REVIEWJan Mikulicz-Radecki: one of the creators of world surgery
Wojciech Kielan, Bogdan Lazarkiewicz, Zygmunt Grzebieniak, Adam Skalski and Piotr Zukrowski
Second Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland(Received for publication on March 30, 2004)(Revised for publication on December 14, 2004)(Accepted for publication on December 16, 2004)

Abstract. This paper presents the life and achievements of Professor Jan Mikulicz-Radecki and his
contribution to European and world surgery. He was born in 1850. Four periods can be distinguished in
his surgical career: (1) Vienna period, 1875–82, when he worked by the side of the great Theodor
Billroth: he introduced a number of new diagnostic and operative techniques, aseptic and antiseptic
procedures, published research papers. He made the ﬁrst endoscope for examining the esophagus andstomach. (2) Cracow period, 1882–87, when he was head of the Department of Surgery: he inaugurated
his work with a lecture in Polish, which started: Gentlemen, I have been accused that I do not know thePolish language – which is my mother tongue to me as well as to any of you. He published papers
on the use of iodophorm for healing wounds, was the ﬁrst surgeon who sutured a perforated gastriculcer (1885) and invented pyloroplasty (1887), nowadays called Heinecke-Mikulicz pyloroplasty. (3)Königsberg period, 1887–90: he improved the technique of gastric resection, worked on surgery for
peptic ulcer and advocated aseptic and antiseptic procedures. (4) Wroclaw (Breslau) period, 1890–
1905: Mikulicz was appointed head of a newly founded Surgical Department. He rebuilt it and designed
one of the largest and most modern operating theaters in Europe that time. He introduced silk gloves
for operations for the ﬁrst time in the world. In 1892 he described bilateral swelling of salivary andlacrimal glands, called Mikulicz’s syndrome; in 1902 he published his experience with two-stage colon
resection; and in 1904 he described ostitis ﬁbrosa cystica juvenilis. Called ‘‘a king in the kingdom ofsurgeons’’, he was one of the fathers of the world’s modern surgery; having a brilliant surgical mind, he
was a pioneer of many new operations and an inventor of surgical tools, permanently assimilated in theworld’s surgery. (Keio J Med 54 (1): 1–7, March 2005)
Key words: Mikulicz, history, surgery

tially as a surgical assistant, and later heading surgicaldepartments.

Introduction
The intention of this paper is to present the life andachievements of Professor Jan Mikulicz-Radecki andhis contribution to the world surgery. Some surgeons
may associate his name with surgical forceps or somemethods of operation but only a few know more details.
Jan Mikulicz-Radecki was born on May 16, 1850
in Czerniowce (Poland). His father was an architect, aPolish nobleman whose coat of arms was Gozdawa. His
mother, Emilia Damnitz, was Austrian. Jan’s brotherwas a general in the Austrian army, and their sister
Emilia Zborowska settled in Myslenice near Cracow.
Jan Mikulicz-Radecki studied medicine at the Facultyof Medicine of the University of Vienna.1–5 In his surgical career four periods can be distinguished according
to the university centers where Mikulicz worked, ini-

Vienna Period of Mikulicz’s Surgical Career
After completing his medical studies in 1875 hestarted working in Vienna. He chose the Surgical Department of Professor Theodor Billroth and worked
with him from 1875 to 1882. Only two full-time assistants were employed at the department that time, alongwith twelve volunteers who worked to learn surgery.
Theodor Billroth’s Vienna surgical center was then amost valued one for its high clinical and research level.
Numerous modern operating techniques were developed there at those times, along with microscopic andexperimental studies.6,7 Billroth began to treat Mikulicz seriously not sooner than after half a year. As Bill-

Presented at the 1343rd Meeting of the Keio Medical Society in Tokyo, January 28, 2004
Reprint requests to: Professor Wojciech Kielan, MD, PhD, 2nd Department of General and Oncological Surgery, ul. Sklodowskiej-Curie 66,
50-369 Wroclaw, Poland, e-mail: chir2@chir2.am.wroc.pl1

