Clinics in Dermatology
Volume 30, Issue 1 , Pages 129-136, January 2012

Jan Mikulicz-Radecki (1850-1905): His impact on modern medicine

  • Andrzej Grzybowski, MD

      Affiliations

    • Department of Ophthalmology, Poznań City Hospital, ul. Szwajcarska 3, 61-285 Poznań, Poland
    • Medical Faculty, University of Warmia and Mazury, Olsztyn, Poland
    • Corresponding Author InformationCorresponding author.
    • ,
  • Jarosław Sak, MD

      Affiliations

    • Department of Ethics and Human Philosophy, Medical University of Lublin, Szkolna 18, 20-124 Lublin, Poland

Article Outline

Abstract 

Jan Mikulicz-Radecki (1850-1905) was the cofounder of modern surgery, aseptic techniques, and the inventor of gastroscopy, but his professional accomplishments go far beyond the field of surgical treatment. Various medical achievements are named in his honor, including the name of the cells that he discovered in rhinoscleroma, the name of Mikulicz disease, and the name of an ointment that he developed and continues to be used in the treatment of wounds and ulcers in surgery and dermatology. Noteworthy are also his interdisciplinary approach towards diagnosis and treatment, and his cordial attitude towards his patients.

 

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Introduction 

Despite the passage of more than 100 years since the death of Jan Mikulicz-Radecki, the assistant of Theodor Billroth (1829-1894) and the founder of the Breslau School of Surgery, his name would frequently appear in the first decade of the 21st century, concerning the historical background of modern European surgery1, 2, 3, 4, 5 and in research relating to the modern treatment of chronic diseases, addressed within the confines of internal medicine, ophthalmology, and dermatology.6, 7, 8, 9, 10, 11, 12 What is more, Mikulicz made great achievements in the development of modern techniques in surgery of the gastrointestinal tract13, 14 and the thyroid.15 His contribution to the development of the gastrointestinal endoscopic examination earned him a well-deserved title of the “father of surgical endoscopy.”16

His contemporaries called Mikulicz “a King in the kingdom of Surgeons.” He obtained excellent results in the surgical treatment of patients using innovative, for that times, aseptic techniques.17, 18 The researchers of the history of medicine often neglect Mikulicz's interdisciplinary attitude toward the diagnosis and the treatment of patients. The effect on the shaping of this attitude had both: his professional training, which took place in Vienna under the tutelage of Billroth,19, 20 and his broad interests that extended far beyond the field of surgery and even beyond medicine.

An important accomplishment was the establishment by Mikulicz and Bernhard Naunyn (1839-1925)21, 22, 23 of an interdisciplinary journal Mitteilungen aus den Grenzgebieten der Medizin und Chirurgie, which integrated surgery and internal medicine. Owing to Mikulicz's broad research interests, his name is frequently mentioned in everyday clinical practice, not only among contemporary surgeons but also by dermatologists. Mikulicz explained the pathogenesis of the rhinoscleroma and described the cells characteristic of this disease, which were later named after him.24, 25 He also described a noninflammatory disease of the salivary and lacrimal glands, which still exists in the international medical nomenclature as Mikulicz disease,6, 11 to be distinct from Sjögren syndrome.26 He developed an innovative method for treating difficult-to-heal wounds and ulcers of the skin by using preparations containing iodine and lapis ointment with balsam of Peru.25 This ointment—also called Mikulicz ointment—is used to this day in surgical and dermatologic practice.

