JF Ptak Science Books Post 2711
I don't intend to say anything at all, really, about the following drawings--I was attracted to them and purchased them a while ago, figuring them to be pituitary tumor removal of some sort and knew that for being done in 1930 that they were sort of early. The twelve fine pen and ink images were made by the prolific anatomical/medical illustrator Bruno Keilitz (b. 1898) and do indeed show some of the stages of the removal of a pituitary tumor. The illustrations seem to have been for an article written by Dr. Prof. Oscar Hirsch (1877-1965), who was an early and influential Viennese rhinologist who made major contributions to pituitary surgery, performing this transspheroidal procedure for Harvey Cushing in 1911, and who would go on to perform the procedure more than 500 times in his long career.1 Cushing of course is the Big Name, though in this area of neurology I found out that Hirsch is looms pretty large as well. I don't know how these stand in the history of this operation, but they certainly seem interesting enough to share online, and so I do:
Details:
- Of the 12 drawings, 9 are very closely related and show the progress and route of a transsphenoidal surgery for the removal of a pituitary tumor. I feel pretty confident that these drawings were done in 1930 (see below). These images are labeled I-VIII (including a “Ia”). These images measure about 6x8.5 inches each, drawn on a heavy stock, and done in colors. Each of these images is drawn from the same perspective and show different aspects of the surgery in progression. These drawings I-VIII are all rubbers tamped on the back with Bruno Kelitz's name and address; two of this series are signed by Kelitz in the drawing, both of which are dated 1930. There are also some other notations in ink on the reverse that I can't quite place, as well as some later dates, as the images seem to have been used on more than one occasion.
One drawing in this series has an old American Medical Association label (seemingly stamped Feb 11, 1952), identifying the publication of origin ("Arch. Otol" Archives of Otolyrngology), the author ("Hirsch"), and the type of reproduction to be used when illustrating the article.
The last of this series is signed and dated (1930) by Kleitiz.
The 10th drawing is similar to the preceding nine, though is smaller and is without color, and shows the interior radium application of the tumor. Measurement: 4.5 x 6 inches.
The 11th drawing shows six different types of tumors, I think, and is rendered in black and white. Measurement: 4.5 x 6 inches.
10 of the images have their original wax paper protective covering; one has a plastic cover and the last has no cover at all. All are in fine condition. The 9-drawing series are all quite bright and fine.
Notes:
1. Transsphenoidal Surgery: Complication Avoidance and Management Techniques, edited by Edward R. Laws, Jr, Aaron A. Cohen-Gadol, Theodore H. Schwartz, Jason P. Sheeha, pg 16.
"...Harvey Cushing and Oskar Hirsch, two prominent pituitary surgeons who pioneered the transsphenoidal technique. Cushing championed the sublabial approach, whereas Hirsch was the master of the endonasal route..."--“Harvey Cushing and Oskar Hirsch: early forefathers of modern transsphenoidal surgery” James K. LIU, M.D., et alia, Journal of Neurosurgery December 2005 / Vol. 103 / No. 6 / Pages 1096-1104
Other Notes:
Bruno Keilitz: "The remaining numerous text illustrations are all from the academic painter Mr. Bruno Keilitz, done with the greatest accuracy and beauty, which we acknowledge gratefully here ... "from The Cytoarchitectonics Of The Adult Human Cortex by Professor Constantin Baron von Economo”--Database of Scientific Illustrators, University of Stuttgart
Oscar Hirsch: (A) "The evolution of pituitary surgery over the past century dates back to the work of Oscar Hirsch and Harvey Cushing in the early 1900s. Hirsch's dedication to the transsphenoidal technique as the most effective method to approach the sella ran contrary to his contemporary's opinion. Cushing, with large series' of cases using both transcranial and.transsphenoidal approaches to the sella, would ultimately choose the former as the more efficacious procedure. Citing its distinct advantage in providing a direct and gross exposure of the gland, Cushing helped establishwidespread employment of the transcranial method throughout Europe by the 1930s."
Oscar Hirsch (B): "Oscar Hirsch, also from Vienna, suggested in 1909 an endonasal operation by the ethmoid. But he modified this procedure to an endonasal sub-mucosal rhino-septal approach which he performed on dune 4, 1910, the same day that Cushing, unknowingly, did his first case through a sublabial incision and sub-mucosal resection of the septum." From: History of Pituitary Tumors and Microneurosurgery by Jules Hardy, MD, from the Cyber History of Neurosurgery website.
Oscar Hirsch (c) "Prof Oscar Hirsch, a Tribute. Eye, Ear Nose Throat Monthly, 1966; 45 (4) 76-9.
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