[Our surgical heritage. The 1988 surgical historical calender].
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Biomedical subjects
Publications and source records attributed to V Klimpel.
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After a short historical survey on the foundation of the scientific association of Erfurt at 1754 some famous gynaecologists and obstetricians as members of this academy are being described. In this way the development of obstetrics and gynaecology and the relations between historical base, medical specialization and personalities are illustrated, too.
On the basis of several selected instances a short review of the role internal therapy in the history of cholelithiasis is given. The multifarious medicamentous, physical and dietetic measures remained for centuries the only, though not always satisfying therapeutic alternative to operation. Thereby is also referred to the misuse which was done by irresponsible physicians and laymen even in the field of the treatment of gall-stones. Only the flowering of the operative medicine compelled the internal medicine towards the end of the 19th century to give the supremacy over to surgery, because only this part of medicine was able to remove the causes of the disease. With the development of new chemolitholytic substances and the crushing of the stone on endoscopic and extracorporal way new perspectives again begin to limn themselves in the conservative treatment of cholelithiasis.
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Taking the example of the renowned German surgeon of the bile ducts Hans Kehr (1862-1916) and two cases published by him, the possibilities and limitations of neurosurgical activity within the frame of general surgery at the turn of the 19th to the 20th century at a private surgical hospital are outlined. A typical factor of the early history of specialised medical fields can be considered to be the successful autodidactic performance of almost all major interventions in all parts of the body and at the same time the turn to a topographically or pathophysiologically determined field of working. Here, peak performances in a partial field could still be well connected with a maintenance of the shole field. Kehr's actions in the practical-surgical treatment of the lesions of the skull corresponded in their basic conceptions to our present ideas. The further development, however, showed that the responsible and successful surgery in a special field-in the case of Kehr the surgery of the bile ducts-could only be performed with a far-reaching renunciation of other surgical activities.