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roth operated on a patient with rhinoscleroma, he gave
Mikulicz the task of examining it under a microscope.
The results of Mikulicz’s examination changed theformer views on the pathology of rhinoscleroma completely. Mikulicz proved it to be chronic inﬂammation,
not a malignant tumor, and the giant cells found by
him to be typical of this desease are now called Mikulicz’s cells.8 After that discovery, in 1879 Mikulicz wassent by Billroth on a 5-month research tour round theoutstanding surgical centres of Europe. The main purpose of this journey was visiting the leading surgicaldepartments of Germany, France and England. Therehe met Richard Volkmann and Joseph Lister, and got
acquainted with Lister’s antiseptic ideas which appeared to him very much. Soon, in 1880 he presented
his habilitation dissertation on genu varum et valgum.5,9,10
But the greatest invention made by Mikulicz during
his employment in Billroth’s Department in Vienna wasthe construction of the ﬁrst endoscope in the world,
designed for examining the esophagus and the stomach(Fig. 1).1,11–14 Hilary Schramm, Mikulicz’s disciple,
wrote the following words about this event in 1881: After long efforts and numerous experiments carried out
together with Leiter, Mikulicz has ﬁnally succeeded in
making a gastroscope, with which he was afterwards
able to see the inside of the stomach of a living man.
Mikulicz expects that his new tool will possibly set a
new direction in diagnosing diseases of the stomach.14
Mikulicz’s gastroscope was a rigid metal tube, 65 cm
long and 14 mm in diameter. It was slightly ﬂexed, its
middle and lower segments forming the angle of 150 .
Inside the gastroscope there was an electric wire andtwo inner tubes, one for inﬂating the stomach with air,the other for water. In 1881 Mikulicz was the ﬁrst one
in the world to diagnose endoscopically cancer ofthe lower esophagus and esophageal narrowing due
to its compression by an aneurysm of the descending
aorta.1,11,12,14 He was also the ﬁrst surgeon who
observed that the results of surgical treatment of gastriccancer depend on its early diagnosis.1,15,16 In 1883 hepublished his remarks on this fact; he wrote: In fact inmany cases cancer of the pylorus can be diagnosed beyond any doubt only when it can not be operated onany more. Therefore the future of the excision of thepylorus depends mainly on working out some methodof early detection of gastric diseases. I hope thatmy gastroscope will also contribute to this, sooner orlater.15 Mikulicz continued his endoscopic examinations in Cracow, Königsberg and Wroclaw, convincedthat it would bring new light to diagnosing diseases ofthe stomach and esophagus (Fig. 2).
When Mikulicz worked with Billroth, he also dealt
with such problems as resection of the prolapsed large
bowel, surgical treatment of tonsillar carcinoma, andKielan W, et al: Jan Mikulicz-Radecki

Fig. 1 A drawing depicting Mikulicz’s endoscope (Reproduce from‘‘Über Gastroskopie und Ösophagoskopie’’, Wiener medizinische
Presse 1881, Bd. 22, S. 1441, after W. Kozuschek, ‘‘Jan Mikulicz
Radecki, 1850–1905. A promoter of Modern Surgery’’, Wroclaw
University Publishing House, Wroclaw 2003, ﬁg. 23, Copyright 6(2003), with permission from Professor Waldemar Kozuschek).

resection of the thyroid gland.1 In 1880 Jan MikuliczRadecki married Henriette Pacher, who stayed by hisside till the end of his life. According to the Austriancustom a married assistant could no longer be employed
in a university department. Nevertheless, Billroth prolonged his contract for another year, which had been
unprecedented for 25 years at the Faculty of Medicine
in Vienna.5
Cracow Period of Mikulicz’s Surgical Career
Leaving Vienna Mikulicz moved to Cracow where he
was given the post of Professor and head of Department of Surgery at Jagiellonian University. In Cracow
he worked in the years 1882–87, which accounted forthe second important period in his life.16,17 He beganwith an inaugurating lecture, given in Polish on OctoberKeio J Med 2005; 54 (1): 1–7

3

Fig. 2 A result of endoscopic examination of the esophagus and stomach, handwritten by Mikulicz in 1887 (Reproduce from the collection of
professor Waldemar Kozuschek, after W. Kozuschek, ‘‘Jan Mikulicz Radecki, 1850–1905. A promoter of Modern Surgery’’, Wroclaw University Publishing House, Wroclaw 2003, ﬁg. 26, Copyright 6 (2003), with permission from Professor Waldemar Kozuschek).