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Family and education 

Jan Mikulicz-Radecki was born on May 16, 1850, in Czerniowce in north Bukowina (nowadays southwest Ukraine). His father, Andreas Mikulicz, came from a Polish noble family whose coat of arms was Gozdawa. His mother, Emilia von Damnitz, was a great-granddaughter of the Prussian General von Tauentzien. Jan Mikulicz finished elementary school in Prague, where he was sent by his father to obtain a comprehensive education.1, 2, 27 Primarily, he began attending a gymnasium in Prague and later in Vienna and Klagenfurt, where his family moved so that his sister Karoline would be able to develop her talent as an opera singer. In Prague, Jan learned to play the piano at the famous Joseph Proksch (1794-1864) music school. After his beloved sister died of typhoid fever, the family returned to Czerniowce in 1866, where Jan graduated from school in 1869 and passed his Matura examination with honors.27

In October of the same year, he started studying medicine at the University of Vienna. His father, who demanded that his son study law, refused to finance his education. To be able to study medicine, Jan earned his living by giving private lessons in German and in playing the piano. Soon, however, he received a scholarship of 700 guilders a year from the Silberstein Foundation and could then devote all his energies to studying medicine.

The time Mikulicz-Radecki spent studying medicine coincided with the heyday of the so-called Younger Vienna School. The school was created by Carl Rokitansky (1828-1862), the cofounder of modern pathologic anatomy; Joseph Hyrtl (1810-1894), professor of anatomy; Ernst Wilhelm von Brücke (1819-1892), professor of experimental physiology; Josef Skoda (1805-1881), who was the precursor of examining patients using percussion and auscultation; Joseph Dietl (1804-1878), professor of internal medicine; and Theodor Billroth (1829-1894), the cocreator of modern surgery and the creator surgical school in Vienna. Mikulicz-Radecki's teachers also included the ophthalmologist Carl Stellwag-Carion (1823-1904), the discoverer of one of the eye signs in Basedow disease, and Ferdinand Hebra (1812-1884), the creator of 19th century dermatology.27

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Mikulicz in Vienna: Explanation of the pathomechanism of rhinoscleroma and the invention of the gastroscopy 

Mikulicz-Radecki (Figure 1) made the decision to select surgical specialization during his medical studies. He graduated from the Medical Faculty on March 23, 1875, with a doctorate in medicine. He later became a volunteer at the II Surgical Department in Vienna, directed by Theodor Billroth. The duties of the volunteer, who was subordinate to an assistant, included completing the examination and observation of the patients, registering the history of the disease, preparing materials for dressing wounds, passing instruments during surgery, and performing microscopic examinations of the surgical preparations.

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  • Fig. 1. 

    Jan Mikulicz-Radecki in 1873. (From the private archive of F. Anschütz. Reprint from the book: Kozuschek W. Johann von Mikulicz-Radecki 1850-1905. Mitbegründer der modernen Chirurgie. Wrocław: Wydawnictwo Uniwersytetu Wrocławskiego, 2003, p. 49).

The last of these tasks contributed to making of a very important discovery. Mikulicz's microscopic examination conducted on a tissue removed from a patient operated on for rhinoscleroma (Figure 2) completely changed the current views on the nature of the disease. According to previously established knowledge, through the research of Ferdinand Hebra, rhinoscleroma was treated as a neoplastic process. Mikulicz, thanks to his inquisitiveness, depicted the nature of this disease as a chronic inflammatory process.27, 28 The discovered cells (Figure 2) to this day are known as the Mikulicz cells.29 During this period, while still a volunteer, Mikulicz announced in addition to reports on the histopathologic essence of rhinoscleroma, many other valuable contributions including those on the origins of sebaceous cysts on the scalp,30 on the removal of vaginal tumors,31 and on the antiseptic treatment of wounds.32

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  • Fig. 2. 

    Histological image of rhinoscleroma (original magnification × 90 to × 400) by Jan Mikulicz-Radecki. Mikulicz cells: on the right-hand side at the bottom of the figure. (Reprint from: Mikulicz J. Über das Rhinosclerom (Hebra), Arch Klin Chir 1877, 20, 485-534.)

