SURVEY OF OPHTHALMOLOGY
VOLUME 37. NUMBER 2. SEPTEMBER-OCTOBER
REMEMBRANCES
1992
OF THINGS
PAST
FREDERICK C. BLODI AND BARRIE JAY, EDITORS
Remembrance
of Hans Goldmann,
FRANZ FANKHAUSER,
M.D.
C’ni~wrsitiit
Bern,
Bun,
1899-l 991
Switwlctnd
Abstract. Professor Hans Goldmann died in Bern on November 19th, 1991 at the age of92 years. His outstanding intellectual capacity was discovered at an early age and demonstrated throughout his life. He was appointed as teaching assistant of the famous A. Cermak von Seysenegg, Chairman of the Institute of Physiology of the German Charles University in Prague. During his stay at the University of Prague, he was influenced by the famous people of his time, such as Einstein (physicist), hlach (physicist and psychophysicist). Lorenz (behavioral scientist), Popper (philosopher), S&lick (physicist and philosopher). Hering (physiologist), and others. Goldmann absorbed the essence of these disciplines to ;I very large extent. This, together with his remarkable intellect, enabled him to produce outstanding research work within a large spectrum ofsciences more or less directly related to ophthalmology. Goldmann became known in particular for his exceptional and fundamental work on perimetry and glaucoma and he managed to cast his basic insight into practical, easy-to-operate, high-precision diagnostic instruments which, several decades after their invention, are still used by every ophthalmologist. He will enter history as OIW of the very great pioneers in ophthalmology. (SUIT Ophthalmol 37:137-142. 1992)
Key words.
(ioldmann,
Hans
l
history
Hans Goldmann was born in 1899 in Komotau, Bohemia, a town near Prague in the formel Austro-Hungarian monarchy, which became part of Czechoslovakia after the first world war. He was first educated at a Jesuit school where the teachers became aware of his mental prowess fo1 mathematics and the natural sciences, but also fi)r philosophy. His exceptional memory became apparent at that time. His older brother, already at the university studying law, taught him the beginning of Vergil’s Ilind in Greek and the capuchin’s sermon in Schiller’s Wallenstein (Part 1: Wallmstein’.~ Heerlager), which he then repeated, without having any idea of what it meant, before
l
perimerer
a highly amused
audience. He was attracted by astronomy and would have loved to become an astrophysicist, but was persuaded by his parents “to do something practical,” so, for lack of anything better, he decided to become an ophthalmologist. After high school, he became a student at the medical faculty of the German Charles University in Prague, which was at that time one of the world’s leading centers of sciences. The director of the Institute of Physiology, the reputed A. Cermak von Seysenegg, soon discovered Goldmann’s talents and appointed him a teaching assistant, providing him with a room at his institute and also helping him finan-
138
Surv Ophthalmol
Fig. 1. Hans
Goldmann,
37 (2) September-October
as a young
professor.
1992
Fig. 2. Hans Goldmann,
FANKHAUSER
shortly
after his retirement
in
1968.
cially. This was essential for Goldmann, because his father had lost most of his money buying war bonds in WWl and had difficulty supporting his son. Because of his obligations at the institute, he missed most lectures and courses at the medical school, but caught up by reading at night. He concluded his studies successfully and on time. University professors at that time used to sit together with their students and assistants in Vienna-style coffeehouses in the late afternoon and during the evening, discussing the latest advances and revelations of science. During this time Goldmann met some of the great men, such as Philip Frank, professor of theoretical physics, Moritz Schlick, one of the leading authorities in philosophy of science and Karl Popper, whose strength was the theory of cognition. He also met Konrad Lorenz, the father ofbehavioral sciences and was fascinated by his way of thinking. Both Albert Einstein’s theory of relativity (special theory 1905, general theory 1917) and Friedrich were Nietzsche’s work (Also Spmch Zaruthustru) discussed. He also had a chance to discuss topics
of interest with a number of pioneers in ophthalmology. Anton Philip Elschnig was chairman of the Department of Ophthalmology of the German University in Prague. He met E. Fuchs in Vienna and Th. Axenfeld in Freiburg im Breisgau. In 1923, Goldmann became an assistant at the Department of Ophthalmology of the University of Bern, chaired by August Siegrist whose successor he became in 1935. One year later he married Erna Renfer and became a Swiss citizen. At the age of 36, he was the youngest chairman of a Swiss university eye clinic. To become professor and chairman at that early age was indeed very exceptional, because - with few exceptions - in order to be accepted as a university chairman, many years of exhaustive labor and service (and, as today, good connections) were necessary. I joined Goldmann as an assistant in 1954 and served him later as an 0berarz.t and Privatdozent with one interruption until his retirement in 1968. Figs. 1 and 2 show him as a young tnan and after his retirement. We remained close friends
