M E E T I N G S , C O N F E R E N C E S , S Y M P O S I A

E D I T E D B Y T H O M ;

THE JULES G O N J N CENTENNIAL CELEBRATION

During the week of September 14-19, 1970, the Club Gonin, the Swiss Ophthalmo-logical Society, and the city of Lausanne joined together in celebrating the 100th anni-versary of the birth of Jules Gonin. About 300 members and 150 associates of the Club Gonin, members of the Swiss Ophthalmolog-ical Society, and certain of the University and public figures of Lausanne took various parts in the event.

The meeting place was the Ecole Poly-technique Fédéral (Fig. 1) of Lausanne (EPFL) . This is a handsome, modern, more or less circular building with a terrace over-looking Lac Léman and Mount Blanc. The appointments, including a bar and restaurant, were adequate and comfortable.

Opposite the entrance, a Gonin exhibit was displayed. The Master's instruments, in-cluding the famous "Paquelin" cautery, early and late photographs, Gonin's original sketches and drawings of retinal holes, some case records, reprints, a copy of his book, telegrams from all over the world seeking appointments and so on, were of fascinating interest.

The organizing committee composed of Streiff (Chairman), Dufour (Secretary), Cuendet (Treasurer) and Rempf had every-thing perfectly under control and the regis-tration apparatus functioned efficiently.

A dozen or so scientific exhibits were the usual centers of interest. Almost all of them were by Swiss firms whose names are well known to eye surgeons everywhere.

The afternoon of September 14 was de-voted to registration and orientation. That evening a get-together reception in the EPFL was held. This was a cheerful re-union of "retinophiles," their wives, com-panions, and families from many countries.

The scientific sessions of the Club Gonin

C H A L K L E Y , M.D.

began at 8:30 the next morning (Sept. 15). The theme of the first session was "New Progress in Retinal Surgery and Photoco-agulation." The subject, comprising 23 pa-pers, included replacement of the vitreous, detachment of the posterior vitreous, idio-pathic retinal detachment, giant retinal holes and their treatment, cyrosurgery, lasers, di-agnostic contact lenses, various implants, ad-vances in instrumentation, vitrectomy, and a number of ingenious and novel experimental studies.

After a quick lunch, the session was re-sumed. The members and guests then de-parted by bus to Gruyères to visit the inter-esting castle ( 10th-16th century), later to dine in various colorful restaurants in this pic-turesque village. Delectable Swiss dishes such as cheese fondue, excellent local wines, and the music of Swiss bands and choirs, were wonderfully enjoyed. The long bus ride home in a fog (externally and internally) over narrow and winding mountain roads gave added adventure, sometimes enlivened by off-key singing.

Early the next morning, the second ses-sion, with its general theme "Secondary Non-Traumatic Detachments with the Ex-ception of Tumours and Congenital Abnor-malities" began. Eales' and Coats' diseases, retrolental fibroplasia, vascular and blood diseases, and fluorescein angiography were the main topics discussed in 27 papers.

It was a long day, but the program ran on schedule. The meeting concluded just in time to allow the participants to leave the pier at Ouchy by boat for the castle of Chillón for a wine and cheese party in the centuries-old halls, graciously offered by the Council of State of the Canton of Vaud and the Munic-ipality of Lausanne. It was a delightful and romantic excursion.

The next morning (Sept. 17) was given over to the memorial day celebration of the

1

1144 AMERICAN JOURNAL OF OPHTHALMOLOGY MAY, 1971

Gonin Centenary. It was a heart-warming and moving affair. The ceremonies began promptly at 8:15 A.M. at the Esplanade de Montbenon, in front of the handsome Palace of Justice and directly at the foot of the fa-mous statue of Wilhelm Tell.