During this period, Mikulicz received great acclaim from Billroth, who in a letter sent to him from Berchtesgaden on August 1877 wrote: “I still hope that you will be the first professor of surgery in your hometown of Czerniowce on the new university.”33 In October 1875 in Czerniowce, the University of Franz Joseph was established with German as the main language of lectures. The medical department, however, was not established at the university due to financial reasons.27

Mikulicz and Billroth were brought closer by professional subordination, a passion for surgery, and their love for music. Billroth was not only a surgeon but also a composer,34, 35 and composed several piano pieces, including The Longing for Death. Billroth invited Mikulicz-Radecki to his home, where they played the piano for four hands and studied the unfinished manuscript of Brahms' symphony No. 3.27, 36, 37

In 1877, Mikulicz received the position of a salaried assistant and a company room in the General Hospital in Vienna. During this period, he began intensive research on the varus and valgus knee deformity.38 In 1879, Billroth sent Mikulicz with a 5-month scholarship to become acquainted with Lister's antiseptic principles and their effect on different European centers, including Halle, Leipzig, Munich, Basel, Cologne, Aachen, Paris, London, and Glasgow. At King's College Hospital in London, Mikulicz had the opportunity to discuss the principles of antisepsis with its founder, Joseph Lister (1827-1912).

After returning to Vienna in February 1880, he was awarded veniam legendi from surgery, based on the work on the varus alignment of the knee.27 As the assistant lecturer at Billroth's clinic, he still engaged in the scientific aspects of antiseptics. He modified the principles of antiseptics by introducing a solution of iodoform to decontaminate wounds.32

In the Spring of 1881, he began research on constructing a device for endoscopy of the esophagus and stomach.

In 1880, Mikulicz married Henriette Pacher (1853-1937), with whom he had seven children. Pacher supported him, not only in keeping the home but also in his scientific activities. Among other activities, she conducted linguistic reviews of papers being prepared for publication.

He left Billroth's clinic in 1881 in accordance with the custom then that a married assistant could not work at the university clinic and became head of the surgical polyclinic in Vienna.27 Mikulicz-Radecki continued his research on endoscopy of the stomach. In 1881, after the construction of the gastroscope with the help of Josef Leiter (1830-1892), a medical devices manufacturer, he became the first person in the world to diagnose cancer of the lower esophagus by endoscopy. Observations that he made concerning the endoscopic examination of patients with stomach cancer were published in 1883 in the Przeglad Lekarski.39 This work contains the world's first endoscopic description of gastric cancer. In the same journal, Mikulicz-Radecki also published a paper on the use of iodoform in the treatment of wounds.40

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Mikulicz in Cracow: The development of antiseptics 

Mikulicz's publishing of the results of his work in the Polish language was associated with his desire to take over the Department of Surgery at Jagiellonian University in Cracow. Through Billroth's intercession, Mikulicz was appointed for this position in September 1882. He immediately undertook renovations and substantial organizational changes aimed at increasing the facility's operational capacity. Mikulicz assigned a separate room for operations within the abdominal cavity. What is more, he made efforts to build a new surgical clinic that would be much better adjusted for the treatment of surgical patients than the current ones.27

While working in Cracow, Mikulicz developed the basis of endoscopic anatomy and the techniques of performing endoscopy of the esophagus and stomach. He performed the world's first endoscopic procedure by moving a bone derived from food residing in the esophagus into the stomach. In the same period, along with Napoleon Cybulski (1854-1919), he published a work on the physiology of the esophagus.41

For the treatment of surgical wounds, infected wounds, and ulcers arising in the course of tuberculosis, syphilis, lupus, and furuncles, he applied iodoform and 1% lapis ointment with the addition of balsam of Peru Mikulicz's ointment has antibacterial and antiparasitic properties and stimulates granulations of the wounds. To this day, it is used in surgery and dermatology for the treatment of difficult-to-heal chronic wounds and ulcers.25, 27

Among the new and original operational techniques developed by Mikulicz was pyloroplasty,42, 43 which is currently named the Heinecke-Mikulicz technique.44 When he performed it for the first time on February 13, 1887 in Cracow, Mikulicz was not aware that Walter Heinecke (1834-1901) had completed a similar procedure a year earlier in Erlangen. Mikulicz was an unquestionable expert in the field of surgery of the stomach. In 1885, he was the first person in the world to perform a successful operation of perforation of an ulcer of the stomach.

