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The Eye Institue in New York. An Intimate History
VOL. 70. NO. 2
BOOK REVIEWS
ume. The material was originally presented at a symposium held in Kyoto in 1967, at the time the International Congress of Bio chemistry met in Tokyo. For more than a century it has been ap preciated that bare stroma in isotonic Ringer solution swells to many times its original thickness and loses transparency. This sort of thing happens clinically when a corneal laceration admits aqueous humor to the edge of the cut cornea. Equally common clinical experiences deal with Fuchs' dystrophy on corneal ulcers where admittance of fluid is partial. In all these situations the question of what has gone wrong with what normal de hydrating mechanism is fundamental. For some years now, researchers have been impressed by the electrochemical po tential measured across the corneal epi thelium as a sign of an active transport proc ess. Because this potential is negative out side, it requires that sodium be transported from tears toward stroma. Keith Green pos tulates in his essay that corneal mucopolysaccharide binds some sodium ions so that sodium ion concentrations are maintained in stromal fluid equal to those in aqueous and that epithelium continues to push slightly hypertonic fluid from tears to aqueous. To fur ther compound the dilemma Dr. Zadunsi sky's essay gives persuasive evidence for extrusion of chloride from stroma to tears by the cor neal epithelium of the bullfrog. Others, es pecially Mishima, who participates in two essays, have made measurements of water flow and salt transfer across endothelium in particular. Logical reasons are cited for en dothelium being the site of active transport to maintain dehydration, but no such demon stration has been made as yet. Somewhat separate from the above is an electron microscope study of the "polygonal cell" of the epithelium by Sujura, another on normal and swollen cornea from West Ber lin, and an account of the biochemistry of connective tissue by Matthews of Chicago. Although these essays were prepared three years ago, the situation in this field is fun
309
damentally unchanged. The symposium may be used by students and researchers as an authentic account of the multiple aspects of the cornea problem. Albert M. Potts THE
EYE
INSTITUE IN
N E W YORK.
AN
By Maynard C. Wheeler. New York, Cooper Square Pub lishers, 1969. Clothbound, 240 pages, blackand-white illustrations, index. This is the story of a great institution and the people who made it so, told by a man who devoted his entire professional career to it. Maynard Wheeler began the last year of his residency at the Eye Institute and is now clinical professor emeritus and consultant. His narrative is dominated by a few men: Edward S. Harkness, who conceived the In stitute ; John M. Wheeler, its first head ; and his early associates, Tom Johnson, Dan Kirby, and John Dunnington. Each great institution reflects the men who have worked there, and provides the biog raphies of many of the greats in ophthalmol ogy: Professors Bruce, DeVoe, Dishe, Dun nington, Hardy, Johnson, Reese, Smelser, Thygeson, von Sallman, and Wheeler. There are capsule biographies of others: Berke, Braley, Carroll, Kirby, the Knapps, Knighton, McGavic, Wise, Burns, Calhoun, Campbell, Clark, Guerry, Jones, Locke, McCulloch, McGraw, McGuire, McTigue, Merrian, O'Connor, Perera, Pfeiffer, Regan, Sherman, Spalter, Straatsma, Unsworth, Wadsworth, Lowenstein, Sanders, and many others. A major portion of the text is devoted to the staff, as well it might be, and it is evident that staff members have played a major role in the development of ophthalmology, not only in New York but in the entire world. Thus, one has a personal history of one's ophthalmic friends in the Institute that they made outstanding. This is more than an intimate history of the Eye Institute with the gossip, the ïntri^ INTIMATE
HISTORY.
AMERICAN JOURNAL OF OPHTHALMOLOGY
310
cacies, and the like, which make up a part of every institution. Maynard Wheeler describes the design of the Institute and its wonderful new wing. He devotes a chapter to pathology and the school built around Algernon B. Reese. He tells of the special clinics and the problems that arise in every institution in attempting to provide a continuity in sem inars, grand rounds, journal clubs, and alumni meetings. Maynard Wheeler has written two his tories in his great professional life—first, on the American Ophthalmological Society on the occasion of its centennial, and now the Eye Institute. All of American medicine would be richer if those involved with other institutions undertook similar labors of love. Frank W. Newell SYMPOSIUM
ON
OCULAR
PHARMACOLOGY
Transactions of the New Orleans Academy of Ophthalmol ogy. St. Louis, C. V. Mosby Co., 1970. Clothbound, 311 pages. Price: $27.50 AND THERAPEUTICS.
