Billroth, Christian Albert Theodor

(b. Bergen, on the island of Rügen; Germany, 26 April 1829; d. Abbazia, Istria, Italy [now Opatija, Yugoslavia], 6 February 1894)

pathological anatomy.

Billroth’s father, Theodor, was a clergyman; his mother, Christine Nagel, was the daughter of a Berlin Kammerrat (counsellor of the exchequer). His father died when Theodor was five, and his mother then moved to Greifswald, where Billroth attended the Gymnasium. He was musically inclined (a family characteristic) and probably for that reason was not an exceptional pupil, even needing tutoring at home; he seemed unable to master languages and mathematics, was not quick-witted, and spoke slowly.

His mother and two professors of medicine in Greifswald, Baum and Seiffert, induced Billroth to become a doctor for financial reasons. He was nevertheless an artist: intuitive, humane, inventive. His home in Vienna later became a musical center where he played second violin or viola and became friends with Johannes Brahms and with the musical theorist and writer Eduard Hanslick. Two of Brahms’s string quartets are dedicated to Billroth, and during his last illness Billroth was working on the physiopsychologicalbook Wer ist musikalisch?, published by Hanslick in 1896.

During his first semester as a medical student in Greifswald, Billroth studied natural sciences and began the multifaceted activity and careful use of his time that characterized his later years. He followed Baum to the University of Göttingen, where he established a lasting friendship with Georg Meissner. Like Billroth, Meissner was interested in music and a pupil of the physiologist Rudolf Wagner, who taught Billroth microscopy. With Wagner and Meissner, Billroth went to Trieste to study the origin and insertion of the nerves of the torpedo fish. In 1851 he continued his studies at Berlin with Bernard von Langenbeck, Johann Lukas Schönlein, Moritz Romberg, and Ludwig Traube. Traube taught him experimental pathology and encouraged him to write the thesis “De natura et causa pulmonum affectionis quae nervo utroque vago dissecto exoritur.” On 30 September 1852 Billroth received his doctorate, and that winter he passed the state medical examination, after which he worked in the ophthalmological clinic of Albrecht van Graefe.

In order to take courses in dermatology with Ferdinand von Hebra, in pathology with Henschel, and in internal medicine with Johann von Oppolzer, Billroth went to Vienna in the spring of 1853. That fall he tried in vain to establish himself as a general practitioner in Berlin, but after a few months he was appointed assistant to Langenbeck at the surgical clinic of Berlin University. He published on pathological histology and in 1856 became Privatdozent in surgery and pathological anatomy. Later he lectured on surgery and gave practical demonstrations.

It was in Berlin that Billroth met his wife Christine, daughter of the court physician Edgar M. Michaelis and of Karoline Eunike. They were married in 1858, and of their four daughters and one son, three daughters survived.

In 1860 Billroth was nominated ordinary professor and director of the well-known surgical hospital and clinic at Zurich. He added greatly to its fame and its growth during the seven years he was its director. Modern surgery was in its infancy, and Billroth was especially interested in the causes of wound fever. He insisted on regular temperature-taking and believed that wound fever was caused by a chemical poison produced by some living organism. His Die allgemeine chirurgische Pathologie und Chirurgie in fünfzig Vorlesungen (1863) is a classic surgical textbook. Billroth collaborated with Pitha on Handbuck der Chirurgie (1865–1868) and with Lücke on DeutscheChirurgie (1879). After having declined calls to Rostock and Heidelberg, he was appointed professor of surgery and director of the surgical clinic at the University of Vienna, where he remained until his death, much beloved by his students, assistants, and patients.

Billroth excelled as a surgeon, as a teacher, and as a scientist. He performed many hazardous operations successfully because of his great ability and caution. Chirurgische Klinik (1869–1876), his collection of clinical experiences and the surgical results of his Zurich and Vienna years, is notable because it reports failures and successes alike. Billroth was one of the first to introduce antisepsis on the Continent and was the first to resect the esophagus (1872), to perform total laryngectomy (1873), and to resect a cancerous pylorus (1881), which caused a great sensation in medical circles. His methods of resection, although modified, remained in use for many years. Plastic surgery, especially of the face, was another of his specialties.

Billroth founded the House of the Society of Physicians in Vienna and the Rudolfinerhaus, a nursing school for which he wrote the handbook Ueber die Krankenpflege im Hause und im Hospitale (1881). He was a member of the Academy of Sciences in Vienna and honorary member of thirty-two scientific societies, and a member of the Austrian Herrenhaus (from 1886); he was also honored with sixteen high decorations. His bibliography contains some 150 items.

Billroth kept his robust health until February 1887, when he contracted pneumonia and suffered from cardiac weakness that increased during his last years. His pupils, who spread his teaching all over the Continent, included Czerny, Gussenbauer, Mikulicz, Eiselsberg, Wölfer, Nikoladoni, Hacker, Winiwarter, Gersuny, Salzer, Fraenckel, and Narath.

