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More about Ernst Fuchs
MORE ABOUT ERNST FUCHS
335
References Murray, W. R. Two splinters of steel removed from the interior of the eye with the magnet. Jour. Minn. State Med. Assoc, 1906, July 1. 2 Randolph, R. L. The importance of prompt x-ray examination in cases of penetrating wounds of the eyeball. Ophthalmic Record, 1910, July, p. 341. 3 Lagleyze, M. Double intraocular foreign body. Arch, de Oft. de Buenos Aires, 1925, Dec, v. 1, p. 70. 1
M O R E ABOUT ERNST FUCHS 1. Interesting details of his life (Excerpts translated from an obituary address by Professor K. Lindner of Vienna, read before the Gesellschaft der Aerzte, Vienna, November 28, 1930. Professor Lindner's address furnishes much information of a personal character which does not seem likely to reach American readers from other sources. An excellent account of certain aspects of Fuchs's professional career and relationships is presented by Mr. Treacher Collins in the Febru ary issue of the British Journal of Ophthalmology.) The death of Professor Fuchs on No vember 21, 1930, was quite unexpected. He had recently made a series of diffi cult journeys in South America, some times at sea level in tropical heat, some times in mountain atmospheres at ele vations of ten thousand feet, using the airplane for quick connections from place to place. By all this his health seemed in no way disturbed. His end occurred after an illness of only a few hours, shortly after returning from a journey to Italy. The Fuchs family came from the Bo hemian forest, near the Bavarian bor der, where Ernst Fuchs's forbears lived as poor farmers. His grandfather mi grated to Passau barefoot, with twenty marks in his pocket and a loaf of bread for sustenance by the way. Ernst Fuchs's father, Hofrat Professor Dr. Adalbert Fuchs, born in 1814, at first studied medicine, but had to interrupt his studies for two years on account of hemoptysis. He recovered his health on a Polish country estate, where he became very much interested in agri culture. He returned to Vienna and took his doctorate in medicine and later in philosophy. However, he did not practice medicine, but became a proiessor of natural sciences in Tarnow, where he again became interested in agricultural problems. In 1848 he set tled in Innsbruck as professor of zool ogy, and two years later he was called to Vienna as professor of agriculture.
Ernst Fuchs was the first of three children, and grew up in Vienna. He spent his vacations in Kritzendorf, on his mother's father's estate, the home of his declining years and the place of his burial. His youth was passed in rather penurious circumstances. He never had butter on his bread. He later noted as a special reminiscence that once when invited to visit a neighbor a soft egg was put before him, a detail which he could never forget. Early in life Fuchs developed a fond ness for natural science, and if he could have had his wish he would have been an astronomer or a physicist. His father wanted to make an engineer of him, and in later life Fuchs himself could not remember why this plan had not been carried out. An anecdote illustrates his lifelong fondness for becoming acquainted with facts at their source. He had heard that in the Danube between Kritzen dorf and Klosterneuburg there was a whirlpool which sucked even good swimmers under water. This was in his early college life. He persuaded friends to take him to the spot and jumped from his boat into the water. The whirlpool seized him and he was hauled into the boat half-conscious. His medical studies were pursued in the brilliant period of the Vienna school, and his teachers included Hyrtl, Briicke, Rokitansky, Skoda, Billroth, and Arlt. Briicke exerted the greatest
336
K. L I N D N E R
influence upon him and young Fuchs almost became a physiologist. In his fifth year of study he declined an as sistantship with the ophthalmologist Becker at the Heidelberg clinic. A little later, upon Briicke's recommenda tion, he accepted an assistantship in the physiological institute at Inns bruck, where he stayed a year. Dur ing his time at Innsbruck he made ex tensive tours in the mountains, and his love for the mountains persisted undiminished from that time to his latest years. His wish to become a physiologist was shattered by recognition of the fact that his limited means would not per mit of further theoretical training. His monthly allowance from home was only five gulden (two and a half dol lars). He returned to Vienna in the winter of 1873. Next to Briicke he was most at tracted by Arlt and Billroth. So he went first with Arlt as an unpaid as sistant ("Aspirant"). After a while Arlt induced him to submit himself in the first place to surgical training, so that for two years he became Billroth's pupil at operations. During this period occurred the introduction of antisepsis by