a second. Then look at the near letter again for part of
a minute, close your eyes and remember it, and then glance at the same letter on the distant card for not longer than a second,
and imagine it as well as you can. Alternate. When you become able to see the bottom line on the distant card, place it a
few inches further off and repeat.
Practice with both eyes together, one eye at a time, then both
together again.
Q—What method is most helpful in myopia?
A—Palming, swinging, and the use of
the memory or imagination (described above), are most helpful.
Q—Can you tell me what to do for inflammation of
the white of the eye? Do you think sun gazing would help?
A—The light treatment is beneficial. Sit in the sun with
the eyes closed and let the sun shine directly upon the closed eyelids. Move the head a short distance from side to side.
Practice this for half an hour or longer three times daily when possible.
Q—Will you kindly tell me what I can
do in order to read as well with the eyelids fully open as I can when they are slightly parted?
A—Improve your
vision with the aid of the imagination cure as described above in answer to question 1. When your vision improves, your eyelids
will be more open.
Q—Is there any exercise or any particular, method of relaxation that will help double vision?
A—Closing the eyes and resting them is a cure for double vision. Blinking frequently, just as the nor-mal eye does,
is also beneficial.
Q—Please explain the elliptical swing.
A—In the elliptical swing, the head and eyes
are moved continuously in the orbit of an ellipse or a circle. The continuous movement of the head and eyes prevents the stare
or strain, since staring requires that one try to keep the eyes from moving.
The Figure Eight,
Infinity Swing is a modern variation of the Elliptical Swing.
Q—How
many times a day should the sun treatment be given?
A—The sun treatment should be given for half an hour or longer
three times a day, or more often, when possible. The more sun treatment, the better, as it rests and strengthens the eyes.
Q—What treatment helps most people?
A—Palming is generally most helpful.
Q—Is it possible for
some people to be cured by the help they may obtain from your book "Perfect Sight Without Glasses"?
A—Yes.
By practicing the methods recommended in my book, many readers have improved their vision without my supervision. It helps
to have someone with perfect sight supervise your treatment.
Q—Is myopia hereditary?
A—No. It is, however,
contagious in many cases. When parents are cured of myopia, their children may recover without treatment.
Q—How
long does it take to cure an average case of myopia?
A—Some patients are cured more quickly than others. The length
of time is uncertain, as patients differ in their response to treatment.