Born at Helsen, Waldeck, Germany on 24 November 1861, son of Theodor Bier and Christine Becker. He was educated at Corbach gymnasium and at the Universities of Berlin, Leipzig, and Kiel, where he graduated in 1888 with a thesis, "Ueber circuläre Darmnaht", and qualified as a surgeon the following year, 1889. From 1886 he had acted as assistant to Professor Friedrich von Esmarch at Kiel, and with G A Neuber had been responsible for the change from antiseptic to aseptic methods in their clinic. He became a Privatdozent at Kiel in 1889, was promoted to be a professor extraordinarius (ausserordentlich) in 1894 and moved to Greifswald on his appointment as professor ordinarius and director of the surgical clinic on 1 April 1899. He took up the corresponding posts at Bonn on 1 April 1903, and in 1907 succeeded Ernst von Bergmann at Berlin, where he remained for the rest of his life. His strongly Prussian patriotism precluded him from accepting the flattering invitation to a professorial chair at Vienna on the death in 1903 of Billroth's successor, Carl Gussenbauer. Bier was always an innovator. The three new methods which he most prided himself on having introduced to surgery were spinal anaesthesia, artificial hyperaemia (Bier's stasis), and the treatment of amputation stumps (see list of publications). He was also a pioneer in the use of blood-transfusion, in regenerative surgery, the treatment of enlarged prostate by arterial ligation, and blood-vessel surgery. His early experiments on spinal anaesthesia were made upon himself, inducing a severe illness, through which he was nursed by Frau von Esmarch, his professor's wife. In later life he became interested in organotherapy and homoeopathy, and also made some serious historical research upon Hippocrates and Heracleitus, for he was a good classical scholar. He was much interested in sport and its value for health, and enjoyed shooting, with its development of the observant eye so valuable to diagnostician and scientist. He founded at Berlin an institute for the study of life and health, the Hochschule für Leibesübungen, which he directed from 1919 to 1932. Here he developed his philosophical teaching of the bases of health. His outlook was teleological, not mechanical, and he propounded a doctrine of "roots" (Reizen) to explain various vital and pathologic functions such as nutrition, metabolism, callous formation, etc. In this his thought reverted to eighteenth-century vitalist ideas, which were very general in Germany and also had influenced John Hunter's view of life. Bier's more strictly scientific research was chiefly concerned, in early life, with the physiology and pathology of the collateral circulation. He was a founder of the Hohenlychen institute in the Alps for high-altitude treatment of tuberculosis. Bier received many honours. He was elected an Honorary Fellow of the College at the time of the last general International Medical Congress in London in 1913. He had been awarded the Cameron prize at Edinburgh in 1905 and was elected an honorary Fellow of the Edinburgh College of Surgeons and an honorary Doctor of Laws of the university. He won the Kussmaul prize at Heidelberg in 1906. He was an honorary member of the Vienna and Berlin Medical Societies and the Munich Surgical Association, and was elected an honorary member of the German Society for Surgery in 1927, having been president of its annual conferences in 1910 and 1920. He was a Medical Privy Councillor of the German Empire. Bier married on 29 August 1905 Anna, daughter of Dr Esan of Bielefeld; there were two sons and three daughters of the marriage. His house was at Lessingstrasse No 1, Berlin, NW23. He survived the second world war, and died at Sauen in the Russian zone on 12 March 1949, aged 87. There is a photograph of Bier in the Honorary Fellows' album in the College library, and he appears in the group of Honorary Fellows taken on the College portico in 1913. He was a square-faced Prussian, with a heavy moustache. Publications:- *Hyperämie als Heilmittel*. Leipzig: Vogel, 1903, 220 pp; 6th ed 1907; American translation: *Hyperaemia as a therapeutic agent*. Chicago, 1905. Absetzungen an die Gliedern. *Deutsche Klinik*, 1905, 8. Editor with H Rochs of E v Bergmann and H Roch's *Einleitende Vorlesungen für den Operationskursus an der Leiche*. 5th ed 1908. Contributed to H Braun and H Kümmell's *Chirurgische Operationslehre*. Leipzig, 1912; 4th and 5th ed 1923. Wie sollen wir uns zu der Homöopathie stellen? *Münchener medizinische Wochenschrift*, 1925, 72, 713, 773. *B Heines Versuche über Knochenregeneration*. Berlin, 1926. *Organhormone and Organtherapie*. Munich, 1929. *Hormonisches System der Heilkunde*. Munich, 1929. Tributes to Bier: On his 60th birthday: *Archiv für klinische Chirurgie*, 1921, vol 118, with a portrait. On his 70th birthday: *Deutsche Zeitschrift für Chirurgie*, 1931, vol 234, with a new portrait and a dedicatory letter (pp 1-5) by Anton von Eiselsberg; for surveys of special aspects of Bier's work see in this volume: pp 19-30, Fritz König. Etwas von Lieb und Seele des Chirurgen; pp 76-82, Eugen Kisch. Biers Einfluss auf die moderne Tuberkulosebehandlung. On his 70th birthday: *Zentralblatt für Chirurgie*, 1931, 58, 2931, by V Schmieden, with a portrait. On the 50th anniversary of his qualification, 30 January 1888: *British Medical Journal*, 19 February 1938, 1, 431. On his 80th birthday: *Klinische Wochenschrift*, 22 November 1941.