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Asset Name:
E000864 - Bergmann, Ernst von (1836 - 1907)
Title:
Bergmann, Ernst von (1836 - 1907)
Author:
Royal College of Surgeons of England
Identifier:
RCS: E000864
Publisher:
London : Royal College of Surgeons of England
Publication Date:
2010-02-25
Description:
Obituary for Bergmann, Ernst von (1836 - 1907), Fellow of the Royal College of Surgeons of England.
Language:
English
Source:
Plarr's Lives of the Fellows
Full Name:
Bergmann, Ernst von
Date of Birth:
December 1836
Place of Birth:
Riga, Russian Baltic Provinces
Date of Death:
25 March 1907
Place of Death:
Wiesbaden, Germany
Occupation:
Titles/Qualifications:
Hon FRCS July 25th 1900
Details:
Came of a family of Lutheran Pastors, of long standing in East Prussia and Livonia, his father being Pastor of Rujen in Livonia; but his mother, having to take refuge from an epidemic, he was born at Riga, then the capital of the Russian Baltic Provinces, in December, 1836. On leaving school he failed to get permission from the Czar to enter the theological faculty, so he matriculated in the medical faculty of the Germano-Russian University of Dorpat in 1854. He graduated in 1860 with a “Dissertation on the Passage of the Balsams of Copaiba and Cubebs into the Urine”. After visits to German Hospitals he settled down in Dorpat as a Clinical Assistant and qualified as Dozent in Surgery in 1863. Inspired by the renown of Pirogoff, he volunteered for employment in the Prussian and Austrian War of 1866, and after the battle of Königgrätz, which ended the fighting, was appointed to a Prussian Lazaret. Later he returned to Dorpat for the autumn session. Similarly he served as Chef-Artz at Base Hospitals in Alsace, at Mannheim, and Carlsruhe during the Franco-German War of 1870-1871. Upon this in 1871 followed his appointment to the Professorship of Surgery at Dorpat in succession to Adelmann. When in April, 1877, Russia declared war upon Turkey, Bergmann became Surgeon Consultant to the Army of the Danube invading Roumania. During the campaign up to the battle of Plevna he had the additional advantage of treating wounded under the better conditions supplied by the Baltic Hospital of the Red Cross. He then made a name for himself in the History of Military Surgery by adopting Lister’s antiseptic methods for the first time, for Lister’s proposals had been ignored in the Franco-German War. Moreover, Larrey’s immediate amputation had dropped out of use, being rendered largely impracticable by the wider manoeuvres of war. Bergmann had learnt the principles of Listerian surgery through Nussbaum and Richard Volkmann, and thus replaced the vague ideas concerning putridity and fermentations, about which Bergmann himself had written in 1865. Statistics from the American Civil War stated that of 1000 gunshot wounds of the knee-joint 837 died, of 1000 gunshot wounds of the elbow 194 died. After the battle of Gorni-Dubnik Bergmann dressed 15 cases of gunshot fractures involving the knee-joint, and that for the first time, some thirty to sixty hours after the injury, by thoroughly exploring and cleaning the wound and joint, using as fluid 5 per cent carbolic acid; 8 healed without suppuration, or as good as none; in 7 cases there was suppuration, in 2 slight, in 5 severe and prolonged; 2 dressed forty-eight and sixty hours after wounding underwent secondary amputation through the thigh and recovered. One dressed forty-eight hours after the injury, suffered from pyaemia, underwent secondary amputation, and died. There was much limitation of movement in all the healed cases, in many ankylosis. Among a more inclusive number of 59, 30 healed, 2 after secondary amputations; 24 died, 9 of whom had been amputated; and 5 cases were lost sight of. Even so, this was an enormous advance both in respect to the saving of life, and avoidance of amputation. Bergmann’s service was cut short by severe dysentery complicated by pyaemia. Upon his recovery he accepted the call to become Professor of Surgery at Würzburg, the title of his inaugural lecture in October, 1878, being “The Treatment of Gunshot Wounds of the Knee-joint in War”. There he remained until 1882, when the call to become Professor of Surgery at the Universität’s Klinik in Berlin placed him in the highest rank of German surgeons. Later he was raised to Geheimrath. Bergmann’s