"Status Thymolymphaticus" - a Risk of Anaesthesia?

Abstract

The administration of narcotics such as ether and chloroform to combat pain during surgery was overshadowed from the beginning by serious, often fatal incidents. Even the use of local anaesthetics, which were praised as being less dangerous, was not as uncomplicated as had initially been hoped for and was often fatal. Investigations into the various causes of anaesthetic incidents were carried out at an early stage, but usually did not lead to clear results. In these cases, the physicians involved in the administration of narcotics adopted the explanation attempts of the Austrian physicians Arnold Paltauf and Rudolf Ritter von Kundrat, who at the end of the 1880s also explained inexplicable narcosis incidents in apparently healthy individuals with the presence of a constitutional anomaly: the so-called "status thymicus, lymphaticus or thymolymphaticus". If, in case of a fatal anaesthetic incident, the event was attributed to the presence of this anomaly, one also spoke of "thymus death" and usually refrained from further legal investigations. Corresponding statements therefore acquired a great forensic significance, since now also in cases of a "mors subita" in infants or small children in the domestic sphere unjustly accused persons in the presence of a verifiable thymus hyperplasia did not have to be prosecuted further under criminal law. In operative medicine, the "status thymolymphaticus" has become a topic for decades, especially among the persons performing the anaesthesia, so that a historical review of the feared alleged syndrome appears justified.