Heinz Fischer (Cloppenburg):
Modern Ophthalmology in North-West Germany

When in the second half of the 19th century Albrecht von Graefe began to reform the ophthalmology in Berlin, this was soon known in all parts of Germany, also in the duchy of Oldenburg in north-west. So Dr. Dode-Emken Müller, a military physician in Oldenburg came to Berlin, to learn in the courses given there by Albrecht von Graefe.

Dr. Müller was born on a farm near Jever in North-Oldenburg. He visited the universities of Tuebingen, Wuerzburg and Giessen and subsequently for advanced studies Zurich clinics from 1846 till 1848. In 1848 he joined the army of Oldenburg and became a military doctor. Here at last he was “Oberstabsarzt”. In 1856 he opened a private clinic for ophthalmology in Oldenburg. But as military doctor he was depending on the political events of his time. So he had to take part in the wars at the time. After the war between Germany and France 1870/71 he had to stay in France with wounded soldiers till 1873. He again began with his ophthalmologic clinic, that in the meantime has gone back. Till 1894 he was commander of the military hospital and doctor of the ducal family. In 1896 Dr. Müller suddenly died on a visit, still working at an age of 74 in the hospital of the protestant church. His son Prof. Paul Müller-Kaempf was a landscape-painter. He has founded the artist village of Ahrenshoop on the Baltic sea near the island Ruegen.

Dr. med. Heinz Fischer, Bahnhofstr. 47, D-49661 Cloppenburg

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Josef Haslbeck (Neumarkt):
An Old Ophthalmologist Reports

About the resumption of medical education at the Julius-Maximilians-University after world war II.

Dr. med. Josef Haslbeck, Karl-Speier-Str. 41, D-92318 Neumarkt

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Robert Heitz (Strasbourg):
The Invention of Contact Lenses by August Müller (1887–89)

In his Inaugural-Dissertation of February 28, 1889, representing his doctorate thesis at the Medical Faculty of Kiel University, August Müller described the results of his studies, which he took up in 1887 on the dioptric correction of his myopia by means of contact lenses.

August Müller deposited lenses in 1937 to the Deutsche Museum in Munich. These lenses correspond to those ones described by him in his doctorate thesis.

An account of the life history of August Müller (1864-1949) is given.

Dr. med. Dr. phil. R. F. Heitz, 23 A rue Trubner, F-67000 Strasbourg

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Jutta Herde (Halle):
Carl Ernst Theodore Schweigger – On His Life and Work

Carl Ernst Theodore Schweigger was born on October 28th 1830 at Halle/Saale. He descended from a family famous for science. His father was the well-known professor of chemistry and physics, the creator of the galvanometer. C. Schweigger studied medicine in Erlangen and in Halle too. After his thesis in 1852 he became a medical assistant by Peter Krukenberg. The fields of his special interest were the auscultation and percussion.

In 1856 Carl Schweigger went to Heinrich Müller in Wuerzburg to learn the anatomic-pathologic microscopic investigation of the eye. This work made him enthusiastic about ophthalmology. Then he moved to Albrecht von Graefe in Berlin, one of the famous ophthalmologists at the time, for specialization in ophthalmology and working with him for six years. In 1864 Schweigger made a study trip to Utrecht, London and New York. Having come back to Berlin he practised as ophthalmologist in the town. In 1868 he was appointed professor of ophthalmology at the Goettingen university, and in 1871 for the same function at the Charité of the university in Berlin as successor of his deceased teacher A. v. Graefe. The chairmanship of the department of ophthalmology he carried out 28 years. In 1881 was the opening ceremony of the newly built eye clinic at the Ziegelstrasse.

His extensive scientific work contains numerous topics – the microscopic pathology of the eye, the cataract operations, and the strabismus, the ophthalmoscope technique of the examination, the glaucoma’s, visual card tests, the relationship between general and eye diseases and others. His manual of special eye diseases was examplary for many further textbooks. Since 1882 he was the co-editor of the Archiv der Augenheilkunde by Knapp and Schweigger. By reason of his proceeding muscular dystrophy he prematurely resigned the chair. He died on August 24th 1905. On the occasion of the 100th day of his death we will appreciate the achievements in ophthalmology by Carl Schweigger.

Prof. Dr. med. Jutta Herde, Univ.-Augenklinik, Ernst-Grube-Str. 40,
D-06120 Halle/Saale

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Gerhard Holland (Kiel):
About the Eye of Horus

At the beginning there was the myth, the story of Osiris and Isis, the fight between Seth and Horus, in which Horus lost one eye. More than 4000 years ago, for the first time there were written records testifying the story in the so called text of the pyramids on the walls of five pyramids of Saqqara. The "Eye of Horus" became the "Sacred Eye" called Udjat. In the pictorial representation, which is typical for its recurrence form. In the Middle Kingdom, the Udjat was painted for the first time on the coffins and later on in the New Kingdom it was frequently painted in the tombs of Theban Necropolis. lt is to be seen on the walls, false doors, steles, barks, as a part of exquisite jewellery and on vignettes of the "Egyptian Book of Death", which is a source for understanding the various meanings of the "Eye of Horns". The different meanings and their evolution till date are especially discussed in this paper. Today, we find the Udjat as a souvenir and in a modified logo-form on prescriptions of American physicians.

