Fedor Krause: The First Systematic Use of X-rays In Neurosurgery
Fedor Krause: The First Systematic Use of X-rays In Neurosurgery
World War I broadened the adoption of x-rays in surgery. Marie Curie launched a project to make x-ray machines mobile and trained soldiers to use them in battlefield hospitals. By the end of the war nearly 20 mobile radiographic units were established and had acquired about a million radiographs. On the 50th anniversary of his doctorate on June 22, 1919, the Prussian Academy of Sciences lauded Röntgen's work:
The eminent practical significance of the new rays which you recognized at once but which you, in your noble unselfishness, have left to others to develop practically, was revealed in a most striking manner during the world war. One can say with complete authority that the fruits of your scientific investigations have spared life and limb to hundreds of thousands of poor wounded soldiers, both friend and foe. Thus you are not only esteemed by physical science as its immortal master but also by all humanity as its benefactor. (88)
During the war Krause was a surgical consultant in the German Army and brought his surgical and radiographic expertise together in the treatment of traumatic injuries. Krause edited the 1914 text General Surgery of Brain Diseases, which included clear correlations between x-rays and cranial anatomy and pathology. In the post-war period, x-ray technology would become rapidly developed based on experience and use in the war.
Krause continued to expand his use of x-rays as described in his later text of neurosurgery in 1933, published with his assistant Emil Heymann. Heymann, who is regarded as one of the most eminent disciples and a good friend of Krause, succeeded him at the Augusta Hospital in 1923. Their book Surgical Operations of the Head Illustrated by Clinical Observations for Physicians and Surgeons published in 1933 (Fig. 10) quoted Krause: "…an exposition of the operations of surgery from their clinical aspect…. Each individual case…supplied with a history, a short account of symptoms…the course and after-treatment, and in the cases which ended fatally…important findings from the autopsy record" (v). The text contains 136 pages devoted to brain tumors and 54 pages to posterior fossa surgeries. X-rays, which had become routine in patient care, were used to guide such delicate maneuvers as "opening of the antrum of Highmore" and to visualize even mucous polyps as shadows. Posterior fossa surgery sections contained detailed descriptions. For example, with regard to "extirpation of an arachnoidal sarcoma of the posterior fossa" and symptoms and signs description, Krause wrote, "The X-ray plate showed nothing pathological," suggesting routine, second nature, and widespread use of the technology. In the forward to the book, Albert Ehrenfried from Boston mentioned with regard to the wide use of x-rays and neurosurgery in Krause's book: "The presentation is by no means a narrow one; various methods and modifications of technique are discussed, their advantages compared, and the reasons given why one should be preferred over another" (vii). Krause had found in Heymann "an experienced collaborator" and masterful association; however, the intimate association of Krause and Heymann was not to last. Being Jewish, Heymann was persecuted by the Nazi regime and committed suicide in 1936. Krause, who had fully supported Heymann, was deeply affected by this loss.
(Enlarge Image)
Figure 10.
A: Title page from Krause and Heymann's masterful 1933 text. B: Fedor Krause about the time of the publication of his book with Heymann. C: Emil Heymann succeeded Krause as Chief Surgeon at the Augusta Hospital in Berlin in 1921. Heymann was responsible for many new technical and surgical innovations and brought into full application the neuroradiological techniques begun by Krause. Because of his Jewish heritage, he was dismissed from the University of Berlin in 1935 and died shortly before he could take a position overseas.
Krause's Expanded Use of X-rays
World War I broadened the adoption of x-rays in surgery. Marie Curie launched a project to make x-ray machines mobile and trained soldiers to use them in battlefield hospitals. By the end of the war nearly 20 mobile radiographic units were established and had acquired about a million radiographs. On the 50th anniversary of his doctorate on June 22, 1919, the Prussian Academy of Sciences lauded Röntgen's work:
The eminent practical significance of the new rays which you recognized at once but which you, in your noble unselfishness, have left to others to develop practically, was revealed in a most striking manner during the world war. One can say with complete authority that the fruits of your scientific investigations have spared life and limb to hundreds of thousands of poor wounded soldiers, both friend and foe. Thus you are not only esteemed by physical science as its immortal master but also by all humanity as its benefactor. (88)
During the war Krause was a surgical consultant in the German Army and brought his surgical and radiographic expertise together in the treatment of traumatic injuries. Krause edited the 1914 text General Surgery of Brain Diseases, which included clear correlations between x-rays and cranial anatomy and pathology. In the post-war period, x-ray technology would become rapidly developed based on experience and use in the war.
Krause continued to expand his use of x-rays as described in his later text of neurosurgery in 1933, published with his assistant Emil Heymann. Heymann, who is regarded as one of the most eminent disciples and a good friend of Krause, succeeded him at the Augusta Hospital in 1923. Their book Surgical Operations of the Head Illustrated by Clinical Observations for Physicians and Surgeons published in 1933 (Fig. 10) quoted Krause: "…an exposition of the operations of surgery from their clinical aspect…. Each individual case…supplied with a history, a short account of symptoms…the course and after-treatment, and in the cases which ended fatally…important findings from the autopsy record" (v). The text contains 136 pages devoted to brain tumors and 54 pages to posterior fossa surgeries. X-rays, which had become routine in patient care, were used to guide such delicate maneuvers as "opening of the antrum of Highmore" and to visualize even mucous polyps as shadows. Posterior fossa surgery sections contained detailed descriptions. For example, with regard to "extirpation of an arachnoidal sarcoma of the posterior fossa" and symptoms and signs description, Krause wrote, "The X-ray plate showed nothing pathological," suggesting routine, second nature, and widespread use of the technology. In the forward to the book, Albert Ehrenfried from Boston mentioned with regard to the wide use of x-rays and neurosurgery in Krause's book: "The presentation is by no means a narrow one; various methods and modifications of technique are discussed, their advantages compared, and the reasons given why one should be preferred over another" (vii). Krause had found in Heymann "an experienced collaborator" and masterful association; however, the intimate association of Krause and Heymann was not to last. Being Jewish, Heymann was persecuted by the Nazi regime and committed suicide in 1936. Krause, who had fully supported Heymann, was deeply affected by this loss.
(Enlarge Image)
Figure 10.
A: Title page from Krause and Heymann's masterful 1933 text. B: Fedor Krause about the time of the publication of his book with Heymann. C: Emil Heymann succeeded Krause as Chief Surgeon at the Augusta Hospital in Berlin in 1921. Heymann was responsible for many new technical and surgical innovations and brought into full application the neuroradiological techniques begun by Krause. Because of his Jewish heritage, he was dismissed from the University of Berlin in 1935 and died shortly before he could take a position overseas.
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