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Honorary Lecture
105th DOG Congress 2007

“150 Years of DOG: Memories and Thoughts

by Prof. Dr. Jens Martin Rohrbach (Tübingen)

in 1856 Albrecht von Graefe wrote to his friend and scholar Adolf Weber: I was wondering if it were possible that certain diligent disciples of ophthalmology could meet each year at a nice place, for example Heidelberg, and spend some time together partly in scientific study and communication and partly in innocent leisure“.

Von Graefe had made friends with Frans Cornelis Donders in 1851. Since Donders frequently travelled south, they decided to meet halfway. That way Heidelberg became a rather coincidental choice. 12 ophthalmologic friends met there from 3rd to 5th September 1857. 12 lectures were given, 4 by Graefe himself. But it didn’t stop there. Still under the impression of the first meeting, Albrecht von Graefe wrote in a letter: “After Würzburg there were two enjoyable days in Heidelberg. During lunch in the old castle’s garden, it was really touching to see the well-known faces surge one by one, full of life, full of joy because of this meeting, full of juvenile cheerfulness. It is needless to say that we did not only practice ophthalmology. We bravely drunk and even good old Arlt got a bit jaunty when wine from Neckarsteinach and old German songs were gradually changing the scene. … This night I slept profoundly – no wonder after the great deal of wine and commotion - and got awakened by the joined congress for the last session. “

This was the genesis of the „Ophthalmologische Gesellschaft“, the first society of medical specialists in the German Reich and the first ophthalmologic society worldwide. The reputation of Albrecht von Graefe went far beyond the frontiers of Germany and since there did not exist any other ophthalmologic associations and a purely national science was something unthinkable at the time, the „Ophthalmologische Gesellschaft“ was international right from its beginning. In 1864 the membership consisted to 41 % of foreign members. In some years there were even more members from abroad than from Germany. The fact that the DOG is an international society thus has a long tradition!

Very soon there was a growing desire from the rising number of congress participants to give the meetings an official character, which until then had been merely casual. And thus on 5th of September 1863 the Society became established. The statutes developed by Albrecht von Graefe comprised 4 paragraphs. For the sake of historical truth, it must be said that until 1940 the DOG administrators have counted all anniversaries back to the formal date of foundation in 1863. It was only after World War 2 that the society’s founding was dated to the year 1857.
In 1871 there was an amendment of the statutes, and it was not until 1903 that a legal capacity was obtained with the entry into the Heidelberg Register of Associations. Finally, in 1920 the „Heidelberger Ophthalmologische Gesellschaft“ received its current name „Deutsche Ophthalmologische Gesellschaft“. In 1922 for the first time the DOG congress did not take place in Heidelberg, but in Jena.

Dear Ladies and Gentlemen, thanks to our ophthalmologic historians no other medical discipline offers more accurate historical knowledge than ophthalmology. Let me  just mention names like Albert Esser, Wolfgang Münchow and especially the von Graefe student Julius Hirschberg from Berlin with his epoch-making work on the history of ophthalmology. By the way, Albrecht von Graefe himself was very interested in ophthalmologic history.

The presentation of the ophthalmoscope in 1851 by Hermann von Helmholtz, who according to Albrecht von Graefe had opened the door into a new world, i.e. the fundus - was decisive for the development of ophthalmology, which at that time was no subject of its own. For this achievement Helmholtz was the first to receive the von Graefe Medal in 1885.

The use of the ophthalmoscope led to a highly increased number of diagnostic findings and that way forced specialisation. Eye clinics – for the most part private eye clinics - were founded.
The new knowledge had to be transported. Therefore Albrecht von Graefe in 1854 , three years before the first meeting in Heidelberg, published the first volume of the „Archiv für Augenheilkunde“, which then after his death in 1871 became „Graefes Archiv für Ophthalmologie“ and which is the world’s oldest journal of ophthalmology.
 
What was missing, was the creation of ophthalmologic chairs, the establishment of ophthalmology as a medical subject and the building of university eye clinics. It was Graefe’s favourite student Julius Jacobson from Königsberg who would later get deeply involved in this subject. In his pamphlet of 1868 „Ophthalmology in Prussian universities – a cultural emergency “ which he sent to the party leaders in the Prussian parliament and also to the responsible minister, he stated among other issues:
“Clinics and polyclinics have to exist in parallel and must complete one another in the same time. Each one alone will create dilettantes and smatterers instead of capable practitioners and scientifically educated ophthalmologists“. And he continues:
“If my presentation of the general educational deficits is not clear and demonstrative enough to cause drastic changes, I myself will continue to show in detail the untenable state of the actual circumstances so that even the most stupid eye will be able to see them.“
Jacobson‘s sharpness was understandable: at that time his polyclinic consisted of two rooms which were located within the mortuary of the institute of pathology and if there was a bigger rush, patients had to wait outside in good or bad weather for any length of time.
Jacobson‘s engagement lead to success. In 1869 ophthalmology became a medical subject in Prussia and after the Reichsgründung in 1871 and until 1883 all of the existing faculties in Germany held a chair of ophthalmology. On the whole the ensuing building of the first new university eye clinics was completed by 1910.
In view of today’s increasing denationalisation of medicine, we are back on the way to the conditions that already existed at the time of Albrecht von Graefe.
 