second memorial in the history of surgery is the establishment of the aseptic method. Lister’s antiseptic method reached its acme of fame and of general use on the occasion of the 7th International Congress held in London in 1881. After Koch’s report upon the effect of sublimate in destroying anthrax bacilli, Bergmann substituted for carbolic acid the use of perchloride of mercury. The further work of Koch at the Gesundheit’s Amt in Berlin introduced the bacteriological apparatus necessary to produce sterilization by heat. Numbers of Koch’s pupils explored all possible modes of infection of wounds, through the surgeon and his assistants, through the patient’s skin, the dressings, the hospital, the operating theatre, instruments, and apparatus, also the means of sterilizing by steam under pressure, by boiling water, to which salt or bicarbonate of soda was added. Neuber began, at a special hospital in Kiel, to attain sterility in everything coming in contact with a wound. Bergmann in his Klinik, together with his Assistant, Schimmelbusch, and others, adapted bacteriological apparatus and methods to the purposes of surgery. Thus at the 10th International Medical Congress at Berlin in July, 1890, Bergmann and Schimmelbusch demonstrated the methods which ensured sterility of dressing and apparatus, using the bacillus of blue pus as the naked-eye indicator. The Preface by Bergmann to the book by Schimmelbusch begins: “During the 10th International Medical Congress the undersigned exhibited in the Klinik the apparatus for the sterilization of dressings, and entrusted his surgical Assistant, Dr C S Schimmelbusch, with the demonstration of their efficacy against the micro-organisms which affect the course of healing and the treatment of wounds”. The illness and death of Frederick, Crown Prince and Kaiser, was a severe trial and a grave misfortune to Bergmann. The Crown Prince began to suffer from hoarseness in January, 1887. At the beginning of the following March, Gerhardt saw an irregular projection of the left vocal cord and on the diagnosis of a polypoid thickening the galvano-cautery was applied. There followed a further growth and a diminution of movement of the cord. On May 15th epithelioma was definitely diagnosed, and in consultation on May 16th Bergmann recommended laryngofissure and the removal of the affected cord, also possibly part of the thyroid cartilage if involved. It was common knowledge that Hahn in Berlin had successfully operated upon Montague Williams (*Dict Nat Biog*) in that way for the same disease. On May 18th Tobold confirmed the recommendation, and to the proposed operation the Crown Prince agreed, using the words, “Fort muss die Schwellung auf jeden Fall” (Buchholtz, s 462). The operation was fixed for the morning of May 21st, the Crown Princess, the promoter of nursing in Germany, in full accord and supervising preparations. Throughout the operation of complete laryngectomy had been specifically excluded. However, by a telegram sent to Queen Victoria, Morrell Mackenzie had been summoned, and he arrived at 5 pm on the 20th. He brought no instruments with him, and if the use of strange instruments had anything to do with his primary mistakes, quite apart from his persistence in them subsequently, then upon him lay the responsibility. At the consultation held at 6 pm immediately upon his arrival Mackenzie gave the opinion that the growth was of a non-malignant polypous or fibromatous nature. Gerhardt objected on the ground of his previous observations of the fixation of the vocal cord. Mackenzie proposed to nip off a bit for examination, to which Bergmann objected as complicating the operation and its result. On the following day Mackenzie punched off what proved to be a bit of normal mucous membrane, and there was afterwards visible a wound of the *right* vocal cord which had previously been seen to be quite sound. On June 8th, in the absence of Gerhardt, Mackenzie removed two superficial bits of tissue which Virchow reported to be specimens of ‘pachydermia’. As to Virchow’s aloofness in using an indefinite term ‘pachydermia’ instead of ‘leukoplakia’, already defined as a precursor of epithelioma, there is to be noted that the galvano-cautery had already been applied, and there was the uncertainty as to what Mackenzie had actually removed. As far as it went it was claimed for