Theodore Billroth
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Christian Albert Theodor Billroth (26 April 18296 February 1894) was a German
surgeon In medicine, a surgeon is a medical doctor who performs surgery. Even though there are different traditions in different times and places, a modern surgeon is a licensed physician and received the same medical training as physicians before spec ...
and amateur musician. As a surgeon, he is generally regarded as the founding father of modern
abdominal surgery The term abdominal surgery broadly covers surgical procedures that involve opening the abdomen (laparotomy). Surgery of each abdominal organ is dealt with separately in connection with the description of that organ (see stomach, kidney, liver, e ...
. As a musician, he was a close friend and confidant of
Johannes Brahms Johannes Brahms (; ; 7 May 1833 – 3 April 1897) was a German composer, virtuoso pianist, and conductor of the mid-Romantic period (music), Romantic period. His music is noted for its rhythmic vitality and freer treatment of dissonance, oft ...
, a leading patron of the Viennese musical scene, and one of the first to attempt a scientific analysis of musicality.


Early life and education

Billroth was born at
Bergen auf Rügen Bergen auf Rügen is the capital of the former district of Rügen in the middle of the island of Rügen in Mecklenburg-Western Pomerania, Germany. Since 1 January 2005, Bergen has moreover been the administrative seat of the '' Amt'' of Bergen au ...
in the
Kingdom of Prussia The Kingdom of Prussia (, ) was a German state that existed from 1701 to 1918.Marriott, J. A. R., and Charles Grant Robertson. ''The Evolution of Prussia, the Making of an Empire''. Rev. ed. Oxford: Clarendon Press, 1946. It played a signif ...
, the son of a pastor. His father died of
tuberculosis Tuberculosis (TB), also known colloquially as the "white death", or historically as consumption, is a contagious disease usually caused by ''Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can al ...
when Billroth was five years old. He attended school in
Greifswald Greifswald (), officially the University and Hanseatic City of Greifswald (, Low German: ''Griepswoold'') is the fourth-largest city in the German state of Mecklenburg-Western Pomerania after Rostock, Schwerin and Neubrandenburg. In 2021 it surpa ...
where he obtained his ''
Abitur ''Abitur'' (), often shortened colloquially to ''Abi'', is a qualification granted at the end of secondary education in Germany. It is conferred on students who pass their final exams at the end of ISCED 3, usually after twelve or thirteen year ...
'' degree in 1848. Billroth was an indifferent student, and spent more time practicing piano than studying. Torn between a career as a musician or as a physician, he acceded to his mother's wishes and enrolled himself at the
University of Greifswald The University of Greifswald (; ), formerly known as Ernst-Moritz-Arndt University of Greifswald, is a public research university located in Greifswald, Germany, in the state of Mecklenburg-Western Pomerania. Founded in 1456, it is one of th ...
to study medicine, but gave up the whole of his first term to the study of music; Professor Wilhelm Baum, however, took him with him to
Göttingen Göttingen (, ; ; ) is a college town, university city in Lower Saxony, central Germany, the Capital (political), capital of Göttingen (district), the eponymous district. The River Leine runs through it. According to the 2022 German census, t ...
, and his medical career was fixed. He then followed Professor Baum to the
University of Göttingen The University of Göttingen, officially the Georg August University of Göttingen (, commonly referred to as Georgia Augusta), is a Public university, public research university in the city of Göttingen, Lower Saxony, Germany. Founded in 1734 ...
, and completed his medical doctorate at the Frederick William University of
Berlin Berlin ( ; ) is the Capital of Germany, capital and largest city of Germany, by both area and List of cities in Germany by population, population. With 3.7 million inhabitants, it has the List of cities in the European Union by population withi ...
in 1852. Along with Rudolph Wagner (1805–1864) and
Georg Meissner George Meissner (19 November 1829 – 30 March 1905) was a German anatomist and physiologist born in Hanover. He studied medicine at the University of Göttingen, where he worked closely with Rudolf Wagner (1806–1864). In 1851 he accompa ...
(1829–1905), Billroth went to
Trieste Trieste ( , ; ) is a city and seaport in northeastern Italy. It is the capital and largest city of the Regions of Italy#Autonomous regions with special statute, autonomous region of Friuli-Venezia Giulia, as well as of the Province of Trieste, ...
to study the torpedo fish.


