Wilhelm Fabry

Biography

• Born on June 25, 1560
• 1587 – Married the Swiss midwife Marie Colinet (1560 – 1640)
• 1588 – Left Geneva with Wilhelm and travelled through France and Germany to Hilden, where they stayed for three years, living in the ‘Haus auf der Bech‘ (the house on the stream).
• 1591 – Moved to Cologne and build a surgical practice. Attended lectures on Anatomy and heard Professor Manlius discoursing on the Aphorisms of Hippocrates.
• 1593 – Published first book De gangraena et sphacelo
• 1596 – Moved back to Geneva then Lausanne to continue his study of Anatomy, performing dissections and giving demonstrations.
• 1598 – Published the first 25 of his documented case-histories in ‘Observationum et curationum chirurgicarum‘. These would later be collated in groups of 100 cases as ‘Centuriae‘, the first being published in 1606. In all, 6 such volumes were published.
• 1602-1611 Town-practitioner to the small town of Payerne (Peterlingen) in the Vaud Canton between Fribourg in Uchtland and the Lake of Neuchatel. However, his ever-increasing reputation brought in requests for consultations from far and wide, some of which entailed an absence from home of several weeks.
• 1615 – Official surgeon to the town and Canton of Berne.
• 1616 – Granted citizenship of the town of Berne.
• 1617 – Master of the Smiths’ Company of Berne; Surgeon to the French Embassy in Switzerland
• Died February 15, 1634 at Berne, 74 years of age leaving a widow Marie and a son, Johannes Fabricius, the only one of eight children to survive him.

Key Medical Attributions

1598 – Richter hernia with treatment. [Centuria I, Observatio; LV: 1682: 45-46] [Observation LXXVIII: 1669: 112]

1606 – One of the earliest descriptions of the neurofibromata of von Recklinghausen disease quoted in [Centuria II, Observatio; XXVI: 1682: 105-106]

1607 – Fabricius was the first to classify burns into three degrees based upon the cause of the burn and distinguishing signs

The Signes by which those three Degrees of combustions may be knowne and distinguished:

First degree burns are caused by a burning object which does not stick to the body for long, e.g. burning straw and hot water or alternatively by the body only touching the object momentarily. The signs and symptoms are redness of the skin and pain followed later by inflammation and the formation of ‘Pustels’ containing clear white water.

Second degree burns are caused by the fiery substance touching the body for a longer period of time, or by its retaining more heat, e.g. hot iron, liquid metal, oil or wax. The place doth presently inflame, waxeth red, painfull and burneth. And in the very same moment pustels are elevated, in which are contained thin water, and waxeth yellow and is sore by reason of the stretching of the skin. The dermis is made destitute of radical moisture from the part and it is something dryed and drawn together but not as yet any eschar made.

Third degree burns are caused by the fiery matter sticking for a long time or by its containing a most violent heat. ‘Pustels’ (or more correctly vesicles) are raised instantaneously. Not only the true skin or dermis but also the flesh, veins, arteries and nerves are burned, drawn together and dried into an eschar. When this falls off a deep ulcer remains.

Fabricius Hildanus, 1607

1608 – First description of talus fracture in his report De admiranda pedis fractura in Centuria II.

…the Rev. Master Woolfbrand of Duisburg, a man strong and fleshy, in jumping from a bank three feet high so twisted and broke his right foot that the whole of the os tali was not only displaced but the ligaments by which it is bound to the other bones, being broken, it burst through the skin and hung out.

