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Remarks on Acceptance of Friedenwald Memorial Plaque
REMARKS
O N
ACCEPTANCE
OF
FRIEDENWALD
MEMORIAL
PLAQUE
June, 1 9 5 7 J O H N E . HARRIS,
Of his generation Dr. Jonas Friedenwald was certainly one of the foremost, if not the foremost, experimentalist devoted to the study of the problems of ophthalmology. I t is particularly appropriate, therefore, that the Association for - Research in Ophthal mology should dedicate part of its meeting to his memory. F o r the privilege of present ing the Friedenwald Memorial Lecture I am very grateful. My personal contacts with Dr. Frieden wald were all too few and I can add nothing to the many tributes already written by oth ers, tributes which have attested to his sci entific acumen, his widespread interests, and his devotion to his fellow man. Instead I should like to discuss briefly my reaction to his impact on the field of ophthalmology, a field with which I first became acquainted when I entered medical school in 1946. F r o m the time I first read his published papers I have been intrigued by, and mar veled at the extreme imagination with which he approached his experimental work. H e brought an entirely fresh outlook to every problem. Consider his studies of aqueous formation which first began to bear fruit some 20 years ago. Physical chemistry as applied to biology came into its own in the 1920's. T h e popular explanation for biologic phenomena was in terms of simple (or compUcated as the case may be) equilibria. T h e issue of aqueous formation seemed to have been settled by chemical analyses and the Donnan equilibrium—to all except Jonas Friedenwald. Perhaps, intuition led him to disbelieve this thesis. At any rate he recog nized that the problem would have to be re opened from an entirely diflFerent perspective whereupon he undertook an amazing series of experiments which continued for many years. Indeed, this work and the resuhant formulation of his ideas serve as a point of
M.D.
departure in present-day thinking on this subject. Similar ingenuity and radical de parture from a stereotyped approach marked his other endeavors. Coupled with his imag ination was an experimental audacity which saw him shrink from n o task, however tedi ous or impossible it appeared. T o channel properly this imagination re quired an ability t o ^ p p l y various disciplines, particularly the basic science disciplines, to problems of his interest, an interest that was extremely diversified. This amalgamation of disciplines was well exemplified in D r . Friedenwald's approach to pathology. O n e could say, as a matter of fact, that he was the first experimental pathologist in oph thalmology. H e was not satisfied with the purely morphologic interpretation but rather was interested in the fundamental alteration of the physiology of the cell which caused the disease process presented to the clinician or the microscopist. By such an approach Jonas Friedenwald succeeded in traversing the barriers of the various disciplines. H e employed the basic science techniques for the study of the nor mal and diseased eye and in return contrib uted to those fields by applying the lessons learned from ocular tissues. In so doing. Dr. Friedenwald maintained constant and penetrating contact with other efforts in clinical and experimental medicine. This example, I feel, is one which J o n a s Friedenwald would not have us forget. T h e breakdown of communication between the various specialties is not an overplayed theme. O n e of the worst oflienders is the ophthalmologist who with his rather peculiar jargon has succeeded unwittingly in isolating himself from his medical confreres. The same criticism applies to many of us who work in laboratories devoted to research on problems of the eye. W e borrow the tools
259
260
JOHN Ε. HARRIS
we need from the other discipHnes but often fail to return the favor when we do not apply the lessons learned from the eye to the solu tion of community problems. O u r responsibility to the education of the medical student deserves special mention. It is becoming increasingly apparent that seem ingly diverse diseases affecting individual systems represent a common biochemical or physiologic fault at the cellular level. U n dergraduate instruction gains considerably when ophthalmology is approached from this basic point of view. Moreover, the ophthal mologist can offer the medical student an in sight into many aspects of sensory physiol ogy, certain phases of vegetative physiology and biochemistry and an excellent approach to pharmacology. I n short he is in a good
position to help the student integrate the prechnical and clinical years. T h e future of ophthalmology as an undergraduate subject is assured when its teaching is approached from this point of view. T h u s , I interpret some of the lessons which D r . Friedenwald has left us. H e would integrate ours with other medical specialties and resist any attempt to make ophthalmol ogy a superspecialty (surgical or otherwise) beyond the ken of the average physician. T h e emphasis of clinical practice in ophthalmol ogy must be built on a sound understanding of basic principles of physiology and bio chemistry and their pathologic alterations. I submit that Jonas Friedenwald would ap prove.
