Antall József szerk.: Orvostörténeti közlemények 60-61. (Budapest, 1971)
KISEBB KÖZLEMÉNYEK — ELŐADÁSOK - Kótay Pál: Százéves a vesesebészet (angol nyelven)
branches of medicine, but when it came to some practical activity, he was more capable and better informed than hundreds of his colleagues. He pursued his aims with such persistency and determination that, according to many, he did never retreat. Besides, he is cold and apathetic". When, after being a military surgeon, he was appointed a university professor, Jobert de Lamballe inspired him. While speaking about his famed Parisian master, Simon always referred to him as the great teacher and inspirer of his youth, as the man having marked out for ever the entire future course of his life and —indirectly—that of the great venture of nephrectomy as well. In 1851 and 1852 he witnessed various successful vesico-vaginal fistulectomies, performed in Paris by Jobert. In an era when obstetrical knowledge was still in its teens, a fistula caused by the injury of the birth canal condemned many a young mother to a life of suffering and death. This suffering, as well as the helplessness of the surgeons of that time was dramatically described by the father of plastic surgery, Dieffenbach, who himself has stood helpless before the great task: ,,There is no more miserable sight than when a woman is affected by a vesico-vaginal fistula. The once beloved wife will become the subject of her own, as well as that of her husband's revulsion. The fondest mother must flee from the midst of her children. I operated one of these women no less than eighteen times, but couldn't bring her back to health ; whole wards were filled with these unfortunate people, gathered from all parts of the country. Although I devoted myself entirely to this task, my efforts proved to be either completely useless or resulted only in a very slight improvement." As regards the subject of fistulectomies, there is no doubt that Jobert has served as Simon's paragon. Having returned home and after eight more years of hard work, he became the most reputed German surgeon specializing in the operation of fistulas. Therefore, as a recognition of his merits and excellent reputation he is appointed in 1861 as professor of surgery, first at Rostock, then—in 1868—at Heidelberg. This is where, in the summer of 1866, he is visited by a poor, 46-years-old workwoman— Margaretha Kleb—, mother of two children, who was living in the small neighbouring city of Offenbach. The unfortunate, emaciated, deathly pale woman was leaning feebly on her stick, giving off a foul smell. One and a half years ago she was operated by an Offenbach surgeon for an ovarian tumor. Both the tumor, as well as the ovary were closely interlaced and, therefore, had to be removed together, but unfortunately a large portion of the left ureter was also excised. Noting this, the surgeon got frightened, closed the wound and left the patient to her fate. During his long practice Simon has seen many critical cases involving fistulas, but of all these none appeared to be more hopeless than this one. The wound of the abdominal wall has turned into an open channel of the fistula and, depending of the fact whether the woman was lying, standing or walking —the evacuation of the urine was taking place either through the abdominal fistula or the birth canal. And what is more, despite her grave condition, the patient was compelled to take care of her household and attempted to make some money by washing, so