During a Congress of German Surgeons in Berlin, he delivered a report on 103 stomach resections in the course of cancer and peptic ulcer disease, which he performed by himself in Cracow.45 This rich experience resulted in an original modification of the method of gastric resection by Billroth's second method (Krönlein-Mikulicz modification). Mikulicz's great success was that, according to the published statistics of 180 operations performed in his clinic in Cracow in the period between October 1882 and June 1884,46, 47 none of the patients died of postoperative septic complications of the wounds.

Mikulicz became the president of the Cracow Medical Society in 1886. When it became obvious that the Austrian authorities would not comply with his proposal for constructing a new surgical clinic, he decided to leave Cracow.27

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Mikulicz in Königsberg: Description of the noninflammatory disease of the salivary and lacrimal glands 

In 1887, Mikulicz (Figure 3) accepted an invitation to take over the Albertus-Universität Clinic in Königsberg. At this time, Königsberg was a much larger and more prosperous city than Cracow and was inhabited by approximately 150,000 citizens.27 As in Cracow and now in Königsberg, Mikulicz introduced to surgical practice the use of iodoform in disinfecting wounds and tools. What was new, however, was the use of a steam apparatus to sterilize surgical instruments.18 This created an excellent basis for the development of abdominal surgery, which enabled Mikulicz to improve the technique of the gastric resection.

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  • Fig. 3. 

    Jan Mikulicz-Radecki in Königsberg. (From the private archive of F. Anschütz. Reprint from the book: Kozuschek W. Johann von Mikulicz-Radecki 1850-1905. Mitbegründer der modernen Chirurgie. Wrocław: Wydawnictwo Uniwersytetu Wrocławskiego, 2003, p. 106).

He also described a syndrome that consisted of bilateral edema and enlargement of the salivary and lacrimal glands.48 During a session of the Scientific Medical Society in Königsberg in 1888, he presented a 42-year-old patient with a bilateral enlargement of the salivary and lacrimal glands.27, 47 The patient's face was distorted due to the bilateral swelling of the upper eyelid and the parotid and submaxillary glands (Figure 4). This swelling, which occurred 7 months earlier, was not accompanied by pain. The patient's oral cavity glands were painless and did not exhibit characteristic traits of inflammation. As Mikulicz claimed, “the interpretation of this case caused me a lot of trouble, because it did not fit into the confines of the contemporarily known and already named diseases.”48 After 2 months, Mikulicz surgically removed the patient's enlarged submaxillary glands. On the basis of the histopathologic examination of the removed glands, he originally described the disease as “a benign and chronic dacryoadenitis.” In the microscopic examination of the resection tissue of the tumor, he stated:

…the main mass of the tumour was a pretty uniformly arranged tissue consisting of small round cells… Here and there, the cells lay compactly together; in other places a fine reticulum is to be seen between them. In single, large cells karyokinetic figures can be recognized. Imbedded in these small-celled main masses there appear, partly single and partly in groups, the apparently unchanged acini of the salivary gland; they are separated from one another in varying distances by the round cell tissue.48

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  • Fig. 4. 

    Patient with Mikulicz disease: bilateral swelling of the upper eyelid, parotid and submaxillary glands. Histologic image of Mikulicz disease at the bottom of the figure. (Reprint from the book: Kozuschek W. Johann von Mikulicz-Radecki 1850-1905. Mitbegründer der modernen Chirurgie. Wrocław: Wydawnictwo Uniwersytetu Wrocławskiego, 2003, p. 108).

