Lorenz Böhler
Encyclopedia
Lorenz Böhler was an Austria
Austria
Austria , officially the Republic of Austria , is a landlocked country of roughly 8.4 million people in Central Europe. It is bordered by the Czech Republic and Germany to the north, Slovakia and Hungary to the east, Slovenia and Italy to the south, and Switzerland and Liechtenstein to the...

n physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 and famous surgeon.

Böhler is most notable as one of the—or even the—creator of modern accident surgery. He was the head of the AUVA-Hospital in Vienna, Brigittenau, that was later named after him: Lorenz-Böhler-Unfallkrankenhaus. This hospital was an international model during his time as the leading surgeon there.
In radiology
Radiology
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...

, the measurement of Böhler's angle on a foot x-ray
X-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...

 can help detect fractures of the calcaneus.

Early life

At the early age of 5 Böhler – son of a family of craftspeople - knew he wanted to become a surgeon.
When he was a little boy he used to anatomize small birds and squirrels. On December 6, 1896 an X-ray
X-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...

 of a hand by Wilhelm Röntgen was published in the "Das interessante Blatt" magazine. Lorenz Böhler saw it, cut it out and stuck it on his reading book.
In 1896 he attended the fürsterzbischöfliche Knabenseminar in Brixen
Brixen
Brixen is the name of two cities in the Alps:*Brixen, South Tyrol, Italy*Brixen im Thale, Tyrol, AustriaBrixen may also refer to:*Bishopric of Brixen, the former north-Italian state....

. After two years he left that school and attended secondary school in Bregenz
Bregenz
-Culture:The annual summer music festival Bregenzer Festspiele is a world-famous festival which takes place on and around a stage on Lake Constance, where a different opera is performed every second year.-Sport:* A1 Bregenz HB is a handball team....

, where he had to repeat the third grade. He graduated in 1905.
He started his studies in medicine in 1905 at the University of Vienna
University of Vienna
The University of Vienna is a public university located in Vienna, Austria. It was founded by Duke Rudolph IV in 1365 and is the oldest university in the German-speaking world...

.
In 1910 he met his wife—a nurse—at Bregenz’s hospital where he was working as a trainee.
On July 1, 1911 Böhler became Doctor of Medicine at Vienna’s University.

Occupational activity until 1914

For a short time (1911—and then again in 1919, 1920) Lorenz Böhler was working at the clinic of surgeon Julius Hochenegg, who was his Professor at University. Hochenegg was one of the first doctors who had a department for accident surgery in his clinic.
Since September 1911 Böhler worked as a physician on a ship for a few months, until he started to work at the garrison’s hospital at Ragusa
Ragusa, Italy
Ragusa is a city and comune in southern Italy. It is the capital of the province of Ragusa, on the island of Sicily, with around 75,000 inhabitants. It is built on a wide limestone hill between two deep valleys, Cava San Leonardo and Cava Santa Domenica...

, where he became a k. u. k. substitute medical assistant. There he mostly did bacteriological work.
In Autumn 1912 he became an assistant doctor at the hospital in Bozen
Bozen
Bozen may refer to:*Bolzano, a bi-lingual northern Italian provincial capital city of which Bozen is the official German name*Bözen, a Swiss municipality*Bożeń, a village in Poland*Bozen Green, a village in Hertfordshire, England...

 and in April 1913 he became assistant doctor in Tetschen an der Elbe
Decín
Děčín is a town in the Ústí nad Labem Region in the north of the Czech Republic. It is the largest town and administrative seat of the Děčín District.-Geography:...

.
In 1914 Lorenz Böhler went to an international surgeons congress in New York
New York City
New York is the most populous city in the United States and the center of the New York Metropolitan Area, one of the most populous metropolitan areas in the world. New York exerts a significant impact upon global commerce, finance, media, art, fashion, research, technology, education, and...

. On his way to the congress he met Belgian doctor Albin Lambotte, who told him about surgical methods of fracture treatment.
Afterwards Böhler spent some time at the Mayo Clinic
Mayo Clinic
Mayo Clinic is a not-for-profit medical practice and medical research group specializing in treating difficult patients . Patients are referred to Mayo Clinic from across the U.S. and the world, and it is known for innovative and effective treatments. Mayo Clinic is known for being at the top of...

, Rochester, Minnesota
Rochester, Minnesota
Rochester is a city in the U.S. state of Minnesota and is the county seat of Olmsted County. Located on both banks of the Zumbro River, The city has a population of 106,769 according to the 2010 United States Census, making it Minnesota's third-largest city and the largest outside of the...

, where he met Charles Horace Mayo
Charles Horace Mayo
-External links:*...

