Harald Hirschsprung (14 December 1830 – 11 April 1916) was a
Danish
Danish may refer to:
* Something of, from, or related to the country of Denmark
People
* A national or citizen of Denmark, also called a "Dane," see Demographics of Denmark
* Culture of Denmark
* Danish people or Danes, people with a Danish a ...
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
who first described
Hirschsprung's disease
Hirschsprung's disease (HD or HSCR) is a birth defect in which nerves are missing from parts of the intestine. The most prominent symptom is constipation. Other symptoms may include vomiting, abdominal pain, diarrhea and slow growth. Symptoms usu ...
in 1886.
Life and medical career
Harald Hirschsprung was a native of
Copenhagen
Copenhagen ( or .; da, København ) is the capital and most populous city of Denmark, with a proper population of around 815.000 in the last quarter of 2022; and some 1.370,000 in the urban area; and the wider Copenhagen metropolitan ar ...
. Hirschsprung chose to become a doctor instead of joining his father's
tobacco
Tobacco is the common name of several plants in the genus '' Nicotiana'' of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants. More than 70 species of tobacco are known, but the ...
factory,
A.M. Hirschsprung & Sønner. He passed his acceptance exam for university in 1848 and passed the
Staatsexamen
The ("state examination" or "exam by state"; pl.: ''Staatsexamina'') is a German government licensing examination that future physicians, dentists, teachers, pharmacists, food chemists, psychotherapists and jurists (i.e., lawyers, judges, public ...
in 1855. He was interested in rare diseases affecting the
gut throughout his life, and one such,
atresia
Atresia is a condition in which an orifice or passage in the body is (usually abnormally) closed or absent.
Examples of atresia include:
*Aural atresia, a congenital deformity where the ear canal is underdeveloped.
* Biliary atresia, a condition i ...
of the
oesophagus
The esophagus (American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the ...
and
small bowel
The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the pa ...
, was the subject of his
doctoral thesis
A thesis ( : theses), or dissertation (abbreviated diss.), is a document submitted in support of candidature for an academic degree or professional qualification presenting the author's research and findings.International Standard ISO 7144: ...
, presented in May 1861.
[Harald Hirschprung]
Whonamedit.com
He became the first Danish
pediatrician
Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the ...
in 1870, when he was appointed to a hospital for
neonate
An infant or baby is the very young offspring of human beings. ''Infant'' (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is a formal or specialised synonym for the common term ''baby''. The terms may also be used to ...
s. In 1879, he was made the chief physician at
Queen Louise's Children's Hospital, which opened in 1879. He was appointed a
professor
Professor (commonly abbreviated as Prof.) is an Academy, academic rank at university, universities and other post-secondary education and research institutions in most countries. Literally, ''professor'' derives from Latin as a "person who pr ...
of pediatrics in 1891. Hirschsprung taught small classes on Sunday mornings between 9 and 11, to ensure that only truly dedicated students would come. He was not a great teacher, however, having problems with
public speaking
Public speaking, also called oratory or oration, has traditionally meant the act of speaking face to face to a live audience. Today it includes any form of speaking (formally and informally) to an audience, including pre-recorded speech deliver ...
and a penchant for focusing on rare cases rather than those most beneficial to general practice.
Hirschsprung offered free
health care
Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profe ...
for poor children while continuing to require patients with more means to pay. He also went against the wishes of the queen, the hospital's namesake, in his insistence that pictures of animals, rather than
biblical
The Bible (from Koine Greek , , 'the books') is a collection of religious texts or scriptures that are held to be sacred in Christianity, Judaism, Samaritanism, and many other religions. The Bible is an anthologya compilation of texts of a ...
texts, be placed above each child's bed.
[WS Haubrich]
″Hirschsprung of Hirschsprung's disease″
''Gastroenterology'', 2004, v. 127, n° 5, p. 1299, .
In 1904, when he was 74 years old, Hirschsprung was forced to resign from his practice. He continued his study of what would later come to be called Hirschsprung's disease until his poor health prevented him, and lived out his retirement in his country house in
Øresund
Øresund or Öresund (, ; da, Øresund ; sv, Öresund ), commonly known in English as the Sound, is a strait which forms the Danish–Swedish border, separating Zealand (Denmark) from Scania (Sweden). The strait has a length of ; its width v ...
.
[
]
Hirschsprung's disease
Hirschsprung published on many areas of pediatrics, including pyloric stenosis
Pyloric stenosis is a narrowing of the opening from the stomach to the first part of the small intestine (the pylorus). Symptoms include projectile vomiting without the presence of bile. This most often occurs after the baby is fed. The typical a ...
, intussusception, rickets
Rickets is a condition that results in weak or soft bones in children, and is caused by either dietary deficiency or genetic causes. Symptoms include bowed legs, stunted growth, bone pain, large forehead, and trouble sleeping. Complications may ...
, and rheumatic nodules, but he is most well known for his work on the disease that later came to bear his name.
At the congress of the Congress for Children's Diseases (''Gesellschaft für Kinderheilkunde'') in Berlin
Berlin ( , ) is the capital and largest city of Germany by both area and population. Its 3.7 million inhabitants make it the European Union's most populous city, according to population within city limits. One of Germany's sixteen constitue ...
, Hirschsprung gave a lecture about what would become "his" disease. It was titled "Stuhlträgheit Neugeborener in Folge von Dilatation und Hypertrophie des Colons" and was published one year later. He spoke of two infants who had died from the disease, constipation
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...
associated with dilatation
Dilation (or dilatation) may refer to:
Physiology or medicine
* Cervical dilation, the widening of the cervix in childbirth, miscarriage etc.
* Coronary dilation, or coronary reflex
* Dilation and curettage, the opening of the cervix and surgic ...
and hypertrophy
Hypertrophy is the increase in the volume of an organ or tissue due to the enlargement of its component cells. It is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number.Updated by Linda J ...
of the colon, and near the end of his lecture said that: "it appears unquestionable that the condition is caused in utero, either as a developmental abnormality
A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...
or as a disease process." He published an account of the disease, which he believed to be a new condition, two years later.
Although he was the first to describe the condition, he erroneously believed the proximal
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
, dilated bowel to be diseased. We now know that the diseased segment of intestine is the distal
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
portion (down to the rectum
The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...
), which lacks ganglion
A ganglion is a group of neuron cell bodies in the peripheral nervous system. In the somatic nervous system this includes dorsal root ganglia and trigeminal ganglia among a few others. In the autonomic nervous system there are both sympatheti ...
cells and can therefore not relax. This contracted state (sometimes called rectal achalasia
Esophageal achalasia, often referred to simply as achalasia, is a failure of smooth muscle fibers to relax, which can cause the lower esophageal sphincter to remain closed. Without a modifier, "achalasia" usually refers to achalasia of the esoph ...
) prevents the passage of stools and causes intestinal obstruction
Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs an ...
and constipation
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...
.
References
Further reading
*Richard Skaba ''Historic milestones of Hirschsprung's disease (commemorating the 90th anniversary of Professor Harald Hirschsprung's death)'' (Elsevier Inc. January 2007. Volume 42, Issue 1, pp. 249–251)
External links
Whonamedit.com: Harald Hirschprung
{{DEFAULTSORT:Hirschsprung, Harald
Danish pediatricians
1830 births
1916 deaths