Friedrich Wilhelm Ernst Albrecht von Graefe
- Adson-Graefe forceps
- Graefe's sign
- Graefe's syndrome
- Graefe-Sjögren syndrome (Karl Gustaf Torsten Sjögren)
- Usher's syndrome
Biography of Friedrich Wilhelm Ernst Albrecht von Graefe
Friedrich Wilhelm Ernst Albrecht von Graefe is recognised as the founder of scientific ophthalmology. He was the son of Carl Ferdinand von Graefe (1787-1840), the Prussian Surgeon-general and director of the university surgical clinic in Berlin. Von Graefe's family were wealthy and he had a happy boyhood. He was a clever, intelligent and diligent scholar and was educated at the French Gymnasium in Berlin, graduating with honours at the age of 15 years. He then went to Berlin in the autumn of 1843, still not 16, to study philosophy, logic, natural sciences and anatomy. Of his teachers he was particularly attached to Johannes Müller (1801-1858), Johann Lukas Schönlein (1793-1864), Moritz Heinrich Romberg (1795-1873), and Eduard Wolff (1794-1878).
von Graefe received his medical degree in Berlin on August 21, 1847. In the winter of 1847/1848 he passed the state examination with the note "exemplary good" (vorzüglich gut) and "Operateur", and in the autumn of 1848 went to Prague, still undecided as to which branch of medicine he wanted to make "his". He did not remain undecided for long, however. In Prague he was strongly influenced by the professor of ophthalmology, Carl Ferdinand von Arlt (1812-1887). They entered a lasting friendship based on mutual respect and love.
From Prague Graefe went on to Paris, where he was a regular visitor to the clinics of Jules Sichel (1802-1868) and Louis-Auguste Desmarres (1810-1882). He next studied in Vienna under the Jaegers - father and son - Christoph Friedrich Jaeger (1784-1871) and Eduard Jaeger Ritter von Jaxtthal (1818-1884), who gave him ample opportunity to develop his ophthalmological practice. During his subsequent stay at the Moorfields Eye Hospital in London he made the acquaintance of William Bowman (1816-1892) and George Critchett (1817-1882). In London a happy coincidence brought him together with the Dutch physiologist Franz Cornelis Donders (1818-1889) who, in Graefe, found a friend and inventive colleague in research.
A successful young man
On returning to Berlin in 1850, 22 years of age, he founded his own clinic and soon had a surprisingly busy practice. This was the same year that Hermann Ludwig Ferdinand von Helmholtz (1821-1894) announced his great invention, the eye mirror, or the ophthalmoscope, which von Graefe was the first to use routinely. He said of it: "Helmholtz has opened a new world to us".
von Graefe’s great care for his patients and his genius as a scientist gave his clinic great repute, not only among his patients, but also among his colleagues all over the world. He was very rich and used to treat poor patients with diseases of the eye for nothing. He had immense reserves of energy and in addition to his punishing work schedule, he was able to devote time to his physiological and other scientific studies.
In 1852 von Graefe moved his clinic to Karlstrasse 46, Berlin, where a tablet still commemorates his occupancy. In the same year he submitted a thesis entitled On the action of the ocular muscles to the University of Berlin and qualified for teaching, becoming Privatdozent. Shortly after his lecture on the operation for squint caused a sensation. He was an excellent teacher and postgraduates from all parts og the world attended his clinics. Karl Weber (1819-1875) of Darmstadt commented "One was spell-bound in his clinic, as if in a maggic place. The multitude of new facts and viewpoints never heard before, the fascinating presentation and glowing enthusiasm acted like a revelation."
He was appointed associate professor of ophthalmology in Berlin in 1857 - the first German professor of diseases of the eye, being elevated to full professor in 1866.