. Mayo told him about the centres of fracture treatment at London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...

 and Liverpool
Liverpool
Liverpool is a city and metropolitan borough of Merseyside, England, along the eastern side of the Mersey Estuary. It was founded as a borough in 1207 and was granted city status in 1880...

. There was nothing like this in the German-speaking part of Europe. Mayo gave Böhler a commendatory letter for Arbuthnot Lane in London, who was one of the leading European doctors in surgical fracture treatment, but the breakout of World War I
World War I
World War I , which was predominantly called the World War or the Great War from its occurrence until 1939, and the First World War or World War I thereafter, was a major war centred in Europe that began on 28 July 1914 and lasted until 11 November 1918...

 made it impossible for Böhler to visit Lane.

Böhler’s career during World War I

Shortly after conscription Böhler wanted to work as a surgeon and so he did: From 1914-1916 he was working as a surgeon at the Divisions-Sanitäts-Anstalt Nr. 8 der Tiroler Kaiserjäger and in August 1916 he became the leading surgeon at a military hospital for minor casualties in Bozen
Bozen
Bozen may refer to:*Bolzano, a bi-lingual northern Italian provincial capital city of which Bozen is the official German name*Bözen, a Swiss municipality*Bożeń, a village in Poland*Bozen Green, a village in Hertfordshire, England...

.
Though he wasn’t allowed to treat shot fractures he managed to get soldiers with broken bones and was able to treat them very successfully so he finally was allowed to treat them and the military hospital was expanded to a special station for bone fractures and renamed “Spezialabteilung für Knochenschussbrüche und Gelenkschüsse”. There Lorenz Böhler was able to realize some of his most groundbreaking ideas: everything got specialized and standardized, records were kept for later (statistic) analyses, the most important information got written on the plaster and the patients got sorted according their kind of physical injury, and those who were able to do some kind of work had to help at the military hospital.
Böhler had seen the chaos in other military hospitals where patients were lying higgledy-piggledy which of course caused difficulties in treating them.
For a short time in 1918 Böhler was in Italian war captivity and had to work as an advisory surgeon for Italian military hospitals.

The interwar years - the founding of the AUVA hospital

Back in Austria Böhler wanted to establish special stations for casualty treatments. Therefore he approached the Arbeiterunfallversicherungsanstalt (AUVA) (labourer’s accident insurance) in Vienna and tried to explain the (both medical and economic) advantages which it would have if the AUVA would have an own specialized hospital. Though the AUVA agreed with Böhler the project wasn’t realized until 1925. The AUVA-hospital opened on December 1, 1925 in Vienna Webergasse 2-6. Böhler (meanwhile he was working as a surgeon in Bozen and Brixen) became the head of the hospital.
Böhler’s reputation as a surgeon increased, especially abroad, while some of his colleagues in Vienna rejected him.
Encouraged by the American Medical Association of Vienna (A.M.A.) he wrote the first edition of his book on bone fractures and modern techniques to deal with them called Treatment of fractures – which became his classic work – in 1929.
On March 29, 1930 Böhler was promoted to professor at the University of Vienna. There he was teaching surgery and accident treatment. On August 3, 1936 he became an associate Professor.

Böhler during World War II

Little is known about Lorenz Böhler’s life during the Second World War. On May 25, 1938 he became a member of the NSDAP (No. 6.361.999). In the summer of 1939 he was one of the 13 physicians of Vienna’s University (7 professors and 6 private lecturers) who signed a protest letter against the suggested move of the A.M.A. from Vienna to London claiming "... that we the undersigned, know of not one case of persecution of a professor for his racial or religious adherence. ... It could rather be said that by the removal of certain influences a trend of charlatanism, which was beginning to damage the reputation of the Vienna medical clinics in the eyes of serious medical men, was eliminated".

During World War II Böhler was inter alia working as an advisory surgeon for the Wehrmacht
Wehrmacht
The Wehrmacht – from , to defend and , the might/power) were the unified armed forces of Nazi Germany from 1935 to 1945. It consisted of the Heer , the Kriegsmarine and the Luftwaffe .-Origin and use of the term:...

 and at the Rudolfspital in Vienna, where he was the head of the surgery department and of a specialized military hospital for bone fractures.

After 1945

Böhler was one of the scientists who continued a successful career as Professor (in 1954 he became a professor) and physician (publishing many medical papers), despite his membership in the Nazi-Party. Until 1963 he remained the head of the AUVA-hospital. His son Jörg Böhler, who was a surgeon too, was the head of the AUVA-hospital from 1970 to 1983.

In his life Böhler received many awards and decoration (e.g.: 1915 Ritterkreuz des Franz-Josefs-Ordens des Militärverdienstkreuzes, 1917 Österreichisches Verdienstkreuz vom Roten Kreuz, 1918 Military Merit Medal (Austria–Hungary), 1959 Österreichisches Ehrenzeichen für Wissenschaft und Kunst,...).
He has also been an honourable member of 33 world wide associations.