Dear Ladies and Gentlemen, during the last 150 years there has been great progress in which the DOG has been significantly involved. Above all, progress has taken place where ophthalmology has worked closely together with other disciplines – especially bacteriology, pathology and medical technology. Slit lamps and operation microscopes, associated to the names Gullstrandt and Harms, have strongly changed the work of the ophthalmologist.

40 years ago certain interventions - especially vitreoretinal - were unthinkable. Implants as well as excipients and substitutes for intraocular operations are widespread now and the procedures have become more successful and most notably safer. Highly potential medicaments have replaced certain forms of therapy, like for example phototherapy for inflammable eye diseases, which led to a profound change in the area of ophthalmologic diseases.
 
Some great achievements in ophthalmology, such as for example Credé’s prophylactics, which since 1880 have saved thousands of children from blindness, have fallen into oblivion. At this point, I would like to thank the physicians who contributed to the progress in ophthalmology without being ophthalmologists themselves such as Credé, the gynaecologist and obstetrician.

To illustrate the enormous progress let me mention only 3 examples: While in the year 1900 there was practically no treatment for the detachment of the Retina, today in more than 90 % of all cases a reattachment can be accomplished. And while in 1900 90 % of the children with a retinoblastoma did not survive, the retinoblastoma-induced mortality rate today is below 5 %. For the University Eye Clinic Tübingen and its sphere of activity, the number of cataract operations in 2000 is 80 times higher than in 1900. This is not only due to development in demography but mainly due to an enormous increase in quality. We should be very grateful for these achievements.

But these achievements have also claimed sacrifices, which we tend to easily forget. According to Heinrich Böll the history of progress is the history of ingratitude. Those born later thoughtlessly adopt and enjoy the advantages without bearing in mind the price which had to be paid. And we must also realise that for some disease patterns, such as the Retinitis pigmentosa, there was almost no therapeutical progress at all during the last 150 years.

The role textbooks have had in the ophthalmologic progress may not be underestimated. Out of the numerous brilliant works let us just mention the Handbook of Ophthalmology by Alfred Graefe, a cousin of Albrecht and Theodor Saemisch.

The morphologically oriented textbook by Ernst Fuchs and the still modern appearing textbook of Paul Römer, who was very devoted to youth. Of today’s textbooks only „Der Grehn“ does have a longer tradition.

To the huge number of atlases belongs the “Atlas der äußeren Augenkrankheiten” by Richard Greef (1909), the „Atlas der Kriegsaugenheilkunde” by Aurel von Szily (1918) as well as the “Atlas der Spaltlampenmikroskopie” by Alfred Vogt, first edition 1921 - just to mention a few of them.
 
I have already mentioned the foundation of “Graefe’s Archiv für Ophthalmologie” which was mainly intended for scientific ophthalmologists. It was complemented in 1863 by the „Klinische Monatsblätter für Augenheilkunde“, which are mainly designed for ophthalmologists in practice and shall help to transfer the results of the latest research to everyday ophthalmologic life without any delay.

The „Monatsblätter“ were also designed to publish the DOG congress reports, which they did from 1863 to 1895. Starting in 1896 the „Berichte der Ophthalmologischen Gesellschaft“ were introduced, which later became „Fortschritte der Ophthalmologie“ and today are called „Der Ophthalmologe“. Today, „Graefe’s Archive“ as well as „Der Ophthalmologe“ and the „Klinische Monatsblätter“ are – historically correct – the official journals of the DOG.

The „Zentralblatt für praktische Augenheilkunde“ was initially published in 1877 by Julius Hirschberg and suspended in 1996. Not everything should be conserved and every now and then I hear comments that our old German scientific journals have outlived themselves. The way I see it, this is not true. Our old German journals are ophthalmologic and cultural assets, which we should try to conserve with all our heart – irrespective of impact factors!
 
The „Zeitschrift für Augenheilkunde“ was founded by Hermann Kuhnt and Julius von Michel in 1899. As the Karger family had a Jewish family background, the publisher emigrated to Basel, where the journal was edited under the name „Ophthalmologica“ ever since 1938.

Ladies and Gentlemen, in the year 1934 about 11 % of the DOG members had a Jewish family background. It  was possible to identify them by comparing the DOG membership lists to the Reichsarztregister (registry of German doctors). Their further destiny may partially be clarified by an inquiry into the database of the Israeli memorial Yad Vashem. Today we may assume that the Jewish DOG members no longer participated in the DOG congresses of 1936, 38 and 40 and that by 1940 80 % of them voluntarily– as stated in the DOG reports -  left the society. It is needless to say that from today’s point of view this „voluntariness“ is more than questionable.