REMEMBRANCE
OF HANS GOLDMANN,
1899-1991
139
I
StilesCrawford-effect
Clinical research, such as diabetic and hypertensive retinopathy;
Intraocular pressure and haemodynamics of optic nerve head Philosophical writings relating to the philosophy, spirit, power, limits and reasoning in medicine and in science
Retinopathy prematurity
of
Diverse undertakings pertaining to ophthalmology, such as the vision in animals
Fig. 3. A diagrammatic summary of some of Hans Goldmann’s most significant (Sketch of Hans Goldmann was drawn in 1937 by a medical student. Loaned
until his death on November 19, 1991. During his last years he became more and more disabled, but his intellect remained as sharp as ever. He is survived by his wife. He characterized her once, according to Lao-tse’s dictum, “as the best ruler whose existence you hardly realize.” When I started with Goldmann, he impressed me as someone who apparently knew just everything, starting from ancient history and philosophy to the most recent advances in the natural sciences. At that time, he was intensely engaged with psychophysical problems. He had invented sometime earlier his well-known perimeter and adaptometer. First I had to do research on night vision, then I had to solve problems related to perimetry. In particular, I had to analyze questions of spatial summation, i.e., explore the validity of the classical summation laws of Kicco, Piper and others for perimetry. These experiences, I think, enabled me later to design an automated perimeter (Octopus system). It
I
contributions to ophthalmology. courtesv of Dr. Rudolf Witmer.)
was not always easy to live with Goldmann due to his practice of producing new ideas at high frequency. Practically every morning he arrived with a fascinating new idea and, at the same time, proposed an experimental approach to solve the problem. Before leaving at night, together with proposing new projects, he regularly asked me whether I had done what he had proposed in the morning. I never could find out whether he was kidding or whether he really thought that one could work at such high speed. His mental superiority, the feeling during discussions with him “to fall literally into pieces and to be crushed,” often had a destructive effect. As a result of these “private lessons,” one felt that the gradient of the learning curve for all possible fields of ophthalmology was extremely steep. Goldmann’s universality was overwhehning. In Fig. 3, I have tried to demonstrate a synopsis of his mental activities. By 1923 in Bern, he was intrigued by the pathogenesis of cataract in gen-
140
Surv Ophthalmol
37 (2) September-October
eral, but in particular by the cause of the glassblower cataract. Here he clashed with Alfred Vogt, chief of the University Eye Clinic in Zurich, who maintained that the glassblower cataract was the result of infrared energy being absorbed directly by the lens, while Goldmann thought that it was caused by heat transferred to the lens from infrared energy absorbed by the iris. A number of ingenious experiments appeared to confirm Goldmann’s concept, and his hypothesis was accepted at that time (1930). Only much later, in 1980, were Wolbarsht and others able to show that both mechanisms, claimed by Vogt and Goldmann, depending on the experimental conditions, could explain the pathogenesis of the glassblower cataract. When I joined Goldmann, he also had performed, together with Rudolf Witmer, basic research on immunological problems, in particular, uveitis. He also had carried out a kinetic analysis of ocular fluorometric experiments and had determined in 1950 for the first time the aqueous flow in human eyes, finding it of the order of 2.5 l.J/min-‘. This value was later confirmed by others. His experiments were simple and he performed his computations with the help of a slide rule. Looking back, it appears to me that the lack of computer assistance had definite advantages, because it forced the research worker to push his brain to the limits of its performance. Goldmann was among the first to study fluid dynamics in the eye and had localized the site of increased resistance to outflow at the inner wall of Schlemm’s canal. A number of important papers appeared in the late ’40s and the early ’50s. Among many others, two should be mentioned: Der Druck im Schlemm’schen Kanal bei normalen Druck und bei Glaucoma chronicum simplex and Zur Frage des S&es der Widerstandserhohung beim einfachen Glaukom (“The Pressure in Schlemm’s Canal in Eyes with Normal Pressure and in Open Angle Glaucoma,” and “The Site of Increased Outflow Resistance in Open Angle Glaucoma”). He had already presented in 1937 at the 15th International Congress of Ophthalmology in Cairo his mirror gonioscope which was afterwards used by him and others to study and classify the chamber angle. Many authors before him had developed instruments for gonioscopy, but Goldmann’s contact lens, due to its outstanding optical properties and its simplicity, proved to be the best and the most suitable for gonioscopy and goniophotography. He improved the slit-
1992
FANKHAUSER
