On This Date: The birth of Emil Theodor Kocher, MD, Swiss surgical pioneer

With the pace of change in the modern world and the emphasis on what's just around the corner, it can be edifying to take a moment to ask where we've been. And so we reflect for a moment on the work of Emil Theodor Kocher, MD, who was born 170 years ago on this date, Aug. 25, 1841.

Kocher was born in Berne, Switzerland, where he earned his medical degree in 1865. He took the position of director of surgery at the Inselspital (Island Hospital), also in Berne, seven years after graduation and would finish his career there. Inselspital is itself no spring chicken, having been founded nearly five centuries ago in 1534.

In the years following his graduation from medical school, Kocher kept himself busy with medical advances such as his work to advance surgical treatment of hyperthyroidism. According to Kocher's biography at the website for the European Thyroid Association (ETA; Altdorf, Germany), Kocher adapted the practice of full excision of ovarian cysts to the treatment of goiters, which is said to have resulted in cretinism in some patients (presumably juveniles) and lesser consequences of hypothyroidism in many others. Kocher would adopt the practice of partial thyroidectomy to address this unforeseen predicament.

Kocher might be at least as well known to modern surgeons for a more methodical approach to surgery than had previously been observed, according to the ETA website. This approach would be adopted by two of the essential figures in the history of the Johns Hopkins Hospital (Baltimore), William Halstead, MD, and Harvey Cushing, MD. Like Kocher, Cushing would also become a seminal figure in surgery of endocrine organs, leading medical science to diagnose and treat the condition named for him, Cushing's disease, attributable to the pituitary gland.

Kocher is also known for Kocher's maneuver, a surgical technique that allowed surgeons to clamp down on bleeding from the inferior vena cava, located behind the heart, and to access tumors of the pancreas. He published on a number of topics, including hemostasis, and his surgical approach to partial and total thyroidectomy is now known as capsular dissection, a technique still in use today.

Among Kocher's legacies is the craniometer, a device intended, as the word indicates, to measure the skull. While there were practical uses for this instrument such as in hat-making, many readers will understand immediately the social ramifications of such a pursuit, namely phrenology, a pseudo-science that caught on with but a few.

Kocher would win the Nobel Prize for Medicine in 1909 for his work on the problems of the thyroid gland, and the ETA website states that a volcano in Manchuria was named for him, as was a crater at the south lunar pole in 2009. Indeed, Dr. Kocher resides in the heavens as well as here on Earth.

Kocher's legacy is not just about surgery, however. The Theodor Kocher Institute can be found on the grounds of the University of Bern (Bern, Switzerland) and was seeded by his Nobel Prize winnings. One discrepancy in the record between the various websites is over Kocher's date of birth. The Kocher Institute claims that Kocher's birth date is Aug. 23 rather than Aug. 25, as is indicated by the ETA.

Kocher and his wife Marie (nee Marie Witchi, 1851-1921) had three sons, including surgeon Albert Kocher, MD (1872-1941), who is said to have assisted his father extensively in the operating room and who presented at the International Society of Surgeons in 1923 on the subject of hypothyroidism. Like his father, the younger Kocher was a published author, writing extensively on surgical technique. Father and son appear in print together in the 1899 edition of the Transactions of the American Surgical Association.

Kocher lived in Berne, the place of his birth, when he passed away on July 27, 1917. In a world of transience and transients, the fact that he died in his birthplace is remarkable by itself. His service to patients with thyroid disease and his efforts to advance the science of surgery, however, make him a legend in the history of medicine.