Ernst Ferdinand Sauerbruch: rise and fall of the pioneer of thoracic surgery

The Medical Professional Elimination Program and the Ideology and Motivation of Nazi Physicians

The appointment of a new chancellor in 1933 marked the beginning of the Third Reich in Germany. The ideology of the Nazi Party focused on establishing a pure Aryan state characterized by nationalism and racial superiority. Their goals would be achieved through a totalitarian form of government that enforced the subjugation, exclusion, and elimination of those they defined as inferior minorities, particularly Jews, who were depicted as non-human. Implementation of the Nazi ideology required the exclusion of Jewish people and other dissenters, particularly Jewish physicians, from their professions. The exclusion of Jewish physicians, referred to herein as a "Medical Professional Elimination Program," was gradually imposed on other Jewish professions in nations absorbed by the Third Reich, and particularly enforced by incorporated Austria. Why did German and Austrian doctors support the Nazi racial ideology, the removal of Jewish physicians from every possible sphere of influence, and subsequently participate in criminal medical research and experimentation, as well as euthanasia of perceived non-contributors to society, and become involved in refining the effectiveness of the death camps? Was the Medical Professional Elimination Program an opportunistic political concept, or was it part of an entrenched ideology? With these questions in mind, the lives of four key Nazi physicians and two institutions are examined.

Rare diseases of esophagus: Surgical treatment of cysts in adults. Case report

INTRODUCTION AND IMPORTANCE

Esophageal cysts (EC) are congenital, extremely rare malformation. Up to 80% of EC are diagnosed in childhood, therefore, we can find only few clinical observations of EC in adults in literature.

CASE PRESENTATION

During the period from October to December 2019, a successful surgical treatment of 2 patients (1 male and 1 female) with enterogenous and duplication cysts of esophagus was performed at the Clinic of Faculty Surgery at Sechenov University. In both cases thoracic tumors were incidental findings during routine health investigation.

CLINICAL DISCUSSION

Clinical manifestations of ECs are caused by compression or displacement of the adjacent anatomical structures, therefore, most often patients complain of dysphagia, vomiting, pain in the chest, which may be constant or occur during an act of breathing. There are also observations of neurological symptoms due to compression of the radicular nerves The method of choice in the treatment of ECs is their surgical removal.

CONCLUSION

Patients with mediastinal tumors should be treated in specialized hospitals by experienced surgeons who can cope with an unexpected intraoperative finding and carry out the appropriate surgery.

Historical development of the anesthetic machine: from Morton to the integration of the mechanical ventilator

The first anesthetic machines appeared following their public demonstration by Morton in 1846. These initial devices were simple inhalers based on the evaporation of the anesthetic agent. Their main problem was the loss of effectiveness with cooling. More complex inhalers were subsequently developed, in which the main difference was the possibility to provide more than one agent. Moreover, the concentration of the inhaled anesthetic was regulated for greater efficiency. At the beginning of the twentieth century, gas machines emerged, allowing the application of an anesthetic flow independent of the patient's inspiratory effort. These machines incorporated technological advances such as flow meters, carbon dioxide absorption systems and fine adjustment vaporizers. In this period, in the field of thoracic surgery, intraoperative artificial ventilation began to be employed, which helped overcome the problem of pneumothorax associated with open pleura by applying positive pressure. From the 1930s, the gas machines were fitted with a ventilator, and by the 1950s this had become a basic component of the anesthesia system. Later still, in the 1980s, alarm and monitoring systems were incorporated, giving rise to the current generation of workstations.

Cardiothoracic Anesthesia and Critical Care in the United Kingdom (UK) Part 1: Some Insights Into the History and Development

This review is intended to highlight some of the historic events that contributed to the development of thoracic and cardiac anesthesia and surgery in Great Britain and Northern Ireland (UK). The aim of this first of two parts is to concentrate on the development of techniques, facilities, and pharmacology that allowed progress and advancement in patient management that were developed primarily in the UK. However, progress usually requires input from a wide variety of sources of knowledge, and cardiothoracic practice is no exception. Reference is, thus, made to sources outside of the UK that guided, influenced, or inspired changes in practice, such as the techniques of operating on the heart and great vessels in war casualties, developed by Dr. Dwight Harken, or the demonstration of the Blalock-Thomas-Taussig shunt by Alfred Blalock. In addition to advances in medical equipment, such as computed tomography, the UK contributed greatly to pharmacologic interventions that were unique at the time in such varied areas as nonflammable volatile anesthetic agents, heart failure treatments, and neuromuscular blocking agents for both cardiac and thoracic surgical practice.

Jan Mikulicz-Radecki (1850-1905): his impact on modern medicine

Abstract Jan Mikulicz-Radecki (1850-1905) was the cofounder of modern surgery, aseptic techniques,and the inventor of gastroscopy, but his professional accomplishments go far beyond the field of surgical treatment. Various medical achievements are named in his honor, including the name of the cells that he discovered in rhinoscleroma, the name of Mikulicz disease, and the name of an ointment that he developed and continues to be used in the treatment of wounds and ulcers in surgery and dermatology. Noteworthy are also his interdisciplinary approach towards diagnosis and treatment, and his cordial attitude towards his patients.

