Sahli’s test for estimating the functional activity of the stomach.

Abbe, a New York surgeon, introduced catgut rings for intestinal suturing. See also Med. News (Phila.), 1889, 54, 589-92.

Bloch was first to employ the two-stage (Mikulicz) operation for cancer of the colon. See also No. 3527.

Einhorn introduced the concept of achylia gastrica, to indicate a primary nervous functional disorder of the gastric secretion.

Introduction of gastroduodenostomy.

In 1892 Ludwig Heusner (1846-1916) successfully sutured a perforated gastric ulcer, the first successful case on record. It was reported by H. Kriege.

First description of the syndrome of symmetrical inflammation of the lacrymal and salivary glands (“Mikulicz’s disease”). English translation in Medical Classics, 1937, 2, 165-86.

“Murphy’s button” introduced.

See No. 3512.

Pénières of Toulouse conceived the idea of the valvular method of gastrostomy.

A careful examination of the records of post mortems carried out at Guy’s Hospital, 1826-92, was made by Perry and Shaw, who showed that of 70 reports of duodenal ulcer, ten occurred in cases of severe burns.

Senn, Professor of Surgery at Chicago, was one of the first to investigate experimentally the subject of gastro-intestinal anastomosis.

Ssabanejew and Frank independently developed a new method of gastrostomy, the Ssabanejew-Frank operation. The above is an abstract of the original, which appeared in Khirurgitscheski Vestnik, June 1893.

Toepfer’s test for hydrochloric acid in gastric juice.

“Battle’s incision”.

Paul’s operation of extra-abdominal resection of the colon.

Becher introduced a solution of lead into the stomach of a guinea-pig, making it opaque to x rays; he thus showed the possibility of radiological diagnosis of gastric disease.

Rosenheim’s gastroscope.

First successful total gastrectomy.

Operation performed by Baldy in 1893. He refers to a claim in J. Amer. med. Ass., 1898, 30, 341-44 giving credit for the first excision of the stomach in America to A. C. Bernays (1854-1907). While Baldy probably deserves priority, the point is moot since neither Baldy’s nor Bernays’ operations were successful.

Cannon introduced the bismuth meal. He showed that bismuth, opaque to x rays, could be of great use in conjunction with roentgenology in the investigation of the digestive tract. See No. 1029.

A false diverticulum of the sigmoid flexure, described by Graser, has been given the eponym “Graser’s diverticulum”.

Describes the first clinical use of the oesophagoscope by Kussmaul in 1867-68. The latter made only brief mention of it himself in his paper on the stomach pump, Dtsch. Arch. klin. Med., 1869, 6, 456.

Mayo’s operation of partial gastrectomy. Mayo was co-founder of the Mayo Clinic.

Depage used a tube formed from the anterior wall of the stomach, lined with mucous membrane, in his gastrostomy operation.

Weir’s appendicostomy operation.

Various rectal and vesical specula were designed by Kelly.

Development of Bloch’s two-stage Operation for resection of tumors of the rectum. English translation in Medical Classics, 1937, 2, 210-29.

“Herter’s infantilism”. Called also “Gee-Herter disease” (No. 3491).

Miles devised the operation of abdomino-perineal resection.

Report of Hofmeister’s modification of the Billroth II gastro-enterostomy.

Radium therapy by means of the esophagoscope.

Lane’s operation for chronic intestinal stasis (“Lane’s kink”) consisted in short-circuiting the intestine.

Balfour’s operation for resection of the sigmoid colon.

First demonstration of the characteristic niche in gastric ulcer.

Mayo’s radical operation for carcinoma of the rectum.

Moynihan greatly advanced our knowledge of duodenal ulcer. He developed the concept of the so-called ulcer sequence, pain-food-ease, and he stressed the well-ordered sequence of symptoms. More than any other he established treatment of duodenal ulcer on a sound basis.

Elsner designed a straight gastroscope with a rubber tip and an optical system to be pushed into the outer tube, which had a lamp at its tip.

Treatment of congenital atresia of ileum by lateral anastomosis.

Pólya’s modification of the Billroth II operation. Pólya is believed to have been murdered by a Nazi group during the siege of Budapest by the Russians in December, 1944, although his body was never recovered.

First description of the “dumping syndrome”, so named by C. L. Mix, Surg. Clin. N. Amer., 1922, 2, 617-22. (During WWI Hertz changed his name to Hurst; see No. 8604.)