lamp, originally invented by Gullstrand in 1912 in two essential steps in 1933 (Eine neue Spaltlampe) and in 1939 (“An Improved Slitlamp Apparatus”). He constructed both a practical and a high performance instrument. In 1940, he published a basic paper on slitlamp photography and photometry and fluorometry (Spaltlampenphotographie und photometric and Ein neues Spaltlampenfluorometer). At the annual meeting of the French Ophthalmological Society in 1954, he presented for the first time his newly invented applanation tonometer which he improved in 1955 and 1956 (Un nouveau tonombtre a applanation). After intense studies of the laws of Imbert and Fick, which were basic to the development of applanation tonometry, he arrived at the conclusion, ‘Bei Einhaltung eines Applanationsdurchmessers von 3.06 mm und kurzfristiger Messung heben sich die Krafte, hervorgerufen durch Verformung der Hornhaut als Membran mit endlicher Dicke sowie Eigenstetfigkeit, und die Kapillarkrafte, hervorgerufen durch die benetzende Fliissigkeit auf der Augenoberjlache, gerade auf. Der Einfluss der Rigiditat wird dabei vernachlassigbar Klein” (“With an applanation diameter of 3.06 mm and brief measurements, the forces produced by the deformation of the cornea as a membrane of definite thickness and rigidity and those produced by the capillary adhesion of the whetting fluid on the ocular surface will just neutralize each other. Ocular rigidity becomes negligible”). Biomicroscopy of the posterior segment of the eye had come a long way, starting with the earliest attempts by Gullstrand (191 l), Wolff (1912), Schieck (1912), Koeppe (1918), Meesmann (192 l), Gallemaerts and Kleefeld (1922), Lemoine and Valois (1923), Lopez Lacarrere (1925), Zamenhof (1930), Lindner (1936) et al. All these examination methods were demanding exercises which could only be carried out at a clinic. For instance, the large and heavy Koeppe lens was complicated in its application and unpleasant for the patient. Goldmann managed the essential breakthrough in biomicroscopy of the posterior segment in 1949, designing his famous three-mirror contact lens which has remained to this day the instrument for the biomicroscopist (Einige Ergebnisse der Spaltlampenuntersuchung des Kammerwinkels und des Augenhintergrundes). I could use this lens without changing it at all to feed the beam of a xenon arc lamp and a ruby laser into the eye, a work which was performed with the physicist Walter Lotmar in
REMEMBRANCE
OF HANS GOLDMANN,
1899-1991
1967 (Photocoagulation through the Goldmann Contact Glass). Goldmann presented his experiences and clinical results together with Busacca and Schiff-Wertheimer (Biomicroscopie du Corps Vitre et du Fond.s de l’oeil). Hans Goldmann was a visiting professor during one year after his retirement at the Department of Ophthalmology, School of Medicine, Washington University, St. Louis, Missouri, which was at that time chaired by Bernard Becker. There he had mainly three partners representing two different directions of thought. These were Jay M. Enoch, with whom he discussed the latest developments in psychophysics of the light sense, and Robert Moses and Bernard Becker, the leading authorities in glaucoma research at that time. I have offered a few remarks and observations about Goldmann’s research activity, which are in no way complete. How did he work? I saw him doing his experimental work in the outpatient department, usually at places where the crowd was most dense. Apparently this did not disturb him. Did it perhaps even stimulate him? For sure, one advantage of having at all times a sufficient number of patients at hand, was obvious, because it meant that “there were always anterior and posterior segments of the eye available.” Since I was most of the time quite close to him, I advanced to the honorable job of a chief guinea pig. A few times my cornea1 epithelium was abraded, but my retina did not object. I once collapsed following an intravenous injection of fluorescein given in a hurry, but woke up safely in the recovery station and felt perfectly well. Concluding from the aspect of his desk, Goldmann was disorganized, but, obviously when one has a memory comparable to a megacomputer one does not depend much on “external” order. Others, like myself, who have been less gifted by destiny have always been intrigued by the question of where people like Goldmann have derived their mental power and creative imagination. I assume that this depends to a large extent on hereditary factors; however, the influence of external factors may be just as important. I found that Goldmann could not be understood without knowing his background. He grew up in an environment which nurtured unrestrained critical and stubborn scientific inquisitiveness and skepticism. Probably Jesuitic reasoning and logic in high school, where he got an excellent classical education, contributed to sharpen his mental ap-
