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Ernst Ferdinand Sauerbruch

Born  1875
Died  1951

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German surgeon and scientist, born July 3, 1875, Barmen; died July 2, 1951, Berlin.

Biography of Ernst Ferdinand Sauerbruch

Ernst Ferdinand Sauerbruch was the son of the technical director of a weawing mill. His father died in 1877 and he was brought up by his mother and grandfather, a shoemaker. He passed the Abur in 1895 and at the age of twenty began the study of natural sciences at the University of Marburg. There he became a member of a Society of students in the natural sciences, the Naturwissenschaftlicher-Medizinischer Verein Studierender zu Marbaurg, a precursor to the present Landmannschaft Nibelungia. However, already in the first semester had to leave this body because of unbecoming behaviour.

He then wanted to change to medicine. However, due to his lack of knowledge of Greek, he had to spend another semester at the state Gymnasium in Mühlheim/Ruhr. He graduated in the autumn of 1896 and then began his medical study in Leipzig. He passed the Staatsexamen in 1901 and continued his education Jena, before returning to Leipzig where he qualified as a physician and received his doctorate. As a student he was influenced by the Swiss anatomist and embryologist Wilhelm His (1831-1903) and besides medicine he attended psychological-philosophical lectures by the German psychologist Wilhelm Wundt (1832-1920).

The poor doctor and the mother superior
Because of the death of his grandfather, Sauerbruch was unable to receive his professional clinical training on a university level. For that, he would have to work for one year as an unpaid voluntary physician, which he could not afford. He therefore worked for a short period of time as country practitioner in Thüringen, but already the same year he came to Kassel to commence a position as assistant physician at a deacon hospital – the Diakonissenkrankenhaus. Here he soon came in conflict with the mother superior (Oberin), as his conscience as a physcian could not comply with the religious dogmatism of the nurses. In October 1901 he therefore changed to the Stadtkrankenhaus in Erfurt, where he first assistant physician in 1902 and devoted himself to surgical education. From this period stems his first scientific work, on lesions of the intestine ruptured intestine. (Darmrisse). He left Erfurt in 1903 to work for a bried period of time in Robert Langerhans’ (1859-1904) pathological-anatomical institute in the Krankenhaus Berlin-Moabit.

Working with Mikulicz-Radecki
It was the father of a deceased friend of his who made it possible for Sauerbruch to embark on an academic career. With his support, Sauerbruch on October 1, 1903 came to Johannes von Mikulicz-Radecki (1850-1905) in the university surgical clinic at Breslau. As an ambulant physician (Volontärarzt) Sauerbruch here conducted his first attempts at thoracic surgery and started to work on his most important invention: a negative-pressure chamber enabling the safe opening of the chest while conducting a pneumothorax. After series of test on animals, Sauerbruch proudly presented his contraption to Mikulicz-Radecki – but the experiment misfired. Mikulicz-Radecki felt insulted and dismissed Sauerbruch from his clinic.

Sauerbruch continued his experiments at a private clinic and eventually won the acceptance of Mikulicz-Radecki. Together they presented the under-pressure apparatus at the surgical congress in Berlin. The first operation conducted on a human failed, however, but subsequently thoracical surgery using the under-pressure chamber advanced rapidly.

On June 8, 1905 Sauerbruch was habilitated with the thesis Experimentelles zur Chirurgie des Brustteils der Speisröhre. Only six days later he attended the funeral of his teacher Mikulicz-Radecki.

With Friedrich in Breslau and Marburg
Sauerbruch then left Breslau to work as head physician in the University Surgical Clinic in Greifswald with Paul Leopold Friedrich (1864-1916) Together they undertook experimental investigations (Parabioseversuche) on the metabolism in two animals that had been surgically conjoined like siamese twins. The question they tried to answer was: How far can the organism of one animal functionally take over for that of the other?

On January 3, 1908, Sauerbruch married Ada Schulz, the daughter of a pharmacologist. They had five children.