Prof. Dr. med. Gerhard Holland, Esmarchstr. 51, D-24105 Kiel

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Guido Kluxen (Wermelskirchen):
Discovery of Ocular Onchocerciasis in Africa and Central America

The first persons to mention ocular onchocerciasis were Rodolfo Robles and Pancheco-Luna in Guatemala in 1915/1916. Ophthalmic symptoms and signs were marked in the Triassic, also known as ‘Morbus Robles’: 1. Filarial worm infection of an adult Onchocerca in America, 2. Erisipela de la costa, red skin inflammation of the coast, a skin disease located on the face, 3. Conjunctivitis and iritis of the anterior segment of the eye. The early investigators of onchocerciasis from 1874–1930 in Africa made no mention at all of concomitant severe eye disease. Publications of the observations in Central America by Rodolfo Robles and Émile Brumpt in 1917/1919 prompted some specialists in tropical medicine to look for eye disease associated with African onchocerciasis. However, there did not seem to be any eye disease leading to blindness. Only Ouzilleau and his colleagues recorded in 1921 that one of the 16 infected persons of 27 inhabitants they had found in a village near Brazzaville had keratitis.

It was not until 1930/1931 that Jean Hissette reported that 20% of patients with onchocerciasis were blind in an onchocerciasis focus on the Sankuru river in the Belgian Congo, and that 50% of the villagers suffered from eye troubles. Two years later, he found a second focus with the same pathology on the Uéle river. Hissette described the pathomechanism of this blindness in a long paper in 1932 and in addition to a description of anterior eye disease, he drew attention to an association with chorioretinitis. Two years later the Harvard African Expedition to the Belgian Congo under Richard Pearson Strong with five American colleagues was organized at Belgium expense. His members had to check Dr. Jean Hissette’s reports because there were doubts about his findings. Confronted by this commission in the form of the Harvard African Expedition, Hissette traveled once more to the Sankuru with the Americans as seventh member of the expedition and showed them "his" river blindness patients. The Americans finally confirmed all the observations on river blindness caused by onchocerciasis in the American Journal of Tropical Medicine (1938) that had already been communicated by Hissette (1932).

Hissette’s findings prompted renewed efforts to find ocular complications of onchocerciasis in other parts of Africa, now known as river blindness. In 1944, Harold Ridley found that slightly more than one third of patients with onchocerciasis in a region of the Gold Coast (Ghana) had evidence of either anterior or posterior disease of the eye, with nearly half of them being blind or nearly blind. Ridley’s monograph Ocular onchocerciasis (1945) was of considerable success in river blindness research.

Prof. Dr. med. Guido Kluxen, Brückenweg 1, D-42929 Wermelskirchen

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Peter Kober (Schwelm):
The "Club of the Anomals"

The ophthalmologists working for the German Railway around 1912 were already equipped with the Anomaloscope constructed by Nagel in 1905 for the quantitative registration of colour perception malfunction. So those ophthalmologists ironically called themselves "Club of the Anomals".
Since the middle of the 19th century medical care by railway doctors had been given to the employees of the German railways before they amalgamated to form the "Deutsche Reichsbahn" in 1924. Only towards the end of the 19th century people began to realize the necessity of examining and monitoring eyesight especially of train drivers.

As a result additional ophthalmologists were employed to provide permanent eye care for railway personnel. They contributed their knowledge of the function of the eye to industrial medical care and to the safety of rail traffic. Thus at an early stage they also opened up an area of practical importance for ophthalmology going beyond curative medicine. It was (these) well – known ophthalmologists who set the standards which are still used today by the railway.

The present-day traffic ophthalmology, including far more now than just rail traffic, is closely linked in its development with this early sphere of industrial
medicine.

Dr. med. Peter Kober, Zamenhof-Weg 4, D-58332 Schwelm

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Frank Krogmann (Thüngersheim):
Wuerzburg – Peak of His Career: Carl von Heß (1863–1923)

Carl von Heß died in Munich in the year 1923 as holder of the chair of ophthalmology at the universitiy of the Bavarian capital. But the peak of his career were the twelve years before, which Heß spent in Wuerzburg. The scientific results of this excellent ophthalmologist will be honoured in the lecture.