141 paratus. One may see here a direct relation to one of his basic principles - “that the meaning and validity of theoretical assumptions can be determined only if detailed consideration is given to verifiable consequences which such assumptions entail,” and he did not get tired of warning about their fallacious use in support of questionable doctrines. The scientific atmosphere in Prague must have influenced him deeply, and undoubtedly made him a logical positivist, driving him to work on fundamental problems in ophthalmology and related sciences. He knew the famous Philipp Frank personally and had read and understood one of his major works, Das Kausalgesetz und seine Glrnzen (1912). In the circle around Karl Popper and Moritz Schlick, Goldmann was exposed to fundamental questions, such as the nature, scope and validity of human knowledge, as well as to other questions asked by the philosophy of science and the theory of cognition. The achievement of Moritz Schlick, a scholar of Max Planck, culminated in the logical empirism which is considered to be one of the main trends in the philosophy of the 20th century. Karl Popper had developed his theory of falsification. In his analysis of procedures oriented toward the verification of hypotheses and theories in the natural sciences, he tried to show three conclusions. First, a radical claim of an empiristic verification would not only eliminate metaphysical theorems, but would also destroy the entire knowledge of the natural sciences, just because most axiomata of the natural sciences cannot be verified. Second, one could not even speak 01‘ an inductive confirmation of theories of the natural sciences and, also, the concept of the probability of a hypothesis provides no means for evaluating hypotheses, because no concept for the evaluation of the probability of a hypothesis, which makes sense, can be defined. Third, as a consequence of the above, Goldmann maintained that evaluation methods, applied to theories of the natural sciences, must do without the concepts of verification (German: ~‘r+ie&&eit) and also without the concept of induction and probabilit!, of hypotheses. Goldmann’s universality reminds me ofone of his favorite authors, Ernst Mach. Ernst Mach was also born in the Astro-Hungarian monarchy (at Chirlitz-Tura near Briinn, Moravia, now part of Czechoslovakia). Mach had spent 28 years as professor of experimental
142
Surv Ophthalmol
37 (2) September-October
physics at the Charles University in Prague. Because of fundamental discoveries in physics, his interest shifted at an early period of his life to physiology and psychology of sensation. He also became one of the pioneers of the discipline of psychophysics, which was new at that time, particularly in the field of time sense and space perception. His studies on changes of kinesthetic sensation and equilibrium, associated with physical movement, acceleration, and change of orientation in the body have become classic. His name continues to live in the “Mach bands,” a phenomenon that relates the physiological effect of spatially distributed light stimuli to visual perception. (A Mach band is observed when a spatial distribution of light results in a sharp change in illumination at some poin A negative change corresponds in the to a band brig ter than its surroundings region of sharp change. A positive change corresponds to a band darker than its surroundings in the region of sharp change. This phenomenon, a physiological effect that has no physical basis, was the subject of a number of papers and of numerous investigations.) Some of Mach’s work in physics was devoted to the study of sound waves, wave propulsion, and gas dynamics of projectiles, meteorites, explosions and gas jets. In his celebrated publication on supersonics (published in the Sitzungsberichte of the Academy of Sciences in Vienna, 1887), he defined the angle which a shock wave surrounding the envelope of an advancing gas cone forms with the direction of its motion. This was shown to be related to the velocity of sound (v) and the velocity of the
1992
FANKHAUSER
projectile o as sina = u/o when o > IJ. Later the angle was called the Mach angle. It was recognized that the value of o/v (the ratio of the speed of an object to the speed of sound in the undisturbed medium in which the object is traveling, which came to be known as the “Mach number”) was becoming increasingly significant in aerodynamics for high-speed projectile studies and has gained considerable importance since WWII in theoretical and fluid dynamics. Goldmann’s universality comes close to Mach’s. When one reads Mach’s book, Erkenntnis and Irrtiimer, one is reminded on every second page of Goldmann. Goldmann will go into history as an inventive experimentalist, an acute and imaginative critic of scientific theory who was unusually sensitive to the importance of formulating problems in areas where medicine, physics, physiology and psychophysics interesect. Goldmann’s greatness lies in his incorruptible skepticism and independence. Part of Einstein’s obituary for Mach in 1916 would also apply well to Goldmann - “the unmediated pleasure of seeing and understanding, Spinoza’s amor dei intellectualis, was so strongly predominant in him that to a ripe old age he peered into the world with the inquisitive eyes of a carefree child taking delight in the understanding of relationships.” I am grateful to Dr. F.C. Blodi for his help in the preparation of this manuscript. Reprint address: Prof. Dr. Med. F. Fankhauser, UniversitSt Bern, Lindenhofspital, Bremgartenstr. 117, CH-3012 Bern, Switzerland.