Fabricii G. De admiranda pedis fractura, Centuria II; Observatio LXVII 1682: 140

1627 – Description of pyloric stenosis and management, he wrote:

...a small, wasted, six months child, the eldest son of Henry Otho, Esq. This child’s stomach had been, for days, crammed by the nurse or mother with a thick and viscid pultraceous feed…since he was vomiting up everything given by the mouth and was passing nothing through the lower passages, I prescribed one or two nutrient enemata for every day, made from broth to which was added the yolk of an egg and a small quantity of mixed sugars…now perfectly well. Not every obstruction, therefore, of the lower orifice of the stomach is to be considered incurable

Fabricii G. Observatio singularis de obstructione pylori Centuria I; Observatio XXXIV 1682: 30

Alternate Names…

• Wilhelm Fabry; William Fabry; Wilhelm Fabricius von Hilden
• Fabricius von Hilden; Fabricius Hildanus
• Guilielmus Fabricius Hildanus; Guilielmi Fabricii Hildani(Latinized names)

Major Publications

• Fabricii Hildani G. Guilielmi Fabricii Hildani Paterniacensis chirurgi ordinarii Observationum et curationum chirurgicarum centuriae in qua inclusae sunt viginti et quinque. (1606)
• Fabricii Hildani G. De combustionibus, quae oleo et aqua fervidâ ferro candente, pulvere tormentario, fulmine, & quavis alia materiâ ignitâ fiunt libellus 1607
• Fabrici Hildani G. De gangraena et sphacelo, tractatus methodicus : in quo horum morborum differentiae, causae, signa, prognostica, ac denique methodica curatio continentur. 1617
• Fabricius Hildanus. Opera observationum et curationum medico-chirurgicarum, quae exstant omnia 1641 [Talus fracture] [Neurofibromata]
• Fabricius Hildanus G. Experiments in surgery: concerning combustions or burnings made with gun powder, iron shot, hot-water, lightning, or any other fiery matter whatsoever: in which is excellently described the differences, signs, prognostication, and cures of all accidents and burning themselves: very necessary and useful for all gentlemen, and soldiers, as well of the trained bands, as others, especially upon sudden occasions. 1607 [John Steer; English translation 1642]
• Fabri de Hilden G. Observations chirurgiques. 1669
• Fabricii Hildani G. Opera observationum et curationum medico-chirurgicarum, quae exstant omnia. 1682

References

Biography

• Platt WB. Fabricius Guilhelmus Hildanus: The father of German Surgery. Johns Hopkins medical journal. 1905; 166: 7-10
• Jones E. The life and works of Guilhelmus Fabricius Hildanus (1560–1634). Med Hist. 1960; 4: 112-134 and 196–209
• Editorial. Wilhelm Fabry (1560-1624) – The other Fabricus. JAMA. 1964;190(10):933
• Bakay L. Neurosurgeons of the past. Illinois. 1987: 27–38
• Antweiler W. Wilhelm Fabry – Surgeon, Inventor, and Publicist. Wilhelm Fabry Museum. 2010
• Tubbs RS, Song YB, Loukas M, Shoja MM, Gadol AA. Wilhelm Fabricius von Hilden (Guilhelmus Fabricius Hildanus) 1560-1634: pioneer of early neurosurgery. Childs Nerv Syst. 2012 May;28(5):657-9

Eponymous terms/medical attributions

• Schaefer RJ. Ausgewählte Observationes Wilhelm Fabry’s von Hilden (Fabricius Hildanus). Leipzig: Johann Ambrosius Barth. 1914
• Kirkpatrick JJ, Curtis B, Fitzgerald AM, Naylor IL. A modern translation and interpretation of the treatise on burns of Fabricius Hildanus (1560-1634). Br J Plast Surg. 1995; 48(7): 460-70.
• Naylor IL, Curtis B, Kirkpatrick JJ. Treatment of burn scars and contractures in the early seventeenth century: Wilhelm Fabry’s approach. Med Hist. 1996; 40(4): 472-86
• Greenblatt SH. A history of neurosurgery: in its scientific andprofessional contexts. AANS 1997:202
• Steinke W, Zellweger R. Richter’s hernia and Sir Frederick Treves: an original clinical experience, review, and historical overview. Ann Surg. 2000; 232(5): 710-718
• Laios K. Wilhelm Fabricius von Hilden (1560-1634): The Pioneer of German Surgery. Surg Innov. 2018;25(3):301-303.