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Wilhelm Fabry

Wilhelm Fabry (1560-1634)

Wilhelm Fabricius von Hilden (1560-1634) was a German neurosurgeon.

Guilielmus Fabricius Hildanus considered to be the most famous German surgeon of the Renaissance and the ‘Father of German Surgery’. For centuries Fabricius remained one of the foremost surgical authorities not only in Germany and Switzerland but throughout a large part of Europe.

His mental activity was untiring, and he was still working on his books when death overtook him. Among his many contributions to Surgery may be listed his pioneering of amputation of the thigh for which he invented a special tourniquet; the excision of involved axillary glands in a case of cancer of the breast; the first classification of burns into three degrees with appropriate treatment for each variety and the first description of a medical field-chest for military use.

In 1682 the full edition of Fabricius’ Observationum et curationum chirurgicarum centuriæ was published in Latin. This great collection remained the Bible of German Surgery up to the time of Lorenz Heister and included the six ‘Centuriae’ of observations and cures; Letters; and Monographs. He outlines new surgical techniques and surgical instruments for the novel treatment of amputations; nasal polyps; bladder stones; hydrocele; hernia; and ascites…to name but a few


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

References

Biography

Eponymous terms/medical attributions


BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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