On September 30th, 1938 the Jewish colleagues lost their licence to practice medicine. Worse was to follow. In an exemplary study by the Freiburg medical historian Seidler, the Deutsche Gesellschaft für Kinder- und Jugendheilkunde (German society for paediatry) has investigated its Nazi involvement and has admitted its responsibility with a ceremonial act in 1999. Figures are abstract and cannot give us any idea of the personal fates behind the numbers. Therefore in the following I would like to commemorate some of the well-known Jewish DOG members and - above all - some of the Jewish members whose names are relatively unknown. They stand representatively for all our colleagues prosecuted during the Nazi era.

Rudolf Aron, ophthalmologist in Breslau. In 1937 emigration to the USA, in 1941 denial of his medical certification by the University of Bonn

Karl Wolfgang Ascher, extraordinary professor of ophthalmology in Prague. Inter alia descriptor of aqueous veins and the corneal Ascher Ring. Escape to England in 1941 and from there to the USA in the same year.

Alfred Bielschowsky, from 1923 professor of ophthalmology in Breslau (Wroclaw), Co-founder of the Blindenstudienanstalt (educational establishment for the blind) in Marburg, descriptor of the head tilt test for the diagnosis of trochlear paresis. In 1934 forced retirement, in 1935 relegation from his position as editor of the „Graefesche Archiv für Augenheilkunde“ and emigration to the USA.

Oskar Fehr, from 1906 director of the ophthalmologic section of the Rudolf Virchow hospital in Berlin. First descriptor of macular corneal dystrophy and endemic swimming-pool conjunctivitis. In 1934 forced relegation from this position. In 1939 emigration to England.

Josef Igersheimer, from 1925 head physician of ophthalmology in Frankfurt/Main. In 1933 denial of his teaching certificate and emigration by accepting the chair at the Istanbul university. In 1939 emigration to the USA.

Rudolf Paederstein, ophthalmologist in Berlin. Editor of the minutes of the Berliner Ophthalmologische Gesellschaft in the „Klinische Monatsblätter für Augenheilkunde“ from 1903 to 1934. His destiny after 1934 remains unknown.

Ernst Rahlson, ophthalmologist in Frankenthal/Pfalz, on this picture as military surgeon in the year 1916. In 1938 loss of approbation. In the same year he  still attended the 52. congress of the DOG in Heidelberg. Thus Rahlson probably was the last Jewish DOG member to attend a DOG congress during the NS era. In January 1944 he was deported to the concentration camp Theresienstadt, where he died only 6 days after his arrival.

Aurel von Szily. From 1924 professor of ophthalmology in Minster. In 1935 compulsory suspension, in 1937 emigration. In the same year relegation from his position as editor of the „Klinische Monatsblätter für Augenheilkunde“. In 1939 emigration to his native town Budapest.

Today we must assume that in the period of time between 1933 and 1945 about 60 Jewish DOG members lost their existence in practice and clinic and that about 50 % of all Jewish DOG members, as for example Friedrich Pincus, died in the concentration camps. It is a matter of particular concern for me to commemorate them all. I would like to point out that a film with the names of all Jewish DOG members known until today can be accessed at the poster terminal.

Dear Ladies and Gentlemen, the DOG will defy the oncoming and unavoidable turbulences. Nevertheless it will change its appearance and will become more feminine. For a long, time the DOG has been a purely masculine society and in 1870 only men were asked to submit abstracts. In 1881 the first woman participated in a DOG congress and in 1911 – more than 50 years after its foundation – the first female member was admitted. It was only after 1920 that the admission of female ophthalmologists became quite a routine. Nevertheless, until the beginning of World War 2 only about 3 % of the DOG members were female. The first female president was Gabriele Lang, congress president of the 100th congress five years ago. In about 1 or 2 decades a female DOG president will probably be the rule and no longer an exception.
 
Let me come back to the medical historian and ophthalmologist Albert Esser. At the occasion of the 100th DOG birthday in 1957 he wrote:
“A hundred years“ - and today I will say 150 years – „may be of great or small importance in the history of science: small importance, if they are passing by as times of outdated or effete mentality, archaic ideas, antediluvian methods or fruitless work; great importance if they are pillared and nourished by dynamic tensions, great conceptions, spiritual originality, energetic vigour, unflagging zeal and successful activities. In this sense 150 years of DOG are of very great importance. And they are, above all, a mirror of German history.

I will close my speech with Michael, a boy unknown to me. His thoughts on the occasion of the 200th anniversary of Australia’s colonialisation may also be applied– slightly modified –to our old and at the same time young lady DOG:
We wish you, DOG, that you as a bond for all ophthalmologists will continue your contribution to science and the gain of knowledge for the benefit of the global population and, above all, that you will remain a successful society.

I thank you.

Sources

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