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Presentation of the Portrait to Sir Stewart Duke-Elder
P R E S E N T A T I O N O F T H E P O R T R A I T T O SIR S T E W A R T DUKE-ELDER The new Council Chamber of the Royal College of Surgeons was the scene of a ceremony of world-wide interest to ophthalmologists when, on April 26, 1956, Sir Stewart Duke-Elder was presented with his por trait. Hundreds of Brit ish and Commonwealth ophthalmologists, and many of Sir Stewart's friends from abroad, had subscribed to the presen tation which took place in the beautiful sur roundings of the Council Chamber paneled with oak from a tree which was planted in the reign of Queen Elizabeth I. At the same time, Lady Duke-Elder and Sir Stewart were associated in a personal gift of two handsome antique silver candlesticks.
The portrait of Sir Stewart Duke-Elder painted by the
distinguished artist, Ruskin Spear. The presentation was Sir Stewart has probably done more for oph held during the course of the annual meeting of the Ophthalmological Society of the thalmology than anyone since Sir William Bow man. His industry has been astonishing, and he United Kingdom and was witnessed by a has never spared himself, but above all he has had large gathering. All present will remember for years a vision of what British Ophthalmology the occasion which was characterized by the should be in the future, and he has seen it come true and our specialty flourish. polished speeches of presentation made by I am sure you will agree that no one has been Mr. Gayer Morgan, president of the Oph such a popular or successful overseas ambassador thalmological Society of the United King in ophthalmology. I often think with some amuse ment of the first meeting of an artist with his dom, and Dr. John Marshall, president of sitter. The latter looking with some apprehension at the Faculty of Ophthalmologists. Mr. Mor the artist—the artist surveying the collection of bumps and hollows and wondering how he can pos gan said: There are two reasons why a distinguished per son should have his portrait painted. One is that his features are so irresistible that artists flock round begging to be allowed to put them on canvas—the other is that his friends and colleagues realize that his character and attain ments are so outstanding that they wish to accord him one of the highest honors they can think of.
sibly find the clue to the real man behind them. Sometimes the meeting is a failure, but often, and I am sure you will agree in this case, it is a success and produces what we all hoped for. You see in this portrait the quick bright deter mined and yet humorous eyes—the evidence of the midnight oil burned in the production of that monu mental work for which in part we are honoring him today. There is the mouth just about to say
215
216
PRESENTATION OF PORTRAIT
something quite outrageous! How did the artist know about that characteristic feature which we all expect and enjoy so much. In fact here is Sir Stewart and I would like to congratulate artist and sitter on the production of something we shall all enjoy. We are happy also that we can associate this presentation with Lady Duke-Elder as she and Sir Stewart have chosen two silver candlesticks as a personal present from us all. I will now pass you over to Dr. John Marshall, president of the Faculty of Ophthalmologists.