In 1908 Paul Friedrich was appointed ordinarius of surgery in Marburg and was accompanied there by Sauerbruch. In Marburg Sauerbruch was physician-in-chief, professor extraordinary, and director of the outpatient clinic.

Professor in Zurich and Munich
In 1910 he was appointed to the chair of surgery in Zurich and came there in 1911, 35 years of age, succeeding Rudolf Ulrich Krönlein (1847-1910). When war broke out in 1914, the Swiss authorities gave Sauerbruch leave to serve with the German medical military service. He was a consultant surgeon to the XV Army Corps. When he returned to work in Zürich after a few months, he devised the arm prosthesis that became famous as the Sauerbruch-Hand. In Zurich Sauerbruch also had a private clinic which was managed by his wife.

Sauerbruch enjoyed working in Zurich and turned down invitations from both Königsberg and Halle. However, he could not resist an invitation from Munich and moved there in 1918. This was just in time for the last King of Bavaria to lend hom the title of Geheimer Hofrat (privy counsellor). In Munich he created the so called Sauerbruch school which would later reach its peak in Berlin.

The peak of his career: Professor in Berlin
In 1927 he was invited to the chair of surgery at the Berlin Charité as well as ordinarius at the university surgical clinic in Ziegelstrasse. Sauerbruch decided to accept the chair at the Charité, succeeding Otto Hildebrand (1858-1927). Before he entered the chair at the Charité in November 1927, Sauerbruch spent six weeks travelling. With his friend Rudolf Nyssen he visited Cordoba to lecture at the Panamerican Congress on Tuberculosis, before visiting Buenos Aires, Montevideo, Santos and Rio de Janeiro.

Because Munich had problems finding his successor, Sauerbruch spent much time travelling between Munich and Berlin, until Eric Lexer (1867-1937) took over the chair in Munich at the end of the winter semester 1928.

In 1931 Sauerbruch made a sensation surgical breakthrough when he operated on an aneurysm of the heart. He also achieved great results with operations of the oesophagus and many other innovative procedures. Proud of his pioneer achievementsand his success, Sauerbruch did not forget to praise his collaborators.

Sauerbruch was never a Nazi, but . .
In Berlin, Sauerbruch became a friend of Max Liebermann (1847-1935), a Jewish painter who was his neighbour and had portrayed Sauerbruch. Despite the increasing reprisals to which the Jewish Liebermann was exposed by the National Socialists, Sauerbruch remained his friend. Sauerbruch and his son were among the few who took part in the funeral procession after the death of Liebermann in Berlin in 1935.

Sauerbruch was neither an ardent Nazi, nor a clear opponent. He was never a member of the Nationalsosialistische Deutsche Arbeiterparteior, nor any of its organisations. However, in 1933 Sauerbruch was among the physicians who signed a letter ”to the physicians of the world” in support of Hitler and National Socialism. The following year Hermann Göring appointed him Staatsrat. Yet, in 1934, Sauerbruch and August Bier were awarded a National Prize (Nationalpreis). At the 94. annual meeting of the Gesellschaft Deutscher Naturforscher und Ärzte in Dresden, he ridiculed the hollowness of Nazi superiority.

Then, in January 1937, in a private context, he warned that Hitler, whom he had known since 1920, could become ”the most insane criminal in the world". Despite this, in September 1937, Sauerbruch, together with Wilhelm Filchner, an explorer of Asia and the Antactic, received (shared) the Deutscher Nationalpreis für Kunst und Wissenchaft (The National Prize for Art and Sciences) at the annual assembly of the National Socialist Party – the Reichsparteitag der NSDAP – in Nuremberg. This prize had been created by Adolf Hitler and was the National Socialists’ answer to Carl von Ossietzky being awarded the Nobel Peace Prize.

In 1937, Sauerbruch was called to the Reichsforschungsrat (Reich Research Council), after having been a member of the central committee of the Deutsche Forschungsgemeinschaft. The Reichsforschungsrat supported the ”research projects” of the SS, including experiments on humans in the concentration camps.

