Biography of Harald Hirschsprung
Harald Hirschsprung was born in Copenhagen in 1830. His father, who was of German stock, was a tobacco merchant and founded the tobacco factory A M Hirschsprung & Søner. Harald was the younger son and it was expected that he would take over the family business. He refused, however, and the father gave in to his son's wish to become a physician.
Already in high school he proved to have a good head for study and in 1848 passed his examination for admittance to the university (baccalaureate - studenteksamen) with top marks in everything but history. He qualified in medicine passing the Staatsexamen in Copenhagen in 1855 and, whilst serving his internship, published several papers on visceral disorders. He was attracted to gastroenterology and his doctoral thesis, which he presented on May 11, 1861, was on the topic of atresia of the oesophagus and small bowel. His interest in rare conditions, especially of the gut, continued throughout his life and he produced a steady stream of publications in this field.
In 1870 Hirschsprung was appointed to a hospital for neonates, thus becoming the first paediatrician in Denmark and was subsequently the obvious choice as chief physician of the Queen Louisa Hospital for Children, which was opened in 1879. A period of academic activity followed and the hospital gained an international reputation for paediatric research. He was appointed professor of paediatrics in 1891. Thereafter Hirschsprung gave tutorials to small groups during the periods allocated to him on Sunday mornings. This arrangement gave him time to conduct a flourishing private practice. As a teacher, however, Hirschsprung was no great success. He had difficulties speaking in front of a large audience, and in his lectures rarely concerned the clinically common and important problems, but preferred to stay with peculiarities. Hirschsprung was against obligatory teaching, and to make sure that only those students who were really interested attended his lectures, he often lectured Sunday morning between 9 and 11 am.
Besides his great achievements in academic research, Hirschsprung also asserted himself as a highly appreciated clinician, both at the hospital and in his private practice. In his daily work Hirschsprung seemed to take an interest in everything, he was as concerned about his patients whether they suffered from some trivial disorder or an "interesting" disease, and regardless of their social standing. On the social level he succeeded in asserting free Medicare for poor children, while well-off families had to pay for themselves.
Hirschsprung was a withdrawn, difficult man, with a streak of determination which alienated many of his peers. The Queen, after whom the hospital was named, requested that biblical texts be placed above each bed but Hirschsprung insisted upon pictures of animals. He achieved his objective, much to the annoyance of the Queen, who thereafter refused to enter his hospital.
In 1904, at the age of 74 years Hirschsprung's abilities were blunted by "cerebral sclerosis" and he was obligated to resign from his hospital and academic appointments. However, he continued his studies of the disorder which bears his name until these activities were precluded by ill-health. At this time he was honorary president of the Danish as well as most foreign paediatric societies. He spent his years in retirement in his country house by Öresund. After the death of his wife in 1910 his life was darkened by a progrediating sclerosis. Harald Hirschsprung died on 11 April 1916 at the age of 85 years.
I 1886, at the congress of the Gesellschaft für Kinderheilkunde (Berlin Congress for Children's Diseases) in Berlin, Hirschsprung gave a lecture titled "Stuhlträgheit Neugeborener in Folge von Dilatation und Hypertrophie des Colons". In this lecture, which was published the following year, he described two infants who had died from the disease that was to bear his name - constipation associated with dilatation and hypertrophy of the colon.
He concluded his account by commenting "it appears unquestionable that the condition is caused in utero, either as a developmental abnormality or as a disease process." He believed the condition to be a new disorder and published a detailed account two years later in the German literature. His report attracted interest and was followed by numerous descriptions which generally employed the eponym that has been retained.
During early years of the present century there was controversy concerning the separate identities of Hirschsprung disease and acquired megacolon consequent upon chronic constipation. This issue was resolved in 1901 when Tille recorded a paucity of ganglion cells in the colonic wall in Hirschsprung disease. Bretano made a similar observation in 1904 and the nature of the basic abnormality was eventually confirmed in 1949 by Bodian et al. who reviewed a large number of autopsy specimens at the Hospital for Sick Children, London.
Hirschsprung published in many areas of paediatrics, including intussusception, rickets, rheumatic nodules, and "his" disease.
We thank Saulo Rodrigues Júnior for correcting a spelling error in the original entry.
- Et Tilfaelde af Subakut Tarminvagination.
Hospitalstidende, 1876, 3: 321-327.
Discouraged by the high mortality of intussusception, Hirschsprung instituted a plan of controlled hydrostatic pressure reduction. By 1905 he was able to present a 35 percent mortality based on 107 personal cases in a disease that was usually fatal in over 80 per cent of cases.
- Fälle von angeborener Pylorusstenose, beobachtet bei Säuglingen.
Jahrbuch für Kinderheilkunde und physische Erziehung, Berlin, 1887-88, n.F. 27: 1-7.
- J. Lister:
Hirschsprung: the man and the disease.
Journal of the Royal College of Surgeons of Edinburgh, 1977, 22: 378.