Dr. John Marshall said: I count it a signal honor that as president of the Faculty of Ophthalmologists I have the privilege of assisting my fellow president of the Ophthalmological Society of the United Kingdom in this presentation to Sir Stewart Duke-Elder. As a fellow Scot I feel that it would be appro priate to misquote the words addressed to John Shand in J. M. Barrie's play "What Every Woman Knows," words which might well have been ad dressed to the youthful Elder ere he left the king dom of Fife—"A young man of your ability, let loose upon the world what could he not do? It's almost appalling to think of; especially if he went among the English." It is to take notice of this foray among the English that we are here tonight. While we of the Faculty of Ophthalmologists are particularly indebted to him for his services in the medicopolitical and administrative fields of oph thalmology and to him as one of the founders, these are probably the spheres in which he himself would take least credit. It is to do honor to him for his work in completing a world textbook in oph thalmology—a book unique both in its completeness and its readability—a task of the magnitude of that of the seven maids with seven props which he com pleted in a mere 25 years while taking in his stride the administration of ophthalmology for the British Army, the duties of president of an International Congress and of president of the International Council of Ophthalmology, the editing of the British Journal of Ophthalmology, and above all the creation and control of the Institute of Oph thalmology. Ophthalmology, national and international, owes an incalculable debt to this man of genius who witli all his success and all his brilliance has still not had success go to his head. He has remained a leaderdoubtless a successful strategist but never a dicta tor. The factors responsible for this humanity are his charm which we have all experienced. Secondly, his ability to meet men on their own level, to judge their abilities and to direct their energies to work for him on projects suited to those abilities and above all to see that they got the credit for that work. He has a tenacity of purpose which has not allowed material success to cause any slackening of his efforts, he has enjoyed the fruits of success
—material and academic—with a verve which has left younger men exhausted and yet produced a new volume at about the appointed day. And finally, like John Shand in the play, he has been fortunate in his wife. I am sure that but for her he would not have been half the man that he is. How she has controlled and guided this man of genius I do not know but I do know that she has done what no body of men has ever succeeded in doing. We in ophthalmology owe to her almost as much as we do to her distinguished husband. Sir Stewart is still a young man. We have in the Glasgow Eye Infirmary two portraits of Wil liam Mackenzie. In the first he is clean shaven, in the second he has a beard. I hope that 20 or 30 years hence some of the young men here today will have the privilege of presenting the bearded DukeElder with his second portrait.
Sir Stewart gave an endearing reply of acceptance of the portrait and gift, on behalf of himself and his wife, Phyllis: What has been said about me and what has been given to me leaves me speechless with embarrass ment. It cannot be true; it surely must be a dream; but at the same time I suppose Gayer Morgan and John Marshall are relatively critical and responsi ble people; and so I suppose there is something in it. "How did all this happen?" I ask myself. I think I can best tell you by a parable. The parable deals with a young man who picked up a lady in Piccadilly. When he got to her flat he saw on one side of the bedroom a very large bookcase and, going up to it, he found that it was full of Latin and Greek texts. On the other side of the room he saw a similar bookcase and, on inspecting it, he found that it was full of advanced books on law. "How come?" said he. "Well," she said, "I studied classics at Oxford and then read law in the Middle Temple." "Then how did you take up a life like this?" "Oh," she said "just sheer good luck." My luck has been largely in the people I have met and who have helped me. There was first of all Herring, my professor of physiology at St. Andrews. Then Sir John Parsons, who guided my young footsteps in ophthalmology at Moorfields and who introduced me to Sir Walter Fletcher at the Medical Research Council, and who told Phyllis that she had to marry me. There was also Bayliss and Starling at University College who inspired me in research and taught me its techniques. And, above all, there was Phyllis who has looked after me with great care for 28 years and who, in the early days, worked all day in the laboratory and most of the night in the study. This, of course, is the way of the world. It is one task after another; but all great fun, all most enjoyable, and all a great adventure because each one leads on to another adventure. You organize ophthalmology in the Army in the war and that leads to its organization in peace— from the medicopolitical point of view that means
PRESENTATION OF PORTRAIT starting the Faculty and taking an interest in the International Council; from the academic point of view it means starting the Institute of Ophthalmol ogy. At the Institute before one year is over you are thinking of the budget for the next; and be fore one research project is finished you are plan ning the next two or three that it has suggested. You write one volume of a textbook and that leads to seven; and when the seventh is finished you turn to your desk and find a great pile of letters, all of them asking—some of them petulantly—why you have not written the first one over again; and so you start. And so life goes on. I suppose it will all stop some time; but meantime an experience like this pulls one up with a jolt. Suddenly everything has changed; the objective has become subjective; facts have been overlaid with emotion. It is not so much that you, forgetting my many faults and failures, have collectedly concluded that, on the whole, the things I have done have been good; it is the way that you have said so; it is your kindliness in telling me of it by this delight ful ceremony and with this gift and the spirit it conveys. It has been said that the gifts that we give each other in life are for the most part cold and expres-
217
sionless because they convey so little of ourselves. The farmer should give of his corn, the sailor coral and shells, and the craftsman the product of his hands. Most things one gets in life—honors, posi tion, and so on—are indeed cold and expressionless, and one leaves them behind with the other bits of tinsel that one gathers in life. But this will remain with me forever because of its emotional content; it is not cold and expressionless but warm and comforting. It is the type of thing that gives an entirely new aspect to life, that gives it a new meaning that one never suspected before. It is like falling in love with a woman or seeing a vision on the road to Damascus. It completely transforms life, which is never quite the same again. For giving me this experience I give you my grateful thanks. From now on life for me will be less of a factual routine and more of a spiritual thing; because of this that you have done to me I will travel on with less of urgency and more of peace. I only wish, looking at things from my sub jective point of view, that I felt within myself that I were more worthy of the spirit of the gift. I only wish that T had done for opthalmology—and for you—as much as ophthalmology—and you— have done for me.
