Surgery

Thoracal drain by BÜLAU

Already the Parisian internist Pierre-Charles Ed. POTAIN (1825-1901) had devised an aspiration apparatus. The lung specialist (surgeon and internist) Gotthard BÜLAU (1835-1900) was supposed to improve him.

biography

Gotthard BÜLAU was born on February 27, 1835 in Hamburg, the son of the physician Gustav Bülau (1799-1857). From 1854 studies in Heidelberg and Göttingen, where he received his doctorate in 1858. In the fall of 1858 he became a medical assistant at the General Hospital St. Georg, and stayed here for three full years. In the spring of 1867 he became a representative for the diseased chief physician of the house, Dr. med. Georg Karl Franz TÜNGEL (1816-1873). As a volunteer doctor remained BÜLAU in the hospital until 1869, and then, after retiring TÜNGEL's, chief physician of one of the four sections of internal medicine of the house. He remained chief physician until 1886, then gave up the hospital post, as his increasing private practice made him impossible this activity. In 1888 he practiced "Alsterterrasse, 10, 1897 Mittelweg 13". BÜLAU died on October 20, 1900.

principle

At St. Georg's Hospital in Hamburg, he devised a "water lock", a continuous suction device for emptying pleural cavities, which works on the lifter principle. In 1875 he combined a chest drainage with permanent suction and healed a pleural empyema. His apparatus is "neither a special tube or catheter, nor a bottle or a localization, but the principle of perpetual suction!" (Dr. med. Thomas Kiefer).

Indicated is the preparation of the device in patients, in which (after surgery and after inflammation) the pleural space with air or liquid (blood, serum, pus) has filled (pleural empyema). With the device you could aspirate liquid, but also pump gas into the chest. This therapy, known as "collapse therapy", was the best treatment option for pulmonary tuberculosis around 1900. The artificial pneumothorax was described in 1882 by the Turin practitioner Carlo FORLANINI (1847-1918). The Marburg surgeon Ludolph Brauer (1865-1951) introduced the method in 1906 in Germany. While spontaneous pneumothorax is not uncommonly fatal, astonishing success has often been achieved with this controlled collapse of the lungs. "Through a system of two communicating tubes filled with water, underpressure or overpressure can be generated, so that air can be filled or sucked into the pleural space by means of a puncture needle connected to a tube, resulting in a healing of the affected patients Lung.

The procedure has long played a prominent role in the treatment of pulmonary tuberculosis and was replaced only after the Second World War by the introduction of antibiotic therapies "(Michel Martin, Institute of Medical Ethics and History of Medicine at the Ruhr University Bochum).

technology

Introduction of a drainage needle via a guide spike in the 2nd or 3rd ICR parasternally.

exhibit

A wooden box measuring 58x40x16.5 cm will be presented, which was used until the 1970s in the St. Elisabeth Clinic in Luxembourg. Manufacturer: Fa. P.A. Stoss' successor in Wiesbaden, Inh. Max Helfferich - a specialized company founded in 1892 that still exists today at the Kreuzberg Ring 36 in Wiesbaden.

Link:
de.wikipedia.org/wiki/Thoraxdrainage

Lit.:
- G. Bülau, Für die Heber-Drainage bei Behandlung des Empyem, in: Zeitschrift für klinische Medicin, Berlin, 1891 S. 480-492.

- Paul E. Van Schil et al., Thoracic Drainage and the contribution of G. Bülau, in: Ann. Thoracic Surg. 1997, 64:1876.