It was a lovely, warm and sunny morning, enhancing the bright colors of the flags of Switzerland and some of its Cantons lining the promenade, and of the formal flower beds against a marvelous backdrop of lake and mountains. A goodly number of partici-pants were present in spite of the early hour. The green-covered podium facing the lake was first occupied by His Honor, the Mayor or Syndic of Lausanne, M. Chevallaz (Fig. 2 ) . He was flanked by two officials, garbed in red and white medieval cloaks and wear-ing black shovel Swiss hats. The mayor gave a gracious address of welcome to the delegates and guests (Fig. 3) and a proud tribute to Jules Gonin, the citizen. Prof. Jules Fran-çois, wearing the badge of the President of the International Council of Ophthalmology, was the next speaker. He expressed the thanks of all of us and eulogized Gonin, the scientist. The president of the organizing committee, Prof. E. B. Streiff, next wel-comed those present and spoke on Gonin, the teacher and compassionate physician. The last speaker was Gonin's son, Edouard (Fig. 4 ) . In affectionate and filial words, he told amusing anecdotes of a rather simple, mod-est, and gentle father, who was dearly loved by his family.

When the speeches were over, the party -moved a few yards west of the Esplanade for the unveiling of the bronze tablet honor-ing Jules Gonin and the naming of an impor-tant tree-lined avenue running east and west in front of the Palace of Justice; formerly called Avenue Montbenon, the avenue was now named Avenue Jules Gonin (Fig. 5 ) . The Asile des Aveugles (Asylum for the Blind), to which Gonin was so devoted that he left a legacy from his modest estate for support of its work, is appropriately in the general area and not too far away.

The unveiling of the Stele was performed by Gonin's grandson, Olivier Gonin, a sturdy, handsome lad (Fig. 6 ) . The inscrip-tion (Fig. 7 ) , translated, reads: "Following patient research on detachment of the retina, a disease that was incurable up to then, he discovered the secret of its cure by an opera-tion, the principle of which is universally recognized, curing numerous patients and instructing surgeons come from all over the world. He is recognized today as the initiator of retinal surgery."

Let us digress for a moment to discuss a nicely illustrated pamphlet of 42 pages put out by the Asile des Aveugles and distrib-uted to the registrants. The first part is con-cerned with "The Life, the Career and the Discovery of Jules Gonin, 1870-1935," de-lightfully written by a devoted disciple, Dr. Jean Rumpf. Here, we learn that Jules Go-nin (Fig. 8 ) , a fine, wholesome, disciplined, and idealistic youth of modest and upright parentage, was brought up by Protestant pastors, grandfather and father, and became, in time, the assistant of Marc Dufour, the Professor of Ophthalmology of the Univer-sity of Lausanne. In 1902, Dufour was asked to prepare the chapter on diseases of the retina for publication in the French En-cyclopedia of Ophthalmology (it appeared in 1904). He asked Gonin to help in its prepa-ration, especially to review the literature. At the 10th International Congress of Ophthal-mology (Lucerne, 1904), of which he was president, Dufour, in the course of his inau-gural address, cried, "Do you believe, gentle-men, that there will never be a direct means to replace the detached retina ? No ! No ! gen-tlemen, I do not believe it. I have faith in science, and I bless in advance those among us, or our successors, who will bring to a fu-ture Congress, good and divine news, similar to that which the Congress of Brussels (1857) learned, through the lips of Albrecht von Graefe, the nature and the cure of glau-coma."

How astonishing it is that Dufour's prophecy was fulfilled only 25 years later

Fig. 1 (Vail). The meeting place (EPFL). Fig. 2 (Vail). Esplanade de Montbenon, Mayor Chevallaz speaking.

Fig. 3 (Vail). Some of the audience at the dedication. Fig. 4 (Vail). Eduoard Gonin speaking.

Fig. 5 (Vail). Jules Gonin's street sign. Fig. 6 (Vail). Grandson Oliver Gonin unveiling Stele.

Fig. 11 (Vail). Centennial audience entering medical school for refreshments.