He maintained lively scientic and friendly associations to those grand men of ophthalmology who, with him, laid the foundation of modern ophthalmiatrics: Hermann von Helmholtz, the genial physicist and optician, Ferdinand von Artl, the great clinician and oparator who had influenced von Graefe to devote himself to ophtalmology, and Cornelis Donders, the founder of the new doctrine of refraction, Eduard von Jager, the skilled ophtalmoscopist, William Bowman, the anatomist, and Friedrich Horner (1831-1886). Among the students who flocked to him from all over the world, were Argyll Robertsen (1837-1909) and Theodore Billroth (1829-1894), who was impressed by his "great personal kindness and his great humility". von Grafe was also the teacher of Friedrich Horner.
His journal still lives
In 1853 there was no ophthalmologic journal apart from Annales d'Oculistique, founded by Florent Cunier (1812-1853) in 1838 in Brussels, and the Archives d'ohthalmologie (suspended in 1855). In 1854 von Grafe, aged 26, founded the journal Archiv für Ophthalmologie. In the first issue (January 1854) 400 of the 480 pages were authored by him and some articles had the nature of a medium-sized monograph. By publication of volume 16, he had contributed 2500 pages. Because of his great reputation, he was soon able to recruit Arlt and Donders as co-editors. The journal was later renamed Albrecht von Graefes Archiv für Ophthalmologie, and is still published and well alive under the title of Graefe's Archive for Clinical and Experimental Ophthalmology, published by Springer. In 1864 von Graefe participated in the founding of Klinische Monatsblätter für Augenheilkunde, a journal intented as a monthly for practicing ophtalmologists in general.
The German Ophthalmological Society
In 1857 he gathered a number of ophthalmologists for a meeting in Heidelberg, where Deutsche Ophtalmologische Gesellschaft was established in 1863, greatly contributing to Heidelberg becoming the most important meeting point for ophthalmologists from all over the world.
Graefe’s most important field of work was impairment of vision withour organic lesions of the eye. He diagnosed sudden visual loss due to retinal artery embolism, optic retinitis and was one of the first to treat glaucoma successfully. He described a large number of new findings, among them stase papillas in brain tumors, retardation of the eyelid in Basedow's disease and gave new operational methods, among them iridictomy in cataract.
von Graefe was the first to demonstrate that blinding and impairment of vision in cerebral diseases was caused by a neuritis optica, not by a paralysis of the optical nerve. Countless people owe him their vision, with eyes that would have been dimmed to darkness without his iridictomy. He was the inventor of the modified linear extraction method of operating for glaucoma, reducing failure rate from 10 % to 2-3 % in his time. He also invented a special knife, which is still used for cataract-surgery.
In personal appearance von Graefe was tall, slender and elegant, with a handsome face, long dark hair and a full beard. He was modest in his lifestyle and his greatest pleasure was entertaining his friends to dinner in his home. His massive workload, which he enjoyed, left time for little else. In 1861 he developed tuberculous pleurisy, but his condition went into remission and he married Anna Gräfin Knuth the next year. His pulmonary tuberculosis was reactivated, and in 1870, aged only 42, von Graefe succumbed to the disease.
A memorial was raised in is honour on May 22, 1882, with a speech by Karl Ernst Theodor Schweigger (1830-1905), a former pupil and collaborator of Graefe, who succeeded Graefe as teacher of ophthalmology at Berlin.
In his short career von Graefe performed more than 10,000 eye operations. He was undoubtedly the most important ophthalmologist of the 19th century.
- De bromo ejusque praeparatis.
Doctoral dissertation, 1847.
- Über die Wirkung der Augenmuskeln.
Habilitation thesis, 1852.
- Beiträge zur Physiologie und Pathologie der Schiefen Augenmuskel.
Archiv für Ophthalmologie. Ist volume, 1854.
- Über Doppelsehen nach Schieloperationen und Incongruenz der Netzhäute.
Archiv für Ophthalmologie. Ist volume, 1854.
- Über die diphterische Conjunctivitis und die Anwendung des Causticum bei acuten Entzündungen.
Archiv für Ophthalmologie. Ist volume, 1854.
- Notiz über die Behandlung der Mydriasis.
Archiv für Ophthalmologie, 1854-1855; 1, 1 Abt.: 351-419.
- Vorläufige Notiz über das Wesen des Glaucoms.