This clinical picture of the disease described for the first time by Mikulicz (Figure 4) was reanalyzed in 1933 by a Swedish ophthalmologist Henrik Samuel Sjögren26, 49 who, also linked the symptoms of the dry eye to the symptoms described by Mikulicz. Currently, the syndrome first described by Mikulicz is known as Mikulicz disease or Mikulicz syndrome,6, 10, 50 appearing in the course of various lymphatic diseases, rheumatic diseases, tuberculosis, and syphilis. The disease described by Mikulicz was treated, before the era of cytogenetic and immunohistochemical tests, as a variant of Sjögren syndrome, indicating the common occurrence of the infiltration of the salivary and lacrimal gland by lymphocytes.49, 50 Currently, more frequently significant immunohistochemical differences occurring between the gland cells in Mikulicz disease and in Sjögren syndrome7, 51, 52 are revealed, indicating that Mikulicz disease is a different entity from Sjögren syndrome.52 In contrast to Sjögren syndrome, in Mikulicz disease, there are no anti–SS-A and anti–SS-B antibodies,9 as well as symptoms such as dry eye and dry mouth.

Mikulicz's description of the noninflammatory disease of the salivary and lacrimal glands was one of the many examples of his crossing the boundaries of surgery. During his stay in Königsberg, he cooperated with Bernhard Naunyn, a professor of internal medicine and the discoverer of the center in the brain responsible for reading. This cooperation later resulted in the establishment of the journal in 1896, Mitteilungen aus den Grenzgebieten der Medizin und Chirurgie, which they coedited, and proved to be a common ground for publications in internal medicine and surgery.27 In the Königsberg period, together with Michelson, the director of the laryngologic and dermatologic clinic, he also created Atlas der Krankheiten der Mund und Rachenhöhle (The Atlas of Diseases of the Mouth and Throat).53

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Mikulicz in Breslau: The development of aseptics 

In 1890 at the height of his career, Mikulicz (Figure 5) moved to Breslau and accepted the position as Head of the Department of Surgery at the University of Breslau. Breslau at that time was a more prosperous city than Cracow and even Königsberg; therefore, it was there that he realized his dream of creating a modern operating theater. The construction of a new surgical clinic was already in progress when he arrived in Breslau. Mikulicz made necessary changes to the project so that in the near future it would be possible to realize the project of a fully aseptic operating unit. Such a project was carried out in close cooperation with Mikulicz.

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  • Fig. 5. 

    Jan Mikulicz-Radecki in Breslau about 1890. (From the private archive of F. Anschütz. Reprint from the book: Kozuschek W. Johann von Mikulicz-Radecki 1850-1905. Mitbegründer der modernen Chirurgie. Wrocław: Wydawnictwo Uniwersytetu Wrocławskiego, 2003, p. 112).

He and his team were given at their disposal the largest and the most modern aseptic operating theater in Europe in 1897.18, 27 Mikulicz was the first surgeon in the world who ordered the building of an aseptic operating room and gave up the performance of procedures in lecture halls, which was then a generally accepted practice in other European clinics.

Mikulicz, next to Gustav Neuber (1850-1932) and Ernst Bergmann (1836-1907), is one of the three great authors of aseptic principles.27 He had already applied these principles in Königsberg with the steam sterilizer. In Breslau, he attempted to perform surgery with a pair of sterile silk gloves. A little later, he introduced sterile rubber gloves, operating masks, and a strict order to wash hands with alcohol before each operation.18, 27, 54 With all these efforts, he achieved in the Breslau clinic an astounding, for those times, level of 99% of wounds healing without complications.27, 55

Mikulicz had a great input into the development of surgical treatment of colon cancer. In 1902, he suggested a two-stage exteriorization of the colon as a form of treatment of this disease,56 a modification of the Paul-Mikulicz,57 or the Bloch-Mikulicz method.58 He also took precautions to minimize the risk of pulmonary and cardiovascular complications in patients operated on in his clinic. To prevent pneumonia in the postoperative period, he introduced the routine heating of the operating table while performing the operation.27 In the age in which nothing was known about blood groups, he warned against using blood transfusion, recommending previous intravenous administration of common salt solutions.27

