MOMENTS IN SURGICAL HISTORY

Ophthalmologic Surgery
Its Early American Roots

PHTHALMOLOGY enjoys the longest history of all surgical specialties in the United States, although prior to the mid 19th century, there were, strictly speaking, no true American ophthalmologists. Scattered throughout the country, however, were physicians who devoted an unusually large part of their practice to diseases of the eye. Yet, the very fact that in 1805, the Medical and Chirurgical Faculty of Maryland adopted a resolution calling for the granting of special licenses to dentists and oculists to practice in their respective branches, subjecting them to an examination only on the branches they possess suggest that during this era oculists represented an already recognized branch of medicine. It is uncertain whether these pioneer oculists became such by their own choice or through public pressure. However, in 1823, George Frick (1793-1870) authored the countrys first textbook on ophthalmology, A Treatise on the Diseases of the Eye. He is also believed to have been the first American physician to have generally restricted his practice to diseases of the eye. Despite the lack of a solid cadre of specialists in ophthalmology, by the 1850s a creditable number of special institutions for the treatment of diseases of the eye had been established. The New York Eye Infirmary, New York City, came into existence in 1820 through the efforts of Edward Delafield (1794-1875) and John Kearny Rodgers (1793-1851). The next year George McClellan (17961847) of Philadelphia, Pa, established the Institution for the Diseases of the Eye and Ear. It was soon rivaled by the Pennsylvania Infirmary for Diseases of the Eye and Ear, Philadelphia (1822), which remained in existence until the founding in 1830 of the Wills Eye Hospital, Philadelphia. The Massachusetts Charitable Eye and Ear Infirmary, Boston, founded in 1824, had its beginnings through the enterprising work of John Jeffries (17961876) and Edward Reynolds (1793-1881). In 1863, members of the American Medical Association decided to recognize ophthalmology as an area of special expertise and included it in their Section on Surgery and anatomy. A decade and a half later, a formal Section of Ophthalmology, Otology, and Laryngology was organized. By 1888, ophthalmology was set apart from the other surgical disciplines and received its own section. In 1864, the American Ophtahlmological Society was conceived and organized through the collaborative efforts of Henry D. Noyes (1832-1900) of New York City and Hasket Derby (1835-1914) of Boston. This was a momentous decision, for no specialty surgical society existed in the United States before the Civil War, and only one, the Deutsche Ophthalmologische Gesellschaft (1857), preceded it in Europe. Beginning in 1865, papers read at the scientific sessions

Because of its poor arrangement and lack of conciseness, John Mason Gibsons Condensation of Matter Upon the Anatomy, Surgical Operations and Treatment of Diseases of the Eye (1832) had little effect on the overall direction of American ophthalmology. Still, it remains the countrys first fully illustrated ophthalmological textbook, and its hand-colored plates provide it with a striking appearance.

of the American Ophthalmological Society were informally published in its Transactions, and this process was formalized in 1874, when that years Transactions was assigned the title of volume 1. In 1869, the countrys first long-lived ophthalmologic periodical not associated with an official organization, Jakob H. Knapps (1832-1911) Archives of Ophthalmology and Otology, was published. Elkanah Williams (1822-1888) is given credit for being the first American to hold the title of professor of ophthalmology, receiving such an appointment from the Miami Medical College, Miami, Ohio, in 1860. But, it was Henry W. Williams (1821-1895) who taught the first organized clinical course in ophthalmology, at Harvard University, Cambridge, Mass, in 1850. The Williamses were not related, and Henry went on to become the foremost American ophthalmologist of his day and, in 1871, the first professor of ophthalmology at Harvard Medical School. Ira M. Rutkow, MD, MPH, DrPH
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