BIOGRAPHICAL JOHN E.
HARRIS,
John E . H a r r i s was born in Toledo, Ohio, on December 27, 1913. H e received his ele mentary and secondary education in that city and graduated from the University of Toledo in 1935 with a major in chemistry. H e sub sequently entered graduate school at the State University of Iowa where he received his P h . D . in biochemistry in 1940. After remain ing a year on the staff as a research associ ate he went to the University of Pennsyl vania as a National Research Council Fellow to work with Dr. M. H . Jacobs of the De partment of Physiology. During these years his investigative work was concerned largely with the permeability characteristics and the factors controlling the cation distribution of the erythrocyte. I n connection with this work he developed techniques which he subse quently adapted to the study of the lens and cornea. I n 1942, he entered the U . S. A r m y Air Corps as an aviation physiologist. U p o n dis charge from the service in 1946, he decided to fulfill a life-long ambition to obtain his
DATA M.D.
medical degree. A n opportunity to achieve this goal was ofliered by D r . Kenneth C. Swan, head of the Department of Ophthal mology, University of Oregon Medical School, a personal friend with whom Dr. H a r r i s had become acquainted while at the State University of Iowa when Dr. Swan was a resident in ophthalmology. W i t h D r . Swan's encouragement and help, Dr. H a r r i s entered the University of Oregon Medical School and became a research as sociate in the Department of Ophthalmology in the fall of 1946. F r o m this beginning has grown a w a r m and rewarding relationship which continues to this day. ' Graduating from the University of O r e gon Medical School in 1950, D r . H a r r i s in terned at the Walter Reed A r m y Hospital. I n 1951 he returned to the University of Oregon Medical School as an assistant pro fessor of ophthalmology and director of the John E . Weeks Memorial Laboratory. T h a t year he received the five-year appointment as a Markle Scholar in Medical Science. In
O N
ACCEPTANCE
OF
FRIEDENWALD
MEMORIAL
PLAQUE
June, 1 9 5 7 J O H N E . HARRIS,
Of his generation Dr. Jonas Friedenwald was certainly one of the foremost, if not the foremost, experimentalist devoted to the study of the problems of ophthalmology. I t is particularly appropriate, therefore, that the Association for - Research in Ophthal mology should dedicate part of its meeting to his memory. F o r the privilege of present ing the Friedenwald Memorial Lecture I am very grateful. My personal contacts with Dr. Frieden wald were all too few and I can add nothing to the many tributes already written by oth ers, tributes which have attested to his sci entific acumen, his widespread interests, and his devotion to his fellow man. Instead I should like to discuss briefly my reaction to his impact on the field of ophthalmology, a field with which I first became acquainted when I entered medical school in 1946. F r o m the time I first read his published papers I have been intrigued by, and mar veled at the extreme imagination with which he approached his experimental work. H e brought an entirely fresh outlook to every problem. Consider his studies of aqueous formation which first began to bear fruit some 20 years ago. Physical chemistry as applied to biology came into its own in the 1920's. T h e popular explanation for biologic phenomena was in terms of simple (or compUcated as the case may be) equilibria. T h e issue of aqueous formation seemed to have been settled by chemical analyses and the Donnan equilibrium—to all except Jonas Friedenwald. Perhaps, intuition led him to disbelieve this thesis. At any rate he recog nized that the problem would have to be re opened from an entirely diflFerent perspective whereupon he undertook an amazing series of experiments which continued for many years. Indeed, this work and the resuhant formulation of his ideas serve as a point of
M.D.
