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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

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

  1. BOSANSKI VJESNIK; 1886, 11:6.
  2. BOŠNJAK; 1891, 1610-1
  3. Jeremić R. Prilozi zdravstvenih i medicinskih prilika Bosne i Hercegovme pod Turskom i Austro-Ugarskom. Beograd: Naučna knjiga 1051;68-9
  4. Konjhodžić F, Simunović V Prve operacije na glavi i mozgu u Vakufskoj bolnici u Sarajevu. Medicinski arhiv 1978;32:325-8.
  5. KreševIjaković H Vakufska bolnica In Spomenica Gazi Husrefbegove četiristogodišnjice, Sarajevo, Priređivački odbor za proslavu; 1932:72-3.
 

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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