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Die Geschichte der Lokalanästhesie beginnt im Jahre 1884, als der Wiener Arzt Carl Koller die anästhetische Eigenschaft des Kokains entdeckte [ref:1]. Nachdem er die sich hieraus ergebenden Möglichkeiten für schmerzloses Operieren erkannt hatte, untersuchte er das Kokain[for full text, please go to the a.m. URL], 28. Internationaler Kongress der Deutschen Ophthalmochirurgen

Adam Hammer, born in 1818, and working as a doctor for the poor since 1847 in Mannheim, was the first person in the German speaking world to use ether for pain relief during labor on February 18th 1847. He took part in the abortive April 1848 Revolution in Mannheim - a pinnacle of German liberalism and later of political radicalism, which attented to abolish the Monarchy and introduce a democratic Republic. After the revolution was put down, Hammer emigrated to the United States and settled down in St. Louis, Missouri. Remaining politically active, he joined the Republican Party, founded in 1854 and served as a military surgeon in the Union Army during the American Civil War. Even before the war, he was engaged in efforts to improve the level of medical training in America and was involved with the foundation of High Schools which offered training courses along the lines of German universities. His ideas and innovations were not introduced immediately, but had a significant impact on medical training methology later on in the US. During a visit in Europe in 1876, he was the first to diagnose a coronary thombosis as the cause of a heart attack on a live patient. The diagnosis was later confirmed by post-morten autopsy on the patient. In 1877 he returned to Germany and died one year later. The biography of Adam Hammer mirrows that of many other German-Americans whose emigration proved to be a gain for America but a loss for Germany. This story was destinated to be repeated in terrible circumstances some decades later.

The news about the discovery of the anaesthetic properties of ether swept rapidly from America to Europe. The first informations concerning this topic reached England in late fall of 1846 and after that came to France and especially Paris. The German physician Aloys Martin from Munich who was living in Paris at that time was largely responsible for conveying the news about these new findings in medical science to the German-speaking nations. Controversial discussions concerning the anaesthetic properties of ether developed among the members of various scientific circles right after the news from America had reached the city--and many members of the "Verein Deutscher Aerzte in Paris" (Association of German Physicians in Paris) took part in them, Martin then was one of the club's most active members and repeatedly reported on the new method as a correspondent for the widely read "Augsburger Allgemeine Zeitung": Documents discovered recently at the archives of the "Leopoldinisch-Carolinischen Akademie" of Halle provide an interesting insight into this association, whose members tried to find out more about the anaesthetic properties and side effects of ether carrying out a series of well appreciated self-experiments in the spring of 1847. The following text reports on the history of the "Verein Deutscher Aerzte in Paris" which has largely fallen into oblivion and emphasizes the importance of Aloys Martin whose name is strongly attached to the spread of the use of ether throughout the German-speaking countries.

Bei einem 46jahrigen Patienten mit Funktionsminderung der linken Niere und sonographischer Grosenzunahme wurde bioptisch ein Rezidiv eines hochmaligen Non-Hodgkin-Lymphoms festgestellt. Zeitlich koinzident mit dem einseitigen Nierenfunktionsverlust wurde ein Anstieg des Serum-Ferritins von 2356 µg/l auf 6254 µg/l als Korrelat der Lymphomprogredienz beobachtet (Serum-Eisen, Transferrin und Transferrinsattigung normal). In der immunhistologischen Untersuchung der Nierenbiopsie zeigten die Lymphomzellen ein negatives Resultat bezuglich der Ferritin-Farbung. Ein positiver Ferritin-Nachweis gelang jedoch in histiozytaren Zellen. Vereinzelte Angaben in der Literatur deuten darauf hin, das die Synthese von Ferritin in den Histiozyten im Rahmen einer Neoexpression durch Lymphomzellen induziert werden kann.

At the beginning of the 20th century, the German surgeon Franz Kuhn (1866-1929) was the leading protagonist of various endotracheal intubation technics. In the period between 1900 and 1912, he wrote several papers on this topic including a remarkable monograph on intubation, which was not widely appreciated for decades. In this, he discussed--among others--the advantages and possible risks of the endotracheal intubation, for patients during surgical procedures as well as in situations of cardiopulmonary resuscitation. Kuhn recommended the use of flexible metal tubes which were generally introduced into the trachea under digital control. Kuhn suggested the advantageous use of Kirstein's autoscope, too, a forerunner of modern laryngoscopes. To overcome the "pneumothorax problem" in thoracic surgery, he emphasized the positive pressure ventilation via endotracheal tubes. As an alternative, he suggested the insufflation technique for this purpose. He was the first to incorporate a carbon-dioxide absorption system within the anaesthesia apparatus. Later, he developed technical devices for the perioperative intravenous administration of fluids or the injection of local anaesthetic drugs under high pressure. In honour of Kuhn's 125th birthday, the various contributions to anaesthesia and emergency medicine are outlined.