Theodor Kocher Biography (1841-1917)
Emil Theodor Kocher was born August 25, 1841, the son of Jacob Alexander andMaria (Wermuth) Kocher, in Bern, Switzerland. Schooled in Berlin, Germany; London, England; Paris, France; and Vienna, Austria, Kocher received his M.D. from the University of Bern in 1869. That same year he married Marie Witschi-Courant--the couple would have three sons. Newly married and newly graduated from medical school, Kocher visited various European clinics, including one inVienna, where he studied under the most famous European surgeon of the day,Theodor Billroth. In 1872 Kocher, who was only 31 years old at the time, was named professor of clinical surgery at Bern University, a post he would hold for the next 45 years.
Kocher first gained recognition for developing a method for treating a dislocated shoulder, a technique now known by his name. Subsequently, he also created new methods or improvements in existing methods for operations upon the lungs, stomach, gall bladder, intestine, cranial nerves, and hernia. He also developed a special pair of surgical forceps, now known as "Kocher's forceps."
Kocher further contributed to medicine with his Textbook of Operative Surgery, his pioneering of ovariotomy and, especially, his application of theantiseptic techniques of the English researcher and doctor Joseph Lister.
Kocher himself credited his success with thyroidectomy operations in part toLister's method of antisepsis. However, despite his mastery over the operation, Kocher himself considered the increased knowledge about the physiological function of the thyroid gland an even greater advancement in medical science. In 1883, at the congress of the German Surgical Society, Kocher reported that out of his first 100 thyroidectomies, 30 had resulted in a serious disorder. This ailment was apparently a result of the whole, rather than partial, removal of the goiter. The symptoms Kocher described were called operative myxedema, and were akin to naturally occurring myxedema. Patients sufferingfrom myxedema usually reported weight gain, slowing of intellect and speech,hair loss, tongue thickening, and abnormal heart rates, as well as developing blood-related problems of anemia and altered white blood-cell counts. Kocher further related that myxedema symptoms were similar to problems experiencedby patients suffering from sporadic cretinism and cachexia strumipriva, diseases that resulted in mental retardation and dwarfism. Because of Kocher's postulations, it was discovered that a lack of thyroid secretions was the causeof all these diseases. Kocher further pointed out that hypothyroidism can betraced not only to absence of the gland, whether congenital or surgical, butalso to a goiter which has caused the gland to stop working.
Kocher's observations opened the way for future treatment of thyroid disorders. Although initial attempts to rectify the condition by administering thyroid hormone were not particularly successful, researchers recognized the importance of iodine, and in 1914 the effective part of the hormone, thyroxin, wasisolated for effective treatment. Meanwhile, Kocher helped perfect the surgical technique for thyroidectomy, and his surgical mortality rates dropped by agreat margin over the years.
During his long surgical career Kocher performed more than 2,000 thyroidectomies. In time the need for the operation declined as iodine-deprived regions incorporated supplements into their diets. Nevertheless, Kocher's contributions to combatting endemic goiter continue to be recognized in a world where nearly 5% of the population still continues to suffer this disorder.
For his many contributions to medicine, and especially the treatment of goiter, Kocher received the Nobel Prize in medicine in 1909. He died in Bern eightyears after receiving the award.