BIBLIOGRAPHY

I. Original Works. A full list of Billroth’s publications is K. Gussenbauer, in Wiener klinische Wochenscrift, 7 (1894), 118–120; and Mikulicz, in Berliner Klinische Wochenschrift, 31 (1894), 203–205. His thesis Was “De natura et causa pulmonum affectionis quae nervo utroque vago dissecto exoritur” (Berlin, 1852). His major publications include “Beobachtungsstudien über Wundfieber und accidentelle Wundkrankheiten,” in Archiv für klinische Chirurgie, 2 (1861); 6 (1864); 8 (1866); 13 (1872); Die allgemeine chirurgische Pathologie und Chirurgie in fünfzig Vorlesungen (Berlin, 1863; 16th ed., 1906), translated as General Surgical Pathology and Therapy (1871; 3rd ed., 1880); and Chirurgische Klinik, 4 vols.(Berlin, 1869–1879). Billroth collaborated with Pitha on Handbuch der Chirurgie (1865–1868) and with Lücke in editing Deusche Chirurgie (1879). On the study of medicine he wrote Uber das Lehren und Lernen der medizinischen Wissenschaften (Vienna, 1876) and Aphorismen to it (Vienna, 1886). His handbook for nurses is Ueber die Krankenpflege im Hause und im Hospitale (Vienna, 1881; 7th ed., 1905), Among his special studies are Chirurgische Briefe aus den Kriegslazarethen in Weissenburg und Mannheim 1870 (Berlin, 1872); Untersuchungen über die Vegetationsformen von Coccobacteria septica (Berlin, 1874); and “Offenes Schreiben und Herrn Dr. D. Wittelshöfer” (on the stomach resection performed 29 January 1881), in Wiener medizinische Wochenschrifi, 31 (1881), cols. 161–165. Billroth’s autobiography is in Wiener klinische Wochenschrift, 7 (1894), 120–122, and Wiener medizinische Blätter, 17 (1894), 91–95. His last work, Wer ist musikalisch, was published by his friend Hanslick (Berlin, 1896).

II. Secondary Literature. Articles on Billroth’s operations are K. Gussenbauer (on the first laryngectomy, 27 November 1873), in Archiv für klinische chirurgie, 17 (1874), 343–356; Mikulicz, “Ueber die Totalexstirpation des Uterus,” in Wiener medizinische Wochenschrift, 31 (1881), cols. 241–245; and “Zur Resektion des carcinomatösen Magens,” ibid., cols 634–635. J. Mundy, “Ein neues Buch von Th. Billroth,” in Wiener medizinische Wochenschrift, 31 (1881), cols. 225–229 and 251–254, consists of notes on Billroth’s work and a bibliography. On his Zurich period see A. Huber, “Prof. Dr. Theodor Billroth in Zürich 1860–1867,” in Züricher meditinische Geschichte I (1924). On Billroth’s relation to Brahms see O. G. Billroth, Billroth und Brahms im Briefwechsel (Berlin-Vienna, 1935). His genealogoy is P. von Gebhardt, “Ahnentafel berühmter Deutscher, I,” in Familiengesch. Blätter, 27 (1929), 88–89. Additional correspondence is in G. Fischer, ed., Briefe von Theodor Billroth (Hannover-Leipzig, 1895; 9th ed., 1922); W. Vall Brunn, Jugendbriefe Theodor Billroth an Georg Meiszner (Leipzig, 1941); and Wiener klinische Wochenschrift, 7 (1894), 122–124, 425–427.

Obituaries are K. Gusstmbauer, in Wiener Klinische Wochenschrift, 7 (1894), 115–117, with complete bibliography and list or honors; Jahrbuch der Universität Wien (Vienna, 1893–1894), pp. 37–46, with Gussenbauer’s bibliography and list of honors; and J. Mikulicz, in Berlinerklinische Wochenschrift, 31 (1894), 199–205 based on R. Gersuny’s biography in Nord und Süd, 141 (1888), with complete bibliography; see also Oehlsebläger, “Jugenderinnerungen an Theodor Billroth,” ibid., 229–230; and E. van Bergmann, memorial speech, ibid., 205–207. Additional obituaries are A. von Bardeleben, in Deutsche medizinische Wochenschrift, 20 (1894), 145; E. von Bergmann and E. Gurlt, in Archiv für klinische Chirurgie (1894); M. Benedikt, in International klinische Rundschau, 8 (1894), 184–189; E. Hanslick, in Deutsche Rundschau, 20 (1893–1894), 274–277; E. Kappeler, in Archiv für klinische chirurgie (1894), 161; Sozin, in Korr. bl. Für Schweizer Ärize (1894), 129; and A. Wölfer, in Archiv für klinische Chirurgie (1894), Wiener medizinische Wochenscrift (1894). 339, and Zentralblatt für Chirurgie (1894).

There is a biography by R. Gersuny (Berlin-Leipzig-Munich, 1922). See also I. Fischer, Billroth undseine Zeitgenossen (Berlin-Vienna, 1929); H. Fischer, in Medical Life, 37 (1930), 432–440; J. C. Hemmeter, in Johns Hopkins Hospital Bulletin, 11 (1900), 297–317; R. E. Weise, in Annals of Medical History, 10 (1928), 278–286; Mitteilungen für die Geschichte der Medizin und Naturwissenschaften, 28 , 238–314; and Winiwarter, in Wiener klinische Wochenschrift, 20 (1909), 309–312.

H. Engel.