Some Flowers in Ophthalmology

SPECIAL ARTICLE Some Flowers in Ophthalmology

Harry H. Mark, MD, FACS

wo men in the annals of ophthalmology are probably better known to gardeners than to ophthalmologists, namely, Leonard Fuchs (1501-1566) and Johann Gottfried Zinn (1727-1759), whose names were given to flowers. Their interest in flowers and plants arose from the fact that botany used to be an integral part of the basic curriculum of Tmedicine, next to anatomy and physiology, given that almost the entire pharmacopeia consisted of plants and their extracts.

Before Fuchs and Zinn, one part of the eye, obtained his Master of Arts degrees in phi- the iris, had already shared its name with a lology (Greek, Latin, and Hebrew; 1521) flower. In Greek mythology, Iris was the and philosophy (1521), and a medical de- name of a beautiful messenger between the gree (1524; DrMed) at the University of Olympian gods and human beings, one Ingolstadt.2 He later moved to Munich. He who, according to legend, descended to is best known as one of the founders of earth on the rainbow. In other legends, she botany, with his publication in 1542 of the wore a multicolored garment. In any case, monumental De historia stirpium,orHis- her name is ascribed to the many colors of tory of Plants,3,4 which contains the names the rainbow. In the eye, the color of the tis- (in alphabetical order) of more than 500 sue around the pupil usually varies from per- wild and domesticated plants, along with son to person, and was reportedly first their detailed descriptions, color pic- named “Iris” by Rufus of Ephesus (approxi- tures, and medicinal uses. He became fa- mately AD 98-117).1 The German name is mous for his drive to abandon the Arabic “Regenbogenhaut,” or “rainbow coat.” style of medicine, as taught for instance In the plant world, the iris (Figure 1) in the school of Salerno, Italy, and to re- is a genus of between 200 and 300 flow- turn to classical Greek sources.5 He was a ering species with a wide, showy variety Professor of Medicine at the University of of colors. The genus is distributed world- Tubingen for 31 years. wide in northern temperate zones and has Leonard Fuchs was no relation to Ernst been known since the earliest times. The Fuchs (1851-1930) of Vienna, Austria, fleur-de-lis, a stylized design of an iris, has whose name is attached to corneal dys- been often used as a symbol on flags and trophy and heterochromic iritis, the reti- coats of arms. Extracts from the rhi- nal black spot of myopia. zomes of the German iris were once used The published contributions to oph- as ingredients in medicines and are used thalmology often attributed to Fuchs con- today in perfumes and some brands of gin, sisted mainly of 1 large table that listed all such as Bombay Sapphire. The dried rhi- the diseases of the eyes then known (64 zomes were once given to babies to help altogether) and 2 booklets. (However, it quell teething pain, despite the fact that is now known that he did not write these some species can be toxic. himself). The table, said to be the first that Leonard Fuchs (Figure 2) was born was specially dedicated to diseases of the in Wemding, Bavaria, to a well-to-do fam- eye, was published in 15386 and contains ily, but lost his father at age 5 years. He the Greek name of each known disease with its brief description in the custom- Author Affiliation: Dr Mark is in private practice in New Haven, Connecticut. ary Latin, together with references to the

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©2009 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/23/2021 Figure 3. Fuchsia magellanica, named for Fuchs. By contrast, the name of Zinn is preserved in several ocular structures: 1) the anulus of Zinn, the tendinous ligament around the optic nerve, at which area the extra- Figure 2. Portrait of Leonard Fuchs. ocular muscles begin; 2) the Zinn zonule of fibers between the lens looking at green objects such as and orbiculus ciliaris; 3) the Zinn- grass or emeralds to prevent eye Haller vascular circle around the Figure 1. The iris as pictured in De historia stirpium by Leonard Fuchs (1542). problems. intraocular portion of the optic The title of the other booklet12 nerve; 4) the Zinn membrane, literature, mostly to Celsus and Avi- published in 1539 may be translated which is the anterior layer of the cenna. The table was an addition to as All the diseases of the eyes, as- iris; and 5) the Zinn (central reti- the 5 medical posters he had pub- sembled by the highly learned Leon- nal) artery. All these parts were lished in 1537 as guides for his hart Fuchs of Onoltzbach [Ansbach], described in great detail, with infor- students. most needed to be known by all eye doc- mation often obtained via micro- The first booklet, of approxi- tors. It is basically derived from the scope, in his landmark ocular mately 24 pages, was reportedly table attributed to Fuchs and con- anatomy book1 which appeared in published in 1538, with another sists of 32 pages, preceded by a re- 2 identical editions in 1755 and edition in 1539. It was believed to production of an old anatomical 1780. Considered the first complete be the first ophthalmology text cross-section diagram of the eye that work in world literature on the written in the vernacular.7,8 The differs from the one published in the subject, its illustrations marked a title may be translated as A new previous booklet. The book details the new level of sophistication in the highly useful booklet, and anatomy anatomy of the eye and symptoms of graphic representation of the globe of an open eye and its description, its diseases in a similar fashion to and orbit, similar to the benchmark how to make and use valuable pur- those in the table, which had been set by the botanical illustrations in gation, plaster, collyria, salves, pow- published the previous year. It ends the “great herbal,” or comprehen- ders, and waters. No author was with prescriptions promoted by the sive book about plants with refer- given. It is sometimes attributed to publisher and author, Heinrich ence to their medicinal properties, Fuchs, perhaps because another, Vogtherr, and his brothers. by Fuchs. The book by Zinn is similar booklet listed him as the The fuchsia plant (Figure 3), exemplary in its orderly exposition author.9 However, communica- whose name is pronounced “fyew of chapters and subchapters, plain tions in print and in correspon- shuh” in English, was named in language, and exhaustive references dence by legitimate medical and honor of Leonard Fuchs by Charles to the literature. scientific men at that time were Plumier, who discovered the plant Johann Gottfried Zinn always in Latin, so historians gen- in 1695 in the Dominican Republic (Figure 4) was born in the small erally deny these attributions.10,11 and published it in his catalog of village of Schwabach, a few miles The text follows standard Greek 1703.13 The genus Fuchsia has more south of Nuremberg, Bavaria, to teachings as to the humoral causes than 100 species that are cultivated prosperous parents. His father was of disease and the emission theory for their decorative appeal; there are counselor of the regional royal trea- of vision. In its acceptance of the many national and local societies sury in Ansbach, the town where idea by Aristotle that the color throughout the world dedicated to Zinn went to high school and green was most salutary because it its cultivation and hybridization. It where Leonard Fuchs had been was in the middle of the linear has no known medicinal value. The active almost 200 years earlier.14 sequence of colors between black name of the magenta dye “fuchsin” Zinn attended medical school at the and white, the book recommended is also derived from “Fuchs.” newly founded University of Got-