Career in surgery

From 1853 to 1860 Billroth was an assistant in Bernhard von Langenbeck’s surgical clinic at the
Charité The Charité – Universitätsmedizin Berlin (Charité – Berlin University of Medicine; ) is Europe's List of hospitals by capacity, largest university hospital, affiliated with Humboldt University of Berlin, Humboldt University and the Free ...
in Berlin. There he was also apprenticed to Carl Langenbuch. In 1860, Billroth accepted an offer from the
University of Zurich The University of Zurich (UZH, ) is a public university, public research university in Zurich, Switzerland. It is the largest university in Switzerland, with its 28,000 enrolled students. It was founded in 1833 from the existing colleges of the ...
to become the Chair of Clinical Surgery, becoming director of the surgical hospital and clinic in Zurich. The beginning of his career in Switzerland was unpromising: during his first semester of teaching, he had only ten students, and he himself said that the income he received from his private practice was insufficient to pay for his morning cup of coffee. His reputation quickly grew however; Billroth had an infectious personality, attracting both students and surgical trainees to his ranks. He was loved by his students, and was an effective undergraduate as well as graduate teacher. Students flocked to his lectures, and with the cooperation of energetic colleagues, he was able to raise the Medical Faculty of Zurich to a prominent position among German speaking schools in only a few years. While in Zurich, Billroth published his classic textbook ''Die allgemeine chirurgische Pathologie und Therapie'' (''General Surgical Pathology and Therapy'') (1863). At the same time he introduced the concept of audits, publishing all results, good and bad, which automatically resulted in honest discussion on morbidity, mortality, and techniques – with resultant improvements in patient selection. He was appointed professor of surgery at the
University of Vienna The University of Vienna (, ) is a public university, public research university in Vienna, Austria. Founded by Rudolf IV, Duke of Austria, Duke Rudolph IV in 1365, it is the oldest university in the German-speaking world and among the largest ...
in 1867, in succession to Franz Schuh; there, he practiced surgery as chief of the Second Surgical Clinic at the ''Allgemeine Krankenhaus'' (Vienna General Hospital). Though he laid the foundation of his fame at Zurich, it was in Vienna, a larger and more conspicuous theater, that he established himself as the power that he was in the surgical world. A speech he gave in 1875, protesting influxes of Jewish medical students, has been counted as one of the first events in the development of Viennese political anti-Semitism. During the Franco-Prussian War, Billroth did excellent work in the military hospital at Mannheim and Weissenburg, treating a variety of horrific battlefield injuries with aggressive and ambitious surgeries; he embodied his experience of war surgery in his ''Surgical Letters from Mannheim and Weissenburg.'' He was so impressed by the horrors of war that he was ever afterwards an ardent advocate of peace. On December 3, 1891, he delivered an address on the care of the wounded in war which made a profound sensation and led to large sums of money being voted by the Austrian legislative chambers for the provision of adequate means of succour for the wounded. He did not limit himself to surgery only, and conducted extensive research on an ailment that affected many surgery patients at the time: wound fever. His treatise on wound fever, ''Untersuchungen über die Vegetationsformen von Coccobacteria septica'' (1874; “Investigations of the Vegetal Forms of ''Coccobacteria septica''”) concluded that the cause was bacterial; Billroth was quick to use
antiseptic An antiseptic ( and ) is an antimicrobial substance or compound that is applied to living tissue to reduce the possibility of sepsis, infection, or putrefaction. Antiseptics are generally distinguished from ''antibiotics'' by the latter's abil ...
