Summary

Heinrich Hoffmann, the writer and so-called father of “Struwwelpeter”, the popular German children’s stories, is regarded in his home town of Frankfurt am Main as a reformer of social medicine. Under his medical leadership, particularly psychiatry set out on a path towards a modern future. His Hospital for Lunatics and Epileptics evolved into the Frankfurt University Hospital for Psychiatry. Heinrich Hoffmann’s doctoral dissertation, which was written in Latin, concerns Phlegmasia alba. At the beginning of the 19th century, there were still three different ideas regarding its pathogenesis: metastases of milk or lochia, injury or disease of the lymphatics and the occlusion of venous trunks in the pelvis. Hoffmann addressed a fourth variant that was documented in the literature – the inflammation of the Tunica cellulosa, the connective tissue shrouding the muscles and tendons as well as the neurolemmal sheaths of the vaginal nerves. He proffered seemingly important arguments against the venous disease theory. The doctoral dissertation concluded with a detailed description of the course of the disease in the young wife of a soldier. Implications: although the work does not actually reveal any original new aspects in terms of the history of medicine, studying it recollects diagnostic details that threaten to be lost under the influence of modern technological possibilities. They include the characteristic pain preceding the stage of swelling, the marked lateralisation of the pelvic vein thrombosis, the apposite description of the oedema as porcelain-like, and, not least, the projection of the Concept of clinical probability in the form of critical days.