13, 1882, which was printed in the Polish Journal ofSurgery (Przeglad Chirurgiczny). Here is one remarkable sentence from it: Moi Panowie, zarzucano mi, ze
nie znam jezyka polskiego, który tak samo jest mowa
ojczysta dla mnie, jak i dla kazdego z Was. Prawda, ze
przez ciagle przebywanie w zakladach naukowych niemieckich, zaniedbalem naszej mowy. (Gentlemen, I
have been accused that I do not know the Polishlanguage – which is my mother’s language to me as wellas to any of you. It is true, however, that due to continuous dwelling at German scientiﬁc institutions I haveneglected our language.).17,18
In spite of very poor housing conditions andhaving only 21 hospital beds, after introducing necessary adjustments in the operating room (the hitherto
existing operating room served at the same time fordressing wounds, out-patients operations and lectureswith corpse demonstrations) and improving the hygienical situation, he started performing operations
never done in Cracow before, like thyroidectomy,
gastric resection for cancer, transvaginal hysterectomy
or osteoplastic foot amputation.5,16,19,20 In Mikulicz’s
times the Surgical Department in Cracow achieved avery high standard and was ranked among the best onesin the state. He was the ﬁrst surgeon in the world who

sutured a perforated gastric ulcer (April 24, 1885) andinvented pyloroplasty (February 13, 1887), called nowadays Heinecke-Mikulicz pyloroplasty (in the same
year it was also published by Heinecke in Erlangen)(Fig. 3).5,16,21 His departure after 5 years was truly re-Fig. 3 Diagram of pyloroplasty by Mikulicz (Reproduce from ‘‘Zur
operativen behandlung des stenosierenden Magengeschwürs’’, Archiv
für klinische Chirurgie 1888, Bd. 37, s. 79–82, after W. Kozuschek,‘‘Jan Mikulicz Radecki, 1850–1905. A promoter of Modern Surgery’’,
Wroclaw University Publishing House, Wroclaw 2003, ﬁg. 34, Copyright 6 (2003), with permission from Professor Waldemar Kozuschek).

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Kielan W, et al: Jan Mikulicz-Radecki

Fig. 4 Jan Mikulicz-Radecki and his disciples in Cracow (Reproduce
from the collection of Department of History of Medicine, Jagiellonian University in Krakow, after W. Kozuschek, ‘‘Jan Mikulicz
Radecki, 1850–1905. A promoter of Modern Surgery’’, Wroclaw
University Publishing House, Wroclaw 2003, ﬁg. 37, Copyright 6(2003), with permission from Professor Waldemar Kozuschek).

gretted. He earned the reputation of an excellent surgeon and researcher. He even became president of the
Scientiﬁc Medical Society in Cracow. At the meetingsof the Medical Society he read scientiﬁc lectures andpresented his own interesting surgical cases (Fig. 4).
Königsberg Period of Mikulicz’s Surgical Career
In 1887 Mikulicz moved to Königsberg to hold thechair of the Surgical Department there until 1890. In
Königsberg he worked mainly on abdominal surgery,further developing the techniques of gastric resection
and surgical treatment of peptic ulcer. He also worked
on introducing aseptic and antiseptic procedures tosurgery. There he also made an observation on thesymmetrical swelling of lacrimal and salivary glands
known later as Mikulicz’s syndrome; he published this
discovery later, in 1892.22,23
Wroclaw Period of Mikulicz’s Surgical Career
In 1890 Mikulicz was appointed head of the Surgical
Department in Wroclaw (in those times named Breslau). Thus began the longest period in his career andthe last one, from 1890 to 1905. Moving to Wroclaw wasa turning point in Mikulicz’s life, with far-reachingconsequences. When he took the post the building of
the new department had not been ﬁnished yet. He had
the opportunity to introduce changes and improvements of his own, ﬁrst of all to rebuild the operating
theater which he considered too small and outdated. In
1887 the new, aseptic operating theater was ﬁnished,
being at the time the largest and most modern one inEurope.1,16,24–27 In this department the ideas changed