TOXOPLASMIC
UVEITIS
T R E A T M E N T W I T H P Y R I M E T H A M I N E AND SULFADIAZINE C H A R L E S J. B U R N H A M , * M . D .
Birmingham, Alabama AND V. A. BEUERMAN,+ M.D.
San Diego. California BACKGROUND 1
In 1938 and 1939, Wolf and Cowan and Wolf, Cowan, and Paige 2 reported cases of natal or intrauterine chorioretinitis caused by Toxoplasma. Later articles by ophthal mologists3-4 stressed the importance of Toxoplasma in congenital chorioretinitis. Prior to 1949, there was considerable specu lation and scattered reports of adult chorio retinitis on a possible toxoplasmic etiology.B,a These speculations were dampened, however, by Walsh, 7 Hogan, 8 and Sabin9 * From the Medical College of Alabama. t Captain (MC) U. S. Naval Hospital.
who concluded in a symposium on toxoplasmosis at the American Academy of Ophthalmology in 1949 that "there is no evidence that noncongenital acute chorio retinitis is caused by Toxoplasma." There the matter remained until the monumental report of Wilder 10 - 11 of the presence of "organisms morphologically indistinguish able from Toxoplasma," in the necrotic re tina of S3 eyes of adults with chorioretinitis. Woods, Jacobs, Wood, and Cook12 studied the role of toxoplasmosis in adult chorio retinitis in a paper at the American Academy of Ophthalmology in 1953. Woods had had the foresight to preserve in the deep freeze
The portrait of Sir Stewart Duke-Elder painted by the
distinguished artist, Ruskin Spear. The presentation was Sir Stewart has probably done more for oph held during the course of the annual meeting of the Ophthalmological Society of the thalmology than anyone since Sir William Bow man. His industry has been astonishing, and he United Kingdom and was witnessed by a has never spared himself, but above all he has had large gathering. All present will remember for years a vision of what British Ophthalmology the occasion which was characterized by the should be in the future, and he has seen it come true and our specialty flourish. polished speeches of presentation made by I am sure you will agree that no one has been Mr. Gayer Morgan, president of the Oph such a popular or successful overseas ambassador thalmological Society of the United King in ophthalmology. I often think with some amuse ment of the first meeting of an artist with his dom, and Dr. John Marshall, president of sitter. The latter looking with some apprehension at the Faculty of Ophthalmologists. Mr. Mor the artist—the artist surveying the collection of bumps and hollows and wondering how he can pos gan said: There are two reasons why a distinguished per son should have his portrait painted. One is that his features are so irresistible that artists flock round begging to be allowed to put them on canvas—the other is that his friends and colleagues realize that his character and attain ments are so outstanding that they wish to accord him one of the highest honors they can think of.
sibly find the clue to the real man behind them. Sometimes the meeting is a failure, but often, and I am sure you will agree in this case, it is a success and produces what we all hoped for. You see in this portrait the quick bright deter mined and yet humorous eyes—the evidence of the midnight oil burned in the production of that monu mental work for which in part we are honoring him today. There is the mouth just about to say
215
216
PRESENTATION OF PORTRAIT
something quite outrageous! How did the artist know about that characteristic feature which we all expect and enjoy so much. In fact here is Sir Stewart and I would like to congratulate artist and sitter on the production of something we shall all enjoy. We are happy also that we can associate this presentation with Lady Duke-Elder as she and Sir Stewart have chosen two silver candlesticks as a personal present from us all. I will now pass you over to Dr. John Marshall, president of the Faculty of Ophthalmologists.