Frank Krogmann, Kirchgasse 6, D-97291 Thüngersheim

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Andreas Mettenleiter (Würzburg):
Ophthalmology Seen with the Eyes of a Caretaker – Notes on the Wuerzburg University Ophthalmologic Clinic in Otto Seidel's diary

The diaries, memories and photos by Otto Seidel (1890–1976) constitute an unusual and insightful document on the history of the Wuerzburg University Ophthalmologic Clinics at the Roentgenring (today Pleicherring). After grammar school, different jobs and military service at the Wuerzburg Infantry Regiment, Seidel was employed as caretaker, factotum and laboratory assistant in 1913, moved into the caretaker's apartment in 1929 and worked there until his retirement in 1955. He proves to be an attend and critic chronicler of the clinic and its directors: Everyday life of the provisional military hospital during both World Wars, instruction of the medical students and research activities as well as the fate of the building after the air raids from March 1945 are described lively and with many details.

Dr. med. Andreas Mettenleiter, Institut für Geschichte der Medizin,
Oberer Neubergweg 10a, D-97074 Würzburg

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Hans-Felix Piper (Lübeck):
Johannes Ohm (1880–1961), Hirschberg's Student to be Remembered for His Work on Squint

Julius Hirschberg, under whom Johannes Ohm worked in Berlin during the years of 1905–1907, awakened his interest in the research of ocular motility diseases. In 1908, Ohm established his ophthalmology practice for mine-employees in Bottrop and continued his research on nystagmus with a particular focus on nystagmus contracted by miners. Additionally, his research on strabismus contributed significantly to a better understanding of this ailment.

He also developed several diagnostic devices, among which are the lever-arm nystagmograph, a recorder for the field of fixation, a double ophthalmoscope, and an objective test for visual acuity. During his research on squinters he recognized: (i) early childhood horizontal and vertical gaze deviations and nystagmus (today called early childhood strabismus); (ii) special forms of oblique strabismus (today discriminated in respect to the horizontal and vertical outer field of fixation); (iii) late occurring strabismus and nystagmus (today normosensoric delayed strabismus). Furthermore, he found that amblyopic eyes exhibit unique features of optokinetic nystagmus and its extinction by a near-threshold fixation mark.

Some of his concepts of coordinated binocularity control were not accepted by the scientific community. For instance, he attributed disturbance of binocularity to a dysfunction of the "main oculomotoric controller", which he assumed to be in the nucleus vestibularis, and regarded it to be the "origin of strabismus". He used the concept of “lateralization” with predominance of one eye to explain abnormal correspondence on the one hand, and the result of the struggle between opposing and equal traction forces to explain strabismus on the other hand.

Through his accomplishments in nystagmus and strabismus research, he bestowed great credit upon his mentor, Julius Hirschberg.

Prof. em. Dr. med. Hans-Felix Piper, Im Brandenbaumer Feld 32, D-23564 Lübeck

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Hans Remky (München):
Ocular Immunology: 1903–1912

„Ursprünglich, d. h. vor etwa dreissig Jahren, bildete die Bakteriologie einen winzigen Abschnitt der Botanik“ Robert Koch said in his inaugural lecture to the Academy of Science in Berlin 1909.

Together with the fulminantly developing of bacteriology in the last quarter of the XIXth century Immunology had its origin; the phenomena of immunity was clarified by the work of Emil von BEHRING (1890) and of Paul EHRLICH. Humeral and cellular theories of Ilja METSCHNIKOFF and of Paul EHRLICH (side chain theory) were competing.

In 1902 Charles RICHET and Paul PORTIER defined the tern "anaphylaxie", in 1903 Clemens Frhr. von PIRQUET introduced the term "allergy". In 1903 the monographs "Immunität bei Infektionskrankheiten" of METSCHNIKOFF and "Die Antikörper" of Emil Frhr. von DUNGERN were published.

E. von DUNGERN described, in the last section of his book, the intraocular formation of Antibodies. In the same year Paul UHLENHUTH reported on the organ specificity of lens Protein in the Festschrift for the 60th birthday of Robert KOCH. Knowing the particularities of the eye and ocular barriers research of the Immunology of the eye began with increasing efforts; in 1981 Gilbert SMOLIN and G. Richard O'CONNOR cited 305 references alone for a general introduction of the monography "Ocular Immunology"!

The Antibodies in the anterior chamber, Anaphylactic reactions and Organ specificity of ocular tissues belonged to the major scientific topics between 1903 and 1912. E. von DUNGERN proved in 1903 in animals, Alfred LEBER in 1906 in humans the intraocular formation of antibodies; sometimes cameral concentration exceeded those of serum and, in studies of Franz SCHIECK were detected earlier than in serum. The principle of comparing serology of Hans GOLDMANN in 1953 is based on these facts. Anaphylactic reactions were examined by Charles NICOLLE in 1908, Carl HUBERT SATTLER in 1909, R. KUMMELL and by Karl WESSELY in 1911, resulting in important knowledge for various ocular diseases.

