Carl Koller: Life and Career (1857–1944)

Carl Koller is remembered for one afternoon’s idea: that the numbing effect of cocaine, an alkaloid taken from the leaves of the Andean coca shrub, could make the surface of the human eye insensible to pain during surgery. In the autumn of 1884, when he was a 26-year-old junior doctor at the Vienna eye clinic, that idea founded local anesthesia. But Koller lived for almost sixty more years after it, and the rest of his life is a story in its own right — a Bohemian childhood, a quarrel that ended his prospects in Vienna, years of training in the Netherlands, and more than half a century as an eye surgeon in New York.

This page follows the man rather than the molecule. It traces his family and schooling, his turn from law to medicine, his student research in Salomon Stricker’s laboratory, his friendships with Sigmund Freud and Sigmund Lustgarten, the January 1885 insult and duel and the different ways historians have read it, his training under Frans Cornelis Donders and Herman Snellen in Utrecht, his long career in New York, and the honours, papers and family memoir that keep his name alive. The discovery itself, the coca leaf and the drugs that came after cocaine each have their own page in this wing.

Table of Contents

  1. From Schüttenhofen to Vienna
  2. Law, Then Medicine
  3. Salomon Stricker’s Laboratory and the 1882 Doctorate
  4. A Junior Doctor at the Vienna Eye Clinic
  5. Friends in Vienna: Freud and Lustgarten
  6. The Year 1884 in Brief
  7. The Insult, the Duel and a Closed Door
  8. Utrecht with Donders and Snellen
  9. A New Life in New York, 1888–1942
  10. Honours, Papers and Memory
  11. Key Research Papers
  12. Connections
  13. Featured Videos

1. From Schüttenhofen to Vienna

Carl Koller was born on 3 December 1857 in Schüttenhofen, a small town in Bohemia, then part of the Austrian Empire; today the town is Sušice in the Czech Republic. The Neue Deutsche Biographie (the standard German national biography) records that he came from a Jewish family and that his father, Leopold Koller, was a merchant from Teplitz (today Teplice), another Bohemian town. One published biography gives a different birthday — the American Academy of Ophthalmology’s biographical page lists 14 August 1857 — but the German biography, the Life in the Fast Lane eponym biography and other reference works agree on 3 December, and that is the date most historians use.

In 1862, when Carl was about four, the family moved to Vienna. The Habsburg capital of the 1860s and 1870s was growing fast, and its university and great general hospital drew students from every corner of the empire. For a Jewish family from the Bohemian provinces, Vienna offered schooling and professional careers that had been closed to earlier generations, and many of the city’s doctors, lawyers and scientists of Koller’s generation came from families with very similar histories.

Little about Koller’s childhood has been documented in the published record beyond these facts. Most of what is known about his private life comes from two later sources: his own papers, now held by the Library of Congress, and the long memoir that his daughter, Hortense Koller Becker, published in 1963 under the title “Carl Koller and cocaine” in the Psychoanalytic Quarterly. Historians writing about his early years lean heavily on both.

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2. Law, Then Medicine

Koller did not set out to be a doctor. According to the dated chronology in the Life in the Fast Lane biography, he first enrolled to study law, in 1875–76, and only then changed course to medicine at the University of Vienna. The reasons for the switch are not set out in the sources this page draws on; what is clear is that once he moved to medicine he took to laboratory work quickly.

The Vienna medical faculty of the late 1870s was one of the most famous in the world. The “Second Vienna School” of medicine had built its reputation on careful bedside observation linked to findings at autopsy, and the university’s institutes in pathology, physiology and experimental medicine were training a generation of students who would go on to found whole specialities. Koller studied alongside, and became friends with, young men who would become famous in very different fields — among them Sigmund Freud, about a year and a half older than him.

For a student who wanted to do research, the path in Vienna ran through the laboratories of the senior professors. Students worked unpaid, learned techniques at the bench, and hoped that a well-received piece of research would lead to an assistant’s post. Koller found his place in the institute of the experimental pathologist Salomon Stricker.

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3. Salomon Stricker’s Laboratory and the 1882 Doctorate

Salomon Stricker ran the Vienna institute of general and experimental pathology, where the processes of disease were studied in animals rather than only described at autopsy. As a student, Koller worked in Stricker’s institute on embryology — the study of how the body forms before birth — according to both the Neue Deutsche Biographie and the Life in the Fast Lane biography. This was patient microscopic work, and it trained him in the habits of animal experiment and careful recording that he would use two years later.

