Emil Theodor Kocher was the first surgeon to initiate the surgery of thyroid gland, hernia and abdomen. He also attained expertise in the treatment of dislocated shoulders and gunshot wounds. A strong advocate of Joseph Lister, the pioneer of antiseptic surgery, Kocher himself began conducting antiseptic treatments and achieved great success. Majority of the patients survived the surgeries which Kocher undertook. He was awarded the Nobel Prize for Medicine in 1909 for his work on the treatment of goiter and other thyroid disorders. Kocher was the first surgeon to remove the thyroid gland in order to cure goiter. He also published a paper on cretinism (a condition caused by the deficiency of thyroid hormone, existing from birth, marked by dwarfism and mental disorders), explaining that cretinism occurs due to the shortage of thyroid function and it could be prevented. Kocher’s research and findings helped and inspired innumerable physicians, surgeons and medical students of later generations.
Childhood And Education
Emil Theodor Kocher was born on August 25, 1841 in Berne, Switzerland. As a youngster, Kocher was quiet, modest and studious. After completing his early education, he went on to study at University in Berne, from where he graduated in 1865. He went on to study in Berlin, London, Paris, and Vienna, as a student of Langenbeck, Billroth and Lücke. Among all his teachers, Kocher was most influenced by Billroth.
While, Kocher was studying under Billroth, he visited various clinics in Europe, including Vienna. From 1866 onwards, he started publishing experimental works on hemostasis, while he was working as an assistant to Professor Lucke. His work on the new method of healing the dislocated shoulders brought him under the limelight. His methods of remedying dislocations were widely accepted for their simplicity and efficacy. Kocher was appointed as a professor at the surgical clinic in Berne upon George Albert Lucke’s death in 1872.
In 1872 and 1874, Kocher published reports of his goiter operations. Only two deaths were reported out of thirteen, following which, he indulged himself in continual goiter related experiments. In 1883, he published his articles on the 101 goiter surgeries which he conducted. In his articles, Kocher mentioned precisely the ways and means of operating a patient suffering from goiter. He explained a process called total thyroidectomy, meaning the complete removal of the thyroid gland. However, he found that even after total thyroidectomy, a distinctive streak of cretinism occurs in the patients. He treated goiter in various parts and organs of the body like skin, muscle, peritoneum, arteries, intestine, etc. Upon further investigation, he found that total thyroidectomy had a transitory effect on the patients. Either the patients died within the seven years of the surgery or there would be goiter, developed later, in those who survived longer. Kocher described the ailments post thyroidectomy as operative myxedema. Patients diagnosed with myxedema had symptoms such as weight gain, hair loss, tongue thickening, and abnormal heart rates etc. Out of the 100 surgeries conducted by Kocher, at least 30 resulted in serious malaises. It was found that these diseases were caused due the lack of thyroid secretions, essential for a human body. Hypothyroidism, a condition where the thyroid gland stops producing thyroid hormone, was explicated by Kocher as a case, which apart from being surgical or congenial, could also be due to goiter.
In 1889, Kocher issued the results of his next 250 goiter surgeries. He introduced an operation method called “inucloatin resection”. This method still remains the conventional way of operating nodular goiters throughout the world. Kocher described the method of collar incision and also the process of leaving the healthy thyroid tissues, ensuring the proper and adequate functioning of the recurrent laryngeal nerve and the parathyroid glands. Kocher continued his inexhaustible research on thyroid functions, and also showed the importance of iodine in the prevention of goiter.
Nobel Prize In Medicine
In 1909, Kocher was awarded the Nobel Prize in Medicine for his extensive and momentous work on the functioning of the thyroid gland. By 1912, he had already done 2000 surgeries of thyroid.
Other Notable Developments
Kocher’s work on the surgery of hernia is one of his most salient contributions. He came up with the new procedure of pylorectomy (the surgical removal of pylorus part of the stomach). The excision of gall stones from the bile duct through surgery and improvements in the operations related to the duodenum are among some other notable works of Kocher.
Personal Life and Death
Kocher was married to Marie Witchi, with whom he had three sons. His eldest son, Albert, became an Assistant Professor of Surgery and assisted his father.
Death & Legacy
Kocher died on 27 July, 1917 in Berne. Kocher’s theories on thyroid conditions were of great aid in finding cures to the related diseases. He was also the first surgeon to have performed more than 5000 operations. Moreover, he was one of the first to take asepsis seriously and worked on development of infection-free methods of surgery. Including the findings on the function of the thyroid gland and treatment of goiter, Kocher made great contributions in the treatment of maladies associated with the stomach, lungs, intestine and gall bladder. He left an everlasting impression on almost all the branches of modern surgery.
Kocher’s works include results and elaborate writings on various surgeries for different diseases. “Über Schusswunden” (on gunshot wounds), was one of his early works. Most of his works are regarding the treatment of goiter and other thyroid malfunctions. Some of his other works include “ Magenresektion” (Resection of the stomach), “Excisio recti” (Excision of the rectum), “Mobilisierung des Duodenum” (Mobilization of the duodenum) and “Chirurgische Operationslehre” (Theory on surgical operations).