VOLUME 37. NUMBER 2. SEPTEMBER-OCTOBER
REMEMBRANCES
1992
OF THINGS
PAST
FREDERICK C. BLODI AND BARRIE JAY, EDITORS
Remembrance
of Hans Goldmann,
FRANZ FANKHAUSER,
M.D.
C’ni~wrsitiit
Bern,
Bun,
1899-l 991
Switwlctnd
Abstract. Professor Hans Goldmann died in Bern on November 19th, 1991 at the age of92 years. His outstanding intellectual capacity was discovered at an early age and demonstrated throughout his life. He was appointed as teaching assistant of the famous A. Cermak von Seysenegg, Chairman of the Institute of Physiology of the German Charles University in Prague. During his stay at the University of Prague, he was influenced by the famous people of his time, such as Einstein (physicist), hlach (physicist and psychophysicist). Lorenz (behavioral scientist), Popper (philosopher), S&lick (physicist and philosopher). Hering (physiologist), and others. Goldmann absorbed the essence of these disciplines to ;I very large extent. This, together with his remarkable intellect, enabled him to produce outstanding research work within a large spectrum ofsciences more or less directly related to ophthalmology. Goldmann became known in particular for his exceptional and fundamental work on perimetry and glaucoma and he managed to cast his basic insight into practical, easy-to-operate, high-precision diagnostic instruments which, several decades after their invention, are still used by every ophthalmologist. He will enter history as OIW of the very great pioneers in ophthalmology. (SUIT Ophthalmol 37:137-142. 1992)
Key words.
(ioldmann,
Hans
l
history
Hans Goldmann was born in 1899 in Komotau, Bohemia, a town near Prague in the formel Austro-Hungarian monarchy, which became part of Czechoslovakia after the first world war. He was first educated at a Jesuit school where the teachers became aware of his mental prowess fo1 mathematics and the natural sciences, but also fi)r philosophy. His exceptional memory became apparent at that time. His older brother, already at the university studying law, taught him the beginning of Vergil’s Ilind in Greek and the capuchin’s sermon in Schiller’s Wallenstein (Part 1: Wallmstein’.~ Heerlager), which he then repeated, without having any idea of what it meant, before
l
perimerer
a highly amused
audience. He was attracted by astronomy and would have loved to become an astrophysicist, but was persuaded by his parents “to do something practical,” so, for lack of anything better, he decided to become an ophthalmologist. After high school, he became a student at the medical faculty of the German Charles University in Prague, which was at that time one of the world’s leading centers of sciences. The director of the Institute of Physiology, the reputed A. Cermak von Seysenegg, soon discovered Goldmann’s talents and appointed him a teaching assistant, providing him with a room at his institute and also helping him finan-
138
Surv Ophthalmol
Fig. 1. Hans
Goldmann,
37 (2) September-October
as a young
professor.
1992
Fig. 2. Hans Goldmann,
FANKHAUSER
shortly
after his retirement
in
1968.
cially. This was essential for Goldmann, because his father had lost most of his money buying war bonds in WWl and had difficulty supporting his son. Because of his obligations at the institute, he missed most lectures and courses at the medical school, but caught up by reading at night. He concluded his studies successfully and on time. University professors at that time used to sit together with their students and assistants in Vienna-style coffeehouses in the late afternoon and during the evening, discussing the latest advances and revelations of science. During this time Goldmann met some of the great men, such as Philip Frank, professor of theoretical physics, Moritz Schlick, one of the leading authorities in philosophy of science and Karl Popper, whose strength was the theory of cognition. He also met Konrad Lorenz, the father ofbehavioral sciences and was fascinated by his way of thinking. Both Albert Einstein’s theory of relativity (special theory 1905, general theory 1917) and Friedrich were Nietzsche’s work (Also Spmch Zaruthustru) discussed. He also had a chance to discuss topics
of interest with a number of pioneers in ophthalmology. Anton Philip Elschnig was chairman of the Department of Ophthalmology of the German University in Prague. He met E. Fuchs in Vienna and Th. Axenfeld in Freiburg im Breisgau. In 1923, Goldmann became an assistant at the Department of Ophthalmology of the University of Bern, chaired by August Siegrist whose successor he became in 1935. One year later he married Erna Renfer and became a Swiss citizen. At the age of 36, he was the youngest chairman of a Swiss university eye clinic. To become professor and chairman at that early age was indeed very exceptional, because - with few exceptions - in order to be accepted as a university chairman, many years of exhaustive labor and service (and, as today, good connections) were necessary. I joined Goldmann as an assistant in 1954 and served him later as an 0berarz.t and Privatdozent with one interruption until his retirement in 1968. Figs. 1 and 2 show him as a young tnan and after his retirement. We remained close friends
REMEMBRANCE
OF HANS GOLDMANN,
