[Kocher and goitre].

Emile Theodor Kocher (1841-1917) studied and spent his entire career as surgeon (since 1866) and professor (since 1872) in his native Berne, apart from a 'grand tour' of surgical institutions in Europe. The discipline of surgery rapidly expanded, not least through the introduction of anaesthesia and antisepsis. Kocher's expertise ranged from ankle fractures to hypophysectomy; he wrote an authoritative textbook on surgical technique. He became most famous through his treatment of goitre, an endemic condition in the mountainous parts of Switzerland. Kocher developed a meticulous technique for thyroidectomy, without major haemorrhage or damage to the recurrent nerve. The 'Kocher clamp' was developed for haemostasis. On discovering that patients might develop cretinism or 'cachexia' many years after total thyroidectomy, he took care to leave part of the gland intact. As the relation with myxoedema became clear, he experimented with thyroid transplantations and attempted to find biochemical function tests. In 1909 he was awarded the Nobel prize for Physiology or Medicine. Five years later thyroxin was isolated.