Lister, who in person spent two weeks in Vienna for this purpose. Fuchs was now seriously occupied with the thought of becoming a sur geon, but, after his two years with Bill roth, Arlt offered him an assistantship in the eye clinic. A noteworthy detail is the fact that during his assistantship with Arlt he gave the first medical courses in Vienna in the English lan guage. From this time his advance was rapid. After scarcely five years of as sistantship, at the age of thirty years, and while he was still occupied with plans for sea voyages and even for emigration to America, in 1881 he was called as professor of ophthalmology to Liege. He left that city at the age of thirty-four years to become leader of the Second Eye Clinic in Vienna. This was in 1885. Fuchs's extraordinarily wide sphere of influence as a teacher was greatly
augmented by his unique textbook of ophthalmology, first published in 1889. He himself has emphasized the fact that he became more widely known through the textbook than through all his other scientific activities put to gether. It was translated into the lan guage of every civilized country, and has often been spoken of in America as the bible of the ophthalmologist. Fuchs occupied an exceptional posi tion as research clinician. His keen powers of observation were supported by a very extraordinary memory and by an inexorable self-criticism. As an example of the way in which, out of an enormous clinical experience, he gathered together records of cases seen at wide intervals of time, to establish a new clinical entity, may be men tioned the fact that his original descrip tion of epithelial dystrophy of the cor nea was based upon thirteen cases seen in the course of ten years among over two hundred thousand new cases. Since his description of the disease, fur ther observations have not demon strated any greater frequency. Fuchs was the author of numerous medicinal and surgical novelties, and it may be mentioned that the number of his original works exceeds two hun dred and fifty. He assumed a strictly ethical atti tude toward all his responsibilities. He offered his patients the best medical knowledge, and his management of the clinic was hardly to be excelled. His extraordinary memory allowed him to keep every individual case in mind. He would never allow any sort of experi ment to be made upon patients, unless consistent with a definite therapeutic purpose. He rejected any testing of methods of treatment which offered an element of risk for the patient. Fuchs examined his students strictly, in the interest both of the patient and of professional standards. It is impos sible to overestimate the importance of this fact, although it is certainly easier and more agreeable to make only mod erate demands upon the student. Seldom has any physician possessed a better knowledge of general medicine
MORE ABOUT ERNST FUCHS
than Fuchs. When, at the Rockefeller Institute in Peking some years ago, he delivered an ophthalmoneurological ad dress, the head of the eye division of the Institute was asked by the chief of the neurological department whether Fuchs had not originally been a neu rologist. His intellectual activities also reached out into nonmedical depart ments. He had a special predilection for geology and related subjects. He traveled in remote parts of Europe at times when traveling was not only diffi cult but often even dangerous; and upon his return he was always able to give his listeners a comprehensive ac count of what he had seen. Returning from his Scandinavian travels in 1875, he was the first to introduce skiing in Vienna. Not only as a listener, but ac tively, he was a member of the Vienna Geographical Society, and he delivered noteworthy addresses before that or ganization, the most recent of which was a very fascinating account of Abys sinia. He was an expert botanist, and loved and cultivated rare plants. He
337
interested himself in literature, art, and the history of art, and was a steady visitor at exhibitions and a frequent guest of the civic theater. His skill in languages was admirable. Beside English, French, and Italian, which he spoke and wrote fluently from his early days, he had never forgotten his Latin and Greek. He learned mod ern Greek, and even, toward the sev entieth year of his life, Spanish, which he later not only spoke fluently, but employed in numerous addresses and in the course of his teaching in Spain and South America. In spite of all his natural endow ments and accomplishments, notwith standing his professional successes, he always remained simple and modest. His mode of living knew nothing of luxury or superfluity. At the age of sixty-five years he retired from the leadership of the clinic, yet the works published by him since his retirement number at least ninety-nine, most of them being developed from his unique collection of pathologic and histologic specimens.
