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William A. Mann 1898–1971
VOL. 72, NO. 2
IN MEMORIAM
damaged, and (3) atropine, in the absence of iris damage, dilates the pupil. Paralysis of the sympathetic was dis missed as causal because (1) miosis is more intense than that found in the usual Horner's syndrome, (2) no other signs of sym pathetic paralysis are seen, (3) pupillary re flex dilation and dilation to cocaine can be shown to persist, and (4) there is no evi dence for a pathway because the descending sympathetic runs quite lateral to the midline. It was concluded that a destructive lesion of a supranuclear inhibitory pathway to the Westphal-Edinger nucleus must be the mechanism therefore of the Argyll Robert son pupil. But what is the nature of the in hibitory pathway? I agree with this analysis that the miosis is cholinergically mediated and that the conven tional sympathetic path descending in the lat eral medulla is not involved. Other central "sympathetic" fibers may well be, however. In fact, there is a richly developed group of adrenergic fibers shown in the rat brain, con taining the catecholamines norepinephrine and 5, hydroxytryptamine in large amounts, that are supranuclear and that contact spe cifically with the cells of the Westphal-Ed inger group but not with those of the larger cells within the oculomotor complex; these, therefore, fit the requirement of a dorsomedial path (avoiding the ventral area described above). 2 Loss of this central "sympathetic" inhibitory path to produce the Argyll Rob ertson pupil is compatible with the site re quired by all the clinical and experimental data reviewed, and fits with the pharmacologic studies cited.1 The nature of the pathway interrupted in the production of the Argyll Robertson pupil would thus be a group of supranuclear inhib itor}' fibers, indeed, but a group of adrener gic fibers. The reproduction of a like miosis by the reserpine-induced depletion of norepi nephrine in the central nervous system with out peripheral (irridial) catecholamine de pletion, as well as the miosis seen during sleep, are phenomena consistent with this
489
concept. A search for these adrenergic fibers in higher animals should now be made so that the final chapter in the story of the Ar gyll Robertson pupil may be written. The purpose of this note is to draw the cli nician's attention to the new finding2 of these adrenergic midbrain fibers2 and to apply the results of the work to our understanding of the Argyll Robertson pupil. Marvin L. Sears REFERENCES
1. Loewenfeld, I. E.: The Argyll Robertson pupil, 1969-1969. A critical survey of the literature. Surv. Ophth. 14:199, 286, 287, 1969. 2. Dahlstrom, A., Fuxe, K., Hillarp, N. A., and Malmfors, T.: Adrenergic mechanisms in the pupil lary light-reflex path. Acta physiol. Scand. 62:119, 1964.
IN MEMORIAM WILLIAM A. MANN 1898-1971 William A. Mann, M.D., Secretary-Trea surer of the Ophthalmic Publishing Com pany, parent company of the AMERICAN JOURNAL OF OPHTHALMOLOGY, and a mem ber of its editorial board since 1946, died May 18, 1971, in Chicago, Illinois. His death was sudden and unexpected; he and Mrs. Mann had planned to leave within the next several days on a leisurely drive to Hot Springs, Virginia, to attend the American Ophthalmological Society meeting and the annual meeting of the board of the Ophthal mic Publishing Company. On the evening of his death, he and Mrs. Mann left for a meet ing of the trustees of Hadley School for the Blind, but returned home because of what was thought to be a slight indisposition. Dr. Mann was Professor Emeritus of Ophthalmology at Northwestern University and Chairman Emeritus of the Department of Ophthalmology at Chicago Wesley Me morial Hospital and the Veterans Hospital at Hines, Illinois. He devoted his entire pro fessional career to these institutions. He be gan as a clinical assistant at Northwestern
490
AMERICAN JOURNAL OF OPHTHALMOLOGY
William Alfred Mann, M.D.