The annual Transactions of the New Or leans Academy of Ophthalmology provides a current presentation of recent advances in a variety of areas—fields as varied as trau matic ophthalmology, cataract surgery, con genital anomalies of the eye, strabismus, and retinal surgery. In 1969, the program chair men, James McComiskey, James H. Allen, Moss L. Antony, Hilliard Haik, and Monte G. Holland, selected ocular pharmacology and therapeutics as the main topic of discus sion. Kenneth T. Richardson described the basic concepts of pharmacology and Philip P. Ellis the suppression of the inflammatory response by means of corticosteroids and noncorticosteroids together with the treat ment of postoperative endophthalmitis. Rob ert P. Burns described the effect of contact lenses on the corneal metabolism and in an other paper emphasized the differences be tween the conjunctival and corneal epithe lium. He also described various aspects of
AUGUST, 1970
the pharmacology and toxicology of the con junctiva. Stephen M. Drance described in detail the management of the glaucomas, combining rich clinical experience with laboratory stud ies. Howard N. Bernstein described iatrogenic ocular disease arising from systemically administered drugs varying from chloroquine to oral contraceptives. William H. Havener dealt with some of the difficulties arising in evaluating clinical therapeutic re sponse, the treatment of traumatic hyphema, and the drugs used in the medical and surgi cal management of cataract. John Adriani discussed drug interactions with anesthetics and preoperative regimes. The volume meets the high standard set previously by this group and provides an in teresting review of a number of related sub jects. Frank W. Newell
PROCEEDINGS OF THE 11TH A N N U A L MEET ING OF THE AMERICAN ASSOCIATION FOR AUTOMOTIVE MEDICINE. Edited by Arthur
H. Keeney. Springfield, Charles C Thomas. Clothbound, 298 pages, index, black and white figures. Price: $19.75 This collection of 23 articles on various aspects of automobile accidents should be read by all Americans who are concerned by the increasing number of accidents. Be cause the approach to the problem is multidisciplinary, it is natural that only three chapters deal with specific ophthalmic prob lems. The article by Albert Burg, Ph.D., "Some Relationships Between Vision and Driving," concludes that the usual method of measuring visual acuity should continue to be a required part of the examination for a drivers license. W. Morton Grant's chap ter, "Drug Induced Disturbances of Vision That May Affect Driving," although of gen eral interest, brings nothing new to ophthal mologists, and W. J. Gibson's "Ocular Find ings in Extension-Flexion Injuries of the Cervical Spine (whip-lash injuries)," de-
BOOK REVIEWS
ume. The material was originally presented at a symposium held in Kyoto in 1967, at the time the International Congress of Bio chemistry met in Tokyo. For more than a century it has been ap preciated that bare stroma in isotonic Ringer solution swells to many times its original thickness and loses transparency. This sort of thing happens clinically when a corneal laceration admits aqueous humor to the edge of the cut cornea. Equally common clinical experiences deal with Fuchs' dystrophy on corneal ulcers where admittance of fluid is partial. In all these situations the question of what has gone wrong with what normal de hydrating mechanism is fundamental. For some years now, researchers have been impressed by the electrochemical po tential measured across the corneal epi thelium as a sign of an active transport proc ess. Because this potential is negative out side, it requires that sodium be transported from tears toward stroma. Keith Green pos tulates in his essay that corneal mucopolysaccharide binds some sodium ions so that sodium ion concentrations are maintained in stromal fluid equal to those in aqueous and that epithelium continues to push slightly hypertonic fluid from tears to aqueous. To fur ther compound the dilemma Dr. Zadunsi sky's essay gives persuasive evidence for extrusion of chloride from stroma to tears by the cor neal epithelium of the bullfrog. Others, es pecially Mishima, who participates in two essays, have made measurements of water flow and salt transfer across endothelium in particular. Logical reasons are cited for en dothelium being the site of active transport to maintain dehydration, but no such demon stration has been made as yet. Somewhat separate from the above is an electron microscope study of the "polygonal cell" of the epithelium by Sujura, another on normal and swollen cornea from West Ber lin, and an account of the biochemistry of connective tissue by Matthews of Chicago. Although these essays were prepared three years ago, the situation in this field is fun
309
damentally unchanged. The symposium may be used by students and researchers as an authentic account of the multiple aspects of the cornea problem. Albert M. Potts THE
EYE
INSTITUE IN
N E W YORK.
