An early description of Crouzon syndrome in a manuscript written in 1828 by Franz Joseph Gall.

Just a few weeks before his death in 1828, Franz Joseph Gall, the father of what others would later call phrenology, wrote a letter to an unknown person, presumably a fellow physician. The manuscript describes the case of girl, 19 months of age. The girl's skull showed marked deformations consistent with what would be called craniosynostosis or Crouzon('s) syndrome by physicians today. Gall related some clinical features of her case and suggested some treatment options. This case report is particularly interesting because it is almost 200 years old, predates Crouzon's description of the syndrome by 84 years, and shows that Gall was still involved with treating patients, even in his final year.

[Natural Science as a Kind of Natural Poetry: A Statement by Christoph Wilhelm Hufeland (1762-1832) Against Natural Philosophical Medicine]. / Naturwissenschaft als Naturpoesie: Eine Stellungnahme Christoph Wilhelm Hufelands (1762­1832) gegen die naturphilosophische Medizin.

At the turn to the 19th century, medicine in Germany became strongly influenced by the teachings of John Brown, who was a scottish physician. He had advocated a theory which regards and treats disorders as caused by defective or excessive excitation. His teachings were welcomed by natural philosophers like Schelling or Hegel. They modified it and integrated it into their systems of thinking. On the other hand Hufeland, who was one of the foremost physicians at that time, heavily opposed Brunonian System. This becomes evident in a fragmentary text that had been found only recently. In it he criticizes that these teachings were based on pure speculation and not on sound science as executed by Albrecht von Haller. It was meant ironically when he concluded that it thus resembled natural poetry. As viewed from today, evidence based medicine eventually established our modern ways for successfully diagnosing and treating disease. However, Hufelands disapproval appears to be still relevant. There are many people that even now advocate alternative ways and who consult quacks, healers etc.

[Natural science vs. natural philosophy: Friedrich Theodor von Frerichs and the emergence of modern western medicine in the 19th century]. / Naturwissenschaft statt Naturphilosophie: Friedrich Theodor Frerichs und die Entstehung der Schulmedizin im 19. Jahrhundert.

The beginnings of modern western medicine reach to about 1800 when under the liberating influence of French Revolution observation of diseases was started to follow more scientifically justified criteria. At that time speculative doctrines prevailed, e. g. those set up natural philosopher Schelling. In this context Internist Friedrich Theodor von Frerichs at Berlin Charité University Hospital gained great merits because of his struggle for a scientifically-based experimental clinical medicine. This is demonstrated nicely in a recently found autograph document.

Locked plate fixation and intramedullary nailing for proximal humerus fractures: a biomechanical evaluation.

BACKGROUND: Internal fixation of proximal humeral fractures is associated with a considerable secondary malalignment rate. Fixed-angle implants have been suggested to increase the stability of fixation. METHODS: The biomechanical properties of four different implants were tested. These included an internal fixator with semi-elastic properties (reference), the Synthes T-plate, a locked plate with rigid properties and a spiral blade locked intramedullary nail (PHN). These implants were assessed in twenty-four osteotomized pairs of human cadaveric humeri. Specimens were subjected to two-hundred cycles of axial loading and torque followed by load to failure. RESULTS: The PHN had greater axial stiffness than the reference and the T-plate. During torque, all implants were stiffer than the reference. During cyclic loading, there were no differences between the T-plate and the reference. Both the rigid internal fixator and the PHN had less irreversible deformation than the reference. Both implants resisted higher loads before failure. CONCLUSION: This study showed that the proximal humeral nail and the rigid internal fixator are stronger than the semi-elastic locked plate and the Synthes T-plate for unstable subcapital proximal humeral fractures.