In 1942 he was appointed Surgeon General to the army and as such that year accepted experiments with mustard gaz on inmates in the concentration camp Natzweiler.

On the other hand, Sauerbruch supported Nazi victims and attempted to put a stop to the ”Euthanasia Program T4” and gave room to a group of persons critical of the regime in his villa at Wannsee. This was the Mittwochsgesellschaft – the Wednesday Society. Because some members of this society were among the conspirators of July 20, 1944, Sauerbruch was interrogated but avoided arrest. Claus Schenk Graf von Stauffenberg, the officer who planted the bomb in the reichschancellery was among his patients.

His increasing rejection of the regime was tolerated because the war necessitated his skills as a surgeon and in the techniques of amputation.

Because of support of National Socialism in public statements and the honours bestowed upon him by the Nazis, he was subject to the denazification process. On October 12, 1945, Sauerbruch was charged with having contributed to the reputation of the Nazi dictatorship and was dismissed from his office at the Berliner Gesundheitsrat. However, he was soon allowed to resume his work at the Charité.

Paul Rosenstein (1875-1964), former pysician-in-chief of the Jewish Hospital in Berlin, wrote that Sauerbruch’s name remained politically clean.

The man and the surgeon
Besides surgery Sauerbruch concerned himself with dietics; he emphasised the importance of this kind of therapy in persons who had been operated upon. For patients suffering from tuberculosis he made up a diet renounsing ordinary salt, introducing numerous minerals in its place. Sauerbruch was a living legend, and his circle of patients numbered several famous personalities.

With Victor Schmieden (1874-1945), Sauerbruch published the sixth edition of Chirurgische Operationslehre by August Karl Gustav Bier (1861-1949), Heinrich Friedrich Wilhelm Braun (1862-1934) and Hermann Kümmell (1852-1937).

Besides being an eminent surgeon, Sauerbruch was also a concerned physician and was one of the first to describe stress as a trigger factor in Basedow’s disease. During his service as a military physician in World War I he had noted that this disease occurred conspicuously frequently in soldieers that had been subject to extreme stress.

Sauerbruch's latter years were marred by dementia that adversely affected his personality, intellect, and capacity as a surgeon. The unjustifiable toll of increasing patient morbidity and mortality forced authorities to dismiss him in 1949.

In the year of his death, Sauerbruch published his memoirs, Das war mein Leben, a cheerful-melancholic book that sold in large numbers and was filmed in 1954. He is buried in the cemetery Neuer Friedhof in Berlin-Wannsee.

An asteroid by Freimut Börngen in Tautenburg on April 30, 1992 was named sauerbruch in his honour.

His son Hans (1910-1996) was a well-known painter and the father of the architect Matthias Sauerbruch (born 1955). His son Peter (born in Zürich on June 5, 1913) was a regular officer. On January 5, 1943 he received the Knight's Cross of the Iron Cross for his services during the campaign in Russia, the Unternehmen Barbarossa. On October 12 that year Major Sauerbruch learned on the radio that his father had received the Knight’s Cross of the War Merit Cross (Kriegsverdienstkreuz). Hans was privy to Claus Schenk Graf von Stauffenberg’s plan to assassinate Hitler on July 20, 1944.

    Bank director: I don’t understand why, with such an income, your account is so frequently overdrawn.
    Sauerbruch: If you as a banker don’t know, how can I possibly understand it?
    Quoted by Thorwald in The Dismissal, Chapter 4.
    Translated by R. and C. Winston.

    Der beste Arzt ist die Natur, denn sie heilt nicht nur viele Leiden, sondern spricht auch nie schlecht von einem Kollegen.