The institute mattered to Koller’s later story in a second way. It was there that he came to know Joseph Gärtner, an assistant in Stricker’s laboratory, who would be beside him in the summer of 1884 when the first cocaine experiments on animal eyes were carried out. The historian Michael Goerig, who studied Koller’s surviving laboratory notes, describes a sequence of animal experiments, self-experiments and experiments on colleagues — the kind of laboratory practice Stricker’s institute had taught him.

Koller received his medical doctorate from the University of Vienna in 1882. The degree qualified him to practise, but in the Viennese system it was only the beginning: an ambitious young doctor next sought a junior post at one of the university clinics of the Vienna General Hospital (the Allgemeines Krankenhaus), where teaching, research and a path toward an academic career could all be found.

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4. A Junior Doctor at the Vienna Eye Clinic

Koller chose ophthalmology. In 1883 he took a junior post as an Aspirant — roughly, a trainee or junior assistant — at the Second University Eye Clinic of the Vienna General Hospital, the clinic associated with the eminent ophthalmologist Ferdinand von Arlt. His English paper of early 1885 in the Chicago Medical Journal and Examiner carries the byline “House Physician” at the Allgemeines Krankenhaus, the title he held while making his name.

Eye surgery in the early 1880s presented a particular problem. General anesthesia with ether or chloroform had existed since the 1840s, but it was poorly suited to delicate operations on the eye. As the historian Howard Markel has described it, a junior eye surgeon of Koller’s time knew that patients put to sleep for an operation such as cataract removal often vomited and moved as they came round, which could threaten a freshly opened eye. A way of numbing only the eye, with the patient awake and still, would have answered a real need.

That need is part of why the numbing of the tongue caught his attention when his friend Freud began studying cocaine. The full story of the experiments belongs on the 1884 discovery page; what matters here is that it was the problem of a junior eye doctor, in a busy teaching clinic, that set the stage.

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5. Friends in Vienna: Freud and Lustgarten

Two friendships from these Vienna years run through every account of Koller’s life. The first was with Sigmund Freud (1856–1939), then a young physician at the General Hospital who had not yet turned to psychoanalysis. The second was with Sigmund Lustgarten (1857–1911), another young Viennese doctor of the same age. In a 1997 article written for the 140th anniversary of their births, the historians Amm and Holubar called the three men “the Vienna Jewish trio”: friends whom the authors present as pathfinders in the cocaine story of 1884, and who each, in their account, later suffered from antisemitism.

Freud is the link between Koller and cocaine. In 1884 Freud was studying the drug’s general effects on mood, fatigue and the body, and he drew his friends into the work, including Koller. Freud’s nickname for him, “Coca Koller”, survives in an inscription Freud wrote and in the title of Amm and Holubar’s article; Markel reports it as Freud’s own name for his friend. Markel’s 2011 essay in JAMA, “Über coca: Sigmund Freud, Carl Koller, and cocaine”, tells the story of the two men side by side.

Credit for local anesthesia later became a matter of argument. Freud’s own 1884 review had mentioned cocaine’s numbing property only in passing, and the Brazilian anesthesiologist dos Reis, reviewing the record in 2009, concluded that Freud had no direct part in discovering local anesthesia. Koller himself, according to the Life in the Fast Lane biography, stated as late as 1941 that Freud had had nothing to do with cocaine anesthesia. The details of that priority question are told on the discovery page; for Koller’s life, the important fact is that a youthful collaboration became, in later decades, a matter of disputed memory.

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6. The Year 1884 in Brief

The events of 1884 are short to tell and are covered in full on the discovery page. In the summer, after Freud had begun his cocaine studies and the friends had noticed that the drug numbed the tongue, Koller tested a cocaine solution on the eye of a frog with Joseph Gärtner in Stricker’s laboratory. The treated cornea no longer responded to touch, while the other eye blinked normally. Rabbits and dogs followed, and then the two men tried the drops on their own eyes. His surviving notebooks of these experiments were given to the Library of Congress by his daughter and were analysed by Goerig in 2015.

Koller could not afford the journey to the meeting of the Ophthalmological Society in Heidelberg, so on 15 September 1884 his preliminary communication was read there on his behalf by the ophthalmologist Josef Brettauer, and a demonstration followed. On 17 October 1884 Koller presented his full report to the Vienna Medical Society. English versions appeared in The Lancet in December 1884 and in the Chicago Medical Journal and Examiner in early 1885.

The response was immediate. Goerig, Bacon and van Zundert, writing in 2012, note that the news spread across the world in less than a month. For the young Koller it was a scientific triumph of the kind most doctors never have — and yet, as the next section describes, within a few months it had not opened the doors in Vienna that it might have been expected to.

