Although most widely recognized for the two types of gastric reconstructions that bear his name, Christian Albert Theodor Billroth was one of the most innovative surgeons of his time. His contributions included developing techniques for procedures on the larynx, breast, and esophagus. He pioneered sterility and antisepsis in operating rooms. He also improved surgical education by advocating for longer apprenticeships, which helped create a framework for today’s residency programs. However, what often goes unnoticed was Dr. Billroth’s love for music, a passion that fueled him throughout his life

Hartendorp, B.S., Patrick A.

Maxwell, IV, MD, Pinckney J.

Yeo, MD, Charles J.

English

Name not available

Theodor Billroth and his musical life.

Jefferson Digital Commons

Thomas Jefferson UniversityJefferson Digital CommonsDepartment of Surgery Gibbon Society HistoricalProfiles Department of Surgery3-1-2012Theodor Billroth and his musical life.Patrick A. Hartendorp, B.S.Thomas Jefferson UniversityCharles J. Yeo, MDThomas Jefferson University, Charles.Yeo@jefferson.eduPinckney J. Maxwell, IV, MDThomas Jefferson UniversityLet us know how access to this document benefits youFollow this and additional works at: https://jdc.jefferson.edu/gibbonsocietyprofilesPart of the History of Science, Technology, and Medicine Commons, and the Surgery CommonsThis Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of ThomasJefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarlypublications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers andinterested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion inDepartment of Surgery Gibbon Society Historical Profiles by an authorized administrator of the Jefferson Digital Commons. For more information,please contact: JeffersonDigitalCommons@jefferson.edu.Recommended CitationHartendorp, B.S., Patrick A.; Yeo, MD, Charles J.; and Maxwell, IV, MD, Pinckney J., "TheodorBillroth and his musical life." (2012). Department of Surgery Gibbon Society Historical Profiles. Paper39.https://jdc.jefferson.edu/gibbonsocietyprofiles/39Surgical LeadersTheodor Billroth and His Musical LifePATRICK A. HARTENDORP, B.S., CHARLES J. YEO, M.D., PINCKNEY J. MAXWELL IV, M.D.From the Department of Surgery, Jefferson Medical College of Thomas Jefferson University,Philadelphia, PennsylvaniaA LTHOUGH MOST WIDELY recognized for the two typesof gastric reconstructions that bear his name,Christian Albert Theodor Billroth was one of the mostinnovative surgeons of his time. His contributions in-cluded developing techniques for procedures on the lar-ynx, breast, and esophagus. He pioneered sterility andantisepsis in operating rooms. He also improved sur-gical education by advocating for longer apprenticeships,which helped create a framework for today’s residencyprograms. However, what often goes unnoticed wasDr. Billroth’s love for music, a passion that fueled himthroughout his life.Dr. Billroth (Fig. 1) was born on April 26, 1829, onRugen, an island off the coast of north Germany. Hewas the oldest of five boys born to Johanna and CarlTheodor Billroth, a Lutheran pastor. With several mu-sician and physician relatives, his family had a richtradition in both music and medicine. After his fatherdied of dysentery, Theodor at age 5 years moved toGreifswald, Germany, to live with his grandparentswho were both professional opera singers.1 It was atGreifswald where Theodor was first exposed to thegreat composers of the Classical period. He studied mu-sical theory and composition at an early age and de-veloped into a talented pianist. He frequently performedin amateur recitals with his two brothers who also shareda fondness for music. Although he excelled with music,Billroth had difficulties in the classroom. Music was hisfirst love and his clear distraction. He was described asan average student and needed tutors to graduate fromhigh school.1At the request of his family, Theodor gave up thepursuit of a musical career and at 19 years of age enteredmedical school under the tutelage of surgeon WilhelmBaum. He followed Dr. Baum to the University ofGottingen where for the first time he developed scho-lastic interests.2 Theodor considered many paths in med-icine; he was attracted to histology and pathology aswell as to clinical care.3 He was able to continue hismusical interest while at Gottingen and even performedwith the famed Swedish Nightingale Jenny Lind. The-odor accompanied the 29-year-old soprano on the pianoin two sell-out recitals.3Theodor transferred to the University of Berlin forhis final year and graduated from medical school in1852. The next year, after brief attempts at ophthal-mology, dermatology, and general practice, he becamean assistant to Dr. Berhnard von Langenbeck, an es-teemed surgeon at the time in Berlin.3 Through thisexperience, Dr. Billroth solidified his interest in aca-demic surgery. Dr. Billroth would spend the next 7 yearsin Berlin studying pathological anatomy and surgicaltechnique. At this time in his life, music pursuits be-came subordinate because most of his time was spentworking to publish numerous papers on pathologyand histology. In 1858, Dr. Billroth met and marriedChristine Michaelis. She too came from a family withroots in medicine and music. Christine was a daughterFIG. 