Dr. John Marshall said: I count it a signal honor that as president of the Faculty of Ophthalmologists I have the privilege of assisting my fellow president of the Ophthalmological Society of the United Kingdom in this presentation to Sir Stewart Duke-Elder. As a fellow Scot I feel that it would be appro priate to misquote the words addressed to John Shand in J. M. Barrie's play "What Every Woman Knows," words which might well have been ad dressed to the youthful Elder ere he left the king dom of Fife—"A young man of your ability, let loose upon the world what could he not do? It's almost appalling to think of; especially if he went among the English." It is to take notice of this foray among the English that we are here tonight. While we of the Faculty of Ophthalmologists are particularly indebted to him for his services in the medicopolitical and administrative fields of oph thalmology and to him as one of the founders, these are probably the spheres in which he himself would take least credit. It is to do honor to him for his work in completing a world textbook in oph thalmology—a book unique both in its completeness and its readability—a task of the magnitude of that of the seven maids with seven props which he com pleted in a mere 25 years while taking in his stride the administration of ophthalmology for the British Army, the duties of president of an International Congress and of president of the International Council of Ophthalmology, the editing of the British Journal of Ophthalmology, and above all the creation and control of the Institute of Oph thalmology. Ophthalmology, national and international, owes an incalculable debt to this man of genius who witli all his success and all his brilliance has still not had success go to his head. He has remained a leaderdoubtless a successful strategist but never a dicta tor. The factors responsible for this humanity are his charm which we have all experienced. Secondly, his ability to meet men on their own level, to judge their abilities and to direct their energies to work for him on projects suited to those abilities and above all to see that they got the credit for that work. He has a tenacity of purpose which has not allowed material success to cause any slackening of his efforts, he has enjoyed the fruits of success
—material and academic—with a verve which has left younger men exhausted and yet produced a new volume at about the appointed day. And finally, like John Shand in the play, he has been fortunate in his wife. I am sure that but for her he would not have been half the man that he is. How she has controlled and guided this man of genius I do not know but I do know that she has done what no body of men has ever succeeded in doing. We in ophthalmology owe to her almost as much as we do to her distinguished husband. Sir Stewart is still a young man. We have in the Glasgow Eye Infirmary two portraits of Wil liam Mackenzie. In the first he is clean shaven, in the second he has a beard. I hope that 20 or 30 years hence some of the young men here today will have the privilege of presenting the bearded DukeElder with his second portrait.
