Antall József szerk.: Orvostörténeti közlemények 60-61. (Budapest, 1971)

KISEBB KÖZLEMÉNYEK — ELŐADÁSOK - Kótay Pál: Százéves a vesesebészet (angol nyelven)

that she may be able to support her children. Therefore, it is not surprising that her own children were repelled by her condition, which in no way differed from that of people suffering of pestilence. Gustav Simon was shocked by this terrible sight. Nevertheless, he didn't turn down the hopelessly-looking patient. He was confident that the condition of the woman will eventually improve and that he—the great expert of these operations—may probably attempt something in her favour. During nine months the unfortunate woman lived in the isolation ward of the hospital, specially created for such patients. During the time necessary for the preparation of the surgical intervention, Simon was equally traversing a most difficult period: a grave epidemic of diphtheria raged throughout the city of Heidelberg, two of his daughters fell victims of the epidemic and his own wife has barely escaped death. In spite of these difficulties, he pursued his clinical work with unswerving diligence, as if nothing would have happened; operated and made detailed preparations for the forthcoming operation to be performed on his patient, who

—as we already know—was willing to assume all risks and endure the most excruciating agonies. At first he made an attempt to close the abdominal fistula with the aid of cutaneous muscle-lobe, so that—later on—the communication may be established between the stump of the ureter and the bladder. He expected to achieve this by plastic surgery. The patient was considerably weakened by the narcosis, as well as by the surgical intervention, which proved to be completely ineffectual, fite same way as the operation performed a few weeks later. After such repeated fahlures, a less determined, a less persevering and—according to the records of the times—a less "obsessed" person would have long given up the fight. Yet, in spite of these difficulties, he refused to retreat: he made a third and even a iourth attempt to achieve a successful operation. It would be difficult to find words to describe the effect which the large amount of this useless suffering and long series of failures have had on both the patient and her physician. While describing his case, the cold and exceptionally reserved Simon has apparently shown no sympathy or compassion towards his patient. But, there is no doubt that the large amount of suffering which he inflicted on his patient by the long series of his unsuccessful operations and apparently fruitless efforts —have implanted in his heart a feeling of recognition and commitment towards this unfortunate woman, for having urged him to explore these new and, as yet, untrodden paths. He was again speculating and brooding over the possibility of a fifth operation, but just couldn't find his way. By this time he was forced to recognize his inability to establish proper communication between the left kidney and the bladder and thus create a natural pathway for the evacuation of the urine. Consequently, the only possibility left was the removal of the kidney. He had to admit that if he is unable to re-establish the natural pathway allowing the evacuation of the urine, the only possibility left is to eliminate the source producing the urine, i.e. remove the kidney, the functioning of which made the patient's life a hell. This, however, appeared to be a desperate undertaking. In those days, Simon couldn't find much encouragement in the history of surgery for the accomplishment of his great task. In the hippocratic writings