1. Theodor Billroth. Originally published in McLaren N,Thorbeck RV. Little-known aspect of Theodor Billroth’s work: hiscontribution to musical theory. World J Surg 1997;21:569–71.Address correspondence and reprint requests to Pinckney J.Maxwell IV, M.D., Assistant Professor of Surgery, Division ofColon and Rectal Surgery, Department of Surgery, JeffersonMedical College of Thomas Jefferson University, 1100 WalnutStreet, Suite 500, Philadelphia, PA19107. E-mail: maxwelpj@musc.edu.282of a physician and also related to Berlin’s premiersinging family, the Eunikes.3 They had five childrentogether.In 1860, Dr. Billroth became Professor of Surgery atthe University of Zurich where he excelled academi-cally, publishing a surgical pathology textbook. Whilein Zurich, his passion for music returned. He quicklybefriended intellectuals who enjoyed playing stringquartets.1 To join his musical colleagues, he took upthe viola and became a proficient player. He alsoserved as guest conductor for the musical organizationAllgemeine Musikgesellschaft Zurich on occasion. Dr.Billroth also became the first music reporter for thenewspaper Neue Zurcher Zeitung.3 With a keen ear, hewas well informed and became known for his ‘‘causticpen.’’1 Despite his busy schedule, Billroth also com-posed songs, which he would dedicate to his friends.Dr. Billroth met one of his favorite composers,Johannes Brahms, when Brahms performed his Ser-enade in D Major in 1865 in Zurich. Brahms was sowell received that Dr. Billroth organized a privateconcert for those that wished to hear him again. Thetwo remarkable men formed a lifelong friendship (Fig.2). In 1867, Dr. Billroth was appointed Chief of Surgeryin Vienna where Brahms resided. The two visited oneanother constantly, played and discussed music, anddined and traveled together.3 Some of Brahms’ musicwas first rehearsed and played in Dr. Billroth’s man-sion. He often sent Dr. Billroth unfinished manuscriptsfor him to critique and eventually honored Dr. Billrothwith dedications of his Opus 51 string quartets in Cminorand in A minor in 1873.Dr. Billroth achieved his greatest surgical feats inVienna. He performed the first total laryngectomy in1873 with the use of a prosthesis that he fashionedhimself for tracheal and phonetic function.4 The tech-niques for esophageal resections were developed in hislaboratory, and in 1877, his greatest pupil, Dr. Vincent,Czerny performed the first human esophagectomy.4 In1881, Dr. Billroth achieved his most famous accom-plishment, the first subtotal gastrectomy on a 43-year-oldwoman with gastric cancer of the pylorus and antrum.In an operation that lasted only 1 and a half hours, heremoved a segment of distal stomach and anastomosedthe remaining stomach directly to the duodenum (aBillroth I reconstruction). Three years later, he per-formed his second type of gastrectomywhere he attacheda smaller segment of the stomach to the jejunum (aBillroth II reconstruction). Despite his many inno-vations, Dr. Billroth believed his greatest legacy washis surgical school where he was disciplined and te-nacious. He had the ability to instill these attributesinto his students, many who later became leaders ofEuropean surgery.2Despite his meticulous care to his patients, Dr. Billrothneglected his own health. He ate and drank heavilyand enjoyed black cigars.1 He battled heart disease andrecurrent pneumonia in his later years. Even with hishealth failing, Dr. Billroth found time to draft a book onthe physiology of music entitled Wer ist musikalisch?(Who Is Musical?). In it, he sought to explore the re-lationship of music to human physiologic and psy-chological nature. Dr. Billroth died at age 65 years onFebruary 6, 1894. His book was completed and pub-lished posthumously by Edward Hanslick, a musiciancritic and close friend.Although the legacy of Theodor Billroth is one ofsurgical innovation and advances in surgical education,he was also a gifted musician and supporter of the arts.Music was a passion that remained with him throughouthis life. His life proved that music and medicine couldcomplement one another. Perhaps Dr. Billroth describedit best in a letter to his friend, Wilhelm Lubke, ‘‘It isone of the superficialities of our time to see in scienceand in art two opposites; imagination is the mother ofboth.’’1REFERENCES1. Sunderman FW. Theodor Billroth as musician. Bull Med LibrAssoc 1937;25:209–20.2. Rutledge RH. A medical musical friendship: Billroth andBrahms. J Surg Educ 2007;64:57–60.3. Claman HN. Billroth and Brahms. A musical friendship. ThePharos 2003;66:28–33.4. Lewis JM, Oleary JP. Theodor Billroth: surgeon and musi-cian. Am Surg 2001;67:605–6.FIG. 2. From right to left: Theodor Billroth, Johannes Brahms,and music critic, Edward Hanslick. Originally published inMcLaren N, Thorbeck RV. Little-known aspect of Theodor Billroth’swork: his contribution to musical theory. World J Surg 1997;21:569–71. Drawing by AF. Seligmann, Institut fur die Geschichte deMedizine, Vienna.No. 3 THEODOR BILLROTH AND HIS MUSICAL LIFE ? Hartendorp et al. 283

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Theodor Billroth and his musical life.

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