VOL. 71, NO. 5 MEETINGS, CONFERENCES. SYMPOSIA 1147

Fig. 7 (Vail). The inscription on the Stele.

when Jules Gonin, his own beloved pupil, stood before the members of the 13th Inter-national Congress at Amsterdam and quietly introduced to a world audience, his new op-eration for the cure of retinal detachment by closure of the retinal tear.

His paper was followed by a report from Arruga confirming that this disease for the first time had been amenable to surgical con-trol. Up to that moment, Gonin's work had been received with scepticism and disbelief, almost scorn, by most of the surgeons. All of us now know the almost unbelievable and continuous story of complete victory over the malady.

Beginning in 1902, Gonin studied and brooded over three main problems : He was concerned with the nature, pathogenesis, and the cure of the disease (1920). Between 1919 and 1929, he had published 15 papers, most of which met with widespread indiffer-ence. His cry "Seek the tears, find them, close them !" was largely ignored.

All of this was changed after Amsterdam.

From then on his life, too, was abruptly changed. Patients and surgeons from all over the world made pilgrimages to Lau-sanne. I, too, joined the throng. In July, 1930, I spent two dramatic weeks at the side of the Master who was kind, courteous, and patient to a very young and rather brash young man. After 40 years, I can still hear him say, during the torrent of surgery, to a stream of visiting surgeons, "la distance, la direction," repeatedly checking and recheck-ing these vital guides to success. Inspired by this good man, his artistry with the ophthal-moscope, his honesty, and his genius, I per-formed my first "pure" Gonin procedure on a young and highly myopic school teacher, who, every year until her recent death, has sent me a card of gratitude at Christmas for the gift of her sight.

Dr. Rumpf had much to say about the cheerful, human side of Gonin: his fondness for collecting and studying butterflies, for mountain climbing in his youth, and for travel (once, for a short time, he was ar-

1148 AMERICAN JOURNAL OF OPHTHALMOLOGY MAY, 1971

Fig. 8 (Vail). Jules Gonin about 1929.

rested as a spy while prowling around the ruins of the Acropolis of Corinth in Greece). He was interested in the study of history, especially that of his own country of which he was fiercely proud, and of litera-ture. A delightful teen-age photograph of him and his family was shown by Rumpf. It shows him with a guitar ! He was fond of in-nocent practical jokes. For example, in 1909, at the Congress in Naples, he and some of his colleagues became exceedingly bored with Rémy and his diploscope, which he in-

sisted on showing at every opportunity. Go-nin constructed a primitive diploscope and bribed workmen excavating at Pompeii, to bury this apparatus in the ruins. The next day, when members of the Congress were making an excursion of the ruins, the work-men dug up the "old" diploscope in front of the visitors. It was a good joke on Rémy.

In 1934, his masterpiece, "Le Décollement de la Rétine, Pathogenisis-Treatment," was published by Payor et Cie. of Lausanne. It was dedicated to "My faithful collaborator, Dr. Othmar Dufour, in memory of his father, Professor Marc Dufour (1843-1910)." This volume, an ophthalmic classic, consists of 279 pages, richly illustrated, sometimes by himself, and also contains 33 colored plates, many of which were executed by his devoted disciple, Mile. Dr. H. Dubois; a generous number of his own illustrations (crayon tech-nique) were signed with the initials J.G. A few others were borrowed from the literature, which by then was exploding.

In my own cherished copy, which he auto-graphed (Fig. 9 ) , he wrote joyfully, "Post pessimismum spes nova !"

Jules Gonin died of a cerebral vascular ac-cident on June 10, 1935, at the moment when the funeral of his 87-year-old mother was taking place. A copy of his death notice is-sued at that time should be of interest (Fig. 10).

On the occasion of his Gonin award, Duke-Elder said, "It is unique that the same man :

Should have heard in his youth the proph-etic benediction of a teacher addressed to those who would discover how to cure a cer-tain serious disease.

Fig. 9 (Vail). Autograph of Jules Gonin.

