Koch's Apparatus and Theodor Kocher

KOCH'S APPARATUS, a device for sterilization in an atmosphere of water vapor at a temperature of 100°. The apparatus consists of a cylindrical tinned copper boiler with a lid, in the center of which is an opening where a thermometer is placed (see figure). The boiler is placed inside a metal casing. Inside the boiler is a stand upon which the items to be sterilized are placed. On the side, outside the boiler, there is a sight tube for determining the amount of water inside the boiler and a tap for draining the water. When using the apparatus, water is poured into the boiler to a height such that the stand is not submerged. The items to be sterilized are placed on the stand, and the lid is closed. Heating is carried out by a primus stove, gas, or some other method, and when steam begins to exit the apparatus in a uniformly strong jet, the start of sterilization is noted. During the entire time the apparatus is in operation, one should ensure that the steam jet does not weaken, thereby maintaining a constant temperature inside the boiler. It is not necessary to use a thermometer, as the boiling point of water is known. In the event that a Koch's apparatus is not available in the laboratory, it can be successfully replaced by any autoclave; one should simply not close the steam outlet valve. It must be kept in mind, however, that with very rapid heating in an autoclave, the temperature may be 1–2° higher because the steam does not have time to escape through the narrow outlet valve, which causes the steam pressure inside the boiler to rise slightly. Moist sterilization at 100°, so-called flowing steam sterilization, is used in cases where the items to be sterilized cannot withstand higher temperatures without damage. Usually, sterilization is carried out for three consecutive days for half an hour. With single-stage sterilization, however, heating must be carried out for one hour.

KOCHER, Theodor (1841–1917), a famous Swiss surgeon, a student of Billroth; from 1872 until his death, he held the chair of surgery in Bern. Kocher left an indelible mark on modern surgery. There is almost no area of surgery in which Kocher did not provide his own original resolution to a problem, his own methods, the majority of which are currently used widely and successfully. Worthy of mention are his method for reducing shoulder joint dislocation, his method for the radical treatment of inguinal hernia, and his methods for the operative treatment of goiter, especially his classic works: cachexia strumipriva, on cretinism, and on the treatment of endemic goiter with iodine. Kocher proposed very practical instruments for grasping bleeding vessels, etc.; this established Kocher's fame as one of the greatest surgeons and scientists. His numerous works, especially in the field of thyroid gland diseases and his manual on operative surgery, have been translated into a number of foreign languages. In addition to his numerous brilliant works, Kocher left behind a galaxy of students, among whom are such outstanding individuals as Roux, de Quervain, Wildbolz, Rollier, and others, who currently enjoy wide renown. Kocher presided at the Congress of German Surgeons in 1902. Kocher's main works: Beitrage zur Kenntnis einiger praktisch wichtiger Fracturformen (Jena, 1896; French ed.—Geneva, 1904); Chirurgische Operationslehre (Jena, 1st ed., 1892; 5th ed., 1907; 2nd Russian ed., parts 1–2, St. Petersburg, 1910–11); Vorlesungen über chirurgische Infektionskrankheiten (together with E. Tavel, Vol. 1–2, Jena, 1895–1909; Russian ed.—St. Petersburg, 1897); Über Basedow (Arch. f. kl. Chir., Vol. XCVI, 1911); Die Therapie des Kropfes (Deutsche Klinik, Vol. VIII, Berlin–Vienna, 1904).