Theodor Kocher( Swiss surgeon, Nobel Prize in Physiology or Medicine, 1909)
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Biography Theodor Kocher
August 25, 1841, Mr.. - July 27, 1917
The Swiss surgeon Emil Theodor Kocher was born in Berne, in the family owned a prosperous middle class. His father, James Alexander Kocher, was an engineer. He managed to teach her son a lot and work hard. His mother, Mary Kocher (vermouth), was a religious woman. Under its influence in Theodore retained throughout his life interest in philosophy and religion. After primary and secondary school in Berne, K. enrolled in medical school at the University of Bern and in 1865. graduated with honors from her.
Thanks to the good financial situation of the family to. able to travel and practice at the famous European surgeons. Within five years he studied surgery in Vienna, Paris, Berlin and, finally, in London under the leadership of the English surgeon Sir Joseph Lister. When Lister was a novice surgeon, he was struck by a high level of postoperative infectious complications and mortality. Later his work played a leading role in the development of surgical antisepsis. Previously, surgeons were included in the operating directly from a hospital ward or sectional hall, where they could work with contaminated objects and corpses. In addition, they operated in everyday clothes, without sterile gloves and not having washed his hands.
. Learning about the experiments of Louis Pasteur, who developed the bacterial theory of disease, Lister suggested that postoperative wound infections could be caused by bacteria, trapped in the wound with dirty instruments due to the negligence of the operating equipment
. Initially, the theory Lister is not popular with his colleagues, . but he began to apply in the operating methods of antisepsis, . forcing surgeons to wash hands before surgery and forearm, . disinfect surgical instruments in a solution of carbolic acid, and wear surgical gowns and gloves,
. Reducing the frequency of postoperative infections in patients Lister convince our colleagues of the importance of antisepsis. Passing a surgical internship under the guidance of Lister, TO. became a supporter of antiseptic methods in surgery.
In Vienna K. studied surgery under the guidance of Theodor Billroth, to develop techniques for operations on the gastro-intestinal tract, which are still used in the surgical treatment of diseases of the stomach. K. assisted Billroth during operations, studied the causes of postoperative wound infections, and wrought the autopsy to identify the relationship between clinical manifestations and pathological changes in some diseases. In addition, K. invented several surgical instruments, and in particular a surgical clamp, which is now used in vascular surgery and is called the Kocher clamp. Modesty and ingenuity to. created him a high reputation. Appreciating the knowledge and surgical technique, K., Billroth invited him to do after graduation to work at the Vienna clinic. Billroth's proposal was for the young man's flattering, but he wrote to his friend in Switzerland: 'My heart commands me to return home and share with their fellow countrymen have the skills and knowledge in medicine, which I bought'. Self-ordering of his future destiny, K. in 1870. returned to Bern.
Two years later, K. was promoted to professor of surgery and director of Surgical Clinic, University of Bern. Here he was able to use antiseptic methods of Lister and flawless technique operating Billroth. Sometimes for hours without leaving the operating room, K. In addition, he conducted biochemical, bacteriological and clinical-pathological-anatomical study.
To. developed an original method of treatment of wounds with solutions of chlorine, , , ,
. In addition, K. Overviewed his clinical and experimental artworks, . and subsequently published a on this theme two books: 'Ob gunshot wounds' ( "On Gunshot Wounds", . 1880) and 'Teoriya gunshots wounds, . inflicted bullets small caliber '( "The Theory of Gunshot Wounds Due to Projectiles of Small Caliber", . 1895),
. His book 'The teaching of surgery' ( "Theory of Surgical Operations") passed the six editions, was translated into many languages and became a common tool for surgery in the U.S. and Europe. His other books and articles were devoted to methods of treatment of many diseases, . including acute osteomyelitis (inflammatory disease of bone and bone marrow), . and surgical treatment of diseases of the stomach, . peptic ulcers, . gallbladder disease, . rectal cancer, . epilepsy and inguinal hernias.,
. However, most of the credit to
. is the study of thyroid function and development of methods of surgical treatment of diseases, in t. h. various types of goiter. At that time it was thought that the thyroid gland does not perform an important biological function, and thus in the years when K. was only beginning to medical activities, with goiter often removed this gland as a whole, while paying little attention to the four parathyroid glands, located near her. (These four glands, located on the four corners of the thyroid gland, plays an important role in the regulation of calcium metabolism in bones and other tissues of the body.)
. Today we know that the thyroid gland produces and releases hormones into the blood thyroxine and triiodothyronine
. These hormones are essential for the regulation of cellular metabolism, including oxygen consumption, energy metabolism and the development of carbon dioxide. If the thyroid glands secrete too much hormone, the level of cell metabolism and respiration becomes pathologically increased and there is a condition called hyperthyroidism. Conversely, if these hormones released is too small, the intensity of cellular metabolism and respiration decreases, and then in adult patients have hypothyroidism, and the children - cretinism. If the diet lowered the content of iodine, thyroid tissue is growing and the thyroid gland increases, a condition called goiter. If the thyroid gland reaches a very large, it compresses the nerves that innervate the vocal cords, trachea and other surrounding tissues. In addition, crop leads to external deformities.
At the very beginning of medical practice to. in accordance with traditional surgical techniques removed the entire thyroid. However, he soon discovered that these patients developed condition similar to cretinism. Cretinism - a disease caused by lack of secretion of thyroid hormones. It is characterized by stunted physical and mental development, dystrophy of bones and soft tissues and a decrease in exchange. In adults, the disease is called myxedema. 'As a rule, - wrote K. - patients complain of fatigue, weakness and drowsiness, slowing of thought and speech, motor retardation swelling of the face, hands and feet ... to. K. not only showed that thyroid function, but also identify the causes of cretinism and myxedema. Later he found that if the patients operated on for goiter, thyroid gland is not removed entirely, hypothyroidism did not develop. In addition, he pointed to the need to preserve the parathyroid glands, as well as care of the nerves to the vocal cords. During his many years of surgical practice to. made more than 5 thousand. tireoidektomy (operations remove the thyroid gland) and became the leading European specialist in surgery of the thyroid gland. In addition, he conducted research on the biochemical changes in hyperthyroidism and hypothyroidism, have no direct relationship to surgical practice. At the beginning of XX century. German biochemist Eugene Bauman for the treatment of patients with myxedema and cretinism suggested crude extract of thyroid tissue. Today in the treatment of these diseases using thyroid hormones.
In 1909, Mr.. K. was awarded the Nobel Prize in Physiology or Medicine "for his work in the field of physiology, pathology and surgery of the thyroid gland '. Scientist from the Karolinska Institute to. Merner a congratulatory speech said: 'In the course of research to. has done pioneering work, the results of which will long retain its value and are crucial to medical science and for suffering humanity '.
To. was married to Mary Uitchi. In the family they had three children, one of them was a surgeon who assisted his father in the work. K. died in 1917. Bern.
To. was an honorary member of the London Royal Society of Surgeons and many medical societies around the world. In 1902, Mr.. He was elected president Germanskogo Surgical Society, three years later - President I of the International Surgical Congress in Brussels.