|Year : 1970 | Volume
| Issue : 4 | Page : 150-153
Editorial - Albrecht Von Graefe
S N Cooper
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Cooper S N. Editorial - Albrecht Von Graefe. Indian J Ophthalmol 1970;18:150-3
The year 1970 has marked the history of this world with the events in the lives of two great men, dedicated to the persuit of peaceful sciences - the 200th birth anniversary of perhaps the greatest composer of Western music, Ludwig Beethoven and the death centenary of the greatest ophthalmologist ever, Albrecht Von Graefe.
Whereas India has celebrated the tooth birth anniversary of Beethoven in many ways, including the issue of a stamp in his honour, we have done nothing at all by way of honouring the memory of the acknowledged pioneer of modern ophthalmology. Though belated, let us dedicate the last issue of our journal for 1970 to the memory of that great and inspired son of God who practised ophthalmology as a speciality for the first time, who in a short span of life of only 42 years, achieved so much for which modern ophthalmology is truly grateful, and who may thus rightly be called the first ophthalmologist of the world.
Albrecht von Graefe was born in Berlin on 28th May 1828, the year after Beethoven died. He was born in a family of ophthalmologists. His father Karl Ferdinand von Graefe was a court physician, who was the founder of modern plastic surgery but he also practised ophthalmology and was the director of the surgical clinic at Berlin, wrote an encyclopaedia dictionary of medical sciences, founded the first Journal of surgery and ophthalmology and had performed the first cataract operation with a corneal upper flap in 1826.
His uncle had also contributed to ophthalmic literature. A cousin of his, Alfred von Graefe, z years his junior also became a celebrated ophthalmologist.
Albrecht had a good start in life, his father and mother being both very rich, living in a fashionable place in Berlin and had a country house. His father died when he was only 12. He was extremely brilliant as a student and was the youngest boy ever to graduate from "The French Gymnasium", the school of his basic studies. He was also the youngest pupil of the University of Berlin, where he learned under teachers whose names have remained famous, like Traube, Schlemm, Romberg, Vinchow.
He lived in an age when everything military was the fashion of the day and when `duelling fraternities' were in existance. A scar across the face sustained in a duel was considered a mark of beauty. Not being a military man, Albrecht founded a society of non-fraternity members - the `Camellias', which participated in all kinds of cultural activities along with some moderate drinking.
In 1847, he graduated from the University at the age of 19, and in the following year, he undertook a trip visiting all the important medical centres, watching mostly eye-work and cultivating some very notable and lasting friendships, particularly with Jaeger in Vienna, Arlt in Prague, Bowman in England and Donders in Holland, with whom he used to correspond freely.
It is said that when he and Donders were sent to see the great exhibition at the Crystal Palance by Bowman, when then were in London, the two of them were so engrossed in their talk on optics that although they went more than once round the exhibition, they failed to notice the new marvels of the day exhibited there and could not say what they saw when asked by Bowman on their return, about the exhibit that may have appealed to them the most.
At the age of 21, he was saturated with all the knowledge he could possibly imbibe in ophthalmology, but he was considered too young to be accepted for any ophthalmic assignment wherever he applied, until at last he decided to start his own private practice as a specialist in ophthalmology in 3 small rented rooms up two flights of stairs on November 1st 1850, as the first specialist practising only Ophthalmology.
A private clinic of this description was unheard of in those days. Practice was poor, until he had to advertise that poor patients would be treated free. The practice then began to grow and soon he had to shift to 46, Karlstrasse where he founded the best possible eye-clinic of those days. He furnished this small hospital rather lavishly under personal supervision out of his own private resources, much to the consternation of the members of his family. For the poor patients he provided free accomodation with food.
It was at this clinic that he built up his reputation and fame as an ophthalmologist. Nothing thrilled him more than the ophthalmoscope invented by Helmholtz about the same time. Helmholtz" had unfolded a new world" he said, and it was he who put its use to the greatest advantage and demonstrated its place in the diagnosis of general diseases and their relation to fundus conditions. Every branch of ophthalmology- he revelled in - squint, cateract, glaucoma, ulcers, night-blindness, ocular pathology and all. The years 1951 to 1957 were the most creative years of his practice. Besides giving an accurate description of several fundus conditions, he devised the precursor of the Maddox rods and introduced clinical perimetry (1856).