Fig. 5 Mikulicz’s Department of Surgery in Wroclaw (Breslau) witha newly built aseptic operating theater (Reproduce from the collection of professor Waldemar Kozuschek, after W. Kozuschek, ‘‘Jan
Mikulicz Radecki, 1850–1905. A promoter of Modern Surgery’’,
Wroclaw University Publishing House, Wroclaw 2003, ﬁg. 43, Copyright 6 (2003), with permission from Professor Waldemar Kozuschek).

from antiseptic to aseptic. Mikulicz organized new
chemical, bacteriology and pathology laboratories. He
carried out bacteriological tests for the surgical tools
and for the hands of the surgeons. He was the ﬁrst surgeon in the world who introduced wearing silk gloves
and surgical masks during operations.3,25,26 4.5% carbolic acid was used for washing hands and surgicaltools. At his Department of Surgery there were also
three outpatient departments: surgical, orthopaedic andurology. There was a well-equipped library, too.25–27
This way Jan Mikulicz-Radecki founded a surgical center ranked among the most modern ones in Europe andin the world (Fig. 5).
In 1902 he published a paper on his experience withcolon resection performed in two stages and in 1904
he described ostitis ﬁbrosa cystica juvenilis.24,27,28
His disciple Ferdinand Sauerbruch (1875–1951), whileworking at Mikulicz’s department, experimented onanimals and constructed a low pressure chamber thatallowed safe intrathoracic interventions. In 1904 Sauerbruch and Mikulicz performed a pioneer operation:
the ﬁrst thoracotomy in the low-pressure chamber forKeio J Med 2005; 54 (1): 1–7

Fig. 6 Sauerbruch’s low-pressure chamber for thoracotomy, ﬁrst
used in Mikulicz’s department in Wroclaw (Breslau) (Reproduce fromthe collection of professor Waldemar Kozuschek, after W. Kozuschek,‘‘Jan Mikulicz Radecki, 1850–1905. A promoter of Modern Surgery’’,
Wroclaw University Publishing House, Wroclaw 2003, ﬁg. 80, Copyright 6 (2003), with permission from Professor Waldemar Kozuschek).

the excision of a mediastinal tumor (Fig. 6).5,27,29 Jan
Mikulicz invented numerous surgical tools, of which the
Mikulicz’ forceps are well known all over the world. In
his department both ether narcosis and the mask of
Schimmelbush were already in use for anesthesia.1,11,30
Jan Mikulicz-Radecki was one of the leading surgeons in Europe. In 1895 at the Congress of Surgeons in
Berlin he presented the results of 103 gastric resections
for cancer or ulcer – no other surgical centre in Europe
except Theodor Billroth’s Department had such an impressive material.4,5Professor Theodor Billroth highly estimated theachievements of his disciple when he visited theSurgical Department in Wroclaw. Jan Mikulicz-Radecki
founded his own surgical school on the verge of the
19th and 20th century. The Wroclaw school of surgery
was highly valued and respected among the surgeons ofEurope and America. Professor Jan Mikulicz-Radecki
was invited to many departments in Europe, and in1903 he even went to America, where he was enthusiastically welcome. He gave lectures and performed
showroom operations in New York, Buffalo, Cleveland,
Rochester, Mines, Philadelphia, Boston, Baltimore andWashington.4,5,16,31 Professor Mikulicz was a memberof numerous surgical societies which granted him theirhonorary memberships for his great merits and his
contribution to surgery.
Mikulicz’s fame spread so wide that his Surgical
Department in Wroclaw was in those times visited bymany outstanding surgeons from all over the world, like
Markins and Sargant from England, and from the USA
the Mayo brothers (the founders of the Mayo Clinic,
the largest one in the world), Cushing from Boston and