1899-1991
139
I
StilesCrawford-effect
Clinical research, such as diabetic and hypertensive retinopathy;
Intraocular pressure and haemodynamics of optic nerve head Philosophical writings relating to the philosophy, spirit, power, limits and reasoning in medicine and in science
Retinopathy prematurity
of
Diverse undertakings pertaining to ophthalmology, such as the vision in animals
Fig. 3. A diagrammatic summary of some of Hans Goldmann’s most significant (Sketch of Hans Goldmann was drawn in 1937 by a medical student. Loaned
until his death on November 19, 1991. During his last years he became more and more disabled, but his intellect remained as sharp as ever. He is survived by his wife. He characterized her once, according to Lao-tse’s dictum, “as the best ruler whose existence you hardly realize.” When I started with Goldmann, he impressed me as someone who apparently knew just everything, starting from ancient history and philosophy to the most recent advances in the natural sciences. At that time, he was intensely engaged with psychophysical problems. He had invented sometime earlier his well-known perimeter and adaptometer. First I had to do research on night vision, then I had to solve problems related to perimetry. In particular, I had to analyze questions of spatial summation, i.e., explore the validity of the classical summation laws of Kicco, Piper and others for perimetry. These experiences, I think, enabled me later to design an automated perimeter (Octopus system). It
I
contributions to ophthalmology. courtesv of Dr. Rudolf Witmer.)
was not always easy to live with Goldmann due to his practice of producing new ideas at high frequency. Practically every morning he arrived with a fascinating new idea and, at the same time, proposed an experimental approach to solve the problem. Before leaving at night, together with proposing new projects, he regularly asked me whether I had done what he had proposed in the morning. I never could find out whether he was kidding or whether he really thought that one could work at such high speed. His mental superiority, the feeling during discussions with him “to fall literally into pieces and to be crushed,” often had a destructive effect. As a result of these “private lessons,” one felt that the gradient of the learning curve for all possible fields of ophthalmology was extremely steep. Goldmann’s universality was overwhehning. In Fig. 3, I have tried to demonstrate a synopsis of his mental activities. By 1923 in Bern, he was intrigued by the pathogenesis of cataract in gen-
140
Surv Ophthalmol
37 (2) September-October
eral, but in particular by the cause of the glassblower cataract. Here he clashed with Alfred Vogt, chief of the University Eye Clinic in Zurich, who maintained that the glassblower cataract was the result of infrared energy being absorbed directly by the lens, while Goldmann thought that it was caused by heat transferred to the lens from infrared energy absorbed by the iris. A number of ingenious experiments appeared to confirm Goldmann’s concept, and his hypothesis was accepted at that time (1930). Only much later, in 1980, were Wolbarsht and others able to show that both mechanisms, claimed by Vogt and Goldmann, depending on the experimental conditions, could explain the pathogenesis of the glassblower cataract. When I joined Goldmann, he also had performed, together with Rudolf Witmer, basic research on immunological problems, in particular, uveitis. He also had carried out a kinetic analysis of ocular fluorometric experiments and had determined in 1950 for the first time the aqueous flow in human eyes, finding it of the order of 2.5 l.J/min-‘. This value was later confirmed by others. His experiments were simple and he performed his computations with the help of a slide rule. Looking back, it appears to me that the lack of computer assistance had definite advantages, because it forced the research worker to push his brain to the limits of its performance. Goldmann was among the first to study fluid dynamics in the eye and had localized the site of increased resistance to outflow at the inner wall of Schlemm’s canal. A number of important papers appeared in the late ’40s and the early ’50s. Among many others, two should be mentioned: Der Druck im Schlemm’schen Kanal bei normalen Druck und bei Glaucoma chronicum simplex and Zur Frage des S&es der Widerstandserhohung beim einfachen Glaukom (“The Pressure in Schlemm’s Canal in Eyes with Normal Pressure and in Open Angle Glaucoma,” and “The Site of Increased Outflow Resistance in Open Angle Glaucoma”). He had already presented in 1937 at the 15th International Congress of Ophthalmology in Cairo his mirror gonioscope which was afterwards used by him and others to study and classify the chamber angle. Many authors before him had developed instruments for gonioscopy, but Goldmann’s contact lens, due to its outstanding optical properties and its simplicity, proved to be the best and the most suitable for gonioscopy and goniophotography. He improved the slit-
1992
FANKHAUSER
