Abstract
Albert John Ochsner was a member of a select group of medical practitioners who made their impact on medical practice and surgical techniques. He was a pioneer in microscopy and made numerous contributions to the medical literature, on topics ranging from the organization of hospitals and advances in the treatment of hernias to the conservative treatment of appendicitis. The latter was controversial but saved lives. He was an innovative surgeon and a greathearted human being who influenced the lives of his colleagues. We are pleased to inaugurate Ochsner Profiles with Albert John Ochsner, a leader in the development of surgery in the United States and Europe and a figure of vast importance in the development of Dr. Alton Ochsner's career in medicine.
Life and Medical Career
Albert John Ochsner was born on April 3 1858, in Baraboo, Sauk County, Wisconsin (1–6). His father, William Henry Ochsner, was serving as county treasurer and, when his term in office was completed, the family returned to their farm where Albert grew up. He attended school for 5 months during the winter and, the rest of the year, worked on the farm.
In 1874, Albert began 2 years of high school in Baraboo. At the age of 18, after passing the county teachers examination, he taught school for five winter terms. In 1881, after serving a year as a principal of graded school at Ironton, Wisconsin, he entered the University of Wisconsin and completed the 4-year course in 3 years, graduating with honors and a B.S. degree. Having discovered an interest in histology, Albert decided to pursue a career in medicine and received his MD from Rush Medical College in 1886.
During his internship at Presbyterian Hospital in Chicago, Albert spent 9 months in Europe where he studied pathology under Kolisko and Paltauf in Berlin and surgery with the famous Billroth in Vienna. While in Europe, he passed an examination in London before a committee of the Royal Microscopical Society, receiving the degree of Fellow of the Royal Microscopical Society (FMRS). Upon his return to Chicago to finish his internship, he gave a course in histology and microscopy at Rush. After marrying Marion H. Mitchell of Chicago, he returned to Europe in 1888 to study in the clinics of professors Billroth, Albert, and Brown in Vienna; Krönlein in Zurich; Bergmann, Hahn, Bardeleben, Olshausen and Martin in Berlin; and Schede in Hamburg.
In the fall of 1888, he returned to Chicago to work in private practice for several years and attend at the surgical clinic at Rush Medical College. Albert Ochsner subsequently became the assistant to his former teacher, Dr. Charles Parkes, and was later named Instructor in Surgery at Rush Medical College. At the age of 33, he was named chief surgeon at Augustana Hospital, and, at the age of 38, Chief Surgeon to St. Mary's Hospital. At the age of 42, he accepted the Chair of Clinical Surgery at the University of Illinois and, thereafter, his teaching at Illinois and his clinical work at Augustana were connected.
Albert John Ochsner was primarily a practical surgeon, very knowledgeable of the principles of surgical management and, by all accounts, a great teacher. He was always willing to teach those who were eager to observe and willing to listen. Dr. E. Garside wrote of Dr. Ochsner that “…his habits were extremely simple and his rules of health were very rigid. He was an early riser and rode horseback in Lincoln Park every morning at 5:30 regardless of the weather. He always arrived at the hospital at 7:00 AM and expected everyone to be as ready and as anxious to work as he was” (1). Dr. Garside also wrote:
Few surgeons of his day rivaled him in basic training, including histology, bacteriology, embryology, and pathology. As an expert microscopist, he assumed the responsibility of every diagnosis made in the hospital laboratory. His ability to evaluate the clinical status of a patient was uncanny.
Dr. Ochsner's publications were numerous and varied (2) including five editions of Clinical Surgery for the Instruction of Practitioners and Students of Surgery; two editions of Handbook of Appendicitis; two editions of the Organization, Construction and Management of Hospitals; and The Surgery and Pathology of the Thyroid and Parathyroid Glands. He also edited a four-volume encyclopedia by American contributors, Surgical Diagnosis and Treatment.
Among his publications, “The Conservative Treatment of Acute Appendicitis,” although controversial, was one of his best known (7). The results of his experience were the basis of his Chairman's Address read before the 52nd annual meeting of the American Medical Association in St Paul, MN in 1901. Some quotes from that address prove interesting today:
…From Jan 1, 1898 to May 1, 1901, I have operated in this hospital (Augustana) upon 565 appendicitis cases, which I have divided into three groups: 1, those who entered the hospital suffering from diffuse peritonitis; 2, those who entered the hospital suffering from gangrenous or perforative appendicitis, and 3, those who entered the hospital suffering from recurrent appendicitis in the interval between attacks or at the beginning of a recurrent attack when the infectious material was still confined to the appendix. Of the first class I treated 18 cases, with 10 deaths, 55.5 per cent mortality; of the second class I operated 179 cases with 9 deaths, 5 per cent mortality; of the third class I operated 368 cases, with one death, 1/3 mortality. Total, 565 cases, with 20 deaths, 3.5 percent mortality…As a result of my clinical observations I am prepared to formulate the following conclusions: 1. Peristaltic motion of the small intestines is the chief means of carrying the infection from the perforated or gangrenous appendix to the other portions of the peritoneum changing a circumscribed into a general peritonitis. 2. This can be prevented by prohibiting the use of every kind of food and cathartics by mouth and by employing gastric lavage …this form of treatment, when instituted will change the most violent and dangerous form of acute perforative or gangrenous appendicitis into a comparatively mild and harmless form.