Bibliography

  • Ueber die physiologischen und physikalischen Grundlagen bei intrathorakalen Eingriffen in meiner pneumatischen Operationskammer.
    Archiv für klinische Chirurgie, Berlin, 1904, 73: 977-987.
    Verhandlungen der Deutschen Gesellschaft für Chirurgie. 1904, 32, part 2: 105-115.
    Lecture at the 33. Congress in Berlin 6.-9. April 1904.
    Sauerbruch's negative pressure chamber for the prevention of pneumothorax.
  • Die Eröffnung der Brusthöhle in meiner pneumatischen Kammer und neues zur Pneumothoraxlehre. In: Verhandlungen des Kongresses für Innere Medizin. 21. Kongress. Leipzig, 18.-21 April 1904. Pp. 555-560.
  • Experimentelles zur Chirurgie des Brustteils der Speisröhre.
    Habilitation thesis, 1905.
  • Die Verwendbarkeit des Unterdruckverfahrens in der Herzchirurgie.
    Archiv für klinische Chirurgie, Berlin, 1907, 83, 537-545.
  • Blutleere Operation am Schädel unter Ueberdruck nebst Beiträgen zur Hirndrucklehre. Gedenkband für J. von Mikulicz, heraugegeben von seinen Schülern. Pena, 1907: 939-987.
  • Technik der Thoraxchirurgie. With With Emil Dagobert Schumacher (1880-1914).
    Berlin, 1911. 2nd edition entitled Die Chirurgie der Brustorgane, Berlin, 1920 and 1925; 3rd edition 1928 and 1930.
  • Thymektomie bei einem Fall von Morbus Basedowi mit Myasthenie.
    Mitteilungen aus den Grenzgebieten der Medizin und Chirurgie, Jena, 1912/1913, 25: 746-765.
    Thymectomy for myasthenia gravis.
  • Die Chirurgie des Brustfells. In: Handbuch der praktischen Chirurgie, 4th edition, volume 2, Stuttgart, 1913; 6th edition with Georg Schmidt, 1930.
  • Die Beeinflussung von Lungenerkrankungen durch künstliche Lähmung des Zwerchfells (Phrenikotomie).
    Münchener medizinische Wochenschrift, 1913, 60 (12): 625-626.
  • Die extrapleurale Thorakoplastik. With Harry Elving. Ergebnisse der Inneren Medizin und Kinderheilkunde. Volume 10, Berlin 1913: 860-990.
  • Die Wirkung der Künstlichen Zwerchfellähmung auf Lungenerkrankungen. In: Verhandlungen des Deutschen Kongresses für Innere Medizin. 30. Kongress, Wiesbaden, 1913: 404-406.
  • Die willkürlich bewegbare künstliche Hand. Eine Anleitung für Chirurgen und Techniker. Mit anatomischen beiträgen von G. Ruge und W. Felix unter Mitwirkung von A. Stadler. Berlin, Springer, 1916.
  • Die Chirurgie der Brustorgane. Zugleich zweite Auflage der Technik der Thoraxchirurgie. 2 volumes. Berlin, J. Springer, 1920-1925.
  • Ueber Versuche, schwere Formen der Tuberkulose durch diätetische Behandlung zu beeinflussen.
    Münchener medizinische Wochenschrift, 1926, 73: 47-51.
    With Adolf Hermannsdorfer and Max Gerson.
    Gerson introduced salt-restricted diet in the treatment of tuberculosis; this was subsequently modified by Sauerbruch and Hermannsdorfer.
    Gerson-Sauerbruch-Hermannsdorfer diet.
  • Die Chirurgie der Lungen.
    In: Handbuch der praktischen Chirurgie, 6th edition with Georg Schmidt, 1930.
  • Die Chirurgie des Herzens, seines Beutels und der grossen Blutgefässe in der Brusthöhle. In: Handbuch der praktischen Chirurgie, 6th edition with W. Felix, 1930.
  • Willkürlich bewegbahre künstliche Hand. 2 volumes; Berlin, 1916-1923.
  • Kriegschirurgische Erfahrungen. Berlin, 1916.
  • Der Stand der Chirrugie der Brustorgane auf Grund der Entwicklung in den letzten 20 Jahren.
