Albrecht Friederich Wilhelm Ernst von Graefe Biography (1828-1870)

eye surgeon

Albrecht von Graefe is best known as the founder of modern ophthalmology. VonGraefe, whose full name was Friederich Wilhelm Ernst Albrecht von Graefe, dedicated his life to becoming an excellent teacher, surgeon, and clinician inthe field of ophthalmology. Although born into a privileged life as the son of Carl Ferdinand von Graefe the Director of the Surgical Clinic for 30 years,author of the Encyclopedic Dictionary of Medical Sciences, a pioneerin plastic surgery, and general in the Prussian army Albrecht based his shortlife on utilizing his talent to benefit those who were in need.

Orphaned at the age of 12, von Graefe focused on his studies. As an extremelygifted student, he decided to follow in his father's footsteps and began byenrolling at the University of Berlin in 1843. At the age of 15, he was the youngest student on record to begin studies at the university. With instructors who were revered in the world of nineteenth-century Berlin medicine, such as Schö nlein, Romberg, Dieffenbach, Virchow, Schlemm, von Br ücke,Du Bouis-Reymond, and Johannes M üller, von Graefe left an impression onhis teachers of being an intense student who would strive for great accomplishments. Four years later he graduated from medical school, and began to planhis Wanderjahre a trip through Europe that would allow him to study some of his day's leading ophthalmologists. Beginning in December of 1847, vonGraefe made several stops along his journey, including the eye clinic of Ferdinand Arlt in Prague, and a 20-month stay in Paris with Sichel, Desmarres, Louis, and Claude Bernard. He then headed to Vienna to observe Eduard Jaeger,followed by a brief trip back to Berlin, then to London to stay with WilliamBowman and George Critchett. His voyage concluded with stays in Glasgow withWilliam Mackenzie and Dublin with William Wilde.

Rich with experience from working with Europe's leading ophthalmologists fornearly three years, von Graefe returned to Berlin to open his first clinic inBehrenstrasse on November 1, 1850. Consisting of three small rooms and little equipment, von Graefe welcomed his first patients with a famous advertisement that ran in all Berlin papers for six weeks, stating that he would treat poor patients free of charge. Von Graefe's surgical cases were performed in two rooms he rented from a tailor. It is there that he completed a successful cataract extraction on a blind man and an artificial pupil on the scarred cornea of an organ grinder. While his treatment was successful for his first twosurgical cases, the blind man developed delirium tremens during the evening while in recovery, fell out of bed and attacked the organ grinder with his fists.

Eager to deliver the best care for his patients, von Graefe searched for waysto properly examine the eyes. He pioneered the design and use of instrumentsfor clinical perimetry, and in 1862, he developed the development of one ofthe first tonometers, which are instruments used to measure intraocular pressure. His talent as a doctor became apparent as the number of his patients grew. At the end of the first two months, his clinic saw 230 patients, and at the end of the first year von Graefe treated over 1,900 patients. To accommodate the recent growth in patients, the clinic was moved to a three-story building at 46 Karlstrasse, which became the most famous eye clinic in nineteenth-century Europe. Shortly after this move, von Graeffe would see over 10,000 patients a year in his clinic.

Recognition of von Graefe's achievements was also given by the students who came to observe and learn from him as he examined patients, operated and explained pathology and treatment. He lectured to many, and hundreds of students were trained at von Graefe's side. At the young age of 26, he published his own journal of materials in the first of many Archiv fur Augenheilkunde.Consisting of 480 pages written by himself, the first Archiv would befollowed by journals containing articles from contributing experts, including Arlt and Donders, and the studies of Helmholtz on accomodation.

In 1857, von Graefe reached the peak of his career by reporting the cure of glaucoma with iridectomy at the first International Congress of Ophthalmology.He referred to glaucoma in three forms: the acute inflammatory, the chronicand amaurosis with advanced cupping of the disc. Von Graefe's work on glaucoma set a standard in the world of ophthalmology. It was at this time he also became engaged to Anna, Countess Knuth in 1861. While traveling that year, hewas struck with acute tuberculous pleurisy. After resting on the Riviera thatwinter, he returned to Berlin and married Anna in 1862. The couple had fivechildren throughout their eight years of marriage, two of whom died .

In 1864, von Graefe embarked on modifying the corneal flap procedure. By using a thin pointed knife (created by himself), a peripheral linear incision wasmade to avoid the large gap of the typically used semicircular corneal incision. This procedure was commended by von Graefe's peers as it reduced infection and the failure rate of the extraction of a cataract from 10-5%, and was soon used internationally by countless ophthalmic surgeons.

As von Graefe's clinic grew, so did his passion for his patients and work. Even as he dealt with an increasing pain caused by his heightened tuberculosis, he continued to perform an enormous amount of surgery, with up to 50cataracts and 15 iridectomies in one week. Von Graefe was also influential inthe founding of the Heidelberg Ophthalmological Society, which in 1864 joined together 80 ophthalmologists from around the world.

As the tuberculosis spread to von Graefe's lungs and throat, he began to workharder and was able to do so after injecting himself with morphine adrug that he had become addicted to due to his continual pain. He died on July 20, 1870 at the age of 42, and his wife passed on two years later at the age of 30. After von Graefe's death, he was memorialized by fellow ophthalmologists who published an encyclopedia in his memory. His image also lives on ina statue that was erected by the Berlin Medical Society in 1882 in front of the CharitéHospital, and a Graefe Museum in the Heidelberg eye clinic by the Heidelberg Society. It was von Graefe's final wishes that his clinic beclosed immediately after his death, ending 20 years of historical happeningsin the world of ophthalmology.

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