Hans Frangenheim - Culdoscopy vs. Laparoscopy, the First Book on Gynecological Endoscopy, and "Cold Light,"Litynski G. Frangenheim's teaching and publication activities spread his name, even though he was not based at a university. A steady stream of gynecologists, especially from German speaking countries, poured into Wuppertal. Frangenheim recalls, "The traffic in the clinic was so heavy that there was little time for anything else, especially since the only method back then of passing on endoscopic technique was one-on-one teaching."14 In the German medical press of the time we find numerous articles promoting laparoscopy.19,20 The First Book on Gynecological Endoscopy In the late 1950s, Frangenheim recognized the need for a book devoted entirely to laparoscopy, a project that Raoul Palmer had surprisingly not undertaken. Frangenheim's work appeared in 1959, the first book about methods of endoscopic examination in gynecology.18 There Frangenheim explained why he preferred laparoscopic examination: "It provides the best diagnostic results," he wrote. "In our opinion, the second best endoscopic method is the culdoscopy in the lithotomy position... [and] we have abandoned the knee-shoulder position in cul- doscopy almost completely," he remarked. At the center of Frangenheim's efforts stood the sterility issue, whereby pri- mary and secondary sterility appeared with about the same frequency. Second place was occupied by the question- able ectopic pregnancy. "Cold-light" A key breakthrough in endoscopic technique, the invention of so-called "cold light," was made around this time. A flex- ible bundle of glass fibers transmitted light from an outside source to the tip of an endoscope. The development was gradually introduced into the various branches of endoscopy. In the early 1960s, a German manufacturer introduced it into laparoscopy.14 Frangenheim was offered the opportunity to test the cold light system, which he did and followed it up with a publication on this test (Figure 6). He announced his experiences with cold light at a con- gress in Palermo in 1964 and one year later in the German medical press. He stated that the light intensity was four to five times greater than with previous equipment and enthu- siastically proclaimed that this kind of illumination belonged to the future of laparoscopy. The succeeding years were to bear out the truth of his words.21 References: 1. Villey R, Bruntet F, Valette G, et al. Histoire de la Medicine, de la Pharmacie, de 1'art Dentaire et de l'art veterinaire. Germany ed. Illustierte Geschichte der Medizin, Vol. 1-9. Salzburg, Austria: Andreas; 1980-1984. 2. Olshausen R. Diskussion uber die vaginalen operationen. Verh Dtsch Ges Gyn. 1897;7:440. 3. Baumm. Uber indikation und grenzen der vaginalen opera- tionen. Verh Dtsch Ges Gyn. 1897;7:433-439. 4. Olshausen R. Diskussion uber die vaginalen operationen. Verh Dtsch Ges Gyn. 1897;7:440. 5. Chrobak R. Die diskussion uber die vaginalen operationen. Verh Dtsch Ges Gyn. 1897;7:445. 6. PfannenstielJ. Die diskussion uber die vaginalen operationen. Verh Dtsch Ges Gyn. 1897;7:44l-443. 7. von Ott DO. Die beleuchtung der bauchhohle (Ventroskopie) als methode bei vaginaler koliotomie. Centrbl Gynakol. 1902;26:817-820. 8. von Ott DO. Die unmittelbare beleuchtung der bauchhohle, der harnblase, des dickdarms nd der gebarmutter zu diagnostis- chen und operativen zwecken. Mschr Geb Gynakol. 1903; 18:645- 673. 9. Villey R, Bruntet F, Valette G, et al. Histoire de la Medicine, de la Pharmacie, de 1'artDentaire et de 1'artveterinaire. Germany ed. Illustierte Geschichte der Medizin, Vol. 1-9. Salzburg, Austria: Andreas; 1980-1984. 10. Decker A. Discussion. 14 Novembre. Proceedings of the First International Symposium on Gynecological Coelioscopy. Palmero, Italy: I.R.E, 1964:65, 186-187. 11. Decker A. Artificial pneumoperitoneum by cul-de-sac punc- ture. A new technique for pelvic pneumograms. New York J Med. 1946;46:3l4-318. Decker A. Culdoscopy: Its diagnostic value in pelvic disease. JAMA. 1949; 140:378-385. Decker A. Culdoscopy. Am J Obstet Gynecol. 1952;63:654-659. 12. Frangenheim H. Die Coelioskopie bei der Sterilitatsuntersuchung. Proceedings of the First International Symposium on Gynecological Coelioscopy. Palmero, Italy: I.R.E, 1964:195-204. 13- Antonovitsch E. Zolioskopie, insbesondere douglasskopie. Zentralbl Gynakol. 1949;71:896. 14. Frangenheim H. Phone interview by G. Litynski, June 18, 1994. 15. Bettendorf G. Zur Geschichte der Endokrinologie und Reproduktionsmedizin. 256 Biographien und Berichte. Berlin, Germany: Springer Verlag; 1995. 360 JSLS (1997)1:357-361