2. Early memories by Adolph Barkan (For many years professor of ophthalmology in Cooper Medical College and Stanford University school of medicine, San Francisco, Dr. Adolph Barkan now resides at Zurich, Switzerland. He knew Professor Fuchs from the beginning of the latter's professional career.)
When a student of medicine in Vienna, between 1861 and 1869, I was a devoted student of ophthalmology under great masters, including Arlt, Jaeger, Stellwag, Backer, and a host of other young, talented men. At that time Fuchs was one or two years short of finishing his curriculum in the fa mous old Latin school in Vienna, pre sided over by the learned order of Benedictines. He entered the medical profession about five years after I had finished my own studies and when I had emi grated to the United States in response to a call as house physician to the Maryland Eye and Ear Infirmary. Eight years later, on the occasion of my first return visit to Europe and Vienna, I met Fuchs as first assistant
to the ophthalmic clinic headed by Pro fessor Arlt. During my eight years' absence, the city of Vienna had been greatly changed. The walls of the old city had fallen, and the Ringstrasse with its magnificent buildings, which even to day excite the admiration of visitors to that splendid city, was in course of construction. Scientific medical meth ods pervaded all the hospitals, and for eigners from all parts of Europe, as well as from oversea countries, came there to perfect their medical educa tion, attracted by such men as Skoda, Billroth, Arlt, and Hebra. The abundant material of the hospi tal, the liberality with which it was put at the service of foreign guests, made A^ienna, the Alser-Vorstadt, and its
338
ADOLPH BARKAN
many restaurants and coffee houses (in the few leisure hours which arduous work in the hospital allowed for recrea tion) an international focus for good comradeship and helpful, mutual work. Fuchs, then first assistant of the clinic, consented to give me a "privatissimum" in operative surgery. During a few weeks, at an appointed hour, I met him in his room, or in the patho logical laboratory; being, during the appointed hour, his only pupil. On in numerable eyes of various kinds, in cluding those in the human cadaver, he gave me instruction with almost pain ful regard, so it appeared to me then, to every possible operative detail. He was unassuming yet most efficient. The "privatissimum" embraced ten hours, and the fee amounted to ten Austrian florins for each hour (about five dol lars). Fuchs was entirely free from the ap pearance of dash and amiability, from the genteel assurance of most of the young assistants who furnished the ma terial for professorships in that period. So little was he himself aware of his great gifts of observation, of teaching, of skill and knowledge in every branch, that when his assistantship came to a close, after about four years, he earn estly considered emigrating to a South American university. His passage to his future destination was already be
spoken and he was to leave in two months. But one day an old man of gentlemanly appearance, a doctor of medicine, was accorded permission to visit Arlt's clinic. After a few days of observation he came to Fuchs and said that he had been commissioned by the Belgian government to visit the clinic with authority to offer the pro fessorship of the university of Liege to whomever he thought best fitted for the position; and that he offered it to Fuchs. Fuchs accepted at once, be came engaged to a young lady of his circle, and went to Liege. (Some further details mentioned by Dr. Barkan have been omitted be cause they repeat what is more fully stated in the excerpts from Professor Lindner's obituary.) A few months ago I attended the memorial meeting held by the ophthal mic society in Vienna. In the com pany of one of Fuchs's surviving daughters who had always been near to his heart as well as to the hearts of my own family, I stood before the freshly made grave in the little village cemetery at Kritzendorf and took leave of my life-long friend and teacher. Tears gave expression to my pent-up sadness. I gently pressed my hand upon the cold stone and thanked God for the blessed friendship which so long had beautified my life.
