[Anaesthesiological management of postmortem organ donors - What Evidence is Out There?] / Anästhesiologisches Management von postmortalen Organspendern.

The transplantation of organs from postmortem organ donors has been a lifesaving and quality-of-life-improving therapy for patients with irreversible organ failure for many years. In Germany, however, there has been an imbalance between the number of organs donated postmortem and the number of patients on the waiting list for years. The anesthesiological management of multiple organ harvesting (MOE) in postmortem organ donors is not an everyday challenge for various reasons: A lack of practical expertise due to the small number of MOE, even at university hospitals (usually < 20 per year), complex pathophysiological changes in the cardiovascular system and other organ functions of the postmortem organ donor and the lack of guidelines complicate anesthesiological management. This paper compiles the existing literature and reviews whether evidence-based recommendations can be derived for anesthesiologic management for MOE.

[From ether anesthesia to "green" anesthesia : Challenges in anesthesiology over the last 175 years]. / Von der Äthernarkose zur "grünen" Anästhesie : Herausforderungen in der Anästhesiologie der letzten 175 Jahre.

The first public demonstration of ether anesthesia took place 175 years ago. Since that time, insensitivity to pain during surgical operations has been possible. The "Ether Day" has been portrayed in many ways. News of the event soon reached Europe and the rest of the world. The development of suitable apparatuses and anesthetics pathed the way for acceptance of the new method. Since the end of the nineteenth century, quality management has become more and more important. In the first half of the twentieth century the use of anesthetic apparatuses prevailed. In Germany, the medical discipline of anesthesiology was established only after 1945. This happened with support from Anglo-American countries. Further methods, such as intubation and muscle relaxation were introduced. The development of atraumatic cannulas made of plastic greatly facilitated the application of drugs. Consideration of workplace safety as a problem was a long time coming. The first concepts were not developed until the late 1970s. By the 1980s the essential elements of modern anesthesia had finally been implemented. In the beginning of the twenty-first century, the focus was initially on procedures that saved allogeneic blood. New topics emerged, ranging from the effects of anesthesia on tumors up to climate change. Anesthesiology must continue to face new challenges in the future.

Nixon and Scheel in China: Acupuncture and Anesthesia in West and East Germany in the 1970s and 1980s.

BACKGROUND: Acupuncture anesthesia was used instead of intubation anesthesia in the 1970s and 1980s in West Germany and West Berlin. In East Germany acupuncture played no decisive role. SOURCES: Different articles and papers in journals, in daily press, statements of contemporary witnesses, films, records in archives. RESULTS: As in other Western countries, acupuncture was hugely popular in the Federal Republic of Germany in the 1970s. Chief triggers were the state visits to China of the American President Richard Nixon in 1972 and shortly thereafter of West German Foreign Minister Walter Scheel and his wife Mildred, an x-ray technician. During that period observation of an operation under acupuncture anesthesia was an obligatory element in the agenda of a foreign delegation. Following this showcasing, acupuncture was widely adopted in Western surgery as an alternative to the previously exclusive employment of intubation anesthesia. While the alternative method was soon abandoned in the frontline city of West Berlin, it continued to prevail in other West German cities, e.g. Gießen and Munich. Following the Chinese example, the acupuncture effect was normally enhanced electrically. In accordance with the animosity between the USSR and the People's Republic of China, exchange between the German Democratic Republic and China was very restricted through the late 1980s. This made it easier for East German acupuncture sceptics to reject the procedure and brand it as unscientific. Those who advocated it were in a precarious position. CONCLUSIONS: Acupuncture was lauded in the West as ancient savvy destined to complement science-oriented medicine. However, the cultural transfer which accompanied the spread of acupuncture was flawed by misunderstanding and misguidance. Acupuncture anesthesia instead of intubation was not practiced in the GDR. Acceptance of acupuncture in East German medicine failed to make any headway until the last few years of the country's existence.

[The speech on Bier as a problem. Arthur Israel (1883-1969) and his struggle to come to terms with the Berlin University Surgical Clinic]. / Die Festrede auf August Bier als problem. Arthur Israel (1883-1969) und seine Auseinandersetzung mit der Berliner Chirurgischen Universitätsklinik.

Arthur Israel was associated with August Bier's University Surgical Clinic in Berlin from 1910 to 1933, in the end as the head of the downgraded (outpatient) clinic. After he was forced out of his Berlin post, Israel was department head in the Israelitisches Krankenhaus Hamburg until he emigrated to the U.S. in 1940, settling in New York. In 1960, he returned to Germany. Based on papers from Israel's estate, the article describes his life stations and his struggle to cope with his time at the Berlin university clinic. The focus is on a meeting in Berlin in 1961. His departure from the usual practice of heaping praise on the clinic and its former head marks the beginning of a never-published critique of conditions in the clinic. The ambivalence reflected in his evaluation is in stark contrast to the traditional cultivation of "Bier's School".

[Pandemic without drama. Influenza vaccination and Asian flu in Germany]. / Pandemie ohne Drama. Die Grippeschutzimpfung zur Zeit der Asiatischen Grippe in Deutschland.

The history of the 1957/58 Asian flu in Germany is systematically presented for the first time. The focus is on flu vaccination, which is discussed as a yardstick of the perception of the pandemic. International expertise on influenza virology was predominantly based in Anglo-Saxon countries. German microbiologists issued no clear recommendation for preventative vaccination until 1960. Instead, quinine was relied upon as the traditional medicinal prophylaxis. Antibiotics were more frequently administered. In East Germany, little fuss was made over the Asian flu. In line with the authorities' social hygiene orientation, vaccination was accepted as a matter of principle. In the Federal Republic and West Berlin, the population rejected the vaccination largely. It was seen as a scandal that many employees were on sick leave because of the flu, thus adversely affecting the economy.

[The influenza pandemic of 1918-20 in medical debate]. / Die Grippe-Pandemie 1918-20 in der medizinischen Debatte.

The Influenza Pandemic of 1918-20 in medical debate. The history of the so called Spanish Influenza 1918-1920 is summarized especially in regard to the developments in medical debate. In Germany, Richard Pfeiffer, who had discovered Haemophilus influenzae after the previous pandemic 1890/91, managed it to defend his thesis that his "bacillus" was the causative agent of the flu, by modifying his theory moderately. The Early Virology of influenza in postwar times was still fixed to bacteriology and did not yet have the force of school-building. Aggressive therapy, e.g. with derivatives of chinine, were used in a concept of polypragmasy. The connection between influenza in animals and influenza in mankind was unknown or of no major interest till the rise of virology as an academic discipline in the 1950s. Since the outbreak of avian influenza in Asia 1997 virological archaeology is challenged to fill the historical part in the attempt to fight the threat of the highly pathogenic bird flu. In the beginning of the "short 20. century" politicians and doctors had no interest to build a "monument" of influenza. Today, virological reductionism does not have the power to (re-)construct such a monument.