Monsieur et Madame EDOUARD GONIN-GAULIS et leur fils OLIVIER ; Mademoiselle GABRIELLE GONIN ; Monsieur RENÉ

GONIN et sa fiancée ;

Madame et Monsieur GEORGES-A. BRIDEL-GONIN, leurs enfants et petits-enfants ;

Madame PAUL SUBLET, ses enfants et petits-enfants ;

Les enfants et petits-enfants de feu Monsieur le D r et Madame EUGÈNE ROUD ;

Les familles GONIN, MONASTIER, RUMPF, GALLIARD, TROG, LIPS, MARTENS, PEREY, BRIDEL, ROUD et PERREGAUX,

Ont la douleur de vous faire part de la grande perte qu'ils viennent de faire en la personne du

Professeur Dr JULES G O N I N

Médecin en chef de l'Asile des Aveugles, à Lausanne Professeur d'ophtalmologie à l'Université de Lausanne

leur cher père, grand-père, frère, oncle et parent, enlevé à leur affection dans sa 65 e année, après quelques jours de maladie, le 10 juin 1935.

Jésus dit : « Je suis la lumière du monde; celui qui me suit ne marchera pas dans les ténèbres, mais il aura la lumière de la vie ».

Jean 8 : 12.

Culte à la Chapelle des Terreaux, jeudi 13 juin, à 10 heures.

Honneurs à 11 heures.

Richemont, Lausanne.

m w i i w » » « u n i t . • . • u u t w M

Fig. 10 (Vail). Jules Gonin's death notice.

u s o AMERICAN JOURNAL OF OPHTHALMOLOGY MAY, 1971

Should search patiently during long years to attain this end.

Should discover little by little the process that is the origin of this disease.

Should invent the surgical procedure that cures this affection.

Should succeed in his purpose in an ever increasing number of cases.

Should struggle endlessly to convince his confreres of the efficacy of his operation.

Should tie together, before disappearing, the sheaf of his works and of his experi-ences, into a masterly monograph."

The second part of the pamphlet, written by Professor Streiff, contains a short history of the establishment of the Gonin Medal, and a list of the past medalists.

The third part consists of an essay by Professor René Dufour on the "Develop-ment of Retinal Surgery since Gonin."

Then comes a charming essay written by Dr. Noëlle Chômé, one of Gonin's first "interns," whom he called his "ophthalmic daughter." She wrote in the form of a letter to "Mon Maître Gonin," with the title of "Jules Gonin. Who is he?" The essay con-sists of her affectionate recollections of her close association with Gonin which began in 1928 and continued for many years, before and after his triumph. These memoirs make delightful reading.

I hope that the entire pamphlet of the Asile des Aveugles will be published in our literature in an English translation, so that those who cannot read French, can enjoy its delicious flavor.

Let us now return to the celebration itself. After the unveiling of the Stele, the mem-bers of the audience were transported to the Aula de Rumine, a handsome university building in the Place de la Riponue. Here, in the impressive auditorium, the rector of the university, Dominique Rivier, a graduate of Princeton University, greeted the large audi-ence and expressed his pleasure over the co-incidence of the Centennary of Gonin and the required official reception and recogni-tion of the current medalist. He recalled that

it is this medal, instituted in 1937 by the University of Lausanne and the Swiss Soci-ety of Ophthalmology in memory of the de-parted, that has as its first purpose the stim-ulation of research and progress in ophthal-mology, and as its second, an award to an ophthalmologist of international repute. The choosing of the medalist is the function of the International Council of Ophthalmology, which awards the medal at an official con-gress. After this is done, it has become gra-cious custom for the University and the So-ciety to solemnly receive the medalist at Lau-sanne and to present the official diploma with a copy of the Act of Foundation.