AN
By Maynard C. Wheeler. New York, Cooper Square Pub lishers, 1969. Clothbound, 240 pages, blackand-white illustrations, index. This is the story of a great institution and the people who made it so, told by a man who devoted his entire professional career to it. Maynard Wheeler began the last year of his residency at the Eye Institute and is now clinical professor emeritus and consultant. His narrative is dominated by a few men: Edward S. Harkness, who conceived the In stitute ; John M. Wheeler, its first head ; and his early associates, Tom Johnson, Dan Kirby, and John Dunnington. Each great institution reflects the men who have worked there, and provides the biog raphies of many of the greats in ophthalmol ogy: Professors Bruce, DeVoe, Dishe, Dun nington, Hardy, Johnson, Reese, Smelser, Thygeson, von Sallman, and Wheeler. There are capsule biographies of others: Berke, Braley, Carroll, Kirby, the Knapps, Knighton, McGavic, Wise, Burns, Calhoun, Campbell, Clark, Guerry, Jones, Locke, McCulloch, McGraw, McGuire, McTigue, Merrian, O'Connor, Perera, Pfeiffer, Regan, Sherman, Spalter, Straatsma, Unsworth, Wadsworth, Lowenstein, Sanders, and many others. A major portion of the text is devoted to the staff, as well it might be, and it is evident that staff members have played a major role in the development of ophthalmology, not only in New York but in the entire world. Thus, one has a personal history of one's ophthalmic friends in the Institute that they made outstanding. This is more than an intimate history of the Eye Institute with the gossip, the ïntri^ INTIMATE
HISTORY.
AMERICAN JOURNAL OF OPHTHALMOLOGY
310
cacies, and the like, which make up a part of every institution. Maynard Wheeler describes the design of the Institute and its wonderful new wing. He devotes a chapter to pathology and the school built around Algernon B. Reese. He tells of the special clinics and the problems that arise in every institution in attempting to provide a continuity in sem inars, grand rounds, journal clubs, and alumni meetings. Maynard Wheeler has written two his tories in his great professional life—first, on the American Ophthalmological Society on the occasion of its centennial, and now the Eye Institute. All of American medicine would be richer if those involved with other institutions undertook similar labors of love. Frank W. Newell SYMPOSIUM
ON
OCULAR
PHARMACOLOGY
Transactions of the New Orleans Academy of Ophthalmol ogy. St. Louis, C. V. Mosby Co., 1970. Clothbound, 311 pages. Price: $27.50 AND THERAPEUTICS.
The annual Transactions of the New Or leans Academy of Ophthalmology provides a current presentation of recent advances in a variety of areas—fields as varied as trau matic ophthalmology, cataract surgery, con genital anomalies of the eye, strabismus, and retinal surgery. In 1969, the program chair men, James McComiskey, James H. Allen, Moss L. Antony, Hilliard Haik, and Monte G. Holland, selected ocular pharmacology and therapeutics as the main topic of discus sion. Kenneth T. Richardson described the basic concepts of pharmacology and Philip P. Ellis the suppression of the inflammatory response by means of corticosteroids and noncorticosteroids together with the treat ment of postoperative endophthalmitis. Rob ert P. Burns described the effect of contact lenses on the corneal metabolism and in an other paper emphasized the differences be tween the conjunctival and corneal epithe lium. He also described various aspects of
AUGUST, 1970
the pharmacology and toxicology of the con junctiva. Stephen M. Drance described in detail the management of the glaucomas, combining rich clinical experience with laboratory stud ies. Howard N. Bernstein described iatrogenic ocular disease arising from systemically administered drugs varying from chloroquine to oral contraceptives. William H. Havener dealt with some of the difficulties arising in evaluating clinical therapeutic re sponse, the treatment of traumatic hyphema, and the drugs used in the medical and surgi cal management of cataract. John Adriani discussed drug interactions with anesthetics and preoperative regimes. The volume meets the high standard set previously by this group and provides an in teresting review of a number of related sub jects. Frank W. Newell
PROCEEDINGS OF THE 11TH A N N U A L MEET ING OF THE AMERICAN ASSOCIATION FOR AUTOMOTIVE MEDICINE. Edited by Arthur
H. Keeney. Springfield, Charles C Thomas. Clothbound, 298 pages, index, black and white figures. Price: $19.75 This collection of 23 articles on various aspects of automobile accidents should be read by all Americans who are concerned by the increasing number of accidents. Be cause the approach to the problem is multidisciplinary, it is natural that only three chapters deal with specific ophthalmic prob lems. The article by Albert Burg, Ph.D., "Some Relationships Between Vision and Driving," concludes that the usual method of measuring visual acuity should continue to be a required part of the examination for a drivers license. W. Morton Grant's chap ter, "Drug Induced Disturbances of Vision That May Affect Driving," although of gen eral interest, brings nothing new to ophthal mologists, and W. J. Gibson's "Ocular Find ings in Extension-Flexion Injuries of the Cervical Spine (whip-lash injuries)," de-