University in 1927, and ascended the aca demic ladder to become professor in 1949. He was acting chairman of the department of ophthalmology following Sanford Gifford's unexpected death in 1943, and managed the department until Derrick Vail became a pro fessor in 1945. He was devoted and loyal to the department and did yeoman service in its organization and activities. He served on the staffs of both Wesley and Passavant hospitals, and with the open ing of the new Wesley Hospital in 1940, he became chairman of its department of oph thalmology and a consultant at Passavant. He began service with the United States Veterans' hospital in Hines in 1933 and be came its chairman in 1946. He was responsi ble for instituting the residency program at both Wesley and Hines hospitals. In addi
AUGUST, 1971
tion, he played an active role in the forma tion of the facility at Hines for training newly blinded soldiers. The details of Dr. Mann's career are re lated in the special issue of the JOURNAL published in his honor in October, 1967. He attended the public schools in Chicago and Wilmette. He graduated from the University of Illinois and interned at Evanston hospital. His ophthalmic training was obtained at the University of Illinois and in Vienna. In his early professional career he was ac tive in the affairs of the Alpha Kappa Kappa medical fraternity. He served as president of the professional interfraternity council from 1933 to 1935 and was chairman of the medi cal interfraternity conference from 1947 to 1949. He was Grand Primerius of the Alpha Kappa Kappa Fraternity from 1949 to 1953, and again from 1963 to 1965. He also edited the Centaur, their official magazine, and served as president, grand vice-president, and grand historian. He was president of Omega Beta Pi, honorary national fraternity from 1932 to 1935 and served as president of Lambda Chi Alpha while attending the University of Illinois. His scientific contributions were in two main areas, photography of the eye, and therapy. He was active in the development of color and infrared photography of the fundus and wrote his thesis for the Ameri can Ophthalmological Society describing an animal eye as a camera after Scheiner. He was active in the initial development of ACTH and the corticosteroids. For many years he gave a course in the optical correc tion of aphakia at the American Academy of Ophthalmology and Otolaryngology, from which he received its honor medal, and he wrote extensively concerning hysterical amblyopia. His major love, however, was history. And at the time of his death he was historian of the Chicago Ophthalmological Society and had written extensively concerning the his tory of ophthalmology in the Illinois region.
VOL. 72, NO. 2
491
IN MEMORIAM
He combined his interests in his final contri bution, relating the history of photography in ophthalmology (Surv. Ophth. 1970). Dr. Mann served as secretary-treasurer of the Ophthalmic Publishing Company from 1948 until his death. When he first took office the circulation of the JOURNAL was 4,000 and he saw it grow to more than 13,000. He also participated in the transition of the JOURNAL from a small enterprise managed principally in the office of its editor to an independent publishing group. In reviewing Bill Mann's career, one is impressed by the number of successful en terprises with which he was associated: the training of nearly 100 ophthalmologists in residency programs he established at Wesley and Hines; the remarkable growth of the Hadley School for the Blind, where Bill served on the executive committee for many years; the extraordinary work done with rehabilitation of the blind at Hines Veterans Hospital; and the development of ophthal mology at Northwestern University. He was a member of numerous organiza tions: American Medical Association, Illi nois State Medical Society, Chicago Medical Society, American Ophthalmological Soci ety, American Academy of Ophthalmology and Otolaryngology, Association for Re search in Vision and Ophthalmology, Ameri can Association of Ophthalmology, Oxford Ophthalmological Congress, and American Society of Ophthalmology and Chicago Oph thalmological Society (President, 1946-47). He served as a member of the revision com mittee and as chairman of the panel on oph thalmology of the U.S. Pharmacopia from 1950 to 1960, and on the panel of ophthal mology from 1960 to 1965. He was a Congregationalist and a Knight Templar. No description of Bill Mann's life would be complete without mention of the major role of his wife. They met at Northwestern University in 1928 where she worked in the social service department. In 1931, they were married, and since then she has played an ac
tive role in the things in which Bill was in terested. Mrs. Mann is active in the Women's Board of Wesley Hospital, North western University, and served as a trustee with him at the Hadley School for the Blind. She entertained his friends, colleagues, and residents at a sumptuous home in suburban Wilmette, and later, in their apartment over looking Lake Michigan in Chicago. She trav eled with him on his professional journeys and they were going to celebrate their 40th wedding anniversary at the Homestead dur ing the meeting of the American Ophthalmo logical Society. Chancellor Roscoe J. Miller of North western University, a friend of Bill's since the time both were members of the faculty in medical school, stated in his eulogy, "Great ness is a quality that is measured by the im pact a man creates on his family, his peers, his associates. Greatness in a man is found in the quality of his life, whether he be re nown or unknown, popular or unsung, rich or poor, and the quality of a man's life is measured by the ways in which he comes to terms with life as that life unfolds itself to him." The JOURNAL and its staff extend to Mrs. Mann, their three children, and seven grand children, their sincerest sympathies. We shall miss him greatly. Frank W. Newell H A I L AND FAREWELL
The executive family of the American Journal of Ophthalmology has sufifered a grievous blow in the loss of William A. Mann. For 25 years as secretary-treasurer of the Ophthalmic Publishing Company, the parent of the JOURNAL, Bill had always given sound advice in the exercise of his calm judgement and great common sense. He was a good balance wheel, controlling my impulsive nature and quick decisions that might have been harmful. I am grateful for this.
