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Theodore Kocher was Professor of Surgery at Berne for almost half a century. His experimental studies which included those on coagulation of blood, function of the brain and spinal cord, investigation of intracranial pressure, and bullet wounds and his contributions to general surgery were overshadowed by his pioneer work on the thyroid gland. He became the first surgeon to receive the Nobel Prize in Physiology or Medicine. The Nobel Committee cited Kocher for his “work on the physiology, pathology and surgery of the thyroid gland”. Goitre was especially common in Switzerland. In 1883 he found that around one third of his patients who had undergone thyroidectomy developed postoperative myxoedema and the associated idiocy and associated symptoms were indistinguishable from cretinism. He showed that these tragedies could be prevented by not removing the whole of the thyroid gland. By 1898 Kocher reported a series of 600 thyroidectomies with only a single death. He emphasised avoidance of injury to the recurrent laryngeal nerves, which could lead to changes in the voice and tracheal obstruction especially if both recurrent nerves were injured. At the end of his career Kocher had performed more than 5000 thyroldectomies for goitre with a very low mortality of 1%. Calm, cool, imperturbable, and deliberate, Kocher was complete master of all surgical situations. For many years his clinic was a mecca for visiting surgeons from all parts of the world. Harvey Cushing as a young man “found Horsley pre-occupied and everyone else in England on their holidays”. He left England and went to Berne to work with Kocher, who had neurological interests. Cushing's first impression was recorded in his diary for 1 November 1900. He commented on his “detailed technique, tedious operating, absolute hemostasis”. Of interest, Horsley's first work was on myxoedema, for which he suggested implantation of normal thyroid tissue. In 1967 the Swiss honoured Kocher philatelically on the 50th anniversary of his death (Stanley Gibbons 746, Scott B365).
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