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The first two patients were free of seizures after the operation,
and with the third one fits ceased without any other therapy.
Discussion
We have no evidence of the special surgical training of the Dr
Bayer. He had some surgical experience as a war surgeon. Also
he was probably "very clever" with his hands, because he worked
as a doctor, even professor of foren- sic medicine, but his operating
technique remains obscure. There were several Turkish military
surgeons before Dr Bayer in Sarajevo. They performed several kinds
of operations including trepanation for extracerebral hemorrhage,
and the operation of the severe depressed fracture but none of
them made any kind of osteoplastic flap and cerebrotomy. We estimate
that Dr Bayer's contribution was great. VB was a small provincial
hospital, without the separate ward for surgery. There was no
experience in surgical cases, and the osteplastic craniotomy because
of epileptic seizures was the first one in Bosnia. It was short
period after the first removal of brain abscess by Mc Ewen in
1876., and the first craniotomy by F. Durante in 1882. It is regrettable
that we do not know more about Dr Bayer's technique. There is
no evidence about his instrumentation and facilities. We could
not determine from his description of the operations whether he
used the aspirator or Gigli saw? We also cannot say how he controlled
bleeding? His description was modest as he was. We only had his
description of the operation in his personal papers because VB
had not operating protocol. Dr Bayer performed three operations
only. The reason was probably due to organizational matter. In
1894., the new hospital was opened General Hospital (Landesspital),
with the new surgical department, and modern operating
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theaters. The new main surgeon was an experienced surgeon from
the General Hospital of Wiena, associate professor of Wienna University,
Dr Preindelsberger, who preferred mainly urological operations.
So, no similar brain operation was done for next several years.
VB became insane asylum, named the Department for Mental Diseases,
and Dr Bayer was appointed chief of it. He had not any opportunity
to perform other brain operation, because the door of the Department
of General Surgery was closed to him. He did not even try. The
modesty of the pioneer of brain surgery in Bosnia is revealed
in the fact that not even his photograph has been saved.
Acknowledgements
All papers related to the Dr Bayers curriculum vitae, were provided
by Mrs Emilka Bayer, the daughter of Dr Karl Bayer, who lived
in Belgrade, and died eight years ago. Requiescant in peace.
References
- BOSANSKI VJESNIK; 1886, 11:6.
- BOŠNJAK; 1891, 1610-1
- Jeremić R. Prilozi zdravstvenih i medicinskih prilika Bosne
i Hercegovme pod Turskom i Austro-Ugarskom. Beograd: Naučna
knjiga 1051;68-9
- Konjhodžić F, Simunović V Prve operacije na glavi i mozgu
u Vakufskoj bolnici u Sarajevu. Medicinski arhiv 1978;32:325-8.
- KreševIjaković H Vakufska bolnica In Spomenica Gazi Husrefbegove
četiristogodišnjice, Sarajevo, Priređivački odbor za proslavu;
1932:72-3.
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Paper accepted December 10,1991.
Address reprint requests to:
Prof. Dr Faruk Konjhodzic,
Klinika za neurohirurgiju KCUS-a,
ul. Bolnicka 24,
71000 Sarajevo,
Bosnia and Herzegovina
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