departure in present-day thinking on this subject. Similar ingenuity and radical de parture from a stereotyped approach marked his other endeavors. Coupled with his imag ination was an experimental audacity which saw him shrink from n o task, however tedi ous or impossible it appeared. T o channel properly this imagination re quired an ability t o ^ p p l y various disciplines, particularly the basic science disciplines, to problems of his interest, an interest that was extremely diversified. This amalgamation of disciplines was well exemplified in D r . Friedenwald's approach to pathology. O n e could say, as a matter of fact, that he was the first experimental pathologist in oph thalmology. H e was not satisfied with the purely morphologic interpretation but rather was interested in the fundamental alteration of the physiology of the cell which caused the disease process presented to the clinician or the microscopist. By such an approach Jonas Friedenwald succeeded in traversing the barriers of the various disciplines. H e employed the basic science techniques for the study of the nor mal and diseased eye and in return contrib uted to those fields by applying the lessons learned from ocular tissues. In so doing. Dr. Friedenwald maintained constant and penetrating contact with other efforts in clinical and experimental medicine. This example, I feel, is one which J o n a s Friedenwald would not have us forget. T h e breakdown of communication between the various specialties is not an overplayed theme. O n e of the worst oflienders is the ophthalmologist who with his rather peculiar jargon has succeeded unwittingly in isolating himself from his medical confreres. The same criticism applies to many of us who work in laboratories devoted to research on problems of the eye. W e borrow the tools
259
260
JOHN Ε. HARRIS
we need from the other discipHnes but often fail to return the favor when we do not apply the lessons learned from the eye to the solu tion of community problems. O u r responsibility to the education of the medical student deserves special mention. It is becoming increasingly apparent that seem ingly diverse diseases affecting individual systems represent a common biochemical or physiologic fault at the cellular level. U n dergraduate instruction gains considerably when ophthalmology is approached from this basic point of view. Moreover, the ophthal mologist can offer the medical student an in sight into many aspects of sensory physiol ogy, certain phases of vegetative physiology and biochemistry and an excellent approach to pharmacology. I n short he is in a good
position to help the student integrate the prechnical and clinical years. T h e future of ophthalmology as an undergraduate subject is assured when its teaching is approached from this point of view. T h u s , I interpret some of the lessons which D r . Friedenwald has left us. H e would integrate ours with other medical specialties and resist any attempt to make ophthalmol ogy a superspecialty (surgical or otherwise) beyond the ken of the average physician. T h e emphasis of clinical practice in ophthalmol ogy must be built on a sound understanding of basic principles of physiology and bio chemistry and their pathologic alterations. I submit that Jonas Friedenwald would ap prove.
BIOGRAPHICAL JOHN E.
HARRIS,
John E . H a r r i s was born in Toledo, Ohio, on December 27, 1913. H e received his ele mentary and secondary education in that city and graduated from the University of Toledo in 1935 with a major in chemistry. H e sub sequently entered graduate school at the State University of Iowa where he received his P h . D . in biochemistry in 1940. After remain ing a year on the staff as a research associ ate he went to the University of Pennsyl vania as a National Research Council Fellow to work with Dr. M. H . Jacobs of the De partment of Physiology. During these years his investigative work was concerned largely with the permeability characteristics and the factors controlling the cation distribution of the erythrocyte. I n connection with this work he developed techniques which he subse quently adapted to the study of the lens and cornea. I n 1942, he entered the U . S. A r m y Air Corps as an aviation physiologist. U p o n dis charge from the service in 1946, he decided to fulfill a life-long ambition to obtain his
DATA M.D.
medical degree. A n opportunity to achieve this goal was ofliered by D r . Kenneth C. Swan, head of the Department of Ophthal mology, University of Oregon Medical School, a personal friend with whom Dr. H a r r i s had become acquainted while at the State University of Iowa when Dr. Swan was a resident in ophthalmology. W i t h D r . Swan's encouragement and help, Dr. H a r r i s entered the University of Oregon Medical School and became a research as sociate in the Department of Ophthalmology in the fall of 1946. F r o m this beginning has grown a w a r m and rewarding relationship which continues to this day. ' Graduating from the University of O r e gon Medical School in 1950, D r . H a r r i s in terned at the Walter Reed A r m y Hospital. I n 1951 he returned to the University of Oregon Medical School as an assistant pro fessor of ophthalmology and director of the John E . Weeks Memorial Laboratory. T h a t year he received the five-year appointment as a Markle Scholar in Medical Science. In