Organ specific antibodies against lens protein were found by Carl HESS and Paul RÖMER in 1905 speculating on an important role in cataract formation. These authors also determined antibodies against retinal rods (macular degeneration?). In 1910/11 Anton ELSCHNIG discovered antibodies against the uveal pigment epithelium and concluded a new hypothesis of sympathic ophthalmia; his fellow Ernst KRAUPA described antibodies against corneal stroma.

In 1910 Walther LÖHLEIN proposed an active immunisation before keratoplasty indicating Future trials which finally ended with the Nobel prize of Peter Brian MEDAWAR.

Results an theories of science between 1903 and 1912 were presented without claiming Completeness.

Prof. Dr. med. Hans Remky, Biedersteinerstr. 57, D-80802 München

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Dieter Schmidt (Freiburg)
The Scientific Work of Theodor Axenfeld, Professor in Rostock and Freiburg

Theodor Paul Polykarpos Axenfeld was born in Smyrna (June 24th, 1867). His father was a protestant pastor. Theodor Axenfeld grew up in Bad Godesberg, passed his final school examination ("Abitur") in Bonn (1885) and studied in Bonn medicine (1885 to 1890). Then he worked at several University Institutes (Physiology, Pathology and Bacteriology) and was a medical assistant at the University Eye Hospital in Marburg (1894). In Marburg he passed the faculty examination ("Habilitation") in 1896. The topic of his work for this examination was "On purulent metastatic ophthalmia". Then he changed to the University Eye Hospital in Breslau and was appointed as Professor of Ophthalmology in Rostock (1897) and in Freiburg (1901). Numerous publications which were noted in the international world, gave evidence of his considerable and precise scientific activity. He was known as a well-informed physician, experienced surgeon and a qualified and efficient scientist who enjoyed common popularity. He communicated with many colleagues in the international ophthalmological world. Many of his assistants came from abroad. His main field of interest was bacterial ocular disease and, in addition, he was occupied with themes concerning general ophthalmology such as diseases of the anterior eye segment, glaucoma, surgical techniques, neuro-ophthalmological, retinal and orbital diseases. He wrote several important books. His name is still known today in connection with several eye diseases (Embryotoxon corneae posterius; "Axenfeld-Anomaly" and "Axenfeld-Schurenberg syndrome"). He discovered the diplobacterium Haemophilus lacunatus ("Morax-Axenfeld" bacterium) and described a change in the anterior eye segment which was called "Axenfeld-loop" ("Axenfeld-Schlinge").

Prof. Dr. med. Dieter Schmidt, Univ.-Augenklinik, Killianstr. 5, D-79106 Freiburg

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Gottfried Vesper (Leipzig):
About the Painter Edgar Degas' Retina Disease (1834–1917)

Edgar Degas, a very important artist of the 19th century, had for a painter unusual weak eyes. When he was forty, his problems with his eyes increased dramatically, due to a retina disease. Finally he was forced to reduce his painting tremendously. Since 1890 he mainly focused on sculpture.

San.-Rat Dr. med. Gottfried Vesper, Harnackstr. 9, D-04317 Leipzig

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Gregor Wollensak (Berlin):
Ernst Alban – Ophthalmologist and Steam Machine Engineer

Ernst Alban was born on 7/2/1791 in Neubrandenburg. Already in his childhood he was interested in mechanical problems like the build-up of wind mills. In 1810 he started studying theology in Rostock. At the time he also wrote a tragedy about “Aeneas in Carthage”. In 1811 he turned to studying medicine first in Rostock, then Berlin, Greifswald and Göttingen where he also attended Himly´s lectures. In 1815 he opened a private office in Rostock where he specialized in ophthalmology. In 1816 he wrote his habilitation on the treatment of eyes by people without medical education. From 1815 to 1817 he was able to teach ophthamology at the university of Rostock. He also operated successfully on 72 cataracts. Stimulated by the success of steam engines in England, Alban started to work on high pressure steam engines and finally went to England in 1825 to gain more experience. In 1827 Alban moved to Stubbendorf near Rostock where he developed various new ideas for steam egines, hydraulic presses, mills, and drilling machines most of which he published in Dingler´s Polytechnisches Journal. In 1829 he established the first mechanical factory of Mecklenburg in Klein Wehnendorf where he built farming machines. In 1840 he built a new big mechanical factory in Plau where he produced high pressure steam engines, textile machines, fire brigade pumps, tool and farming machines. In 1845 his steam-driven wheel-boat “Alban” was finished and used on the Plauer See. On 13/6/1856 Ernst Alban died due to recurrent strokes.

PD Dr. med. Gregor Wollensak, Wildentensteig 4, D-14195 Berlin

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