Albert John Ochsner believed in medical organizations and planned periodic visits to other clinics throughout the US to observe their surgical practice first hand. He was president of the Clinical Congress of Surgeons of North America from 1910 to 1912; one of the founders of the American College of Surgeons, of which he was president 1923–1924; president of the American Surgical Association in 1924; and editor of Surgery, Gynecology and Obstetrics. During World War I, Ochsner served in base Hospital Unit 11 with the Rank of Major. He received the LLD degree from the University of Wisconsin and was an honorary fellow of the Royal College of Surgeons of Ireland.
Practicing the highest professional ethics and endowed with great industry, a kindly manner, a philosophical approach to day-to-day affairs, and a gentle but halting voice, Dr. Ochsner was quick to command the confidence of his patients and respect from associates and pupils from all over the world. On July 25, 1925, Albert John Ochsner died at the age of 67 and was buried in Honey Creek, Wisconsin (1–5).
Mentor to Dr. Alton Ochsner
Dr. Alton Ochsner noted that the person who most influenced his life was his father, Edward Philips Ochsner (EP). Regarding the difference between his father's and his own life, Alton said, “His was more of a humdrum thing, the same thing every day; whereas mine is a different challenge every hour” (6 p1). When it came time to launch a career in medicine, EP Ochsner turned to his cousin Albert (AJ), the Chicago surgeon. AJ regarded his cousin highly and became interested in the future of his cousin's son, Alton. Alton Ochsner was uncertain as to when he first met his mentor. In one interview, he said that he could remember from his young boyhood AJ coming to South Dakota to hunt prairie chickens. Later, however, Alton Ochsner said, “He [AJ] was very close to my father when they were young, but I never knew him until I was in medical school” (6 p15), when AJ called Alton to Chicago to work in the summers at Augustana Hospital. AJ formed an attachment to the young Alton, in whom he recognized potential greatness. Since AJ's only son, Albert Henry, did not choose a career in medicine, he transferred his hopes to Alton.
In the summer of 1918, Alton Ochsner left for Chicago to be an extern at Augustana Hospital. It has been said that AJ became fond of Alton, to whom he referred as “my nephew.” Some of Alton's recollections shed light on AJ's character and working habits. Despite the fact that Alton was used to working long hours at the University of South Dakota and very much enjoyed his newfound life in surgery, he found it difficult to keep up with AJ's schedule. His sister, Mary Kaynor, quoted Alton telling the family, “He [AJ] is going to kill me before we get through.” As described above, AJ rode horseback every morning and he expected Alton to get up early and accompany him to discuss medicine. “I'll be too tired,” Alton said. “You are an Ochsner and you can take,” AJ responded. After a while, AJ instilled in Alton his work habits and shaped his future. No one heard the mature Alton Ochsner express any reluctance about working long and hard (6 p21).
Albert John Ochsner was key in planning the young Alton Ochsner's medical training for a successful career in surgery. AJ selected the Washington University Medical School in Saint Louis for Alton to obtain his MD. According to AJ, Washington University and John Hopkins University were the best places in the United States to study medicine. When Alton completed his junior year at Washington, AJ brought Alton back to Augustana and gave him the charge of the laboratory while he was away. AJ's interest in microscopy carried over to Alton, who became a regular in AJ's “Sunday school” where each Sunday AJ, Alton, and the residents met in the laboratory to study the specimens that had been surgically removed the prior week. Guided by AJ, they reviewed all the clinical history and examined the gross specimens and microscopic sections. AJ also insisted that Alton have training in internal medicine and, after earning his MD, Alton spent a year as an assistant resident in medicine at Barnes Hospital in Saint Louis under the internist George Dock, one of the country's leading physicians and a former trainee of the venerated physician and teacher Dr. William Osler. With his international connections, AJ was able to arrange surgical residences for Alton with Professor Paul Clairmont in Zurich and Professor Victor Schmieden in Frankfurt; these two centers were recognized as the best in the world.
All these steps helped Alton Ochsner achieve future greatness. He never forgot AJ's help and kindness. Subsequently, Alton Ochsner was always there to boost the confidence of medical students and to help other young physicians' careers; his doors were open to any young trainee. Long afterwards, AJ's grandsons, AJ II and Seymour Ochsner, both physicians, worked at Ochsner Medical Institutions (6 p15).
Conclusion
Alton Ochsner and the institution that he helped to found were both to become leaders in medicine due in large part to his own hard work and superb intelligence. The importance of a mentor to the career of a young physician is seen clearly in Alton Ochsner's life. His mentor, Albert John Ochsner, was in his own right one of the best surgeons of his time. Above all, Albert was a teacher of whom it was said, “he sought to teach in the manner of a German professor.” He had numerous friends among the most important surgeons in the US and Europe. One of his closest friends was William J. Mayo of the Mayo Clinic who wrote of him: “A fearless crusader for the truth, he was so far advance of his time and so little interested in attracting attention to himself, that his name is not associated with many of his great contributions…Ochsner was a man without vanity” (8). As a mentor to many young people throughout his, life Alton Ochsner kept Albert's legacy alive.
Acknowledgments
The author would like to acknowledge the recollections of Dr. Seymour Ochsner regarding his grandfather's life and career.
Footnotes
As The Ochsner Journal's new Associate Editor for Resident Publication and the History of Medicine, I am pleased to inaugurate Ochsner Profiles with Albert Ochsner. Ochsner Profiles will appear in each issue of the Journal and will provide brief biographies of the Ochsner institutions' numerous important historical figures. I encourage anyone related to the Ochsner institutions past or present to contribute to the section by submitting brief synopses of the lives and careers of influential Ochsner personalities, including personal recollections. Submissions should be directed to the Journal's Editorial office as described in the Information for Authors (page 245).
Hector Ventura, MD
- Ochsner Clinic and Alton Ochsner Medical Foundation