Surgical Innovation, Vol 12, No 2 (June), 2005: pp 105-106 105

The 200th Anniversary of the First Endoscope:

Philipp Bozzini (1773-1809)
Leon Morgenstern, MD

Endoscopy, a major innovative diagnostic and and unwieldy by present day standards, it was the
therapeutic technique in medicine, has had first endoscopic instrument of practical clinical
some difficult beginnings. Not the least of these was use, earning for Bozzini his well-deserved fame as
the introduction of the very first endoscope by the first endoscopist.
Philipp Bozzini in 1805. As this year marks the The Lichtleiter (Figure 2) was a leather covered
200th anniversary of that seminal event, the inter- vase-like device, more than a foot high and several
esting tale associated with the first instrument and inches wide. To describe its complicated structure is
its inventor bears retelling.1,2 beyond the scope of this article, but the essentials
The Bozzini family lineage was Italian, but were an eyepiece for viewing, a candle as a light
Philipp Bozzini was German. His father had fled to source, a reflecting mirror to direct the light and the
Mainz, Germany in 1760 after killing a man in a image, plus an assortment of tubes or specula for
duel. It was in Mainz that Philipp was born in 1773 insertion into the body orifices.
and where he graduated in medicine in 1796. It was Bozzini made the announcement of this novel
a turbulent period for the beginning of a career. The device in a German daily newspaper in February
Napoleonic armies conquered Mainz in 1797 in 1805. It was a strange way to introduce the prog-
their conquest toward the East. Rather than accept enitor of instruments that some day would revolu-
French citizenship, Bozzini moved to Frankfort on tionize medical diagnosis and treatment, but ap-
Main, his mother's native city. In Frankfort, he parently such was the custom of the day. In the an-
served with distinction as a military physician in the nouncement, Bozzini predicted his instrument
army of the Archduke Karl Ludwig during the sec- would make possible the examination of body cav-
ond "War of the Coalition" (1799-1802), once more ities as well as the performance of surgical proce-
arrayed against the armies of Napoleon. This con- dures within them. He invited colleagues to use the
nection to the Archduke Karl, the brother of the instrument, as he had done successfully in many
Emperor Franz I of Austria, is an important part of cases. This they did with mixed results, as published
our story, as will later be seen. in the newspapers of the day. Some waxed enthusi-
I would surmise that the young Bozzini (Figure astic, while others were openly scornful. It was not
1) had a difficult time in Frankfort on Main. As a a resounding success as an innovation.
"foreigner" he had trouble in obtaining citizenship Re-enter the Archduke Karl, to whom Bozzini had
and a license to practice medicine, but managed to an obligatory loyalty. It was the Duke who had helped
overcome this obstacle with the aid of a letter from
the Archduke Karl. Even after licensure, his practice
never flourished, allowing him time to indulge in
his real talent, which was inventing. Among his in-
ventions were a flight machine, a "repositor" for an
aberrant umbilical cord, and most relevant of all
for this account, an instrument for examining the
body cavities (bladder, rectum, vagina): the
"Lichtleiter" or "light-conductor." Though crude

From the Center for Health Care Ethics, Cedars-Sinai Medical

Center, and UCLA School of Medicine, Los Angeles, CA.
Address reprint requests to Leon Morgenstern, MD, FACS,
Emeritus Director, Center for Health Care Ethics, Emeritus,
Director of Surgery, Cedars-Sinai Medical Center, 8700 Beverly
Boulevard, Becker Building - Suite 216, Los Angeles, CA 90048
(e-mail: morgenstern@cshs.org).
C2005 Westminster Publications, Inc., 708 Glen Cove Avenue, Figure 1. Self-portrait of the young Bozzini (ca. 1805)
Glen Head, NY 11545, USA. from the Frankfort town archives.
106
106 Morgenstern

him achieve citizenship in Frankfort as a reward for by the Emperor, still under the influence of his ad-
his military service as a hospital commander. Bozzini visor Stift.
decided to send a description of the device to him in So the Lichtleiter fell from grace, clever and in-
Vienna, hoping that through his auspices the instru- novative as it was. Its inventor and its promise were
ment would receive the attention it deserved. His in- the victims of an absolutist monarchy, professional
tention was not misdirected, but therein began the rivalry, and court intrigue. The comments of Bozzini
convoluted tale of a good idea gone awry. when another of his instruments was rejected are
The Archduke Karl, then commanding the armed just as apt in the case of the Lichtleiter or, for that
forces and its military hospitals, was suitably im- matter, any other innovative device: "It means noth-
pressed. In keeping with the tradition of the time, ing for an invention when somebody gives a judg-
however, he presented it for evaluation to the then-ar- ment based only on his own authority and not on
biter of military medicine in Vienna, the doctors of his own experiments and clinical experience."
the Vienna Joseph-Academy. Their evaluation was Bozzini returned to his practice among the poor
laudatory for both the device and its inventor, but for in the villages on the outskirts of Frankfort, where
permission to introduce the instrument it was neces- typhoid fever was both prevalent and virulent. He
sary to obtain the permission of the Emperor himself, contracted the disease and died of it on April 4,
Franz I. The Emperor in turn turned to his private 1809, at the young age of 35, leaving a wife and
physician for advice, a Joseph Andrea Stift, who was three young children, sans medal, sans money, and
not known for his receptivity to new ideas. Not satis- sans due credit for his role as a pioneer in medicine.
fied with the approbation of the Vienna Joseph- The epitaph on his tombstone in Frankfort is
Academy, he recommended a second opinion from eloquent (translated from the Latin)3:
the Vienna Medical Faculty, a body to which he was
partial. The Emperor concurred and the matter was In memory of the devout, deceased soul of
placed in the hands of the Medical Faculty. Philipp Bozzini, medical doctor. He, German
It took the Medical Faculty only 9 days to form born, was the first who tried to look into the
their opinion. The verdict was chilling. In their opin- hollow cavities of the human body by inge-
ion, the device was a mere toy. It spelled the death niously conducted light. During the rage of a
knell for Bozzini's Lichtleiter. Although the malignant fever which he bravely kept away
Archduke Karl still lauded Bozzini and recommend- from others and from which he cured many
ed that he be awarded a gold medal and given suit- by his art and devotion, death took his life in
able financial reward, no medal was offered nor any his 36th year on the night of April 4th to 5th,
reward given. The suggestion was countermanded 1809. Himself a victor, he became defeated.
His faithful friends.
The vista opened by Philipp Bozzini and his
Lichtleiter was neither seen nor appreciated by his
medical contemporaries till decades later. Although
he was the first to gaze into the body cavities and to
recognize the potential of his discovery, he failed to
receive the recognition he deserved at the time.
Now, 200 years later, this will serve as another
small encomium in his memory.

References
1. Rathert P, Lutzeyer W, Goddwin WE: Philipp Bozzini
(1773-1809) and The Lichtleiter. Urol 1:113-118, 1974.
2. Dans CJ and Filipi CJ. A history of endoscopic surgery. In
Arregui ME, Fitzgibbons RJ, Katkouda N, et al, editors:
Principles of Laparoscopic Surgery. New York, NY:
Springer-Verlag; 4-5, 1995.
Figure 2. The Lichtleiter. (An original, owned by the 3. Reuter HJ and MH. Philipp Bozzini und Die Endoskopie the
American College of Surgeons, Bush collection.) Max-Nitze Museum, Stuttgart. Printed in West Germany.