5Fig. 7 Mikulicz and his team of the Surgical Department in Wroclaw(Breslau) (Reproduce from G. Kraft, Erinnerungen an Johann vonMikulicz Radecki, Leipzg 1926, S. 58, after W. Kozuschek, ‘‘Jan Mikulicz Radecki, 1850–1905. A promoter of Modern Surgery’’, Wroclaw
University Publishing House, Wroclaw 2003, ﬁg. 78, Copyright 6(2003), with permission from Professor Waldemar Kozuschek).

Murphy from Chicago.31 A Japanese surgeon Hiyari
Miyake, later Professor of Surgery at the Kyushu University in Fukuoka, visited Wroclaw and Mikulicz’s
Department several times. In 1900 Hiyari Miyake eyewittnesed an operation during which Mikulicz resecteda cancerous esophagus without opening the chest. Hereis what Hiroshi Akiyama wrote about it: Dr. Miyake,when he was young and ambitious, studied abroad in
the clinic of Professor Mikulicz in Germany. Miyake
described, that in 1900 Mikulicz ﬁrst performed thistechnique (oesophagectomy without thoracotomy, thecolloabdominal method) on a human, and stated: ‘I had
a valuable and rare opportunity to observe this operation directly during my visit with Professor Mikulicz’(. . .).32,33 Hiyari Miyake’s son, Hiroshi Miyake (1901–93), a Professor himself already, in 1934–35 worked in
the Surgical Department in Köln headed by Professor
Anschütz. He became a friend of all the Mikulicz’s
family who lived in Germany, and kept in contact withthem till the end of his life.1,5,27 Another famous Japanese doctor who worked with Mikulicz in Wroclaw was
Mishigi Takayasu, who got the post of an assistant in his
Surgical Department. At the same time he defended his
doctoral thesis on surgery of the pancreas (Fig. 7).34
Jan Mikulicz-Radecki died on June 14, 1905 in Wroclaw for gastric cancer, diagnosed by himself. Half ayear earlier he underwent explorative laparotomy in his
own department. He was operated on under ether anesthesia by his old friend from Vienna, Professor Eiselberg, who found an inoperable tumor with metastases
to the hepatic hilus. Shortly before he died, Mikulicz
said: I am dying without any regret and satisﬁed withmy life. I have worked according to my strength and I
found esteem and happiness in the world.27,35,36

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Kielan W, et al: Jan Mikulicz-Radecki

Fig. 8 Stone relief depicting the Greek goddess Hygiea putting alaurel wreath upon the head of Mikulicz (Reproduce from Wroclaw,
photo by P. Golusik, with permission from Mr. Pawel Golusik).

Jan Mikulicz-Radecki, in his department called ‘‘kingin the kingdom of surgeons’’, a pioneer of modern surgery, founded in Wroclaw a European or even worldwide school of surgery. The merits of Jan MikuliczRadecki are commemorated with a stone relief by
Alfred Volkmann, sculptured 5 years after his death(May 27, 1909) at the wish of his disciples and successors, on which the Greek goddess Hygiea puts a laurel
wreath of victory upon the head of Mikulicz sitting ona throne, with Pallas Athena as the symbol of wisdom
standing behind him. The relief is placed by theentrance to the former Mikulicz’s Department in
Wroclaw, in M. Sklodowska-Curie Street (formerly
Tiergartenstraße), where we have now the honor towork (Fig. 8).
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Chirurg, 15.5.1850–16.6.1905. Schlesien 1982; 27: 101–108 (inGerman)36. Mikulicz J: Letter to Professor A. Eiselberg, of June 10, 1905.
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