The life of Rudolf Nissen: advancing surgery through science and principle

Rudolf Nissen (1896-1981) was a surgeon whose career began in Germany during the first third of the 20th century, a period of rapid progress in biomedical technology, during which neurosurgery, anesthesiology, and other specialties emerged. A protégé and later close colleague of thoracic surgery pioneer Ferdinand Sauerbruch (1875-1951), Nissen resigned from the Berlin Charité Clinic and left Germany in 1933, in response to the rise of Nazi fascism. Throughout his subsequent career in Istanbul, Turkey, the American cities of Boston and New York, and finally Basel, Switzerland, Nissen developed innovative surgical techniques, advocated for patient-centered medical education, and promoted surgical subspecialization. A lifelong proponent of clear scientific writing, Nissen expressed, in extensively published work, his philosophy that progress in surgery depends critically on rigorously applying the scientific method, upholding professional integrity, and respecting human dignity.

On the 100th anniversary of sterile catgut kuhn: Franz Kuhn (1866-1929) and the epistemology of catgut sterilization

The long road to effective catgut sterilization began with the work of Lord Joseph Lister (1867) and did not end until 40 years later. At the end of the nineteenth century dozens of different techniques were used to "sterilize" catgut, by immersing the cord in a cold chemical solution, by exposing it to steam, or by a combination of the two techniques, yet none of these approaches offered the ultimate solution. One of the many physicians working on the catgut problem at that time was the German surgeon Franz Kuhn (1866-1929), best known as a pioneer of intubation anesthesia. This review offers a brief biographical sketch of Kuhn's life and career on the occasion of the centenary of Sterile Catgut Kuhn. The goal of the present study is to describe several landmarks in the development of the catgut sterilization method. To explain this process, two approaches are taken: first, an analysis to see whether the character traits of the typical surgeon at that time provided the soil in which innovation could thrive, and second, an epistemological examination of the conceptual models for the attainment of knowledge current at that time. Perspectives for the future are explored in light of the "imperative of responsibility" of Hans Jonas.

The clinicide phenomenon: an exploration of medical murder

OBJECTIVE

The aim of this paper is to explore the phenomenon of clinicide.

CONCLUSIONS

The study of medical killers is barely in its infancy. Clinicide is the unnatural death of multiple patients in the course of treatment by a doctor. Serial medical killing is a relatively new phenomenon. The role model is Dr Marcel Petiot, the worst serial killer in French history. More recently, Dr Harold Shipman was Britain's worst serial killer and in the United States and Zimbabwe, Dr Michael Swango killed 60 patients. A number of doctors have such high patient death rates that it cannot be ignored. At some level, these doctors have an awareness of what they are doing, countered by an overweening refusal to acknowledge the implications or desist from further treatment. Treatment killer offences usually occur on the basis of serial mental illness, but may include the contentious area of euthanasia killing. Doctors have frequently been accomplices in state repression, brutality and genocide in direct contravention to their sanctioned role to relieve suffering and save life. They have become mass murderers on an exponential scale, making any comparison with a doctor killing his own patients almost risible. Many clinicidal doctors have extreme narcissistic personalities, a grandiose view of their own capability and inability to accept that they could be criticized or need assistance from other doctors. Such doctors develop a God-complex, getting a vicarious thrill out of ending suffering and by determining when a person dies.

Ernst Ferdinand Sauerbruch and his ambiguous role in the period of National Socialism

The role of German physicians under National Socialism is highly controversial. We show that Ferdinand Sauerbruch, one of twentieth century's most outstanding surgeons and chair of surgery at Berlin's Charité from 1927 to 1949, openly supported National Socialism in his public statements and in his position as head of the medical section of the Reich Research Council. He was appointed state councilor and received the Knight's Cross of the War Merit Cross by the National Socialists. But Sauerbruch also supported victims of Nazi persecution, attempted to use his influence to put a stop to the "Euthanasia Program T4," and in private expressed his criticism of National Socialists. The ambiguous stance of Ferdinand Sauerbruch is probably more typical of the role physicians played during National Socialism than the well-known black-and-white cases.

Jan Mikulicz-Radecki (1850-1905): pioneer of endoscopy and surgery of the sinuses, throat, and digestive tract

The authors described the medical achievements of Jan Antoni Mikulicz-Radecki--a famous surgeon and laryngologist of Polish origin, belonging to the Viennese surgical school of Prof. Theodor Billroth at the turn of the 20th century. His scientific and clinical activity in Vienna, Cracow, Konigsberg, and Wroclaw resulted in 232 publications and several new surgical methods. He changed the opinion on scleroma and described benign lymphoepithelial lesions. He was one of the authors of modern aseptics, antisepsis in surgery, and is regarded as a pioneer of endoscopic procedures. He was interested mainly in thoracic surgery, surgery of the abdomen, orthopedics, and laryngology. Mikulicz was the first to describe the method of surgical treatment of the maxillary sinus, osteoplastic surgery of the nose, esophagoscopy, and lateral pharyngotomy in tonsil carcinoma. Prof. Mikulicz was the first to perform thoracic surgery; he performed the first pyloroplasty, the first partial esophagectomy and gave rise to antiseptic procedures and general surgical management. He described many modifications of surgical operations and he constructed the esophagoscope, scoliozymeter, and many other useful surgical devices.