He was the first to clear the concept of glaucoma, which was hitherto known as the 'green-eye' (glaucoma) and considered incurable. He proved that glaucoma blindness was due to increased intraocular pressure and described the cupping of the disc and corneal anesthesia in glaucoma. Good results of iridectomy in staphyloma, induced him to do the same operation for glaucoma with gratifying results and he published his observations and technique in 1857, which have stood the test of time for over 8o years now. In his paper covering 105 pages, in the, Archives fur Ophthalmologie Vol. 3, he describes its use in acute glaucoma and its prodromal stage and, argues the limitations of the procedure in the chronic stage. He however attributed the lowering of the tension to a reduction of the secreting surface of the iris. In 1858, when he read his paper on the subject at the time of the 1st International Congress of Ophthalmology held at Brussels, he was given a standing ovation by the members present and thus he established himself as an ophthalmologist of world-repute.
In 1860, he described sympathetic ophthalmia, for the first time and devised his knife for a sclero-corneal incision for cataract.
He was a very astute observer, methodical in his records and thus laid the foundation for a systematic ophthalmic examination.
His greatest literary achievement was the foundation of the second journal in Ophthalmology - Archives fur Ophthalmologie, (the first being Annales d'Occulistique) in January 1854. The first volume contained no less than 480 pages of which 394 were contributed by him, in which he gathered all the details of his observations and experiences so far. He was to bring out 16 such volumes. He took Helmholtz, Ar]t and Donders as co-editors. His total contribution to the ophthalmic press was 2500 printed pages. He always used to write his own papers and never dictate and he covered almost all aspects of ophthalmology. The 15th volume of the Archives of April 1869, was the last volume to which he could contribute.
It is indeed a pity that such a brilliant exponent of his subject was denied teaching facilities in the very University of Berlin which appointed him to the Medical Faculty in 1852 on the basis of his treatise "On the Action of the Ocular Muscles". His delight was great, but private jealousies prevented him from being allowed any teaching space in a new speciality. His way towards teaching was blocked for 16 long years by people who refused to let ophthalmology separate from general surgery. But he was proud to wait that long for the University to want him enough to offer him the Chair of Ophthalmology in 1968. That left him just z years of his life to give the benefit of his teaching to the University.
During the waiting period, he was giving lectures and demonstrations to students and visitors, mostly foreign, attending his clinic, but these lectures were declared unauthorised by the very University that had honoured him by an appointment to the Medical Faculty, thanks to the influence of the professor of surgery and ophthalmology, Prof. Juenken. His so-called unauthorised lectures were still attended by several foreign students and his reputation as a teacher was equal to, if not greater than his reputation as a clinician.
One lecture led to another as he held the listeners in the palm of his hand with his flair and finesse, emotion and skill, with which these lectures were delivered. Like a good teacher he remained a student, for he often said, "let us see if we can't learn something about it together".
When at last he became a University teacher in 1868 his lectures became the talk of the University. Students stood enthralled and began to miss other lectures in favour of his. He was everything a teacher ought to be, but this could last for just a year, as in the following year he was forced to give his resignation because of the trouble he was developing in his lungs.
At 20, he was a tall, strong, handsome man with a pointed beard, and had a very engaging personality almost angelic. He was very kind to his patients. hard-working, and always tool. a night-round to see his important clinical patients as long as his health could permit. He bestowed the largesse of his fortune to the clinic at Karlstrassc, denying nothing to the poorer patients who were treated entirely free, without even the cost of food.
In the company of the "Camellias" he spent his leisure hours delighting in all forms of cultural activities. He was careless about his appearance and seldom changed his clothes.
In 1862, he got married to a Danish girl, Anna Countess Kunth, but his luck seemed to have changed after marriage. He was troubled with the health of his wife, whom he loved so much, of his children whom he adored and finally his own health. Like all consumptives in those days, he had to lire mostly on opiates in the later years of his life which gradually undermined his health even more. He breathed his last on 18th July 1970 in the 42nd year of his life.
Reflecting upon his achievements in so short a span of life, one can almost name him as a prophet, an inspired son of God, in tune with the infinite to have achieved so much that was beneficial to mankind and so much that has expanded the horizon of ophthalmology. We hail thee in our daily prayer - Albrecht von Graefe.
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