The presentation of Mikulicz's achievements would be incomplete without a mention of his accomplishments in surgical subdisciplines other than gastrointestinal surgery.3 He introduced the method of a wedge resection of the thyroid gland, which was later developed at Mayo Clinic in the United States.15, 27 He also performed a resection of the foot, which frequently required because of bone tuberculosis or gunshot wounds.27 In the field of urologic surgery, he performed prostatectomy with perineal access, surgical stabilization of a floating hypermobile kidney, ureterolithiasis, and surgical treatment of bladder exstrophy in children.13

He performed plastic surgeries of the nose and skin grafts. He pioneered thoracic surgery in a pressure-differential chamber constructed by Ernest Ferdinand Sauerbruch (1875-1951), one of his assistants.27, 59 Despite initial failures in the surgical treatment of patients with esophagus cancer in the thorax, the pressure-differential chamber was successfully used to treat mediastinal tumors.

In July 1904, Mikulicz performed the world's first successful surgery of a mediastinal tumor. The patient, a 40-year-old woman, was discharged from hospital in good general condition only 10 days after the operation. In Breslau, apart from Sauerbruch's pressure-differential chamber, Mikulicz's assistant Max Tiegel (1877-1952) constructed an apparatus for administering anesthesia, and the Breslau clinic became a cradle for the development of thoracic surgery.

Mikulicz opened a private surgical clinic in Breslau in 1899, which was a center equipped with modern apparatus. In 1901, he organized an orthopedic center and a gym for physical therapy treatments. In the extremely favorable clinical conditions in Breslau, Mikulicz was able to take advantage of his rich medical knowledge and clinical experience. He did this with passion and great respect for the patients. He believed that the patient's illness required the doctor's highest physical and spiritual contribution.27, 60 He did not require payments for treatments from the poor patients, and this was very important to many Jewish people.27 The patients highly valued Mikulicz's professionalism and his attitude toward them. In Jewish society, Mikulicz was continually praised. He became so popular that a saying was heard about him “The first is God and just after him is Professor Mikulicz.”27, 60

Eyewitnesses confirmed Mikulicz's extraordinary talent for surgery, because he operated with great precision and without much blood loss. He was a true artist in the surgical profession, preferring accuracy of the procedure over the speed of its execution.1, 5, 27 Through the process of teaching students and training doctors at the clinic, he attached utmost importance to the preoperative diagnosis. He stressed that the effectiveness of surgery depends on the correct diagnosis. Benefiting from years of experience, he modified the method of general anaesthesia before operations by abandoning the use of chloroform for ether.27, 61

The fame of the Mikulicz's Breslau Surgical School, because such phenomena should be mentioned, exceeded the boarders of Europe. To exchange experiences, surgeons from all over the world came to Breslau, including American surgeons such as William and Charles Mayo from Rochester, Minnesota, John Murphy from Chicago, and Harvey Cushing from Boston. Surgeons and assistant-volunteers from Japan also came, among them Hayari Miyake, who later became a professor of surgery at Kyushu University in Fukuoka.27

Mikulicz travelled to the United States in 1903 at the invitation of U.S. surgeons. He was received enthusiastically and gave presentations in 20 U.S. clinics where he performing demonstrational operations. He received an honorary doctorate from Jefferson Medical College in Philadelphia. One year later, he was awarded an honorary doctorate from the University of Glasgow, during his last scientific trip to England.

A planned tour of Japan did not occur.27 At the end of 1904, Mikulicz felt by palpation a tumor in his abdomen. Soon after this, at the end of December, he consulted with Bernhard Naunyn and underwent an exploratory laparotomy. Mikulicz's friend, Professor Eiselsberg from Vienna, performed the surgery in Mikulicz's private surgical clinic in Breslau in January 7, 1905, using ether anesthesia. The procedure revealed the existence of a large inoperable stomach tumor with metastases to the liver cavity.