techniques in his surgical practice, and the number of surgical patients afflicted with wound fever greatly decreased. With the threat of fatal surgical infections lessened through his work and others’, Billroth proceeded to turn his attention to surgery and the pioneering field of altering or removing organs that had previously been considered inaccessible. An early adopter of the " white coat" (as shown in Seligmann's c.1890 painting), Billroth was directly responsible for a number of landmarks in surgery; in 1872, he was the first to conduct an
esophagectomy Esophagectomy or oesophagectomy is the surgical removal of all or parts of the esophagus. Medical uses The principal objective is to remove the esophagus, a part of the gastrointestinal tract. This procedure is usually done for patients with es ...
, removing a section of the oesophagus and joining the remaining parts together. In 1873, he performed the first
laryngectomy Laryngectomy is the removal of the larynx. In a total laryngectomy, the entire larynx is removed (including the vocal folds, hyoid bone, epiglottis, thyroid and cricoid cartilage and a few tracheal cartilage rings) with the separation of the a ...
, completely excising a cancerous larynx. He was the first surgeon to excise a rectal cancer and by 1876, he had performed 33 such operations. By 1881, Billroth had made intestinal surgery seem almost commonplace. But his most famous accomplishment is unquestionably the first successful gastrectomy for
gastric cancer Stomach cancer, also known as gastric cancer, is a malignant tumor of the stomach. It is a cancer that develops in the lining of the stomach. Most cases of stomach cancers are gastric carcinomas, which can be divided into a number of subtypes ...
. On January 29, 1881, after many ill-fated attempts, Billroth performed the first successful resection for antral carcinoma on Therese Heller, who lived for almost 4 months and died of liver metastases. He accomplished this operation by closing the greater curvature side of the stomach and anastomosing the lesser curvature to the duodenum, in an operation that is still known as the Billroth I to this day. Billroth's literary activity was widespread, with the total number of published books and papers of which he was the author numbering about one hundred and forty. He collaborated with Franz von Pitha on a ''Textbook of General and Special Surgery'' (1882). To this, Billroth contributed the section on Scrofulosis and Tuberculosis, Injuries and Diseases of the Breast, Instruments and Operations, Burns, Frostbites, etc. Billroth passed his restless intellectual spirit to numerous distinguished students, creating the "Billroth School" of followers. No aspect of his profession seemed to escape his intense scrutiny, be it research, teaching, administration, or nursing. He not only had something valuable to say about each but often saw to it that his ideas became concrete reality. In all the spheres he sought to influence, he was guided by a belief in the unity of science and art, and by confidence in his own ability to effect change. Billroth was instrumental in establishing the first modern school of thought in
surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...
. He had radical ideas on surgical training, advocating a prolonged surgical apprenticeship on completion of medical studies consisting of preliminary work in hospitals followed by performing operations on cadavers and experimental animals. This would be followed by a 2-3 year assistantship in a surgical department with studies of the surgical literature and the acquisition of advanced practical skills. Among his disciples were the notable surgeons Alexander von Winiwarter, Jan Mikulicz-Radecki and John B. Murphy. William Halsted's pioneer surgical residency program was greatly influenced by Billroth's own methods of surgical education.