Then Prof. Jean Charamis, past president of the international council, gave a short his-tory of the medalists, describing their contri-butions. He recalled the names of these preeminent ophthalmologists: Vogt of Zu-rich (1941), Baillart of Paris (1945), Ar-ruga of Barcelona (1950), Duke-Elder of London (1954), Woods of Baltimore (1958), Goldmann of Berne (1962), Fran-çois of Ghent (1966), and now Meyer-Schwickerath of Essen, whom he called "the Benjamin of the lot."

Prof. Charamis was followed by Prof. E. B. Streiff, who introduced the 1970 Medalist and described at length the achievements of Meyer-Schwickerath and his light coagula-tor. By his ingenious and dogged work, he had carried the treatment of retinal detach-ment to glorious heights of success, and has provided us with a remarkable tool with which to treat other diseases of the eye.

Prof. Meyer-Schwickerath, President of the Club Gonin, modestly and graciously thanked the university and the society for this great honor. He was then presented with a bouquet of red roses by a très jolie jeune fille. It was all very festive.

Following the ceremony, the members of the audience were taken by bus to the medi-cal school (Fig. 11) where an elaborate col-lation of fine food and wine was served in the capacious reception hall, banked in flow-ers.

VOL. 71, NO. 5 MEETINGS, CONFERENCES, SYMPOSIA 1151

The afternoon was free and the delegates and their families went sightseeing, climbed mountains, listened to cow bells and yodelers, gambled at Evian across the lake, sat around in pretty outdoor cafes, talking shop and messing up tablecloths with pencilled designs of eye things, took boat rides, went to Ge-neva, enjoyed private dinner parties with generous hosts who know their foods and wines so well, etc, etc, until late in the eve-ning.

Then early as usual the next morning, the third scientific session, under the auspices of the Swiss Ophthalmological Society, got un-der way. The official subject was "Traumatic Retinal Detachment." The program was di-vided into three parts (I suppose since we were in Gaul). Part 1 introduced the sub-jects of anatomy, pathogenesis, and medi-colegal problems. It was chaired by Witmer (Zurich). Part 2, chaired by Gailloud (Lau-sanne), consisted of "Clinical Findings in Traumatic Retinal Detachments." Part 3, "Surgery and Conclusions," was chaired by Kloti (Zurich).

Twenty-one papers, given by various au-thors from many places, supplemented the three parts and occupied the entire day.

The evening, in the conference hall, was given over to an informal and pleasant din-ner and entertainment with music and a show by a humourous mimic, René Quellet. It was all very gay and refreshing to the weary scientists (most of them remarkably young looking from where I sit) and their pretty wives and companions.

The fourth and final session, strange to note, began promptly on time the next morn-ing. The official subject was the "Local Sur-gical Treatment of Diabetic Retinopathy." The first report, "Clinical Study and Surgi-cal Indications," was given by Ricci of Ge-neva; the second report, "Results of Treat-ment of Diabetic Retinopathy by the Argon Ion Laser and the High Pressure Xenon Lamp," was presented by Fankhauser, Gloor, Lotmar, and Roulier, all of Berne. The third report, "The Treatment of Diabe-

tic Retinopathy by Photocoagulation: Indi-cations and Results," was presented by A. Leuenberger (Basel).

Then followed one of the most significant reports, in my opinion, of the entire pro-gram: "The Experimental Diabetes of the Rat," by Babel, P. Leuenberger, Cameron, and Renold, all of Geneva. The authors ex-hibited the first results of a long-range study of the induction of diabetes in the Wistar rat by the use of streptozotozine. They were successful in the production of cataracts, ru-beosis irides, formation of microaneurisms, diminution of endothelial cells and pericytes in the retina, and the hyalinization and for-mation of collagen fibers in the basal mem-brane of the retinal capillaries of the experi-mental animals. This well-documented report opens up a new horizon.

Fifteen other good papers followed and the entire day, with a lunch break, was well rewarding. One left this particular session with a feeling of great optimism over the fu-ture of the local treatment of diabetic reti-nopathy.