Mikulicz, aware of the impending end of his life, was active up to his last moments in the clinical, teaching, and research fields. At the first lecture after his operation for the students of the Breslau Medical Faculty, he stressed that, “the greatest and most noble task of the doctor is to help when it is already too late for the surgery, or for other reasons surgery is impossible.”27, 62, 63 Mikulicz performed his last operation, an amputation of the thigh, on March 23, 1905.

Just a few weeks before his death, he reviewed the scientific works of his assistants. Naunyn mentioned that a few days before Mikulicz's death, he received from him a manuscript with critical remarks.27 At the same time, Mikulicz also wrote to Professor Eiselberg in Vienna, “I am dying without regrets and I am satisfied with my life. I worked to the best of my abilities and I found happiness and recognition in the world.”27 Jan Mikulicz-Radecki died June 14, 1905, at the age of 55 years, at his home in Breslau.27, 63

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Conclusions 

Jan Mikulicz-Radecki became famous in the history of medicine, mainly as an outstanding surgeon, founder of the Breslau surgical school, the inventor of the gastroscopy, and the discoverer of a disease entity contemporarily known as Mikulicz disease. His pioneer accomplishments in the field of gastrointestinal surgery, thoracic surgery, and aseptic techniques would be long remembered. With his extremely rich and innovative scientific achievements, he also had a friendly attitude toward his patients. Without doubt, the main reason that determined Mikulicz's scientific and clinical activity was the principle of acting for the benefit of the patient, regardless of religion or material and social status. In his activity, Mikulicz did not limit himself to the field of surgery but also concentrated on other disciplines that arose from surgery in its historical development.

