Highlights in Danish ophthalmology
Mogens Norn.
National history can give us an identity and knowledge of our personal background. Today, global and EU partnership are perhaps most important, but I want to give you a short highlights of the Danish ophthalmic history, hopefully inspiring history from other Nordic and Baltic countries. Let us begin in 1200 A.D..
300 B.C.. – 1200 A.D.
Saxo Grammaticus published his great work Gesta Danorum, the Danish history in 1202-19, ordered by the archbishop Absalon. In this book (1) some ophthalmic topics are mentioned. In short and in almost chronologic order from around 300 B.C. to 1219 A.D.:
King Vermund was an old blind man (1122-127). The king of Sachsen will not fight duel with him “because it is a humiliation to fight against a blind man”.
More examples of blindness , caused by old age, are mentioned (Stærkodder, Maske of Rügen, King Gest of Göterne, Kind Harald Hildetand of Norway, King Gorm den Gamle of Denmark).
Evil eyes are mentioned. They could destroy the sharpness of a sword in battle (1: 270).
The highest God Odin was one- eyed (1:297). In the battle against Hellespont was the Danish soldiers blinded by the troll female Gudrun, but Odin cured them (1:332).
Snake poison could blind (1: 346). Enucleation of eyes as punishment are mentioned two times (King Magnus from Oslo (1:II: 92) and Sune (1:II: 104), both were also sterilised, orchidectomy, so they could not get sons).
Esbern drowned in Arkona Bay, but rescured by rolling (1.II: 116). King Knud the Sacred’s dead body cured etc.
Saxo is sceptical towards treatment at that time, done by self educated barber surgeons, monks and so called clever peoples. Oculists are not mentioned in the book. Religion and medical knowledge are mixed together (King Valdemar the Great (1:II: 154).
1479.
The University of Denmark in Copenhagen was founded in 1479 with medical students from 1537. Christian Th. Morsing was professor medicus primus.
1667 – 70.
The very first lens extraction in the world was performed in Copenhagen. It was done on a goose, and I must confess, not by a Dane, but an Italian alchemist Francesco G. Borri (1625-95) by the king Frederiks III’s court. The goose could see after the operation, but the famous Danish anatomist Thomas Bartholin declined this, because at that time it was a scientific fact, that the visual sense was located in the lens, not in retina. Borri used chelidonium extract, “the golden eye drops”, he believed necessary for the good vision result. But the Danish Henrik Jacobsen Skriver, the kings barber surgeon was scientificically critical. Henrik Skriver repeated the lens extraction without chelidonium on another goose with success (2). – Lens crystallina is not necessary for vision! – Nevertheless lens – declination was still used for cataract, pressure on the membrane in the pupil, believed to be a waterfall (= cataract) anterior to lens crystallina.
1716.
Cataract declinations are still done (Fig.1). The Danish Salomon Quoten, oculist, stone surgeon, teeth extractor and puppet – show – master is metioned by the famous Danish poet Ludvig Holberg (2).
1758.
Georg Heuermann (1723-1768) did the first cataract extraction in Denmark(Fig.2). I admit, that Jaques Daviel (1696- 1763) did the very first in the word, it was in France 1745-50. Heuermann was barber surgeon, later medical doctor, teaching in Simon Crügers anatomic – surgery Theater in Copenhagen 1748-49. (It was before Academia chirurgorum Regia was grounded in Bredgade in 1787 by the King, now Medical Museion).
About 1750 Heuermann invented a filtration operation for glaucoma with a canvas thread.
1810.
Carl Christopher Withusen (1779-1853) did “the first cataract extraction in Denmark” (!) – Heuermann’s operation after some complications was forgotten in the next 52 years. Now it was performed with success. Withusen was a pioneer in the first Danish Blind Institution, in Kjædeordenen.
1840.
Nathan Gerson Melchior do the first squint operation in Denmark, a myotomy. Diffenbach did it a year before. Later, tenotomy was preferred as squinting surgery.
1852.
Georg Carl Heinrich Lehmann (1815-90) demonstrated for the first time in the ophthalmologic meeting in Copenhagen the 3 - plane glass ophthalmoscope a. m. Helmholtz from 1850.
Lehmann was an important ophthalmologist. In 1864 he was the chief in Sct. Annae Hospital (near Nyhavn in Copenhagen), treating and studying the so – called military epidemic keratoconjunctivitis after the Danish war against Germany (Clamydia? Adenovirus?). and in 1866 Lehmann studied the aqueous humour, taken a dead human cornea, placed the unclear cornea on a filter paper, make the cornea clear, because some of the aqueous in cornea was extracted.
1857.
Edmund Hansen Grut (1831-1907) , the first Danish professor in ophthalmology from 1886, postulated in his MD thesis from 1857: “Examinations with the Ophthalmoscope” (øjenspejl), that the optic nerve in glaucoma is convex, because the light was very week in the ophthalmoscope at that time. Later Grut stated correctly, that the papilla nervi optici is concave, excavated in glaucoma.
1872.
Harald Aron Peter Philipsen (1839-92) wrote the first Danish ophthalmic manual, second revised edition in 1880 (3). It is an overview in Danish concerning the last scientific works, mostly German (71%), but also French (11%) Nordic (11%) and only 7% English works.
1876.
Valdemar Krenchel (1844-85) : His MD thesis appeared in 1876 concerning ambyopia centralis, depending on colour vision and contrast sensibility, named light sense, measured with grey tone scale.
Krenchel constructed a special ophthalmoscope with Recoss disc (Recoss invented this in 1852) and with a seesaw mirror for right and left eye. The ophthalmoscope is kept in the Medical Museion in Copenhagen (Fig.3).
Krenchel developed rules for seamen with colour tests (2: 193).
Discussion.
The first Danish ophthalmologic highlights were mostly copies of other scientists work, done short time after the original work, with loyal references. It reveal the excellent European communications already at that time (1750-1880).
There were no autorized eye specialists at that time, bur the persons mentioned had practice in Copenhagen, mostly with only eye patients (Heuermann also otology).
The following Danish highlights will cover the period 1880-1910. Hopefully highlights from other Nordic and Baltic nations also will appear.
References.
1). Saxo Grammaticus: Gesta Danorum 1219 (lat).. Danmarks Krønike, translated to Danish by Winkel Horn 1898, printed again: Vinten Forlag, Copenhagen 1975. Part I pp.427 and part II pp.330.
2) Norrie, Gordon: Den Danske Oftalmologis Historie indtil Aar 1900. Levin & Munksgaards Forlag, Copenhagen 1925. pp 200. In Danish.
3). Philipsen, H: Fremstilling af Øiets Sygdomme til Brug for Læger og Studerende. Kjøbenhavn. C.A.Reitzels Forlag. 2. udg, pp. 616. In Danish.
Fig.text:
Fig. 1: Needle with ivory shaft for cataract depression.
Fig. 2: Heuermann’s instruments for cataract – extraction. Medical Museum, Copenhagen.
Fig. 3: Krenchels ophthalmoscop, RIN 100355, Medical Museum.
All pictures will be added around June 6, sorry for the delay oh