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7. The Insult, the Duel and a Closed Door

In January 1885 — the Life in the Fast Lane chronology gives 6 January — Koller was publicly insulted by a colleague at the Vienna General Hospital, who called him by an antisemitic slur. Koller struck him. In the code of honour of the time, a blow answered with a challenge, and a sabre duel followed. Koller was unhurt; his opponent was wounded. Duelling was forbidden by law, and the affair ended Koller’s hopes of the assistant’s post at the eye clinic that would have been the next step toward an academic career in Vienna.

How historians have read it

Historians agree on the outline of these events but differ on what they meant for his decision to leave Vienna. The Neue Deutsche Biographie and Amm and Holubar’s 1997 article frame his departure around the antisemitism he faced, with the insult as its sharpest expression. The Vienna ophthalmologist Hruby, in a 1986 article in the Wiener klinische Wochenschrift titled “Was Dr. Carl Koller driven from Vienna in 1885?”, set out a different reading: he accepted that the duel and its aftermath cost Koller his career prospects there, but argued that antisemitism was not the principal reason he emigrated.

Goerig, Bacon and van Zundert, in their 2012 study of “less known and forgotten facts” about Koller, discuss his departure from Vienna among the less familiar parts of his story. A reader can hold both readings in view: the insult was antisemitic by any account, and the closed door that followed was real; the historians differ on how much weight antisemitism carries in explaining why, three years later, he left Europe for good.

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8. Utrecht with Donders and Snellen

With no future at the Vienna clinic, Koller went to continue his training in the Netherlands. From 1885 to 1887, according to the Neue Deutsche Biographie and the American Academy of Ophthalmology biography, he worked in Utrecht with two of the most important ophthalmologists of the nineteenth century. Frans Cornelis Donders (1818–1889) had put the measurement of the eye’s focusing errors — long sight, short sight and astigmatism — on a scientific footing. Herman Snellen (1834–1908) had devised the letter chart for testing sharpness of vision that, in its many descendants, still hangs on the walls of eye clinics today.

Training in Utrecht gave Koller something Vienna no longer could: experience in a leading clinic, in the company of men whose names carried weight across Europe and America. The American Academy of Ophthalmology biography also states that in 1885, at an ophthalmology congress in Heidelberg, Koller met the New York ophthalmologist Herman Knapp. That meeting, if the biography’s account is followed, helps explain why New York became his destination.

Some secondary summaries also mention short stays in other European cities during these years; those have not been confirmed in the sources this page relies on, and are left out here.

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9. A New Life in New York, 1888–1942

In May 1888, according to the Life in the Fast Lane chronology, Koller emigrated to the United States and settled in New York City. He would live and work there for the rest of his life. The Neue Deutsche Biographie records that he practised ophthalmology in New York from 1888 until 1942 and worked at Mount Sinai Hospital; the American Academy of Ophthalmology biography describes him as chief of ophthalmology there.

He did not leave cocaine behind as a research subject. In 1892 he published in the Transactions of the American Ophthalmological Society a paper on “The Sub-conjunctival application of Cocaine in Eye Operations” — that is, delivering the anesthetic under the thin membrane covering the white of the eye rather than dropping it on the surface. It shows him, four years after arriving in America, still working on the technique he had introduced in Vienna. (The later history of cocaine in eye surgery, and the safer drugs that replaced it, is told on the After Koller page.)

Koller became an American citizen in 1902. For the next four decades he was, outwardly, a respected New York eye surgeon among many: busy in practice, attached to a large hospital, raising a family. His daughter’s 1963 memoir later became a principal source for historians of his life. The surgeon whose name was known in every operating room in the world remained, in daily life, a working clinician until 1942, when he was in his mid-eighties.

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10. Honours, Papers and Memory

Honours in his lifetime

Recognition came late but steadily. In 1922 Koller became the first recipient of the Lucien Howe Medal of the American Ophthalmological Society, according to the American Academy of Ophthalmology biography. In 1930 the Medical Society of Vienna (the Gesellschaft der Ärzte), the body before which he had read his full report in 1884, honoured him — a gesture that Hruby notes in his 1986 article, coming forty-five years after he had left the city. The American Academy of Ophthalmology biography also lists a 1930 medal from the New York Academy of Medicine.

Hruby further reports that Koller was proposed several times for the Nobel Prize in Physiology or Medicine, but that the prize was not awarded to him because, under the Nobel statutes, his discovery lay too far in the past — it predated the first Nobel Prizes of 1901 by seventeen years. In 1928 Koller published his own “Personal Reminiscences of the First Use of Cocain as a Local Anesthetic in Eye Surgery” in Anesthesia & Analgesia, and the British Journal of Ophthalmology printed a note on “Carl Koller and Cocaine” the same year.