Sir Stewart gave an endearing reply of acceptance of the portrait and gift, on behalf of himself and his wife, Phyllis: What has been said about me and what has been given to me leaves me speechless with embarrass ment. It cannot be true; it surely must be a dream; but at the same time I suppose Gayer Morgan and John Marshall are relatively critical and responsi ble people; and so I suppose there is something in it. "How did all this happen?" I ask myself. I think I can best tell you by a parable. The parable deals with a young man who picked up a lady in Piccadilly. When he got to her flat he saw on one side of the bedroom a very large bookcase and, going up to it, he found that it was full of Latin and Greek texts. On the other side of the room he saw a similar bookcase and, on inspecting it, he found that it was full of advanced books on law. "How come?" said he. "Well," she said, "I studied classics at Oxford and then read law in the Middle Temple." "Then how did you take up a life like this?" "Oh," she said "just sheer good luck." My luck has been largely in the people I have met and who have helped me. There was first of all Herring, my professor of physiology at St. Andrews. Then Sir John Parsons, who guided my young footsteps in ophthalmology at Moorfields and who introduced me to Sir Walter Fletcher at the Medical Research Council, and who told Phyllis that she had to marry me. There was also Bayliss and Starling at University College who inspired me in research and taught me its techniques. And, above all, there was Phyllis who has looked after me with great care for 28 years and who, in the early days, worked all day in the laboratory and most of the night in the study. This, of course, is the way of the world. It is one task after another; but all great fun, all most enjoyable, and all a great adventure because each one leads on to another adventure. You organize ophthalmology in the Army in the war and that leads to its organization in peace— from the medicopolitical point of view that means
PRESENTATION OF PORTRAIT starting the Faculty and taking an interest in the International Council; from the academic point of view it means starting the Institute of Ophthalmol ogy. At the Institute before one year is over you are thinking of the budget for the next; and be fore one research project is finished you are plan ning the next two or three that it has suggested. You write one volume of a textbook and that leads to seven; and when the seventh is finished you turn to your desk and find a great pile of letters, all of them asking—some of them petulantly—why you have not written the first one over again; and so you start. And so life goes on. I suppose it will all stop some time; but meantime an experience like this pulls one up with a jolt. Suddenly everything has changed; the objective has become subjective; facts have been overlaid with emotion. It is not so much that you, forgetting my many faults and failures, have collectedly concluded that, on the whole, the things I have done have been good; it is the way that you have said so; it is your kindliness in telling me of it by this delight ful ceremony and with this gift and the spirit it conveys. It has been said that the gifts that we give each other in life are for the most part cold and expres-
217
sionless because they convey so little of ourselves. The farmer should give of his corn, the sailor coral and shells, and the craftsman the product of his hands. Most things one gets in life—honors, posi tion, and so on—are indeed cold and expressionless, and one leaves them behind with the other bits of tinsel that one gathers in life. But this will remain with me forever because of its emotional content; it is not cold and expressionless but warm and comforting. It is the type of thing that gives an entirely new aspect to life, that gives it a new meaning that one never suspected before. It is like falling in love with a woman or seeing a vision on the road to Damascus. It completely transforms life, which is never quite the same again. For giving me this experience I give you my grateful thanks. From now on life for me will be less of a factual routine and more of a spiritual thing; because of this that you have done to me I will travel on with less of urgency and more of peace. I only wish, looking at things from my sub jective point of view, that I felt within myself that I were more worthy of the spirit of the gift. I only wish that T had done for opthalmology—and for you—as much as ophthalmology—and you— have done for me.
TOXOPLASMIC
UVEITIS
T R E A T M E N T W I T H P Y R I M E T H A M I N E AND SULFADIAZINE C H A R L E S J. B U R N H A M , * M . D .
Birmingham, Alabama AND V. A. BEUERMAN,+ M.D.
San Diego. California BACKGROUND 1
In 1938 and 1939, Wolf and Cowan and Wolf, Cowan, and Paige 2 reported cases of natal or intrauterine chorioretinitis caused by Toxoplasma. Later articles by ophthal mologists3-4 stressed the importance of Toxoplasma in congenital chorioretinitis. Prior to 1949, there was considerable specu lation and scattered reports of adult chorio retinitis on a possible toxoplasmic etiology.B,a These speculations were dampened, however, by Walsh, 7 Hogan, 8 and Sabin9 * From the Medical College of Alabama. t Captain (MC) U. S. Naval Hospital.
who concluded in a symposium on toxoplasmosis at the American Academy of Ophthalmology in 1949 that "there is no evidence that noncongenital acute chorio retinitis is caused by Toxoplasma." There the matter remained until the monumental report of Wilder 10 - 11 of the presence of "organisms morphologically indistinguish able from Toxoplasma," in the necrotic re tina of S3 eyes of adults with chorioretinitis. Woods, Jacobs, Wood, and Cook12 studied the role of toxoplasmosis in adult chorio retinitis in a paper at the American Academy of Ophthalmology in 1953. Woods had had the foresight to preserve in the deep freeze