Music

Billroth was a talented amateur pianist and violinist. During his time in Zurich he regularly played
string quartet The term string quartet refers to either a type of musical composition or a group of four people who play them. Many composers from the mid-18th century onwards wrote string quartets. The associated musical ensemble consists of two Violin, violini ...
with professional musicians such as Theodor Kirchner and Friedrich Hegar. In 1865 he met Brahms for the first time when the rising composer and pianist played
Robert Schumann Robert Schumann (; ; 8 June 181029 July 1856) was a German composer, pianist, and music critic of the early Romantic music, Romantic era. He composed in all the main musical genres of the time, writing for solo piano, voice and piano, chamber ...
's piano concerto and his own works in Zurich. After Billroth had moved to Vienna in 1867 they became close friends and shared many musical insights. Brahms frequently sent Billroth his original manuscripts in order to get his opinion before publication, and Billroth participated as a musician in trial rehearsals of many of Brahms' chamber works before their first performances. Brahms dedicated his first two string quartets, Opus 51, to Billroth. Billroth and Brahms, together with the acerbic and influential Viennese music critic
Eduard Hanslick Eduard Hanslick (11 September 18256 August 1904) was an Austrian music critic, aesthetician and historian. Among the leading critics of his time, he was the chief music critic of the '' Neue Freie Presse'' from 1864 until the end of his life. Hi ...
, formed the core of the musical conservatives who opposed the innovations of
Richard Wagner Wilhelm Richard Wagner ( ; ; 22 May 181313 February 1883) was a German composer, theatre director, essayist, and conductor who is chiefly known for his operas (or, as some of his mature works were later known, "music dramas"). Unlike most o ...
and
Franz Liszt Franz Liszt (22 October 1811 – 31 July 1886) was a Hungarian composer, virtuoso pianist, conductor and teacher of the Romantic music, Romantic period. With a diverse List of compositions by Franz Liszt, body of work spanning more than six ...
. In the conflict, known as the War of the Romantics, Billroth supported Brahms, but was always fair and measured in his comments. "Wagner was indeed a very considerable talent in many directions," he wrote in 1888. Billroth started an essay called "Wer ist musikalisch?" ("Who is musical?"), which was published posthumously by Hanslick. It was one of the earliest attempts to apply scientific methods to musicality. In the essay, Billroth identifies different types of amusicality (
tone deafness Amusia is a musical disorder that appears mainly as a defect in processing pitch but also encompasses musical memory and recognition. Two main classifications of amusia exist: acquired amusia, which occurs as a result of brain damage, and co ...
, rhythm-deafness and harmony-deafness) that suggest some of the different cognitive skills involved in the perception of music. Billroth died in
Opatija Opatija (; ; ) is a List of cities and towns in Croatia, town and a municipality in Primorje-Gorski Kotar County in northwestern Croatia. The traditional seaside resort on the Kvarner Gulf is known for its Mediterranean climate and its historic bu ...
,
Austria-Hungary Austria-Hungary, also referred to as the Austro-Hungarian Empire, the Dual Monarchy or the Habsburg Monarchy, was a multi-national constitutional monarchy in Central Europe#Before World War I, Central Europe between 1867 and 1918. A military ...
, before he could complete the research. Excelling at both his vocation and his
avocation An avocation is an activity that someone engages in as a hobby outside their main occupation. There are many examples of people whose professions were the ways that they made their livings, but for whom their activities outside their workplaces w ...
, Billroth never saw science and music as being in conflict. On the contrary, he considered the two to complement each other. "It is one of the superficialities of our time to see in science and in art two opposites," he wrote in a letter. "Imagination is the mother of both."


Honours

In 1887 Billroth was made a member of the Austrian ''Herrenhaus'', "
House of Lords The House of Lords is the upper house of the Parliament of the United Kingdom. Like the lower house, the House of Commons of the United Kingdom, House of Commons, it meets in the Palace of Westminster in London, England. One of the oldest ext ...
"; a distinction rarely bestowed on members of the medical profession. In 1888, Theodor Billroth was elected member of the German Academy of Sciences Leopoldina.


Footnotes


Further reading

*
Christian Albert Theodor Billroth: Master of surgery
* Telitschkin I., "Theodor Billroth (1829–1894) in Russland". ''Würzburger medizinhistorische Mitteilungen''. Vol. 23, pp. 385–392. Würzburg: Verlag Königshausen & Neumann GmbH, 2004. *


External links

* {{DEFAULTSORT:Billroth, Theodor 1829 births 1894 deaths People from Bergen auf Rügen Surgeons from the Kingdom of Prussia Physicians from Austria-Hungary University of Greifswald alumni Academic staff of the University of Zurich Academic staff of the University of Vienna People from the Province of Pomerania Emigrants from the Kingdom of Prussia Immigrants to Austria-Hungary Burials at the Vienna Central Cemetery Violinists from Austria-Hungary Pianists from Austria-Hungary University of Göttingen alumni Humboldt University of Berlin alumni Members of the German National Academy of Sciences Leopoldina 19th-century musicians Physicians of the Charité