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©2009 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/23/2021 Financial Disclosure: None re- ported. Additional Information: The fig- ures are in the public domain and are available at http://images.google .com/imghp?hl=en&tab=wi. Additional Contributions: Special thanks to Stephen J. Greenberg, MSLS, PhD, National Library of Medicine, for his assistance.

REFERENCES

Figure 5. A bouquet of zinnias, named for Zinn. 1. Zinn JG. Descriptio anatomica oculi humani iconi- bus illustrata nunc altera vice edita, et necessa- Zinn, who had first described them rio supplemento, novis que tabulis aucta. Vol. 2. in detail and had died shortly there- Gottingen, Bavaria: Abrami Vanderhoeck; 1755: after at the age of 31 years, appar- 69. ently of tuberculosis. 2. Newmann F. Leonhard Fuchs, physician and botanist, 1501-1566. In: Annual report Smithsonian The Zinnia, which is a member of Institution. Washington, DC: 1917:129(1):635- the daisy family, is a genus of 20 spe- Figure 4. Johann Gottfried Zinn. 647. cies of annual and perennial plants 3. Fuchs L. De historia stirpium. Basel, Switzer- with flowers that come in a variety land: Isingrin; 1542. tingen, where he was the favorite of bright colors (Figure 5). When 4. Meyer FG, Trueblood EWE, Heller JL. The Great Herbal of Leonhart Fuchs. Stanford, CA: Stan- student of Albrecht von Haller the Spanish first saw the zinnia ford University Press; 1999. (1708-1777), the famous professor flower in Mexico, they called it “mal 5. Stübler E. Leonhart Fuchs, Leben und Werk. of anatomy, physiology, and de ojos,” which means “sickness of Münchener Beiträge zur Geschichte und Liter- botany. After graduation, Zinn the eyes” or “hard on the eyes,” atur der Naturwissenschaften und Medizin. Mu- nich, Bavaria: Verlag der Münchener Drucke. 1928; moved to Berlin, where the large probably owing to its bright colors. 13/14(7):211-223. anatomical institute afforded a bet- The zinnia is a popular garden flower 6. Fuchs L. Tabula oculorum morbos comprehen- ter opportunity for the dissections usually grown from seed. It seems dens, 1538. Palo Alto, CA: (Privately printed fac- that formed the foundation for his especially favored by butterflies; simile); 1949. book. In 1754 he returned to Got- many gardeners cultivate zinnias 7. Anonymous. Eyn newes hochnutzlichs Büchlin. Strassburg, Germany: Heinrich Vogtherr; 1539. tingen University to assume the specifically to attract butterflies. 8. Blanchard DL. Vogtherr’s Büchlin. Doc Ophthalmol. Chair of Medicine. However, the Fuchs and Zinn studied plants and 1997;93(1-2):73-79. department of anatomy was flowers for medicinal purposes; to- 9. Albert DM, Norton EWD, Hurtes R. Source Book assigned to another professor, day, we derive aesthetic pleasure from of Ophthalmology. Vol. 1. Cambridge, MA: Black- well Science; 1995;113-114. which deprived Zinn of further the sight and smell of them. Simi- 10. Hirschberg J. Geschichte der Augenheilkunde. In: studies in this area and led him to larly, we enjoy looking at the most Graefe-Saemisch Handbuch. Leipzig, Germany: W. turn his energies toward botany. He beautiful part of the human body—a Engelman; 1908;13(1):316-317. carried on an active correspon- healthy eye and its adnexa. 11. Sudhoff K. Des Leonhart Fuchs, professor in Tübin- dence with Carolus Linnaeus gen, tabelle der Augenkrankheiten. Arch f Augenkk. 1926;97:493-501. (1707-1778), the great Swedish Submitted for Publication: Janu- 12. Fuchs L. Alle Krankheit der Augen. Strassburg, Ger- botanist, zoologist, physician, and ary 2, 2009; final revision received many: Heinrich Vogtherr; 1539. founder of the modern morpho- January 28, 2009; accepted January 13. Brinkhus G, Pachnicke C. Leonhart Fuchs (1501- logic taxonomy system, which is 30, 2009. 1566): Mediziner u Botaniker. Tubingen, Ger- many: Kulturamt; 2001:213. now gradually being supplanted by Correspondence: Harry H. Mark, 14. Streng B, Ruorecht KW, Witten R. Johann Gottfried genetic DNA classification. Lin- MD, FACS, 16 Broadway, North Ha- Zinn—ein fränkischer Anatom und Botaniker. Klin naeus named a genus of plants after ven, CT 06473 ([email protected]). Mbl Augenheilk. 1991;199:57-61.

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