335
References Murray, W. R. Two splinters of steel removed from the interior of the eye with the magnet. Jour. Minn. State Med. Assoc, 1906, July 1. 2 Randolph, R. L. The importance of prompt x-ray examination in cases of penetrating wounds of the eyeball. Ophthalmic Record, 1910, July, p. 341. 3 Lagleyze, M. Double intraocular foreign body. Arch, de Oft. de Buenos Aires, 1925, Dec, v. 1, p. 70. 1
M O R E ABOUT ERNST FUCHS 1. Interesting details of his life (Excerpts translated from an obituary address by Professor K. Lindner of Vienna, read before the Gesellschaft der Aerzte, Vienna, November 28, 1930. Professor Lindner's address furnishes much information of a personal character which does not seem likely to reach American readers from other sources. An excellent account of certain aspects of Fuchs's professional career and relationships is presented by Mr. Treacher Collins in the Febru ary issue of the British Journal of Ophthalmology.) The death of Professor Fuchs on No vember 21, 1930, was quite unexpected. He had recently made a series of diffi cult journeys in South America, some times at sea level in tropical heat, some times in mountain atmospheres at ele vations of ten thousand feet, using the airplane for quick connections from place to place. By all this his health seemed in no way disturbed. His end occurred after an illness of only a few hours, shortly after returning from a journey to Italy. The Fuchs family came from the Bo hemian forest, near the Bavarian bor der, where Ernst Fuchs's forbears lived as poor farmers. His grandfather mi grated to Passau barefoot, with twenty marks in his pocket and a loaf of bread for sustenance by the way. Ernst Fuchs's father, Hofrat Professor Dr. Adalbert Fuchs, born in 1814, at first studied medicine, but had to interrupt his studies for two years on account of hemoptysis. He recovered his health on a Polish country estate, where he became very much interested in agri culture. He returned to Vienna and took his doctorate in medicine and later in philosophy. However, he did not practice medicine, but became a proiessor of natural sciences in Tarnow, where he again became interested in agricultural problems. In 1848 he set tled in Innsbruck as professor of zool ogy, and two years later he was called to Vienna as professor of agriculture.
Ernst Fuchs was the first of three children, and grew up in Vienna. He spent his vacations in Kritzendorf, on his mother's father's estate, the home of his declining years and the place of his burial. His youth was passed in rather penurious circumstances. He never had butter on his bread. He later noted as a special reminiscence that once when invited to visit a neighbor a soft egg was put before him, a detail which he could never forget. Early in life Fuchs developed a fond ness for natural science, and if he could have had his wish he would have been an astronomer or a physicist. His father wanted to make an engineer of him, and in later life Fuchs himself could not remember why this plan had not been carried out. An anecdote illustrates his lifelong fondness for becoming acquainted with facts at their source. He had heard that in the Danube between Kritzen dorf and Klosterneuburg there was a whirlpool which sucked even good swimmers under water. This was in his early college life. He persuaded friends to take him to the spot and jumped from his boat into the water. The whirlpool seized him and he was hauled into the boat half-conscious. His medical studies were pursued in the brilliant period of the Vienna school, and his teachers included Hyrtl, Briicke, Rokitansky, Skoda, Billroth, and Arlt. Briicke exerted the greatest
336
K. L I N D N E R
influence upon him and young Fuchs almost became a physiologist. In his fifth year of study he declined an as sistantship with the ophthalmologist Becker at the Heidelberg clinic. A little later, upon Briicke's recommenda tion, he accepted an assistantship in the physiological institute at Inns bruck, where he stayed a year. Dur ing his time at Innsbruck he made ex tensive tours in the mountains, and his love for the mountains persisted undiminished from that time to his latest years. His wish to become a physiologist was shattered by recognition of the fact that his limited means would not per mit of further theoretical training. His monthly allowance from home was only five gulden (two and a half dol lars). He returned to Vienna in the winter of 1873. Next to Briicke he was most at tracted by Arlt and Billroth. So he went first with Arlt as an unpaid as sistant ("Aspirant"). After a while Arlt induced him to submit himself in the first place to surgical training, so that for two years he became Billroth's pupil at operations. During this period occurred the introduction of antisepsis by Lister, who in person spent two weeks in Vienna for this