Virchow’s report that it favoured the diagnosis of a non-cancerous growth. Mackenzie persisted in making optimistic assertions as regards prognosis, whilst attributing the fixation of the cord and the steady progress of the disease to perichondritis. Even when Bramann, Bergmann’s first assistant, had been compelled to perform tracheotomy at San Remo on Feb 9th, 1888, Mackenzie continued to make and publish what he afterwards printed in his *Frederick the Noble* about the diagnosis and the adoption of the tracheotomy. Bergmann was urged to go to San Remo, where he arrived on Feb 11th, and spent miserable days arguing with Mackenzie over tracheotomy tubes (*see* his Diary in Buchholtz). After the return to Berlin on March 10th a piece of necrosed cartilage was coughed up, attributed by Mackenzie to perichondritis, but on April 12th Mackenzie had to send to Bergmann for help. When he arrived with Bramann they found the patient nearly asphyxiated, but when another tube was skilfully inserted the asphyxia was relieved and life was prolonged for a further six weeks. A local post-mortem examination was made on June 30th which fully confirmed the correctness of the original diagnosis. Henry Butlin (qv) on November 21st, 1888, addressed a letter to Bergmann on behalf of himself and colleagues expressing sympathy and appreciation. The College conferred the Honorary Fellowship on Bergmann on July 25th, 1900. His speech on receiving the diploma, delivered in vigorous German, was an *apologia pro vita sua*. Bergmann, in conjunction with his assistants, made a great number of contributions to surgery, including articles in the *Deutsche Chirurgie*. He continued active as the Professor of Surgery to the age of 70; towards the end it was noticed that his hand was becoming shaky. His remarkable position at the head of German surgery of his day is shown by the Festschrift in commemoration of his 70th birthday which fills two volumes of the *Archiv für klinische Chirurgie* (1906, lxxxi, with portrait), the first composed of contributions by friends and colleagues, the second volume by assistants and pupils. A fine portrait is included. He died at Wiesbaden on March 25th, 1907, after undergoing two operations for intestinal obstruction, due, as was shown at the post-mortem examination, to an inflammatory stricture of the splenic flexure of the colon. There was a State Funeral at Potsdam. Publications:– *Das putride Gift und die putride Intoxication*, Dorpat, 1868. *Die Resultate des Gelenkresectionen*, Giessen, 1874. “Die Diagnose der traumatischen Meningitis.” – *Volkmann’s Sammlung, klin. Vortr.*, 1876, No. 101, 837. “Kopfverletzüngen.” – *Pitha’s Handbuch*, 1873, Bd. iii, Abt. 1. *Die Behandlung der Schusswunden der Kniegelenks im Kriege*, Stuttgart, 1878, 274, 1. “Die Lehre von den Kopfverletzungen.” – Billroth und Leuke: *Deutsche Chirurgie*, 1880, Lief. 30. “Die Hirnverletzungen.” – *Volkmann’s Sammlung*, 1881, No. 190. “Die Erkrankungen der Lymphdrüsen.” – Gerhardt’s *Kinderkrankheiten*, 1882, Bd. vi, Abt 1. “Die isolerten Unterbindungen der Vena femoralis communis.” –* Würzburg Universität Festschrift*, 1882, Bd. i. Von Bergmann, E, und O Angerer: “Das Verhältniss des Ferment-intoxication zur Septicæmie.” – *Würzburg Universität Festchrift*, 1882. *Die Schicksale der Transfusion im letzten Decennium*, Berlin, 1883. “Die chirurgische Behandlung von Hirnkrankheiten.” – *v. Langenbeck’s Arch.*, 1888, 36, 2 Auf., 1889; 3 Auf., 1899. “Die chirurgische Behandlung der Hirngeschwülste.” – *Volkmann’s Sammlung*, N.F. 200, C 57. “Die Behandlung der Lupus mit dem Koch’schen Mittel.” – *Volkmann’s Sammlung*, N.F., 22, C 7. *Anleitung zur aseptischen Wundbehandlung von Dr. C. Schimmelbusch*. Mit einem Vorwort des Herrn Geheimrath Professor E. von Bergmann, Berlin, 1892. Von Bergmann, Von Bruns, und Von Mikulicz:– *Handbuch der praktischen Chirurgie*, 1902. *Arch. f. klin. Chir.*, 1906, Bd. lxxxi, Th. I, II.
Sources:
Buchholtz, A: *Ernst von Bergmann, mit Bergmann’s Kriegsbriefen*, Leipzig, 1911 3rd ed., 1913

Ponsonby’s *Letters of the Empress Frederick*, London, 1928, passim
Rights:
Copyright (c) The Royal College of Surgeons of England
Collection:
Plarr's Lives of the Fellows
Format:
Obituary
Format:
Asset
Asset Path:
Root/Lives of the Fellows/E000000-E000999/E000800-E000899
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