lamp, originally invented by Gullstrand in 1912 in two essential steps in 1933 (Eine neue Spaltlampe) and in 1939 (“An Improved Slitlamp Apparatus”). He constructed both a practical and a high performance instrument. In 1940, he published a basic paper on slitlamp photography and photometry and fluorometry (Spaltlampenphotographie und photometric and Ein neues Spaltlampenfluorometer). At the annual meeting of the French Ophthalmological Society in 1954, he presented for the first time his newly invented applanation tonometer which he improved in 1955 and 1956 (Un nouveau tonombtre a applanation). After intense studies of the laws of Imbert and Fick, which were basic to the development of applanation tonometry, he arrived at the conclusion, ‘Bei Einhaltung eines Applanationsdurchmessers von 3.06 mm und kurzfristiger Messung heben sich die Krafte, hervorgerufen durch Verformung der Hornhaut als Membran mit endlicher Dicke sowie Eigenstetfigkeit, und die Kapillarkrafte, hervorgerufen durch die benetzende Fliissigkeit auf der Augenoberjlache, gerade auf. Der Einfluss der Rigiditat wird dabei vernachlassigbar Klein” (“With an applanation diameter of 3.06 mm and brief measurements, the forces produced by the deformation of the cornea as a membrane of definite thickness and rigidity and those produced by the capillary adhesion of the whetting fluid on the ocular surface will just neutralize each other. Ocular rigidity becomes negligible”). Biomicroscopy of the posterior segment of the eye had come a long way, starting with the earliest attempts by Gullstrand (191 l), Wolff (1912), Schieck (1912), Koeppe (1918), Meesmann (192 l), Gallemaerts and Kleefeld (1922), Lemoine and Valois (1923), Lopez Lacarrere (1925), Zamenhof (1930), Lindner (1936) et al. All these examination methods were demanding exercises which could only be carried out at a clinic. For instance, the large and heavy Koeppe lens was complicated in its application and unpleasant for the patient. Goldmann managed the essential breakthrough in biomicroscopy of the posterior segment in 1949, designing his famous three-mirror contact lens which has remained to this day the instrument for the biomicroscopist (Einige Ergebnisse der Spaltlampenuntersuchung des Kammerwinkels und des Augenhintergrundes). I could use this lens without changing it at all to feed the beam of a xenon arc lamp and a ruby laser into the eye, a work which was performed with the physicist Walter Lotmar in
REMEMBRANCE
OF HANS GOLDMANN,
1899-1991
1967 (Photocoagulation through the Goldmann Contact Glass). Goldmann presented his experiences and clinical results together with Busacca and Schiff-Wertheimer (Biomicroscopie du Corps Vitre et du Fond.s de l’oeil). Hans Goldmann was a visiting professor during one year after his retirement at the Department of Ophthalmology, School of Medicine, Washington University, St. Louis, Missouri, which was at that time chaired by Bernard Becker. There he had mainly three partners representing two different directions of thought. These were Jay M. Enoch, with whom he discussed the latest developments in psychophysics of the light sense, and Robert Moses and Bernard Becker, the leading authorities in glaucoma research at that time. I have offered a few remarks and observations about Goldmann’s research activity, which are in no way complete. How did he work? I saw him doing his experimental work in the outpatient department, usually at places where the crowd was most dense. Apparently this did not disturb him. Did it perhaps even stimulate him? For sure, one advantage of having at all times a sufficient number of patients at hand, was obvious, because it meant that “there were always anterior and posterior segments of the eye available.” Since I was most of the time quite close to him, I advanced to the honorable job of a chief guinea pig. A few times my cornea1 epithelium was abraded, but my retina did not object. I once collapsed following an intravenous injection of fluorescein given in a hurry, but woke up safely in the recovery station and felt perfectly well. Concluding from the aspect of his desk, Goldmann was disorganized, but, obviously when one has a memory comparable to a megacomputer one does not depend much on “external” order. Others, like myself, who have been less gifted by destiny have always been intrigued by the question of where people like Goldmann have derived their mental power and creative imagination. I assume that this depends to a large extent on hereditary factors; however, the influence of external factors may be just as important. I found that Goldmann could not be understood without knowing his background. He grew up in an environment which nurtured unrestrained critical and stubborn scientific inquisitiveness and skepticism. Probably Jesuitic reasoning and logic in high school, where he got an excellent classical education, contributed to sharpen his mental ap-
