Paul Berger
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Paul Berger (; 6 January 1845
Beaucourt Beaucourt () is a commune in the Territoire de Belfort department in Bourgogne-Franche-Comté in northeastern France. The archivist and palaeographer Élie Berger (1850–1925) was born in Beaucourt. Population Literature ''Beaucourt Revisite ...
,
Territoire de Belfort The Territoire de Belfort () is a department in the Bourgogne-Franche-Comté region, eastern France. It had a population of 141,318 in 2019.Hôpital Tenon and was Professor of Clinical Surgery and Pathology at the
Faculté de médecine de Paris , image_name = Coat of arms of the University of Paris.svg , image_size = 150px , caption = Coat of Arms , latin_name = Universitas magistrorum et scholarium Parisiensis , motto = ''Hic et ubique terrarum'' (Latin) , mottoeng = Here and a ...
. He is noted for ''Berger's operation'', a method of interscapulothoracic amputation, and for improvements in hernia/intestinal suturing.


Life

Berger was a French physician and surgeon who practised in Paris at the Hôpital Tenon and was Professor of Clinical Surgery and Pathology at the
Faculté de médecine de Paris , image_name = Coat of arms of the University of Paris.svg , image_size = 150px , caption = Coat of Arms , latin_name = Universitas magistrorum et scholarium Parisiensis , motto = ''Hic et ubique terrarum'' (Latin) , mottoeng = Here and a ...
. He developed a method of interscapulothoracic amputation, called ''Berger's operation'' after him, and for improvements in hernia/intestinal suturing. In October 1882 Berger amputated the whole upper limb of a patient with an
enchondroma Enchondroma is a type of benign bone tumor belonging to the group of cartilage tumors. There may be no symptoms, or it may present typically in the short tubular bones of the hands with a swelling, pain or pathological fracture. Diagnosis is by ...
of the humerus, publishing a report the following year. In 1887 he published “L’Amputation du Membre Superieur dans la Contiguite du Tronc”, a detailed monograph on forequarter amputation. In the paper's historical review, Berger credited Ralph Cuming as the originator of the operation. Berger noted only two prior such operations for war injuries, by Cuming in 1808 and by Gaetani Bey in
Cairo Cairo ( ; ar, القاهرة, al-Qāhirah, ) is the Capital city, capital of Egypt and its largest city, home to 10 million people. It is also part of the List of urban agglomerations in Africa, largest urban agglomeration in Africa, List of ...
some thirty years later. In 1889 a public display of
aseptic Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is deri ...
instruments was held at the Exposition Universelle (1889) in Paris. Berger noted that
''"it is impossible not to be struck by the complete transformation that surgical instrument making has undergone in the past few years. This renovation of our instrumentation was the consequence of the revolution that antisepsis introduced in surgical practice; it has been necessary to create entirely new equipment that meets and exceeds the conditions that surgeons consider essential."'' Berger drew special attention to the various designs for scissor-like articulations that French instrument makers had devised so that they could easily be disassembled for cleaning.


Surgical mask use

Berger began to don a surgical mask while operating in October 1897. He read a paper "On the Use of a Mask in Operating" before the Surgical Society of Paris on February 22, 1899. He began with the statement: Berger had been alerted by some cases of suppuration after otherwise clean operations with an assistant suffering from an alveolar abscess. A similar situation arose some months later, when Berger himself was afflicted by dental
periostitis Periostitis, also known as periostalgia, is a medical condition caused by inflammation of the periosteum, a layer of connective tissue that surrounds bone. The condition is generally chronic, and is marked by tenderness and swelling of the bone an ...
. He also noticed drops of saliva projected from the surgeon or assistant when speaking. Conscious of
Carl Flügge Carl Georg Friedrich Wilhelm Flügge (12 September 1847 – 10 December 1923) was a German bacteriologist and hygienist. His finding that pathogens were present in expiratory droplets, the eponymous Flügge droplets, laid ground for the concept ...
's discovery of pathogens in saliva, he determined to shield his operation incisions from this cause of contamination, and in October 1897 began to wear "a rectangular compress of six layers of gauze, sewn at its lower edge to his sterilized linen apron (he had a beard to safeguard) and the upper border held against the root of the nose by strings tied behind the neck." Over a period of fifteen months he became convinced that the incidence of infection had been reduced. He ended his paper with: The notion of a surgeon's mouth being a rich source of infection was ridiculed, by a Monsieur Terrier scoffing that "I have never worn a mask, and quite certainly I never shall do so."HC Lowr
"Some Landmarks in Surgical Technique"
Address to Students, opening of Winter Session1947-48, Royal Victoria Hospital, Belfast, Ulster Medical Journal, 1-12


Books


"Chirurgie orthopédique" - Paul Berger, S. Banzet (Paris, 1904)


References

{{DEFAULTSORT:Berger, Paul 1845 births 1908 deaths People from the Territoire de Belfort French surgeons Medical hygiene