Böhlers treatment principles

Böhler’s aim was to:
  • save life
  • save the part of the body
  • save its function.


This should be achieved by:
  • a fast diagnosis
    Diagnosis
    Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...

  • painless adjusting
  • immobilize the injured body part
  • active movement of all other body parts but trying to avoid causing pain.


Böhler rejected the methods of treatment which had been popular at this time: electricity
Electricity
Electricity is a general term encompassing a variety of phenomena resulting from the presence and flow of electric charge. These include many easily recognizable phenomena, such as lightning, static electricity, and the flow of electrical current in an electrical wire...

, hot air
Hot air
Hot air in economics refers to the Assigned Amount Units credits given for the reduction of Green House Gas emissions among the former Soviet Bloc countries since 1990....

 and massage
Massage
Massage is the manipulation of superficial and deeper layers of muscle and connective tissue to enhance function, aid in the healing process, and promote relaxation and well-being. The word comes from the French massage "friction of kneading", or from Arabic massa meaning "to touch, feel or handle"...

.

Publications

It is said that Lorenz Böhler published more than 400 scientific papers

His magnum opus Treatment of Fractures (1929) wasn’t a big success at first. Medical specialist printers refused to publish it, so Böhler asked the bookseller Wilhelm Maudrich (jun.) to help him. Böhler had to pay the printing cost and finally the book – though it was criticized by some of Böhlers colleagues – became a top seller. Wilhelm Maudrich then became a medical specialist printer Verlag Maudrich.
It was translated into eight languages: English
English language
English is a West Germanic language that arose in the Anglo-Saxon kingdoms of England and spread into what was to become south-east Scotland under the influence of the Anglian medieval kingdom of Northumbria...

, Spanish
Spanish language
Spanish , also known as Castilian , is a Romance language in the Ibero-Romance group that evolved from several languages and dialects in central-northern Iberia around the 9th century and gradually spread with the expansion of the Kingdom of Castile into central and southern Iberia during the...

, French
French language
French is a Romance language spoken as a first language in France, the Romandy region in Switzerland, Wallonia and Brussels in Belgium, Monaco, the regions of Quebec and Acadia in Canada, and by various communities elsewhere. Second-language speakers of French are distributed throughout many parts...

, Italian
Italian language
Italian is a Romance language spoken mainly in Europe: Italy, Switzerland, San Marino, Vatican City, by minorities in Malta, Monaco, Croatia, Slovenia, France, Libya, Eritrea, and Somalia, and by immigrant communities in the Americas and Australia...

, Russian
Russian language
Russian is a Slavic language used primarily in Russia, Belarus, Uzbekistan, Kazakhstan, Tajikistan and Kyrgyzstan. It is an unofficial but widely spoken language in Ukraine, Moldova, Latvia, Turkmenistan and Estonia and, to a lesser extent, the other countries that were once constituent republics...

, Hungarian
Hungarian language
Hungarian is a Uralic language, part of the Ugric group. With some 14 million speakers, it is one of the most widely spoken non-Indo-European languages in Europe....

, Polish
Polish language
Polish is a language of the Lechitic subgroup of West Slavic languages, used throughout Poland and by Polish minorities in other countries...

 and Chinese
Chinese language
The Chinese language is a language or language family consisting of varieties which are mutually intelligible to varying degrees. Originally the indigenous languages spoken by the Han Chinese in China, it forms one of the branches of Sino-Tibetan family of languages...

.
The book originally had 176 pages. In 1957 it had already been 2.500 pages. Lorenz Böhler constantly worked on it, updated and expanded it.

Some of his other publications:
  • Die Spezialisierung der Frakturbehandlung für die Kriegszeit, eine Frage von grösster volkswirtschaftlicher Bedeutung. In: Zentralblatt für Chirurgie 44 (1918)
  • Wie schützen wir die Verwundeten vor Amputation und Krüppeltum? In: Zeitschrift für orthopädische Chirurgie 45 (1924): 244-281.
  • Knochenbrüche und Unfallchirurgie in ihren Beziehungen zur Umwelt. Maudrich, Wien 1933.
  • Wundbehandlung. In: Zeitschrift für ärztliche Fortbildung 38 (22) (1941): 545-552.
  • Unfallkrankenhäuser, Unfallabteilungen, Unfallkliniken. In: Archiv für orthopädische und Unfall-Chirurgie 42 (1) (1942): 5-23.
  • Vorschlag zur Marknagelung nach Küntscher bei frischen Oberschenkelschussbrüchen. In: Der Chirurg 15 (1) (1943): 8-13.
  • Verbandlehre für Schwestern, Helfer, Studenten und Ärzte. Maudrich, Wien 1947.

External links

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