141 paratus. One may see here a direct relation to one of his basic principles - “that the meaning and validity of theoretical assumptions can be determined only if detailed consideration is given to verifiable consequences which such assumptions entail,” and he did not get tired of warning about their fallacious use in support of questionable doctrines. The scientific atmosphere in Prague must have influenced him deeply, and undoubtedly made him a logical positivist, driving him to work on fundamental problems in ophthalmology and related sciences. He knew the famous Philipp Frank personally and had read and understood one of his major works, Das Kausalgesetz und seine Glrnzen (1912). In the circle around Karl Popper and Moritz Schlick, Goldmann was exposed to fundamental questions, such as the nature, scope and validity of human knowledge, as well as to other questions asked by the philosophy of science and the theory of cognition. The achievement of Moritz Schlick, a scholar of Max Planck, culminated in the logical empirism which is considered to be one of the main trends in the philosophy of the 20th century. Karl Popper had developed his theory of falsification. In his analysis of procedures oriented toward the verification of hypotheses and theories in the natural sciences, he tried to show three conclusions. First, a radical claim of an empiristic verification would not only eliminate metaphysical theorems, but would also destroy the entire knowledge of the natural sciences, just because most axiomata of the natural sciences cannot be verified. Second, one could not even speak 01‘ an inductive confirmation of theories of the natural sciences and, also, the concept of the probability of a hypothesis provides no means for evaluating hypotheses, because no concept for the evaluation of the probability of a hypothesis, which makes sense, can be defined. Third, as a consequence of the above, Goldmann maintained that evaluation methods, applied to theories of the natural sciences, must do without the concepts of verification (German: ~‘r+ie&&eit) and also without the concept of induction and probabilit!, of hypotheses. Goldmann’s universality reminds me ofone of his favorite authors, Ernst Mach. Ernst Mach was also born in the Astro-Hungarian monarchy (at Chirlitz-Tura near Briinn, Moravia, now part of Czechoslovakia). Mach had spent 28 years as professor of experimental
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Surv Ophthalmol
37 (2) September-October
physics at the Charles University in Prague. Because of fundamental discoveries in physics, his interest shifted at an early period of his life to physiology and psychology of sensation. He also became one of the pioneers of the discipline of psychophysics, which was new at that time, particularly in the field of time sense and space perception. His studies on changes of kinesthetic sensation and equilibrium, associated with physical movement, acceleration, and change of orientation in the body have become classic. His name continues to live in the “Mach bands,” a phenomenon that relates the physiological effect of spatially distributed light stimuli to visual perception. (A Mach band is observed when a spatial distribution of light results in a sharp change in illumination at some poin A negative change corresponds in the to a band brig ter than its surroundings region of sharp change. A positive change corresponds to a band darker than its surroundings in the region of sharp change. This phenomenon, a physiological effect that has no physical basis, was the subject of a number of papers and of numerous investigations.) Some of Mach’s work in physics was devoted to the study of sound waves, wave propulsion, and gas dynamics of projectiles, meteorites, explosions and gas jets. In his celebrated publication on supersonics (published in the Sitzungsberichte of the Academy of Sciences in Vienna, 1887), he defined the angle which a shock wave surrounding the envelope of an advancing gas cone forms with the direction of its motion. This was shown to be related to the velocity of sound (v) and the velocity of the
1992
FANKHAUSER
projectile o as sina = u/o when o > IJ. Later the angle was called the Mach angle. It was recognized that the value of o/v (the ratio of the speed of an object to the speed of sound in the undisturbed medium in which the object is traveling, which came to be known as the “Mach number”) was becoming increasingly significant in aerodynamics for high-speed projectile studies and has gained considerable importance since WWII in theoretical and fluid dynamics. Goldmann’s universality comes close to Mach’s. When one reads Mach’s book, Erkenntnis and Irrtiimer, one is reminded on every second page of Goldmann. Goldmann will go into history as an inventive experimentalist, an acute and imaginative critic of scientific theory who was unusually sensitive to the importance of formulating problems in areas where medicine, physics, physiology and psychophysics interesect. Goldmann’s greatness lies in his incorruptible skepticism and independence. Part of Einstein’s obituary for Mach in 1916 would also apply well to Goldmann - “the unmediated pleasure of seeing and understanding, Spinoza’s amor dei intellectualis, was so strongly predominant in him that to a ripe old age he peered into the world with the inquisitive eyes of a carefree child taking delight in the understanding of relationships.” I am grateful to Dr. F.C. Blodi for his help in the preparation of this manuscript. Reprint address: Prof. Dr. Med. F. Fankhauser, UniversitSt Bern, Lindenhofspital, Bremgartenstr. 117, CH-3012 Bern, Switzerland.