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  31. Mikulicz J. Kasuistiche Beiträge zur Exstirpation solider Geschwülste des Uterus und der Ligamentalatadurch die Laparotomie, Wien Med Wochenschr 1979;29:513-5, 544-5, 599-602.
  32. Mikulicz J. Die antiseptische Wundbehandlung und ihre Technik, Mitt Ver Ärzte Nieder-Österreich (Wien) 1879;5:58-62, 77-82, 92-95, 122-4, 146-53, 161-3, 183-7.
  33. Briefe von Theodor Billroth. Hannover-Leipzig: Hahnsche Buchhandlung; 1910, letter No. 132, 176.
  34. Holinka C. Theodor Billroth: the life of a surgeon in the spirit of music. Mt Sinai J Med. 1981;48:21–41
  35. Lewis JM, O'Leary JP. Theodor Billroth: surgeon and musician. Am Surg. 2001;67:605–606
  36. Weir NF. Theodor Billroth and Johannes Brahms—a thirty year friendship. Hist Med. 1975;6:8–14
  37. Mieny CJ. Theodor Billroth and Johannes Brahms—a musical friendship. Adler Mus Bull. 2000;26:4–6
  38. Mikulicz J. Die seitlichen Verkrümmungen am Knie und der en Heilungsmethoden. Arch Klin Chir 1879;23:561-629, 671-884.
  39. Mikulicz J. Resekcja odźwiernika z powodu raka. Wyleczenie. Uwagi nad pewnym objawem raka żołądkowego, za pomocą gastroskopu spostrzegać się dającym (Resection of the pylorus because of the cancer. Healing. Remarks above the certain symptom of stomach cancer visible with the gastroscope), Przegląd Lekarski. 1883;22:157–158
  40. Mikulicz J. O użyciu jodoformu w leczeniu ran [About using the iodoform in treating wounds]. Przegląd Lekarski 1881;20:481-3, 493-5, 505-6, 519-21, 534-6, 547-8, 564-5, 577-8, 595-6.
  41. Cybulski N, Mikulicz J. O fizjologicznym zachowaniu się przełyku i mechanizmie połykania u człowieka (About the physiology of the esophagus and the human mechanism of swallowing down), Rozpr Spraw Akadem Umiej. 1887;15:203
  42. Heupel HW. Heinecke-Mikulicz vs Finney pyloroplasty. Identical procedures—different vintage. Minn Med. 1970;53:139–141
  43. Mikulicz J. Zur operative Behandlung des stenosieren den Magengeschwüres. Arch Klin Chir. 1888;37:79–90
  44. Hayden WF, Read RC. A comparative study of the Heinecke-Mikulicz and Finney pyloroplasty. Am J Surg. 1968;116:755–758
  45. Mikulicz J. Berichtüber 103 Operationen am Magen. Ver Dtsch Ges Chir. 1895;24:737–767
  46. Mikulicz J. Beiträge zur Wundbehandlung. Zur Sprayfrage. Wien Med Wochenschr. 1884;34:1101
  47. Mikulicz J. Przyczynek do nauki o leczeniu ran (Introduction to knowledge about treating wounds), Przegląd Lekarski. 1884;23:55–57
  48. Mikulicz J. Über eine eigenartige symmetrische Erkrankung der Thränen Und Mundspeicheldrüsen. In: Beiträgezur Chirurgie, Festschrift gewidmet Theodor Billroth von Seine dankbaren Schülern zur Feier des vollendeten fünfzigsten Semesters seines akademischenWirkens. Wien: Stuttgart; 1892;p. 610–630[Concerning a peculiar symmetrical disease of the lacrimal and salivary glands.] English translation in Medical Classics 1937;2:165-86
  49. Morgan WS. The probable systemic nature of Mikulicz's disease and its relation to Sjögren's syndrome. N Engl J Med. 1954;251:5–10
  50. Morgan W, Castleman B. A clinicopathologic study of Mikulicz's disease. Am J Pathol. 1953;29:471–503
  51. Tsubota K, Fujita H, Tsuzaka K, Takeuchi T. Mikulicz's disease and Sjögren's syndrome. Invest Ophthalmol Vis Sci. 2000;41:1666–1673
  52. Yamamoto M, Harada S, Ohara M, et al. Clinical and pathological differences between Mikulicz's disease and Sjögren's syndrome. Rheumatology. 2005;44:227–234
  53. Mikulicz J, Michelson P. Atlas der Krankheiten der Mund und Rachenhöhle. Berlin: I. Hälfte; 1891;
  54. Mikulicz J. Die Desinfektion der Haut und Händemit Seifenspiritus. Dtsch Med Wochenschr. 1899;25:385–387
  55. Mikulicz J. Über die neuesten Bestrebungen, die aseptische Wundbehandlung zuvervollkommnen. Arch Klin Chir. 1898;57:241–279
  56. Mikulicz J. Behandlung der Darmarcinome. Ver Dtsch Ges Chir. 1902;31:67
  57. Gervin AS, Hoffman MJ, Fischer RP. Modified Paul-Mikulicz ileocolostomy. Am J Surg. 1987;154:648–650
  58. Olch PD. Johann von Mikulicz-Radecki. Ann Surg. 1960;152:923–926
  59. Cherian SM, Nicks R, Lord RS. Ernst Ferdinand Sauerbruch: rise and fall of the pioneer of thoracic surgery. World J Surg. 2001;25:1012–1020
  60. Neugebauer J. Weltruhmdeutscher Chirurgie: Johann von Mikulicz. Ulm/Donau: K. F. HaugVerlag; 1965;
  61. Mikulicz J. Chloroform oder Aether?. Berlin Klin Wochenschr. 1895;46:1035–1039
  62. Kausch W. Johanes von Mikulicz-Radecki. Sein Leben und seine Bedeutung. Mitt Grenzgeb Med Chir. 1907;III(suppl):1–64
  63. Ellis H. Death of a pioneer surgeon. Br J Hosp Med (Lond). 2005;66:481

PII: S0738-081X(11)00109-X

doi:10.1016/j.clindermatol.2011.05.004

Clinics in Dermatology
Volume 30, Issue 1 , Pages 129-136, January 2012

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