The first pyloromyotomy for pyloric stenosis, incising the pyloric muscle while leaving the mucosa intact and leaving the muscle to heal: “Rammstedt’s operation.” In 1920 Rammstedt discovered that the family name had originally been spelt Ramstedt; he therefore reverted to the original spelling for the rest of his life (see Lancet, 1963, 1, 674).

See also Arch. Surg. (Chicago), 1925, 10, 353-60, which reported that the patient was still living.

“Sippy diet” for the treatment of peptic ulcer.

Shigella alkalescens described.

Hofmeister-Finsterer gastro-enterostomy (see No. 3529).

Ryle’s tube, for obtaining specimens of gastric juice.

Schindler made gastroscopy a “method”. See also his paper in the Münch, med. Wschr., 1922, 69, 535-37.

Konjetzny suggested that peptic ulceration is the sequel to a specific form of gastritis.

Introduction of gastrophotography.

Introduction of tubo-valvular gastrostomy.

Idiopathic steatorrhoea, first described by Gee (No. 3491) was extensively studied by Thaysen, in so far as it occurs in adults and adolescents in non-tropical countries. It also bears the name “Gee-Thaysen disease”.

“Crohn’s disease” – regional ileitis. With L. Ginzburg and G. D. Oppenheimer.

"Some of Crohn's initial research into the causes of the Crohn's disease was centered around his personal convictionthat it was caused by the same pathogen, a bacterium called Mycobacterium paratuberculosis (MAP), responsible for the similar condition that afflicts cattle called Johne's disease. However, he was unable to isolate the pathogen—most likely because M. paratuberculosis sheds its cellular wall in humans and takes the form of a spheroplast, making it virtually undetectable under an optical microscope. This theory has resurfaced in recent years and has been lent more credence with the arrival of more sophisticated methods of identifying MAP bacteria" (Wikpedia article on Burill Crohn, accessed 1-2020).

"While the causes of Crohn's disease are unknown, it is believed to be due to a combination of environmental, immune, and bacterial factors in genetically susceptible individuals.^[6][7][8][2] It results in a chronic inflammatory disorder, in which the body's immune system attacks the gastrointestinal tract, possibly targeting microbial antigens.^[7][9] While Crohn's is an immune-related disease, it does not appear to be an autoimmune disease (in that the immune system is not being triggered by the body itself).^[10] The exact underlying immune problem is not clear; however, it may be an immunodeficiency state.^[9][11][12] About half of the overall risk is related to genetics with more than 70 genes having been found to be involved.^[1][13] Tobacco smokers are twice as likely to develop Crohn's disease as nonsmokers.^[3] It also often begins after gastroenteritis.^[1] Diagnosis is based on a number of findings including biopsy and appearance of the bowel wall, medical imaging and description of the disease.^[1] Other conditions that can present similarly include irritable bowel syndrome and Behçet's disease.^[1] "(Wikipedia article on Crohn's disease, accessed 1-2020).

Cushing advanced the theory that the hypothalamus is responsible for the development of peptic ulcer (see p. 175 et seq.). This work contains his four principal contributions to pituitary-hypothalamic interrelationships, including a reprint of his description of pituitary basphilism (No. 3904).

Introduction of the flexible gastroscope.

Wangensteen’s apparatus for relief of acute intestinal obstruction. See also his Intestinal Obstructions: Physiological, pathological and clinical considerations with emphasis on therapy, including description of operative procedures. Springfield, IL: Charles C Thomas, 1955.

Meulengracht diet.

Vagotomy for peptic ulcer.

Zollinger-Ellison syndrome.

The Hirschowitz fiber optic endoscope, the "Fiberscope."  In February 1957 Hirschowitz passed the first prototype instrument down his own throat and, a few days later, down that of a patient. Hirschowitz gave the first report on the new much thinner, and much more flexible instrument at the Forty-First Annual Meeting of the Optical Society of America, October, 1956. His first very brief published report on the instrument was "A long fiberscope for internal medial examinations," J. Optical Soc. Am. I (1957), 117. This report was co-authored with the co-developers of the instrument, the physicist C. Wilber Peters (1918-89), who developed the glass-coated fiber with the optical qualities required for the fiber bundle of a gastroscope, and Peters's student Lawrence E. Curtiss. Hirschowtiz's 1958 paper cited here was his first report on the new instrument to the gastroenterology community.

