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Conrad Ramstedt (1867-1963)

Conrad RamstedtConrad Ramstedt was born in Hamersleben, a village in central Prussia in 1867. His father was a local physician. He attended the gymnasium at Magdeburg and studied medicine at Heidelberg, Berlin and Halle, graduating from the latter in 1894. From 1895 to 1901 he was an assistant in the surgical clinic at Halle before joining the German army. As a military surgeon he was promoted several times and served with distinction during the First World War. On his discharge from the army in 1919, he became chief surgeon to the RafaelKlinik at Munster where he stayed for the remainder of his professional life.

As a result of post-mortem examinations on two infants who had died from the disease, hypertrophic pyloric stenosis was first described by Harald Hirschsprung in 1888.  At that time, despite its high mortality, physicians were reluctant to advice surgery for its relief. From 1892 to 1912 reports of attempts to relieve the obstruction by various forms of pyloroplasty appeared. Almost all of the patients died and few successes were reported. One notable exception was a patient operated on by Lobker at Bochum who bypassed the obstruction with a gastrojejunostomy. In 1907 Fredet suggested an alternative operation in which the muscular coat of the pylorus was divided. In 1908 Weber advocated a similar approach and as a result of these two preliminary reports, Ramstedt described two successful operations at a medical congress at Munster in 1912. He published the results in Medizinische Klinik on 20 October 1912. In the first patient he attempted to suture the pyloroplasty in a transverse fashion but this failed and the sutures cut out. He covered the muscular defect with an omental patch. In the second patient the pyloric incision was left open with no attempt made to close it - the operation which is today eponymously associated with him.  In his early series of patients, the mortality associated with pyloric stenosis and the subsequent operation was over 50%. Apart from five articles on the surgical treatment of pyloric stenosis, Ramstedt's main contributions to the medical literature are chapters on the male genito-urinary organs which he wrote for Handbuch der praktischen chirurgie edited by Bergmann, Bruns and Mikulicz in 1927.
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