Death

Koller died in New York in March 1944, at the age of 86. Sources differ on the exact day: the Neue Deutsche Biographie gives 22 March, while the Life in the Fast Lane biography and other reference works give 21 March.

His papers and his daughter’s memoir

Much of what is known about Koller survives because his daughter, Hortense Koller Becker, preserved and gave away his papers. The Library of Congress holds the Carl Koller Papers, spanning 1866 to 1988 with most material from 1884 to 1934, including his 1884 experiment notes and his correspondence. Goerig’s 2015 article in Der Anaesthesist published and analysed those laboratory notes. Becker’s own memoir, “Carl Koller and cocaine” (1963), remains the longest single account of his life, and the Swedish pharmacologist Göran Liljestrand published a monograph, “Carl Koller and the development of local anesthesia”, in 1967.

Today Koller’s name lives on in anesthesia itself: the European Society of Regional Anaesthesia awards a Carl Koller Gold Medal and holds a Carl Koller Lecture. The story of the leaf that made his discovery possible is told on the coca leaf page, and the wider story of his work on the wing hub.

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Key Research Papers

  1. Koller C. On the use of cocaine for producing anæsthesia on the eye. The Lancet. 1884;124(3197):990-992. DOI: 10.1016/s0140-6736(02)28859-5
  2. Koller K. The Application of Cocaine to the Eye as an Anæsthetic. Chic Med J Exam. 1885;50(2):91-100. PubMed PMID: 37618465
  3. Koller C. The Sub-conjunctival application of Cocaine in Eye Operations. Trans Am Ophthalmol Soc. 1892;6:421-4. PubMed PMID: 25259144
  4. Koller C. Personal Reminiscences of the First Use of Cocain as a Local Anesthetic in Eye Surgery. Anesthesia & Analgesia. 1928;7(1):9-11. DOI: 10.1213/00000539-192801000-00004
  5. Anonymous. Carl Koller and Cocaine. Br J Ophthalmol. 1928;12(5):262-3. PubMed PMID: 18168728
  6. Becker HK. Carl Koller and cocaine. Psychoanal Q. 1963;32:309-73. PubMed PMID: 13970115
  7. Liljestrand G. Carl Koller and the development of local anesthesia. Acta Physiol Scand Suppl. 1967;299:1-30. PubMed PMID: 4867543
  8. Altman AJ, Albert DM, Fournier GA. Cocaine’s use in ophthalmology: our 100-year heritage. Surv Ophthalmol. 1985;29(4):300-6. PubMed PMID: 3885453
  9. Hruby K. [Was Dr. Carl Koller driven from Vienna in 1885?]. Wien Klin Wochenschr. 1986;98(5):155-6. PubMed PMID: 3515769
  10. Amm M, Holubar K. [“Coca-Koller” and hist friends. On the 140th birthday of the Vienna Jewish trio: Carl Koller (1857-1944), Sigmund Lustgarten (1857-1911) and Sigmund Freud (1856-1939)]. Wien Klin Wochenschr. 1997;109(5):170-5. PubMed PMID: 9173665
  11. dos Reis A Jr. Sigmund Freud (1856-1939) and Karl Köller (1857-1944) and the discovery of local anesthesia. Rev Bras Anestesiol. 2009;59(2):244-57. PubMed PMID: 19488537
  12. Markel H. Über coca: Sigmund Freud, Carl Koller, and cocaine. JAMA. 2011;305(13):1360-1. PubMed PMID: 21467292
  13. Goerig M, Bacon D, van Zundert A. Carl Koller, cocaine, and local anesthesia: some less known and forgotten facts. Reg Anesth Pain Med. 2012;37(3):318-24. PubMed PMID: 22531385
  14. Goerig M. [From the legacy of Carl Koller. Notations on his experiments with cocaine]. Anaesthesist. 2015;64(6):469-77. PubMed PMID: 26018815

PubMed Topic Searches

  1. https://pubmed.ncbi.nlm.nih.gov/?term=Carl+Koller+cocaine
  2. https://pubmed.ncbi.nlm.nih.gov/?term=Koller+Freud+cocaine+history
  3. https://pubmed.ncbi.nlm.nih.gov/?term=history+of+local+anesthesia
  4. https://pubmed.ncbi.nlm.nih.gov/?term=history+of+ophthalmology+Vienna

Further Reading

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Connections

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