First recorded successful appendectomy. Amyand was Sergeant-Surgeon to George II and first principal surgeon to Westminster Hospital. See also the paper in Surg. Gynec. Obstet., 1953, 97, 643-52, which reproduces part of the text.

First case of appendicitis reported in English, and the first in which perforation was recognized as the cause of death. John Parkinson was the son of James Parkinson (No. 4690).

Report of two cases of fatal peritonitis due to perforation of the appendix. Of this paper, H. A. Kelly says, “It at once established a definite place for lesions of the appendix in the category of recognized diseases”.

Mélier was the first to show the existence of chronic appendicitis; he recognized the causal relationship between the chronic affection and abscesses of the right iliac fossa and was first to suggest operative intervention.

First recorded successful operation for peritonitis due to abscess in the appendix. Hancock was surgeon to Charing Cross Hospital, London.

Parker was the first American to operate for appendicitis. In this paper he described a case from 1864, but mentioned a case he had operated on as early as 1843. He advocated the opening of the appendicular abscesses at an early stage; until his time such abscesses had been opened only when they pointed on the surface.

Sands published an account of 26 cases, in which he had operated successfully in all but two. His later publications show that he recognized the early signs of perforation of the appendix, and he advocated and practised early operation.

In 1884 Fenwick advocated tying off and removal of the perforated appendix.

A conclusive demonstration of the pathology and symptoms of disease of the vermiform appendix. Fitz invented the term “appendicitis”; his paper, which records 25 cases collected by himself, convinced physicians of the need to remove the appendix immediately if threatening symptoms did not subside within 24 hours. Reprinted in Med. Classics, 1938, 2, 459-91.

This is believed to be the first reported case of survival after removal of a perforated appendix. Hall worked with William Halsted during the 1880s and participated in Halsted’s experiments with cocaine as a local anaesthetic. Like Halsted, Hall became addicted to cocaine. It caused his premature death.

Thomas George Morton (1835-1903) was one of the first deliberately to operate for and remove the inflamed appendix after correct diagnosis, April 1887. The patient survived. Case reported by Woodbury.

Describes (p. 678) “McBurney’s point”: “The seat of greatest pain, determined by the pressure of one finger, has been very exactly between an inch and a half and two inches from the anterior spinous process of the ilium on a straight line drawn from that process to the umbilicus”. McBurney also includes a description of some successful cases of early operation for perforative appendicitis. Reprinted in Med. Classics, 1938, 2, 506-31.

Lawson Tait was the first British surgeon to diagnose acute appendicitis and to treat it by removal of the appendix (May 1880). See J. A. Shepherd, Lawson Tait. The rebellious surgeon. Lawrence, Kansas, Coronado Press, 1980.

The first comprehensive book on the pathology of the appendix. Many of the illustrations are by Max Brödel. Digital facsimile from the Internet Archive at this link.

Aschoff’s theory of the enterogenous origin of appendicitis.

Clifford Allbutt considered Franco the best lithotomist of the 16th century. His skill in extracting the stone by the perineal route was of a high order; in 1556 he introduced the operation of suprapubic cystotomy in operating for stone, which is recorded in the above. Franco also provided the first description of an operation for strangulated hernia. Franco, in 1556, was the first to perform suprapubic cystotomy. Poor, and largely self-taught, he greatly improved the technique of herniotomy.

Stroymayr's manuscript was discovered in Lindau in 1909, and remained unpublished until the above edition, which reproduced his drawings in color. Like Bartisch (No. 5817) Stromayr specialized in hernia repair and eye surgery; he was advanced in his concept of hernia. His unique manuscript contains 186 large colored paintings of surgical instruments and procedures. The portrait-like illustrations of eye diseases at the end of this work bear a striking resemblance to the woodcuts in Bartisch. 

Greatly expanded second edition, including Franco's operations for cataract and urinary calculi. Digital facsimile from BnF Gallica at this link.

“Littre’s hernia” – so named from his description of diverticulum hernia. Later Richter (No. 3578) described this condition more fully.

Pott was surgeon to St. Bartholomew’s Hospital. Through a fall in the street he was confined to bed for many days, and during that period wrote his classic book on hernia. He refuted many of the old theories concerning its causation and methods of treatment based on these theories. The book includes the first description of congenital hernia.