Archiv für Ophthalmologie, 1854-1855, 1, 1 Abt.: 371-382.
- Ueber die Coremorphosis als Mittel gegen chronische Iritis und Iridochorioiditis.
Archiv für Ophthalmologie, 1855-56, 2, 2 Abt.: 202-257.
- Exceptionelles Verhalten des Gesichtsfeldes bei Pigmententartung der Netzhaut.
Archiv für Ophthalmologie, 1858, 4: 250-253.
Von Graefe-Lindenow/von Graefe-Sjögren syndrome.
- Ueber Complication von Sehnervenentzündung mit Gehirnkrankheiten.
Archiv für Ophthalmologie, 1860, 7, 2 Abt: 58-71.
- Über Basedow’sche Krankheit.
Deutsche Klinik, Berlin, 1864, 16: 158-159.
Von Graefe’s sign.
- Ueber modificirte Linearextraction.
Archiv für Ophthalmologie, 1865, 11, 3 Abt.: 1-106.
Archiv für Ophthalmologie, 1866; 12. 1 Abt.: 150-223.
Archiv für Ophthalmologie, 1868; 14, 3 Abt.: 106-148.
- Zur Lehre der sympathischen Ophthalmie.
Archiv für Ophthalmologie, 1866, 12, 2 Abt: 149-174.
- Symptomenlehre der Augenmuskellähmungen.
Berlin, H. Peters, 1867.
- Sehen und Sehorgan.
In the series: Sammlung gemeinverständlicher wissenschaftlicher Vortrage, published by Rudolf Virchow (1821-1902) and Franz von Holtzendorff (1829-1889).
2. Serie, Heft 27. Berlin, 1867. 48 pages.
- Ueber Ceratoconus.
Berliner klinische Wochenschrift, 1868, 5: 241-244, 249-254.
- Demonstration in der Berliner medizinische Gesellschaft vom 2.9.1866.
Berliner klinische Wochenschrift, 1868, 5: 127.
von Graefe’s syndrome. Other works published in Archiv für Ophthalmologie:
- Über lineare Extraction.
- Über den Werth einseitiger Cataractextraction.
- Beiträge zur anat. Klinik der Augenkrankheiten.
Written with Karl Ernst Theodor Schweigger (1830-1905). No. 6.
- Über die Iridectomie bei Iritis.
- Über das Gesichtsfeld bei Amblyopie.
- Schielen und Schieloperation.
- Über Morbus Basedowii.
- Die Iridectomie bei Glaucom und über den glaucomatösen Process.
1857, 3, part 2: 456-560.
- Über Embolie der Arteria centralis retinae.
- Neuritis optica nach Cerebralkrankheiten.
- Über Glaucom und Iridectomie.
- Über Calabar-Bohne.
- Über muskuläre Asthenopie.
- Über die modificirte Linearextraction.
- Beiträge zur Pathologie und Therapie des Glaucoms.
- Über die Operation des dynamischen Auswärtsschielen, besonders in Rücksicht auf progressive Myopie.
- Augenkrankheiten und ihre Behandlung.
Vorlesungen gehalten. im W. S. 1859/1860 von Albrecht von Graefe, herausgegeben vom Julius Hirschberg. Leipzig, 1925.
Graefe’s lectures of the winter semester of 1859/1860. Biographical:
- Eduard Michaelis (1824-1891):
Albrecht von Graefe, sein Leben und Wirken. Berlin, 1877.
- Alfred Graefe (cousin; 1830-1899):
Ein Wort zur Erinnerung an Albrecht von Graefe. Halle, 1870.
- Karl Ernst Theodor Schweigger (1830-1905):
Rede zur Enthüllungsfeier des Graefe-Denkmals am 22. Mai 1882. Berlin, 1822.
- E. V. Ullmann:
Albrecht von Graefe: The man and his time.
American Journal of Ophthalmology, Chicago, 1953, 38 Parts 1-III: 525-809.
- H. Leopold:
Albrecht von Graefe.
Diabetes, New York, 1958, 7 (2): 151-154.