FRIEDRICH BEST

More Than Just The Macula

Gerald A. Fishman,
Marlene Fishman

UIC Eye Center at Chicago, 1855 W. Taylor Street, Chicago, Illinois, 60612

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For over 25 years I have examined and counseled patients diagnosed with Best macular dystrophy. Only recently did I realized I knew virtually nothing about the man who initially identified and described this hereditary disease more than 90 years ago.

I specifically wondered whether his professional accomplishments included original observations of any other ophthalmic diseases. I was curious whether any other of his contributions were clinical or entirely descriptive in nature or whether he had pursued any investigational or experimental projects. As I pondered these queries, I also became curious as to what I might learn about the man himself. What interested him outside of his professional work and what sort of a persona did he project? Was there really more to Friedrich Best than just the macula?

Fie was born on May 13, 1871 in Wermelskirchen and died June 6, 1965 in Bonn at age 94 years.

His early medical and ophthalmological education were at the clinic of

Theodor Leber who was professor of ophthalmology at the University of

Heidelberg from 1890 to 1910. While in Heidelberg, Best wrote his

doctoral thesis on the topic of the ectopias of the pupil. Subsequently he

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pursued his ophthalmologic education from 1894 to 1896 with a Dr. Bruckner at Darmstadt. He then embarked upon what would be a particularly productive part of his life from 1896 to 1905 when he was a fellow and senior doctor in Giessen with Adolf Vossius, who at that time was a Professor at the University of Giessen from 1890 to 1923. In 1900, while with Vossius, Best wrote his thesis for a professor's degree on nutritional disturbances in band keratopathy, it was also while he was with Vossius, in 1905, that he reported on a macular degeneration that was observed in 8 of 59 examined members of 1 family. Vossius, in 1921, among others, later reported on 14 additional affected persons from this family which would be described as having Best macular dystrophy. After completing his work with Vossius in Giessen, Best spent a half year with the physiologist Ewald Hering in Leipzig during 1905 to 1906. Best is said to have held a particular reverence for He/ring as well as a profound admiration for Theodor Leber.

In 1906, Best returned from Leipzig and opened an office as an ophthalmologist in Dresden. At that time he also became director of the ophthalmologic department of the local Friedrichstaedter Hospital. He practiced in Dresden until February, 1945 when he lost virtually all of his

personal as well as professional possessions during the war. He did not

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dwell on this misfortune but rather, at age 74, with the help of colleagues

and friends, he built up a new office practice at Niedersmarsberg in the Western part of Germany. He continued practicing until 90 years of age.

At that time he suffered a severe stroke and was unable to speak. Again, his determination conquered adversity as he overcame this affliction and regained his ability to speak.

After reviewing the titles of his numerous publications, I determined four primary areas of overall interest. These included: anatomy and pathology; genetics; neuro-ophthalmology; and psychophysics and physiology of vision. Under the category of anatomy and pathology, he had publications which addressed, among others, the topics of 1) microscopic preparation of diabetic eyes, 2) the risk of blindness after eye inflammation of the newborn, 3) visual performance of facet eyes, 4) filaria in subconjunctival tissue, and 5) a new type of glycogen stain, the so-called "Best's karmin" which was used to differentiate cones from rod receptor cells. In the category of genetics, he explored such issues as 1) heredity and ophthalmology, 2) correlation of hereditary problems of the eye and central nervous system, and 3) Best's macular dystrophy. He had numerous publications in the general area of neuro-ophthalmology which included, among others, 1) ophthalmoscopic findings in head trauma, 2)

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psychosomatic blindness, 3) hemianopic field loss, 4) visual pathway

injuries as a result of war trauma, 4) crossing of sensory and motor pathways and the theory of Cajal, 5) pupillary response in certain diseases and the topic of 6) can the visual nerve be electrically stimulated? In the area of psychophysics and the physiology of vision he addressed such topics as 1) the projection of stereoscopic photographs, 2) the relationship between close work and nearsightedness, 3) amblyopia, 4) dark-adaptation and night blindness (where he was the first to use a logarithmic scale in the measurement of dark-adaptation), 4) can one-eyed individuals drive a motor vehicle? 6) a stimulus projector for campimetry, and 7) a "slot-stick-machine" for the evaluation of depth perception. Other miscellaneous publications included the topics of 1) local anesthesia in ophthalmology, 2) how ultraviolet light can damage vision, 3) instrumentation for cataract surgery and 4) diathermy in ophthalmology.

His son, Werner Best, recounts that his father Friedrich enjoyed wandering in the mountains and forests, especially through brushwood. His father also had a great interest in philosophy and was very much interested in the

fundamental principles of natural science.

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Reviewing the professional contributions and personal attributes of Friedrich Best, it is not difficult to reconstruct the profile of a man who was creative, naturally inquisitive, productive, calm, gentle, and quite humble. Clearly

there was more to the man than just the macula. Much more!