These four scientific sessions were of a high caliber. The excellent presentations of the 90 papers, the showing of slides and specimens, and the discussions from the floor, were outstanding.

The auditorium was spacious and the seats comfortable, the various chairmen efficient, the projections nearly perfect, the simultane-ous translations adequate, and the speakers —well, I have never attended a meeting where the speakers, with few exceptions, had their material so well organized, to the point, and on schedule. Most of the material that was presented was fresh, exciting, and perti-nant. It was a great meeting and superbly or-ganized.

No doubt the transactions of this com-bined meeting will appear, and I would hope soon. These are generally published by S. Karger of Basel and New York.

That evening, most of the participants, at least those with sufficient energy, appeared at the farewell banquet in the Lausanne

1152 AMERICAN JOURNAL OF OPHTHALMOLOGY MAY, 1971

Palace Hotel. Its hosts were the members of the Swiss Ophthalmology Society and their president, Prof. Alfred Huber of Zurich. It was a Lucullan feast and the delicious wines were Swiss. A good band played lively music and the after-dinner speeches were but two, by Prof. Huber and pretty Noëlle Chômé, Gonin's "fille ophthalmologique," after which the old folks faded away, the tables were cleared, and the tireless Fils de Gonin truly relaxed from a most fruitful week.

Derrick Vail

NEW YORK SOCIETY FOR CLINICAL OPHTHALMOLOGY

At the 264th regular meeting of the New York Society for Clinical Ophthalmology, held on February 1, 1971, R. M. Ellsworth moderated a panel discussion on malignant melanomas of the eye. F. D. Kitchen spoke on the biological aspects of melanoma in var-ious species. I. S. Jones spoke on melanomas of the eyelids and conjunctiva, while W. C. Cooper discussed anterior segment melano-mas and excision of portions of the iris and ciliary body. A. W. Forrest spoke on the pa-thology of ocular melanomas. R. M. Ells-worth discussed the diagnosis and treatment of choroidal melanomas, and G. M. Howard discussed errors in the diagnosis of malig-nant melanomas.

On Monday, January 18, 1971, a com-bined meeting of the New York Academy of Medicine Section of Ophthalmology, and the New York Society for Clinical Ophthalmol-ogy was held. There was a panel discussion on laser and photocoagulation of macular le-sions moderated by G. N. Wise. C. Campbell spoke on laser treatments of central serous retinopathy, presumed histoplasmosis, senile disciform macular degeneration, and preret-

inal macular fibrosis (macular pucker). F. Campbell spoke on the use of photocoagula-tion of macular lesions associated with reti-nal telangiectasis. G. Gombos discussed the differential diagnosis and treatment of macu-lar holes, and I. Okamura discussed the treatment of serous macular detachments as-sociated with congenital holes in the optic disk and a racemous retinal aneurysm in-volving the macula.

At the 262nd regular meeting of the New York Society for Clinical Ophthalmology, held on December 7, 1970, A. Spector spoke on aging of the lens. The central region of the lens does not appear to synthesize new protein or to replace existing protein ; there-fore, the protein of this region ages as the lens grows older. Alpha crystallin, one of the major structural proteins of the lens, in-creases in molecular weight as the lens ages. This aging of alpha crystallin may be in-volved in some type of senile cataract.

A. G. DeVoe delivered the 24th annual Mark J. Schoenberg memorial lecture on ep-ithelium invasion of the anterior chamber. Although a downgrowth is an uncommon complication of cataract surgery, it should be suspected if the eye remains red, irritated, and with an irregular pupil. It is extremely helpful to sketch the suspicious area to deter-mine whether or not the lesion is progres-sive. The differential diagnosis includes a corneal incision, stripping of Descemet's membrane and vitreous adhesion to the supe-rior portion of the cornea. Early diagnosis is important, but treatment should not be un-dertaken without histologic confirmation. Mechanical removal of the downgrowth with the dissecting microscope is favored by the speaker.

Ralph Z. Levene