purpose. Fuchs was now seriously occupied with the thought of becoming a sur geon, but, after his two years with Bill roth, Arlt offered him an assistantship in the eye clinic. A noteworthy detail is the fact that during his assistantship with Arlt he gave the first medical courses in Vienna in the English lan guage. From this time his advance was rapid. After scarcely five years of as sistantship, at the age of thirty years, and while he was still occupied with plans for sea voyages and even for emigration to America, in 1881 he was called as professor of ophthalmology to Liege. He left that city at the age of thirty-four years to become leader of the Second Eye Clinic in Vienna. This was in 1885. Fuchs's extraordinarily wide sphere of influence as a teacher was greatly
augmented by his unique textbook of ophthalmology, first published in 1889. He himself has emphasized the fact that he became more widely known through the textbook than through all his other scientific activities put to gether. It was translated into the lan guage of every civilized country, and has often been spoken of in America as the bible of the ophthalmologist. Fuchs occupied an exceptional posi tion as research clinician. His keen powers of observation were supported by a very extraordinary memory and by an inexorable self-criticism. As an example of the way in which, out of an enormous clinical experience, he gathered together records of cases seen at wide intervals of time, to establish a new clinical entity, may be men tioned the fact that his original descrip tion of epithelial dystrophy of the cor nea was based upon thirteen cases seen in the course of ten years among over two hundred thousand new cases. Since his description of the disease, fur ther observations have not demon strated any greater frequency. Fuchs was the author of numerous medicinal and surgical novelties, and it may be mentioned that the number of his original works exceeds two hun dred and fifty. He assumed a strictly ethical atti tude toward all his responsibilities. He offered his patients the best medical knowledge, and his management of the clinic was hardly to be excelled. His extraordinary memory allowed him to keep every individual case in mind. He would never allow any sort of experi ment to be made upon patients, unless consistent with a definite therapeutic purpose. He rejected any testing of methods of treatment which offered an element of risk for the patient. Fuchs examined his students strictly, in the interest both of the patient and of professional standards. It is impos sible to overestimate the importance of this fact, although it is certainly easier and more agreeable to make only mod erate demands upon the student. Seldom has any physician possessed a better knowledge of general medicine
MORE ABOUT ERNST FUCHS
than Fuchs. When, at the Rockefeller Institute in Peking some years ago, he delivered an ophthalmoneurological ad dress, the head of the eye division of the Institute was asked by the chief of the neurological department whether Fuchs had not originally been a neu rologist. His intellectual activities also reached out into nonmedical depart ments. He had a special predilection for geology and related subjects. He traveled in remote parts of Europe at times when traveling was not only diffi cult but often even dangerous; and upon his return he was always able to give his listeners a comprehensive ac count of what he had seen. Returning from his Scandinavian travels in 1875, he was the first to introduce skiing in Vienna. Not only as a listener, but ac tively, he was a member of the Vienna Geographical Society, and he delivered noteworthy addresses before that or ganization, the most recent of which was a very fascinating account of Abys sinia. He was an expert botanist, and loved and cultivated rare plants. He
337
interested himself in literature, art, and the history of art, and was a steady visitor at exhibitions and a frequent guest of the civic theater. His skill in languages was admirable. Beside English, French, and Italian, which he spoke and wrote fluently from his early days, he had never forgotten his Latin and Greek. He learned mod ern Greek, and even, toward the sev entieth year of his life, Spanish, which he later not only spoke fluently, but employed in numerous addresses and in the course of his teaching in Spain and South America. In spite of all his natural endow ments and accomplishments, notwith standing his professional successes, he always remained simple and modest. His mode of living knew nothing of luxury or superfluity. At the age of sixty-five years he retired from the leadership of the clinic, yet the works published by him since his retirement number at least ninety-nine, most of them being developed from his unique collection of pathologic and histologic specimens.
