Antall József szerk.: Orvostörténeti közlemények 60-61. (Budapest, 1971)
KISEBB KÖZLEMÉNYEK — ELŐADÁSOK - Kótay Pál: Százéves a vesesebészet (angol nyelven)
has condemned one of the surgeons, whose attempted splenectomy has ended in failure. Addressing himself to those present, Gustav Simon said the following: "Gentlemen! Today I shall perform such an operation which as yet has never been attempted on man. (Gustav Simon was wrong. E. McDowell has already performed a nephrectomy, but without success. —The Editor). The sufferings of my patient are unbearable and thus, in her case, even such an exceptionally dangerous operation as nephrectomy appears to be justified. One of the accepted principles of surgery is that perilous operations may be performed even in those cases in which the sufferings and physical handicaps make the social existence of man impossible or turn his life into an intolerable burden . ..". Then, he ended his speech like this: "Based on what has been said, you are no doubt convinced, Gentlemen, that the problem regarding the permissibility of the operation has been fully examined in all respects. ... If .. . the result doesn't warrant our expectations and the patient should die as a result of the operation, such an outcome of the matter will hardly change the judgement of our colleagues as to the suitability and permissibility of the operation". The operation began hundred years ago in the surgery of the small German university clinic. Gustav Simon was approaching the organ according to his previously established plan and when finally he succeeded to draw it forth, the pedicle became visible, which was rapidly ligated by one of his assistants. When Simon has cut through the organ, the blood started gushing like a jet. He had to ligate it for a second time, but not even this was sufficient; only a third ligation could stop the haemorrhage. The operation lasted forty minutes, of which the haemostasis required almost ten minutes. Finally, the excised kidney was lying on the table for all to see. But Gustav Simon's tribulations haven't started as yet. The patient has scarcely woken up from the narcosis when she became extremely agitated. She had to be watched constantly by several people, so as to keep her in bed. She was vomiting without interruption and sweating all over. For four days the situation remained unchanged. Simon couldn't get a minute's rest from the problems that were agitating his mind. Weren't the experiences he gained on dogs applied too early on humans? Would the removal of one of the kidneys result in inevitable catastrophy for man? Faced with these difficult problems, he invited one of his Heidelberg colleagues —Professor Delff —for consultation. The latter examined the blood sediment and found no reason for alarm. Nevertheless, the condition of the patient was invariably critical. For days she didn't sleep and her pulse reached 140. The outwardly cold and calm Simon was again tormented by new problems : Did he expect in vain that by applying his method the danger of peritonitis may be avoided? Are the fever and vomiting not symptomatic of the dreaded peritonitis? The vomiting had ceased only on the fifth day. Unlike in the situations characteristic for peritonitis, the abdominal wall was neither sensitive nor stiff.