IN MEMORIAM
damaged, and (3) atropine, in the absence of iris damage, dilates the pupil. Paralysis of the sympathetic was dis missed as causal because (1) miosis is more intense than that found in the usual Horner's syndrome, (2) no other signs of sym pathetic paralysis are seen, (3) pupillary re flex dilation and dilation to cocaine can be shown to persist, and (4) there is no evi dence for a pathway because the descending sympathetic runs quite lateral to the midline. It was concluded that a destructive lesion of a supranuclear inhibitory pathway to the Westphal-Edinger nucleus must be the mechanism therefore of the Argyll Robert son pupil. But what is the nature of the in hibitory pathway? I agree with this analysis that the miosis is cholinergically mediated and that the conven tional sympathetic path descending in the lat eral medulla is not involved. Other central "sympathetic" fibers may well be, however. In fact, there is a richly developed group of adrenergic fibers shown in the rat brain, con taining the catecholamines norepinephrine and 5, hydroxytryptamine in large amounts, that are supranuclear and that contact spe cifically with the cells of the Westphal-Ed inger group but not with those of the larger cells within the oculomotor complex; these, therefore, fit the requirement of a dorsomedial path (avoiding the ventral area described above). 2 Loss of this central "sympathetic" inhibitory path to produce the Argyll Rob ertson pupil is compatible with the site re quired by all the clinical and experimental data reviewed, and fits with the pharmacologic studies cited.1 The nature of the pathway interrupted in the production of the Argyll Robertson pupil would thus be a group of supranuclear inhib itor}' fibers, indeed, but a group of adrener gic fibers. The reproduction of a like miosis by the reserpine-induced depletion of norepi nephrine in the central nervous system with out peripheral (irridial) catecholamine de pletion, as well as the miosis seen during sleep, are phenomena consistent with this
489
concept. A search for these adrenergic fibers in higher animals should now be made so that the final chapter in the story of the Ar gyll Robertson pupil may be written. The purpose of this note is to draw the cli nician's attention to the new finding2 of these adrenergic midbrain fibers2 and to apply the results of the work to our understanding of the Argyll Robertson pupil. Marvin L. Sears REFERENCES
1. Loewenfeld, I. E.: The Argyll Robertson pupil, 1969-1969. A critical survey of the literature. Surv. Ophth. 14:199, 286, 287, 1969. 2. Dahlstrom, A., Fuxe, K., Hillarp, N. A., and Malmfors, T.: Adrenergic mechanisms in the pupil lary light-reflex path. Acta physiol. Scand. 62:119, 1964.
IN MEMORIAM WILLIAM A. MANN 1898-1971 William A. Mann, M.D., Secretary-Trea surer of the Ophthalmic Publishing Com pany, parent company of the AMERICAN JOURNAL OF OPHTHALMOLOGY, and a mem ber of its editorial board since 1946, died May 18, 1971, in Chicago, Illinois. His death was sudden and unexpected; he and Mrs. Mann had planned to leave within the next several days on a leisurely drive to Hot Springs, Virginia, to attend the American Ophthalmological Society meeting and the annual meeting of the board of the Ophthal mic Publishing Company. On the evening of his death, he and Mrs. Mann left for a meet ing of the trustees of Hadley School for the Blind, but returned home because of what was thought to be a slight indisposition. Dr. Mann was Professor Emeritus of Ophthalmology at Northwestern University and Chairman Emeritus of the Department of Ophthalmology at Chicago Wesley Me morial Hospital and the Veterans Hospital at Hines, Illinois. He devoted his entire pro fessional career to these institutions. He be gan as a clinical assistant at Northwestern
490
AMERICAN JOURNAL OF OPHTHALMOLOGY
William Alfred Mann, M.D.