2. Early memories by Adolph Barkan (For many years professor of ophthalmology in Cooper Medical College and Stanford University school of medicine, San Francisco, Dr. Adolph Barkan now resides at Zurich, Switzerland. He knew Professor Fuchs from the beginning of the latter's professional career.)
When a student of medicine in Vienna, between 1861 and 1869, I was a devoted student of ophthalmology under great masters, including Arlt, Jaeger, Stellwag, Backer, and a host of other young, talented men. At that time Fuchs was one or two years short of finishing his curriculum in the fa mous old Latin school in Vienna, pre sided over by the learned order of Benedictines. He entered the medical profession about five years after I had finished my own studies and when I had emi grated to the United States in response to a call as house physician to the Maryland Eye and Ear Infirmary. Eight years later, on the occasion of my first return visit to Europe and Vienna, I met Fuchs as first assistant
to the ophthalmic clinic headed by Pro fessor Arlt. During my eight years' absence, the city of Vienna had been greatly changed. The walls of the old city had fallen, and the Ringstrasse with its magnificent buildings, which even to day excite the admiration of visitors to that splendid city, was in course of construction. Scientific medical meth ods pervaded all the hospitals, and for eigners from all parts of Europe, as well as from oversea countries, came there to perfect their medical educa tion, attracted by such men as Skoda, Billroth, Arlt, and Hebra. The abundant material of the hospi tal, the liberality with which it was put at the service of foreign guests, made A^ienna, the Alser-Vorstadt, and its
338
ADOLPH BARKAN
many restaurants and coffee houses (in the few leisure hours which arduous work in the hospital allowed for recrea tion) an international focus for good comradeship and helpful, mutual work. Fuchs, then first assistant of the clinic, consented to give me a "privatissimum" in operative surgery. During a few weeks, at an appointed hour, I met him in his room, or in the patho logical laboratory; being, during the appointed hour, his only pupil. On in numerable eyes of various kinds, in cluding those in the human cadaver, he gave me instruction with almost pain ful regard, so it appeared to me then, to every possible operative detail. He was unassuming yet most efficient. The "privatissimum" embraced ten hours, and the fee amounted to ten Austrian florins for each hour (about five dol lars). Fuchs was entirely free from the ap pearance of dash and amiability, from the genteel assurance of most of the young assistants who furnished the ma terial for professorships in that period. So little was he himself aware of his great gifts of observation, of teaching, of skill and knowledge in every branch, that when his assistantship came to a close, after about four years, he earn estly considered emigrating to a South American university. His passage to his future destination was already be
spoken and he was to leave in two months. But one day an old man of gentlemanly appearance, a doctor of medicine, was accorded permission to visit Arlt's clinic. After a few days of observation he came to Fuchs and said that he had been commissioned by the Belgian government to visit the clinic with authority to offer the pro fessorship of the university of Liege to whomever he thought best fitted for the position; and that he offered it to Fuchs. Fuchs accepted at once, be came engaged to a young lady of his circle, and went to Liege. (Some further details mentioned by Dr. Barkan have been omitted be cause they repeat what is more fully stated in the excerpts from Professor Lindner's obituary.) A few months ago I attended the memorial meeting held by the ophthal mic society in Vienna. In the com pany of one of Fuchs's surviving daughters who had always been near to his heart as well as to the hearts of my own family, I stood before the freshly made grave in the little village cemetery at Kritzendorf and took leave of my life-long friend and teacher. Tears gave expression to my pent-up sadness. I gently pressed my hand upon the cold stone and thanked God for the blessed friendship which so long had beautified my life.