    Archiv für klinische Chirurgie, Berlin, 1924, 133: 276-311.
  • Die Chirurgie der Brustorgane. 3rd edition, Berlin, 1930.
    1: Die Erkrankungen der Lungen. Unter Mitarb. Von H. Alexander.
    2: Chirurgische Behandlung der Lungentuberkulose, Geschwülste der Lungen . . .
  • Erfolgreiche operative Beseitigung eines aneurysma der rechten Herzkammer.
    Archiv für klinische Chirurgie, Berlin, 1931, 167: 586-588. Kongressbericht.
    First successful surgical intervention in cardiac system.
  • Thoracic surgery. With Laurence O. Shaughnessy, London, 1937.
    A revised and abridged edition of Sauerbruch's Die Chirurgie der Brustorgane.
  • Sammelband 1937-1941.
  • Die Stand der Chirurgie der Brustorgane. Jena, 1940.
    From: Ein Queschnitt durch die neueste Medizin dargestellt von ihren Schöpfern, pp. 227-238.
    Veröffentlichungen der Berliner Akademie für ärztliche Fortbildung. 6.
  • Der Arzt im Kriege: Eindrücke einer Frontreise. Berlin, ca. 1940.
  • Die chirurgische Behandlung der durch Inseladenome bedingten hypoglykämischen Zustände.
    Schweizerische medizinische Wochenschrift 1940, 70 (25): 341-348.
  • Steckgeschosse in Herz und Lunge.
    Deutsche Zeitschrift für Chirurgie, Berlin, 1941, 1940, 255 (1 + 2): 152-170.
  • Anton Freiherr von Eiselberg / Eugen Enderlein / Kothar Heidenhain / Anton Waldmann. Nachrufe.
    Deutsche Zeitschrift für Chirurgie, 1941, 254 (11 + 12): 651-660.
  • Das war mein Leben.
    Bad Wörishofen : Kindler u. Schiermeyer, 1951. 640 pages. Later editions in 1956 and 1964.
    His autobiography was made into the film Sauerbruch – das war mein Leben, with Ewald Balser in the leading role. Biographical:
  • Isidor Fischer (1869-1943), publisher:
    Biographisches Lexikon der hervorragenden Ärzte der letzten fünfzig Jahre.
    Berlin – Wien, Urban & Schwarzenberg, 1932.
  • Richard Toellner:
    Illustrierte Geschichte der Medizin. Andreas & Andreas Verlag, Salzburg, 1990.
    Original title: Histoire de la médicine, de la pharmacie, de l'art dentaire et de l'art vétérinaire. Paris 1978.
  • Jeremy M. Norman, editor:
    Morton’s Medical Bibliography. An annotated Check-list of Texts Illustrating the History of Medicine (Garrison and Morton). Fifth edition. Scolar Press, 1991.
  • Karl Vosschule:
    Ernst Ferdinand Sauerbruch.
    In: Dietrich von Engelhardt and Fritz Hartmann, publishers: Klassiker der Medizin. Verlag C. H. Beck, München 1991
  • Sanjay M. Cherian, Rowan Nicks, Reginald S. A. Lord:
    Ernst Ferdinand Sauerbruch: Rise and Fall of the Pioneer of Thoracic Surgery.
    World Journal of Surgery, New York, July 2001, 25 (8): 1012-1020.
  • Wikipedia, der freie Enzyklopädie.
  • M. Dewey, U. Schagen, W. U. Eckart, E. Schönenberger:
    Ernst Ferdinand Sauerbruch and his ambiguous role in the period of National Socialism. Annals of Surgery, August 2006, 244 (2): 315-321.
    "The ambigupus stance of Ferdinand Sauerbruch is probably more typical of the role physicians played during National Socialism then the well-known black-and-white cases".
We thank Rudolf Kleinert, Bad Reichenhall, Germany; and Patrick Jucker-Kupper, Switzerland, for information submitted.

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