Records (Vol, 1, pp. 153, 160) the first successful operation for mastoiditis, performed by Petit in 1736. “Petit’s hernia” and “triangle” described (vol. 2, pp. 256-58). (See also No. 3357.) A lumbar hernia had previously been described by R. J. C. de Garengeot, Traité des opérations de chirurgie, 1731, 1, 369-71.

Richter, lecturer on surgery at Göttingen, in his classic treatise on hernia, first described partial enterocele, or “Richter’s hernia” (Chap. 24).

Description of Gimbernat’s operation for strangulated femoral hernia. In the same work he also described the ligament in the crural arch named after him. Gimbernat was a pioneer in ophthalmology, vascular surgery, and urology. English translation as A New Method of Operating for the Femoral Hernia, translated by T. Beddoes, London, 1795. For biographical note, see N. M. Matheson, Brit. med. Bull., 1945, 3, 238-39. Digital facsimile of the 1793 edition from Biblioteca Virtual de la  Real Academia Nacional de Farmacia, España at this link.

Camper illustrated his own work, and was an outstanding anatomical artist. His illustrations of hernias are of great value.

Cooper’s first book, luxuriously produced, in which he described for the first time the transversalis fascia, with full appreciation of its importance in hernia, as well as the superior pubic ligament with bears his name. Cooper made a study of femoral hernia and described “Cooper’s ligament”. He also studied diaphragmatic hernia. The second edition of 1827, entitled The anatomy and surgical treatment of abdominal hernia included his description of “Cooper’s hernia” (hernia femoralis fasciae superficialis).

Includes description of “Hesselbach’s hernia” and “triangle”. He wrote a further volume on the subject in 1814.

This splendidly illustrated work with life-size plates includes the description of “Scarpa’s fascia” (creasteric fascia) and Scarpa’s triangle of the thigh.

Scarpa’s work on perineal hernia included a classic description of sliding hernia, or hernia of the large bowel. His contribution to the subject of hernia ranks with that of Cooper, and he did much toward modernizing the knowledge of this specialty.

This is Cloquet’s medical thesis. It was followed by his thesis in competition for head of the anatomy section of the Paris Faculty: Recherches sur les causes et l’anatomie des hernies abdominales. Paris, Méquignon-Marvis, 1819. Marcy (No. 3601) considered Cloquet’s work to be in the class of Cooper and Scarpa. Cloquet's 1817 work was illustrated with plates engraved by his father. The lithographed plates in the work of 1819 were drawn on stone by Cloquet himself, and are among the earliest lithographed medical illustrations. See No. 409. Digital facsimile of the 1817 work, followed by the 1819 work, from the Internet Archive at this link.

Introduction of the principle of dividing a stricture outside the sac in cases of strangulated hernia.

This was the standard text for many years. It first appeared in 1807 as Treatise on hernia.

Luke’s operation for femoral hernia.

Retrocaecal hernia (“Rieux’s hernia”) first described. Digital facsimile from the Internet Archive at this link.

Treitz described retroperitoneal hernia through the duodeno-jejunal recess – “Treitz’s hernia”.

“Gruber’s hernia” – internal mesogastric hernia.

Marcy was the first to stress the importance of reconstruction of the internal ring following reduction of the sac.

Marcy introduced antiseptic ligatures in the radical cure of hernia. See also No. 3601.

The injection method of treating hernia remained a frequently utilized procedure until the 1930s.

First definitely authenticated case of intersigmoid hernia.

Macewen’s method for the radical cure of oblique inguinal hernia. The sac was folded into a pad and used as a plug at the internal ring, the ring being closed in layers. Reprinted in Brit. med. J., 1887, 2, 1263-71.

Bassini’s operation for the radical cure of inguinal hernia. His first account was unillustrated. Translation in J. Hist. Med., 1966, 21, 401-07. Bassini expanded his paper into an illustrated book with the same title, Pavia, 1889. This book was translated into German in Arch. f. klin. Chir., 1890, 40, 429-76.

Simultaneously with Bassini, Halsted devised the modern operation for the radical cure of inguinal hernia. This is known as the Halsted I repair. Later his technique differed much from that of Bassini. See also his later paper on the subject in the same journal, 1893, 4, 17-24, which is reprinted in Med. Classics, 1938, 3, 412-40.