University in 1927, and ascended the aca demic ladder to become professor in 1949. He was acting chairman of the department of ophthalmology following Sanford Gifford's unexpected death in 1943, and managed the department until Derrick Vail became a pro fessor in 1945. He was devoted and loyal to the department and did yeoman service in its organization and activities. He served on the staffs of both Wesley and Passavant hospitals, and with the open ing of the new Wesley Hospital in 1940, he became chairman of its department of oph thalmology and a consultant at Passavant. He began service with the United States Veterans' hospital in Hines in 1933 and be came its chairman in 1946. He was responsi ble for instituting the residency program at both Wesley and Hines hospitals. In addi
AUGUST, 1971
tion, he played an active role in the forma tion of the facility at Hines for training newly blinded soldiers. The details of Dr. Mann's career are re lated in the special issue of the JOURNAL published in his honor in October, 1967. He attended the public schools in Chicago and Wilmette. He graduated from the University of Illinois and interned at Evanston hospital. His ophthalmic training was obtained at the University of Illinois and in Vienna. In his early professional career he was ac tive in the affairs of the Alpha Kappa Kappa medical fraternity. He served as president of the professional interfraternity council from 1933 to 1935 and was chairman of the medi cal interfraternity conference from 1947 to 1949. He was Grand Primerius of the Alpha Kappa Kappa Fraternity from 1949 to 1953, and again from 1963 to 1965. He also edited the Centaur, their official magazine, and served as president, grand vice-president, and grand historian. He was president of Omega Beta Pi, honorary national fraternity from 1932 to 1935 and served as president of Lambda Chi Alpha while attending the University of Illinois. His scientific contributions were in two main areas, photography of the eye, and therapy. He was active in the development of color and infrared photography of the fundus and wrote his thesis for the Ameri can Ophthalmological Society describing an animal eye as a camera after Scheiner. He was active in the initial development of ACTH and the corticosteroids. For many years he gave a course in the optical correc tion of aphakia at the American Academy of Ophthalmology and Otolaryngology, from which he received its honor medal, and he wrote extensively concerning hysterical amblyopia. His major love, however, was history. And at the time of his death he was historian of the Chicago Ophthalmological Society and had written extensively concerning the his tory of ophthalmology in the Illinois region.
VOL. 72, NO. 2
491
IN MEMORIAM
He combined his interests in his final contri bution, relating the history of photography in ophthalmology (Surv. Ophth. 1970). Dr. Mann served as secretary-treasurer of the Ophthalmic Publishing Company from 1948 until his death. When he first took office the circulation of the JOURNAL was 4,000 and he saw it grow to more than 13,000. He also participated in the transition of the JOURNAL from a small enterprise managed principally in the office of its editor to an independent publishing group. In reviewing Bill Mann's career, one is impressed by the number of successful en terprises with which he was associated: the training of nearly 100 ophthalmologists in residency programs he established at Wesley and Hines; the remarkable growth of the Hadley School for the Blind, where Bill served on the executive committee for many years; the extraordinary work done with rehabilitation of the blind at Hines Veterans Hospital; and the development of ophthal mology at Northwestern University. He was a member of numerous organiza tions: American Medical Association, Illi nois State Medical Society, Chicago Medical Society, American Ophthalmological Soci ety, American Academy of Ophthalmology and Otolaryngology, Association for Re search in Vision and Ophthalmology, Ameri can Association of Ophthalmology, Oxford Ophthalmological Congress, and American Society of Ophthalmology and Chicago Oph thalmological Society (President, 1946-47). He served as a member of the revision com mittee and as chairman of the panel on oph thalmology of the U.S. Pharmacopia from 1950 to 1960, and on the panel of ophthal mology from 1960 to 1965. He was a Congregationalist and a Knight Templar. No description of Bill Mann's life would be complete without mention of the major role of his wife. They met at Northwestern University in 1928 where she worked in the social service department. In 1931, they were married, and since then she has played an ac
tive role in the things in which Bill was in terested. Mrs. Mann is active in the Women's Board of Wesley Hospital, North western University, and served as a trustee with him at the Hadley School for the Blind. She entertained his friends, colleagues, and residents at a sumptuous home in suburban Wilmette, and later, in their apartment over looking Lake Michigan in Chicago. She trav eled with him on his professional journeys and they were going to celebrate their 40th wedding anniversary at the Homestead dur ing the meeting of the American Ophthalmo logical Society. Chancellor Roscoe J. Miller of North western University, a friend of Bill's since the time both were members of the faculty in medical school, stated in his eulogy, "Great ness is a quality that is measured by the im pact a man creates on his family, his peers, his associates. Greatness in a man is found in the quality of his life, whether he be re nown or unknown, popular or unsung, rich or poor, and the quality of a man's life is measured by the ways in which he comes to terms with life as that life unfolds itself to him." The JOURNAL and its staff extend to Mrs. Mann, their three children, and seven grand children, their sincerest sympathies. We shall miss him greatly. Frank W. Newell H A I L AND FAREWELL
The executive family of the American Journal of Ophthalmology has sufifered a grievous blow in the loss of William A. Mann. For 25 years as secretary-treasurer of the Ophthalmic Publishing Company, the parent of the JOURNAL, Bill had always given sound advice in the exercise of his calm judgement and great common sense. He was a good balance wheel, controlling my impulsive nature and quick decisions that might have been harmful. I am grateful for this.